the government s vision states that by everyone will live longer healthier lives at home or in a homely setting it sets out as significant challenges scotland s public health record changing demography and the economic environment the document cites as a key challenge an anticipated rise in the proportion of people aged and over in scotland in the next ten years this rise is likely to be accompanied by more chronic disease and growing numbers of older people with complex needs such as dementia it estimates over the next years demography alone could increase expenditure on health and social care by over the vision reiterates die ambition of integrated health and social care and a focus on prevention and selfmanagement