Charles Agyemang: The challenge, especially with minority populations, is building trust
Some communities may seem hard to reach, but the real issue is that we don’t know how to connect with them, says Charles Agyemang, professor of Global Migration, Ethnicity and Health at the University of Amsterdam. As a member of JACARDI’s Scientific Advisory Board and an expert on ethnic inequalities in health and non-communicable diseases, he shares his experiences in working to connect with and empower minority communities. We also discussed the importance of addressing diversity in Europe and how JACARDI is leading the way.
What significance does JACARDI hold for you and your organisation in terms of its mission and values?
JACARDI is bringing a new dimension and aims to change the way things are done at the European level. The extensive network provides an excellent opportunity to interact with people, re-evaluate existing practices, and learn from other countries. It is quite exciting that JACARDI places inequalities at the center of its focus.
For me and my team, this is an opportunity to learn about what is happening across Europe and to contribute to ensuring that care and services related to cardiovascular disease are delivered equitably across Europe, taking into account people from diverse backgrounds such as migrant and ethnic minority groups.
How do you see JACARDI’s role in tackling the increasing prevalence of CVDs and diabetes in Europe?
Over the years, many countries have been working on cardiovascular diseases, but often in silos. When it comes to diversity and its various aspects, such as ethnicity and gender, many countries have been addressing these issues in their own ways and often with limited attention.
Now JACARDI provides an opportunity to raise awareness, share best practices among countries, and develop excellent ideas that can be implemented locally. It also allows countries to assess how far they have progressed, and engage with others in the process. More importantly, it ensures that countries are not working alone in silos. They have a network of people to rely on and seek input from when needed, fostering a collective responsibility to address this issue at the European level.
What is our role in promoting equity in healthcare?
Diversity cuts across the entire project, which is what makes it unique. In other words, regardless of what you are working on in your country, it is essential to apply a vested lens to it. I believe that adopting diversity as a horizontal approach should be the approach that is taken across the world.
This is the flagship element of the project. Everyone involved is expected to take it seriously and actively work on it. Having a dedicated work package focused on this ensures a constant reminder and provides a source of support for those seeking help. Some countries are more advanced in addressing these themes, and this project creates an opportunity to support countries that are less developed in their approach to diversity.
One important issue is the sustainability of the project’s results. There should be a plan and funding to enable the implementation of the diversity lens across all of Europe and ensure equitable healthcare for everyone regardless of ethnic background, gender, sexual orientation and so forth after JACARDI.
How do you see the significance of considering cultural diversity in the development of treatment for diabetes and cardiovascular disease and what is the most critical aspect of this?
The fact of the matter is that Europe today is very diverse, especially in urban centers. This is a reality, and we must address it. Diversity plays a crucial role in cardiovascular diseases, and understanding it is key to addressing inequalities in health and healthcare.
It also makes economic sense to address these gaps. For example, if we know that a specific group is affected by hypertension and we ignore this, individuals may eventually end up in the hospital with strokes, and society will bear a heavy cost of treating and caring for stroke patients. We should focus on the individuals or groups most affected and implement effective interventions to support them in living healthier lives.
Many of these inequalities are tied to social determinants of health and access to resources. For example, not everyone has the privilege of living a healthy life because of financial constraints, which may prevent them from buying healthy food. No matter how much health information you provide to specific communities, it is not going to be effective if their social and economic circumstances are not right. There must be a plan backed by resources to simultaneously promote healthy life and improve social and economic circumstances among a culturally diverse population.
Do you have any tips or valuable experiences on how to implement research findings in healthcare to benefit both the system and the patients?
It is crucial to involve the communities that matter from the very beginning of the implementation process. Their voices, especially those that are often unheard, must be included. We need to empower these communities, ensuring they are not just recipients but co-creators of the initiatives. By working together with communities from the start, we can ensure that the program is meaningful and sustainable.
Often, there is a tendency to go into communities and tell them what they should do. Instead, we should focus on ensuring that people are actively engaged in decisions, so that they take ownership of the program. When communities take ownership, they are more likely to ensure the program’s continued success after its initial implementation.
It’s crucial to recognize that long-term commitment is necessary for the success of a program. Governments must invest in supporting communities, especially those from lower economic groups and minorities, as it offers long-term benefits.
Do you have advice on how we can reach different communities?
People often say some communities are “hard to reach,” but the real issue is that we don’t know how to connect with or reach them. In fact, these communities are quite accessible if we approach them the right way and through proper channels.
The challenge, especially with minority populations, is building trust. To truly connect with people, we need to focus on establishing trust and building bridges. It’s about making people feel comfortable and valued. We need to invest time, establish relationships, and co-create with them.
Many times, researchers only engage when they need something, but we should connect even when we don’t need anything. By forming relationships and spending time with communities, it becomes easier to reach out when the need arises.
Charles Agyemang is a professor of Global Migration, Ethnicity and Health at Amsterdam University Medical Centres, University of Amsterdam. He is currently the Vice President of the EUPHA Migrant health section, Secretary of EUPHA’s Governing Board and Scientific Chair of the Global Society of Migration, Ethnicity, Race and Health. He is also a member of the prestigious US National Academy of Medicine and The European Academy. His work focuses on migration and health, particularly in relation to cardiovascular diseases. One of his most notable projects is the RODAM study, which investigates obesity and type 2 diabetes among African migrants.
Learn more about Charles Agyemang and his work here and connect on Linkedin here
Experts from WHO Europe, JA Prevent and JACARDI gathered for a joint event
Data has the power to save lives
Many passionate voices came together on September 10th in Brussels to address the pressing challenges of preventing and controlling noncommunicable diseases (NCDs). The event, Strengthening NCD Monitoring Systems in the EU: A Collaborative Approach, brought together representatives from WHO Europe, JA Prevent, JACARDI, and several Member States. Their shared insights and best practices sparked crucial discussions, setting the stage for a more coordinated and impactful approach to NCD monitoring.
“Iremember the excitement of the political cadre before the 2011 high-level UN meeting on NCDs” – reflected Dr. Galea Gauden, strategic advisor to the WHO Regional Director for Europe just one year before the next UN high-level meeting 2025. At that time, momentum had been building, but new data show that COVID-19 pandemic derailed Europe’s progress toward achieving NCD targets, as Dr. Ivo Rakovac, WHO’s regional advisor on NCD surveillance highlighted. This setback has had a profound impact on societies, families, and communities and EU countries are still lagging behind in target setting and health examination surveys. Despite the available science and research, demonstrating the success of NCD prevention programs and gaining political support remains a significant challenge.
The way we can fight this challenge, is to bring together and share all recent data on NCD prevention and intervention and turn them into a tool for advocacy. Data-driven policies are essential for combating noncommunicable diseases, the biggest health threat in our region. This event marked an essential first step in coordinating efforts across participating organisations, each showcasing their objectives and achievements. For JACARDI, partnerships with WHO Europe and JA Prevent are vital, as collaboration is key to amplifying our collective impact. As of 2023, only 48% of countries in the WHO European region have fully implemented recommended NCD policies and capacities in key areas such as surveillance and governance, tobacco control, alcohol control, unhealthy diet reduction, physical activity promotion and NCD management in health systems. At the event, frontrunners like Norway, Spain, Estonia and Denmark shared success stories, while Germany, Finland, and Italy offered best practices in NCD monitoring. One of the event’s highlights was an innovative closing session led by Dr. Gauden, where participants contributed to drafting a joint political declaration. Using an AI tool, he summarised the most frequently cited ideas, leading to the following key takeaways:
Data and Monitoring
We should harmonise data collection methods, ensuring the availability and usability of health data. By interconnecting monitoring systems for NCDs, risk factors, and determinants, we will enable more effective decision-making, policy advocacy, and targeted interventions for NCD prevention.
Political Commitment and Accountability
We recognise the need for enhanced political will to address NCDs with evidence-based interventions and clear accountability. Governments must take ownership, set clear targets, and resist industry pressures, prioritising public health over economic interests.
Prevention and Health Promotion
Preventive measures and health promotion are central to reducing the NCD burden. This includes integrating health literacy into education, launching national awareness programs, and creating environments where healthy choices are normalised and accessible. Using a common methodology for implementing and assessing pilot projects can reduce the risk of failure and enable a thorough analysis of the results.
For this reason, all 142 JACARDI pilot projects follow a common structure and timeline, with working methods based on the concepts of ‘grassroots innovation’ and implementation science.
Creation of a Different Landscape for Cardiovascular Diseases and Diabetes in Europe Through JACARDI Joint Action
Scientific publications by JACARDI
In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.
We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe.
Stay informed on how JACARDI turns evidence into action.
Authors: Jelka Zalatel, Farkaš Lainščak, Jerneja
Keywords: Diabetes mellitus, Cardiovascular disease, Europe, Interventions, Collaboration, Sustainability
Abstract:
The Joint Action on CARdiovascular diseases and DIabetes (JACARDI) aims to reduce the burden of cardiovascular disease and diabetes in European countries, both at the individual and societal levels. The initiative covers the entire patient journey, from improving health literacy and awareness of cardiovascular diseases and diabetes, travelling through primary prevention among high-risk populations and screenings, reaching people living with cardiovascular diseases and diabetes, improving service pathways, self-management, and labour participation. The project involves 21 European countries, 76 partners and plans to implement 142 pilot interventions, ensuring diversity in terms of cultural backgrounds, public health priorities, and healthcare systems.
In Slovenia, interventions will be developed and tested to improve screening for diabetes through community involvement, the involvement of people with diabetes in education programmes in health centres, and the involvement of people with diabetes in a screening programme for diabetic retinopathy. A set of unified, comprehensive and integrated health education materials and approaches will be developed for both healthcare providers and patients referred to the outpatient cardiovascular rehabilitation programme. The effectiveness of the upgraded health education intervention will be tested in a randomized trial. Furthermore, Slovenian experts are involved in developing a harmonized implementation methodology across all 142 pilot interventions, including contextual analysis at the country and pilot levels, multidimensional assessment and evaluation.
JACARDI will enhance cross-national collaboration, maximizing the exploitation of lessons learned through a clear strategy, promoting the integration and sustainability of approaches to achieve high-level impact, including the implementation of effective interaction, cooperation and co-creation between science and policy.
Published in: Slovenian Journal of Public Health, Volume 63 (2024): Issue 3 (September 2024)
Tackling the challenge of cardiovascular diseases and diabetes across Europe: a joint action by more than 300 public health professionals
Scientific publications by JACARDI
In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.
We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe.
Stay informed on how JACARDI turns evidence into action.
Authors: Benedetta Armocida, Beatrice Formenti, Marco Silano, Albert Aszalos, Hector Bueno, Mounia Elyamani, Ane Fullaondo Zabala, Matilde Leonardi, Jaana Lindstrom, Karolina Michalak, Bernardino Morillo, Michal Nowicki, Denis Opresnik, Luigi Palmieri, Roberta Papa, Markku Peltonen, Helena Safadi, Hanna Shchetynina, Natalia Skogberg, Hanna Tolonen, Edwin Wouters, Jelka Zaletel, Graziano Onder, on behalf of the JACARDI Consortium
Keywords: cardiovascular disease, diabetes, public health, EU4health
Abstract:
Cardiovascular diseases (CVD) and diabetes pose significant health challenges in Europe, affecting millions and burdening healthcare systems. The recent EU4Health Programme places reducing the burden of non-communicable diseases (NCD) at the forefront, through a Joint Action focused on CVD and diabetes (JACARDI, Joint Action on CARdiovascular diseases and DIabetes). This initiative unites 21 European countries, including Ukraine, and over 300 experts. Employing an innovative approach and standardised methodology, JACARDI implements 142 pilot projects covering the entire
“patient” journey. Particular focus will be given to improvement of data availability and quality. Additionally, JACARDI will emphasise transversal and intersectional aspects, such as health equity, determinants of health, and social, cultural, and ethnic diversity, while pioneering gender-transformative leadership. Committed to evidence-based interventions, JACARDI aims to harmonise strategies and disseminate knowledge for enhanced CVD and diabetes prevention and management. The goal is to identify effective strategies for wider implementation, fostering cross-national collaboration and fortifying Europe’s health resilience.