Far fewer chronic diseases
Also relevant to: Food
Geneva in 2061
Heart disease, type 2 diabetes and high blood pressure have become uncommon. People eat fresh local food, move every day, have meaningful work and good relationships, and the hospital has shrunk because far fewer people need it.
Smaranda was probably in her mid-forties, but looked at least ten years younger.Grooters, Book 1, Part 16 "2061"
Geneva today
35% of Geneva adults aged 35 to 74 have high blood pressure
In the same measured sample, 14% are obese, a further 34% overweight, and 7% have diabetes.
Source: Bus Santé population study, HUG and University of Geneva, data 2015–2023 (Preventive Medicine Reports, 2025)
- Chronic (non-communicable) diseases account for about 80% of health costs in Switzerland, and around half of them could be avoided with more exercise, less alcohol and no smoking, according to the director of the Federal Office of Public Health (2025).
- Health insurance premiums in Geneva will rise by 4.4% in 2027; the Swiss average rises by 5.0% to 412 francs a month. Geneva plans 830 million francs of premium subsidies in its 2027 budget.
- There is good news too: high blood pressure in Geneva fell from 38.9% to 35.2% between 2005–2014 and 2015–2023, with the biggest improvement among people with less education and lower income.
Where it is already done
- Geneva itself shows that progress is possible: the Bus Santé study measured a fall in high blood pressure over twenty years, especially in disadvantaged groups.
- North Karelia (Finland) launched a community-wide prevention programme in 1972 against what was then the highest rate of heart-disease deaths ever measured. Coronary deaths among middle-aged people fell by 84% between 1972 and 2014, and about two-thirds of the decline is explained by changes in diet, smoking and blood pressure.
- The United Kingdom introduced a tiered levy on sugary drinks in April 2018, charged to manufacturers rather than shoppers, with no levy on drinks under 5 g of sugar per 100 ml. Evaluations found that manufacturers reduced the sugar content of their drinks.
How far along
Engineering and scale The principle works, but it needs investment, time or better technology.
The path to 2061
Milestones proposed for discussion.
- 2027Bus Santé results become a public health dashboard for Geneva, updated every year and broken down by neighbourhood.
- 2031No fast food near schools; healthy eateries are supported; a fixed share of the health budget goes to prevention and health education.
- 2041High blood pressure, obesity and type 2 diabetes are clearly falling in every age group; premiums stop rising.
- 2051Hospital capacity can be reduced, and the freed space becomes HUG-Centres and gardens.
- 2061Chronic disease is the exception, and Smaranda’s supply-and-demand principle has done its work.
What moves it
CultureLawInvestment
Human needs it serves
FoodPhysical well-beingMovement / exercisePhysical well-beingRest / sleepPhysical well-beingAirPhysical well-beingLearningMeaning
Open questions
- How much can meaning, relationships and less stress reduce chronic disease, on top of diet and exercise? Bus Santé could add questions on meaning and social life to find out.
- Which food additives harm health, and which protect food when it travels only a short distance anyway?
- How can prevention be financed when insurers mostly pay for treatment?
Sources
- Nehme et al., Twenty years population-based trends in hypertension in Geneva (Preventive Medicine Reports, 2025)
- Federal Office of Public Health: interview with director Anne Lévy on prevention (June 2025, in French)
- La Télé: 2027 premiums rise by 5% on average in Switzerland
- La Télé: Geneva premiums for 2027 and Pierre Maudet’s reaction
- Vartiainen, The North Karelia Project: cardiovascular disease prevention in Finland (Global Cardiology Science and Practice, 2018)
- University of Cambridge, MRC Epidemiology Unit: evaluation of the UK Soft Drinks Industry Levy (statement, 5 December 2023)