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Thinking about the future of health and cities in the Anthropocene

ABSTRACT How we think about the future – including the future of cities and of health – is of great importance. As we enter the Anthropocene, we need to understand how environmental, social, political, cultural and technological forces may shape the future. Alternative futures or scenarios are a useful way to think about the future, and explore possible, plausible and preferable future conditions; the Futures Cone is one way to visualise these alternatives. Based on an understanding of the driving forces, alternative future scenarios may include extrapolative or ‘business as usual’ scenarios; challenging scenarios that include various forms of collapse; and visionary or transformational scenarios that build equity and sustainability. They also enable and encourage a consideration of the underlying values inherent in each scenario. Considering the implications for health and health equity within a scenario is important in our work, and in the context of healthy cities. Preferable futures, when they include commitment to creating them, become shared visions, a projection of values into the future. Rooted in the concept of ‘anticipatory democracy’, our approach has been to help people understand and imagine what may happen, but then to look at their preferred future and what it will take to get there.