Gerold Stucki, Jerome Bickenbach, Christoph Gutenbrunner, John Melvin
Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, CH-6002 Lucerne, Switzerland. E-mail: gerold.stucki@paraplegie.ch
DOI: 10.2340/16501977-2200

There is strong evidence that population ageing and the epidemiological transition to a higher incidence of chronic, non-communicable diseases will continue to profoundly impact societies worldwide, putting more pressure on healthcare systems to respond to the needs of the people they serve. These trends argue for the need to address what matters to people about their health: limitations in their functioning that affect their day-to-day actions and goals in life. From its inception, rehabilitation, 1 of the 4 health strategies identified in the Declaration of Alma Ata in 1978, has had functioning as its outcome of interest. Its practitioners are from fields that include physical and rehabilitation medicine, occupational therapy, physiotherapy, speech and language therapy, orthotics and prosthetics, psychology, and evaluators of functioning interventions, including assistive technologies. Demographic and epidemiological trends suggest that the key indicators of the health of populations will be not merely mortality and morbidity, but functioning as well. This, in turn, suggests that the primary focus of healthcare will need to respond to actual healthcare demands generated by the need for long-term management of chronic conditions, including, in particular, the scaling up and strengthening of rehabilitation. This is the case for thinking that rehabilitation will become the key health strategy of the 21st century.

Rehabilitation the health strategy of the 21st Century
Because people are living longer, and living with more disabilities, in the next decades clinical practice and health policy will need to focus more on improving people’s capacity to do the things they want to do in their lives. Rehabilitation has always aimed to optimise people functioning, especially when their diseases are chronic and incurable. So, while health professionals will always be concerned to prevent premature death, to cure disease and promote good health, in the future there will be more need to turn to rehabilitation services to meet people’s needs. Rehabilitation will become the health strategy of the 21st Century.