Work ability literacy in action: how Finnish leaders are strengthening workplace resilience

In Finland, the concept of work ability literacy, the knowledge and skills needed to understand, support, and strengthen employees’ capacity to work well, is moving from research into real-world practice. Through JACARDI pilot interventions led by the Finnish Institute of Occupational Health, healthcare and social services leaders are being equipped with tools and strategies that help them support work ability, promote recovery, and lead healthier, more resilient work communities.

The Finnish healthcare system has been undergoing changes for several years. In the reform implemented in 2023, healthcare and social services (HSS) were transferred from municipalities to the responsibility of regional authorities known as wellbeing services counties. This brought significant changes to organizational structures and their operations, as well as to the roles and positions of personnel. The healthcare and social services sector has certain profession-specific work strain factors, such as ethical strain, work pressure and shift work. With the reform, employees had some new stress factors to face: new working methods, in some cases new colleagues and a new organization. 

Based on research, work-related stress factors, such as work pressure, job stress, ethical strain, and uncertainty in work, have a significant impact on employees’ well-being. Work stress, shift work and sleep problems related to these increase the risk of cardiovascular diseases (CVD) and type 2 diabetes (T2D). Before the start of JACARDI, in autumn 2023, 38% of Finnish HSS personnel reported lowered work ability and only 35% reported good work recovery. The results are based on the “Mitä kuuluu?” (“How are you?”) study and surveys on well-being at work, conducted for Finnish wellbeing services counties.

Thus, the Finnish Institute of Occupational Health is conducting JACARDI pilots for the Finnish social and healthcare sector aiming to train HSS leaders to better support work ability in their work units. The aim is to increase the work ability literacy of the HSS leaders so that they can support employees who have or are at risk of CVD or T2D, and to support prevention of these diseases. Additionally, the pilots aimed to promote work recovery, health, and work ability through training for so-called work ability partners – employees of the participating work units. These work ability partners are expected to implement tasks that improve work ability in their units alongside their leaders.

What is work ability literacy?
Work ability literacy is defined as the understanding of the demands and the effects of work on one’s health and ability to work, and actions to promote one’s own work ability during work and leisure. 

The concept of work ability literacy was developed by the Finnish Institute of Occupational Health. It builds on health literacy principles and the Work Ability House model. It expands health literacy principles to include the context of work, profession, demands and effects of work on work ability, working conditions, and actions to promote and maintain work ability. By promoting work ability literacy, workplaces can better support employees in maintaining health and work capacity, ultimately contributing to improved labor participation for those living with cardiovascular disease and diabetes.

Put on your own oxygen mask first before assisting others

Starting the work at the end of 2023 and at the beginning of 2024, representatives of wellbeing services counties pointed out that the leaders are stressed and overworked, and the first priority should be to enhance their work ability and work recovery. Thus, the training program is initially aimed at helping leaders strengthen their work ability and recovery skills. 

The leaders began the training online with four group discussions designed to help them reflect on their situation, identify what is going well and where there is room for improvement, and try out methods to enhance one’s work recovery and work ability. The aim was also to provide opportunities for peer support. Subjects of the training included work recovery, work ability and work ability literacy, lifestyle factors, stress management techniques and psychological flexibility.

Results from the “Mitä kuuluu?” (“How are you?) study and well-being at work surveys conducted for Finnish wellbeing services counties: 
Research of the HSS personnel in Finland shows that around 50% of unit supervisors, managers and executive management experience high job demands. However, the management also has high decision latitude, which is why supervisors and managers tend to experience less work stress. 49% to 50% of social and health care unit supervisors, managers and executive management have felt insecurity due to workload exceeding their capacity during the years 2024 and 2025. In autumn 2025, the experiences of uncertainty due to the threat of job termination were most common among managers and executives (32%) as well as unit supervisors (31%).

After the training to improve leaders’ work recovery and work ability, the focus shifts to training aimed at motivating them and teaching them skills to lead work recovery and work ability in their work units, as well as facilitating and supporting the development efforts of their work communities. An important aim is to integrate actions improving work ability into the work processes and structures, such as regular meetings and other recurring events.

The aim is also to support discussions about work ability at the workplace, focusing on work rather than individual work ability. Leaders receive training on how to conduct one-on-one discussions and group discussions. They are also trained on psychological safety within the work community. One of the main tasks in the training is to build an annual cycle for improving work ability. 

Simultaneously, with leaders training, there is ongoing partner training for work ability. Work ability partners are employees of the work units, who received training to improve work ability and work recovery in the work units together with the leaders. These partners delivered tasks and challenges for individuals and the community to improve work recovery, health behaviors and mental wellbeing.

The work ability annual cycle as a solution for implementation

The work ability annual cycle compiles key actions that promote work ability and recovery within the workplace community. It helps leaders to systematically lead the development of work ability and recovery. The work ability annual cycle makes the promotion of work ability a shared responsibility, not just for supervisors or management. This applies to both the planning and implementation. The work ability annual cycle integrates the promotion of work ability and recovery into the daily life of the workplace, highlighting small daily actions. Annual planning facilitates operations amidst everyday busyness. It encourages supervisors to reflect on and discuss work ability, and to seek common solutions and development methods with their teams.

Permanent structures for work ability support

During the JACARDI project, the Finnish HSS sector has faced new challenges due to economic difficulties. HSS organizations have been undergoing downsizing. Challenges in HSS in Finland seem to continue, and the need for work ability support is extremely important now and in the future. Permanent structures for work ability support are needed.

Leaders in HSS play a significant role in promoting work ability and work recovery of the work unit. To lead work ability in their units in an ever-changing work environment, they must first take care of themselves. The work ability annual cycle, developed together with the workplace community, can be utilized by embedding the theme of work ability into workplace meetings and thus keeping the theme alive systematically throughout the year.

Learn more at the Finnish Institute of Occupational Health’s dedicated project page.

References 

Duchaine, C. S., Aubé, K., Gilbert-Ouimet, M., Vézina, M., Ndjaboué, R., Massamba, V., Talbot, D., Lavigne-Robichaud, M., Trudel, X., Pena-Gralle, A.-P. B., Lesage, A., Moore, L., Milot, A., Laurin, D., & Brisson, C. (2020). Psychosocial Stressors at Work and the Risk of Sickness Absence Due to a Diagnosed Mental Disorder. JAMA Psychiatry, 77(8), Article 8. https://doi.org/10.1001/jamapsychiatry.2020.0322 

Gan Y, Yang C, Tong X, Sun H, Cong Y, Yin X, Li L, Cao S, Dong X, Gong Y, Shi O, Deng J, Bi H, Lu Z. Shift work and diabetes mellitus: a meta-analysis of observational studies. Occup Environ Med. 2015 Jan;72(1):72-8. doi: 10.1136/oemed-2014-102150. Epub 2014 Jul 16. PMID: 25030030.  

 Gao, Y., Gan, T., Jiang, L., Yu, L., Tang, D., Wang, Y., … Ding, G. (2019). Association between shift work and risk of type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies. Chronobiology International, 37(1), 29–46. https://doi.org/10.1080/07420528.2019.1683570  

Hackett RA, Steptoe A. (2017) Type 2 diabetes mellitus and psychological stress – A modifiable risk factor. Nature Reviews Endocrinology, 13(9), Article 9. https://doi.org/10.1038/nrendo.2017.64 

Kivimäki M, Kawachi I. (2015) Work Stress as a Risk Factor for Cardiovascular Disease. Current Cardiology Reports, 17(9), 74. https://doi.org/10.1007/s11886-015-0630-8  

Laitinen J, Selander K, Ervasti J, ja Kivimäki M. 2024. ”Mitä kuuluu hyvinvointialueiden työhyvinvoinnille 2023”. https://urn.fi/URN:ISBN:978-952-391-148-2. (in Finnish)

Laitinen J, Selander K, Nikunlaakso R, Ervasti J. 2025. ”Mitä kuuluu sosiaali- ja terveydenhuollon työhyvinvoinnille 2024”. https://urn.fi/URN:ISBN:978-952-391-199-4 (in Finnish)

Laitinen J, Nikunlaakso R, Ervasti J, ja Kivimäki M. 2026. ”Mitä kuuluu hyvinvointialueiden työhyvinvoinnille 2025”. https://urn.fi/URN:ISBN:978-952-391-231-1 (in Finnish

Lamiani, G., Borghi, L., & Argentero, P. (2017). When healthcare professionals cannot do the right thing: A systematic review of moral distress and its correlates. Journal of Health Psychology, 22(1), 51–67. https://doi.org/10.1177/1359105315595120 

Li W, Chen Z, Ruan W, Yi G, Wang D, Lu Z. (2019) A meta-analysis of cohort studies including dose-response relationship between shift work and the risk of diabetes mellitus. European Journal of Epidemiology, 34(11), 1013–1024. https://doi.org/10.1007/s10654-019-00561-y 

Nyberg ST, Fransson EI, Heikkilä K, Ahola K ym. (2014) Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women. Diabetes Care, 37(8), 2268–2275. https://doi.org/10.2337/dc13-2936 

Rosa D, Terzoni S, Dellafiore F, Destrebecq A. (2019) Systematic review of shift work and nurses’ health. Occupational Medicine, 69(4), 237–243. https://doi.org/10.1093/occmed/kqz063 

Rudkjoebing, L. A., Bungum, A. B., Flachs, E. M., Eller, N. H., Borritz, M., Aust, B., Rugulies, R., Rod, N. H., Biering, K., & Bonde, J. P. (2020). Work-related exposure to violence or threats and risk of mental disorders and symptoms: A systematic review and meta-analysis. Scandinavian Journal of Work, Environment & Health, 46(4), Article 4. https://doi.org/10.5271/sjweh.3877 

Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. de. (2017) Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLOS ONE, 12(10), e0185781. https://doi.org/10.1371/journal.pone.0185781 

Sun M, Feng W, Wang F, Li P, Li Z, Li M, Tse G, Vlaanderen J, Vermeulen R, Tse LA. (2018) Meta-analysis on shift work and risks of specific obesity types. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 19(1), 28–40. https://doi.org/10.1111/obr.12621 

Xi J, Ma W, Tao Y, Zhang X, Liu L, Wang H. (2025). Association between night shift work and cardiovascular disease: a systematic review and dose-response meta-analysis. Frontiers in Public Health, 2025:13, 1668848. doi: 10.3389/fpubh.2025.1668848 

 Xie F, Hu K, Fu R, Zhang Y, Xiao K, Tu J. Association between night shift work and the risk of type 2 diabetes mellitus: a cohort-based meta-analysis. BMC Endocr Disord. 2024 Dec 18;24(1):268. doi: 10.1186/s12902-024-01808-w. PMID: 39696306; PMCID: PMC11653577.  

Cantabrians take control of their health: new workshops for heart health and diabetes

The Valdecilla Health Research Institute (IDIVAL) is leading and supporting an initiative in Cantabria focused on heart health and diabetes workshops, contributing its expertise in nursing research and community-based interventions to JACARDI.

As an institutional partner of JACARDI, IDIVAL is implementing a pilot scheme within JACARDI’s Work Package 10 focused on patients’ self-management. The pilot aims to support people living with chronic conditions in developing the practical skills and confidence needed to manage their health effectively.

The Nursing Research Group at IDIVAL is supporting the development, communication and implementation of the workshop series called ‘Taking Control of Your Health’ (‘Tomando el control de su salud’).  These workshops are an adaptation of an evidence-based intervention created at Stanford University by Kate Lorig. The concept of these workshops is rooted in the Chronic Disease Self-Management Programmes (CDSMP), based on Albert Bandura’s theory of self-efficacy and the Chronic Care Model. The Spanish adaptation ensures that the approach is accessible and relevant to the local context. 

Initially implemented in the Cantabria region by the Escuela Cántabra de Salud, it is now responsible for the delivery, development, management of the workshops, and other related initiatives. The local health education center provides logistical support, conducts a multidimensional evaluation of the program, and explores opportunities for further improvement.

Participants learn from each other and strengthen their self-efficacy, as well as their confidence in their ability to act. Seeing peers address similar challenges and achieving small, realistic goals, fosters a strong sense of shared progress. “It helped me to be responsible and not fall into bad health habits, like leading a too sedentary lifestyle”, noted one participant. 

Conscious self-care supported

A central element of the sessions is the use of ‘action plans’, which helps participants turn intentions into concrete, achievable commitments.

“In Cantabria, we are observing that when people feel supported and truly heard, change becomes possible”, concludes Gina Lladó, Coordinator of the pilot in Cantabria. “We want these workshops to be more than a standalone initiative. Our aim is for them to become a sustainable tool that can be firmly integrated into the community and reach more and more people over time. What we are seeing during the ongoing implementation encourages us to continue refining and strengthening this initiative”

By equipping people with the skills to manage cardiovascular disease and diabetes, the pilot supports JACARDI’s objectives of promoting health equity, prevention, and sustainable, person-centered care. Ongoing evaluation and collaboration with community partners will inform the program’s future expansion and integration into routine practice.

Diabetes Data Cell: From fragmented data to a national policy tool

Fragmentation of diabetes data poses several challenges across member states. Tackling this issue is a key step towards transforming fragmented diabetes data sets into actionable evidence for smarter health policy.  Within JACARDI’s Work Package on Data, the Diabetes Data Cell Project is being developed by Sciensano. The Belgian institute for public health aims to address this question in an effort to optimise patient and healthcare data alignment. The project has recently reached a major milestone: approval by the Belgian Data Protection Authority to link individual-level primary care and specialist clinical datasets with national administrative data on reimbursed healthcare use. 

A first data flow covering 2017-2024 has already been completed, resulting in a linked dataset of 76,965 unique individuals living with diabetes across care settings in Belgium. The full governance framework, including legal approvals and secure linkage procedures, has been established and was submitted in December 2025 for publication to BMC Public Health journal. “This marks a crucial step toward building Belgium’s first comprehensive national diabetes dataset,” explain the authors, Astrid Lavens, senior researcher and pilot project coordinator, Kalina Todorova, junior researcher, and Margot Buyle, senior researcher.

What makes this initiative truly unique is how people living with diabetes are identified. Rather than relying on proxy indicators such as therapy use or reimbursement codes, individuals are selected based on the clinical diagnosis recorded in the electronic patient records by their healthcare provider. This ensures a far more accurate and clinically meaningful population definition, a strong foundation for robust real-world evidence.

Primary analyses have already generated valuable insights, such as mapping the overlap between primary and specialist clinical databases and identifying how patients move across levels of care. “For the first time, we can follow individuals across the healthcare system and connect clinical information with data on healthcare utilization and reimbursement,” explain the members of this pilot.

The next phase brings together three institutions: Sciensano, KU Leuven and the Intermutualistic Agency (IMA); each contributing complementary expertise in clinical epidemiology, health services research, and administrative data analysis. By combining these strengths, the consortium – together with the Belgian Diabetes Forum (BEDF) – will transform this linked dataset into a powerful tool for evaluating care quality, treatment patterns, patient pathways, outcomes, and costs. 

The Diabetes Data Cell is more than a technical exercise in data linkage. It is a concrete step toward evidence-informed diabetes policy, supporting better planning, improved quality of care, and more efficient resource allocation. By turning routinely collected data into integrated, policy-relevant evidence, this project demonstrates how collaboration within JACARDI can directly strengthen chronic disease monitoring and decision-making at national level, with potential lessons for other countries and other non-communicable diseases.

Strengthening European Health: JACARDI at the JARED Consortium Day

The Joint Action on REspiratory Diseases (JARED) is a major European initiative dedicated to reducing the burden of chronic respiratory diseases through improved prevention, early detection, and integrated care models across the EU. Since chronic conditions like respiratory diseases, diabetes, and cardiovascular issues often share common risk factors, building strategic synergies between Joint Actions is essential to create a unified, high-impact approach to public health and societal prosperity.

In this context, JACARDI contributes to these goals by strengthening prevention and management strategies for cardiovascular diseases and diabetes across Europe within a single framework. By promoting health promotion, reinforcing screening, integrated care pathways and self-management, together with labour participation and improved data governance, JACARDI reinforces a cross-disease, system-based approach that complements JARED’s goals.

Addressing shared risk factors — such as tobacco use, unhealthy diets, physical inactivity, environmental exposures, and social determinants of health — allows both Joint Actions to amplify their impact beyond single disease areas and move toward a more cohesive NCD strategy at EU level.

Building synergies across European public health initiatives

The event program featured a high-level opening with remarks from the WHO and the European Respiratory Society (ERS), followed by a deep dive into JARED’s first-year achievements in indoor air quality, patient pathways, and reaching vulnerable populations. A dedicated session on Strategic Synergies brought together coordinators from various European projects to discuss how to align our efforts for maximum impact.

During this session, Benedetta Armocida, Coordinator of JACARDI presented on building synergies for impact between JACARDI, JARED, and JA PreventNCD, focusing on how coordinated intervention strategies can drive broader societal prosperity. Together, we are ensuring that European health interventions are not just individual projects, but a cohesive movement toward a healthier future.

From pilots to policy: highlights from the Irish JACARDI Heart Health Symposium

The Irish JACARDI Heart Health Symposium took place on 13 February at University College Dublin, bringing together clinicians, researchers, policymakers and programme leads from across Europe. The day showcased the strength of collaboration under JACARDI and the practical progress being made in cardiovascular and diabetes prevention.

The symposium opened with a welcome from Ireland’s Minister for Health, Jennifer Carroll MacNeill, setting the tone of innovation and equity in cardiovascular and diabetes prevention. Dr Benedetta Armocida, Coordinator of JACARDI, provided an overview of JACARDI’s objectives, highlighting the Joint Action’s commitment to shared learning and scalable implementation across Member States.

The spotlight then turned to the pilots – the core of JACARDI. Six pilots from Ireland, Finland, Belgium, Hungary and Ukraine presented their work, with a particular focus on cardiovascular screening and patient self-management.

Pilot presentations: progress across Europe

• Ireland:
  • STOP‑CVD (HSE): Katie Ellwood and Pooja Salgar outlined progress using natriuretic peptide screening to support risk stratification in primary care.
  • Healthy Heart Clubs (Croí Heart & Stroke Charity): Lisa Hynes highlighted the importance of structured rehabilitation and long‑term self‑management after cardiac events.
• Finland: Mia Färm (Finnish Diabetes Association) presented the Finnish Risk Calculator, supporting early identification and timely lifestyle intervention.
• Belgium: William Leysen (Diabetes Liga) shared preliminary results from the Halt2Diabetes studies, demonstrating the value of coordinated community‑level screening.
• Hungary: Gréta Máto (OKFŐ) discussed the role of advanced nurse practitioners in strengthening cardiovascular and diabetes screening in primary care.
• Ukraine: Nataliia Hryb (Public Health Centre Ukraine) discussed how they are delivering type 2 diabetes screening in challenging circumstances, underscoring resilience and commitment to patient care.

Across all pilots, a clear message emerged: prevention must be systematic, data-informed and patient-centred.

Women and cardiovascular health: advancing equity

The mid-morning session turned the focus on women with cardiovascular disease (CVD), a key pillar of JACARDI’s commitment to equity and diversity in cardiovascular and diabetes care. The session featured a keynote from JACARDI’s own Dr Héctor Bueno, Co-Leader on the Work Package on Data, who delivered a powerful message: “women are not small men”. His presentation emphasised the need to recognise sex-specific differences in disease presentation, diagnosis, and management.

This was further explored by Dr Mary Ryder, Associate Professor of General Nursing, and Prof. Amy O’Higgins, Consultant Obstetrician at The Coombe Hospital, offering complementary perspectives. Dr Ryder discussed the importance of addressing social determinants of health in cardiovascular prevention, while Prof O’Higgins focused on optimising cardiovascular health during pregnancy, a critical window for long‑term outcomes.

The session was rounded out by a patient story, providing a personal perspective on living with CVD. Her experiences reinforced the human impact behind the statistics and research, leaving a lasting impression on all attendees.

Diabetes and cardiovascular health

The afternoon session turned to diabetes, reflecting its deep interconnection with cardiovascular disease. Dr James (Jim) Januzzi from Harvard Medical School delivered a keynote on heart failure risk across the spectrum of dysglycaemia, stressing the need for integrated approaches. Dr Lisa Devine outlined the successes of Ireland’s Chronic Disease Management Programme, demonstrating how structured, national-level programmes can support early detection, patient engagement, and improved outcomes.

Finally, Prof. Sean Dinneen discussed progress toward a National Diabetes Registry in Ireland, reinforcing the importance of robust data to ensure interventions reach those who need them most, and highlighted the synergies brought about by projects such as JACARDI.

People at the heart of prevention

One of the strongest impressions from the day was how much can be achieved when expertise, curiosity, and compassion are translated into structured action. The symposium wasn’t just about data, tools, or programmes. It was about people: the teams working on the ground across Europe translating strategy into practice, the patients whose stories remind us why these efforts matter, and the exchange of knowledge among colleagues united in a common purpose.

The symposium left attendees not only informed but inspired. It reaffirmed the importance of integrated, patient-centred approaches for a healthier and stronger Europe.

Cardiovascular health in focus: new OECD report and JACARDI experts highlight the path from data to implementation

Cardiovascular disease (CVD) still causes around 1.7 million deaths every year in the European Union. It remains a leading cause of mortality, although most of this burden is preventable. That was the key message of the OECD webinar on 10 February presenting the new EU-funded report ‘State of Cardiovascular Health in the European Union’, which also introduced new monitoring tools and highlighted how the EU Safe Hearts Plan can be translated into practical action, with JACARDI playing an active implementation role. 

The webinar, moderated by Francesca Colombo, Head of the Health Division at the OECD Directorate for Employment, Labour and Social Affairs, brought together more than 300 participants from EU institutions, national authorities, research, clinical practice and patient organisations.

Opening the event, Antonio Parenti from the European Commission’s Directorate-General for Health and Food Safety warned that progress in reducing cardiovascular deaths has slowed across Europe. Without stronger prevention and earlier intervention, the overall burden could grow substantially. The recently launched EU Safe Hearts Plan is designed to support Member States in strengthening national plans across prevention, screening, treatment and rehabilitation, with particular attention to vulnerable groups and inequalities in access to care.

New OECD data presented during the webinar show that over three-quarters of cardiovascular deaths in the EU are linked to modifiable risk factors, and trends are worsening in several areas. Around 22% of EU residents live with hypertension, 15% with obesity and 8% with diabetes, while psychosocial risks such as stress, depression and sleep problems affect roughly one third of the population. 

Important screening gaps persist: in the 45–54 age group, nearly three in ten adults have not had their blood pressure checked in the past year, and many have gone five years without testing blood sugar or cholesterol. Speakers stressed that screening only improves outcomes when it is followed by timely diagnosis, treatment and long-term patient support.

From the patient perspective, the panel highlighted that delays and fragmentation in diagnosis and care pathways remain a major barrier to better cardiovascular outcomes. Konstantina Boumaki, Board Member of the European Patients’ Forum, warned that late diagnosis and long waiting times not only worsen prognosis but also erode patient trust in the system. She stressed that reducing inequalities is not about delivering identical care to everyone, but about ensuring that all patients can truly access timely diagnosis, treatment and support; a principle that should guide how national cardiovascular plans are designed and implemented.

Alongside the report, the OECD and the European Commission launched a new Cardiovascular Health Dashboard, an online platform that allows policymakers, researchers and the public to track risk factors, care quality and patient pathways across EU countries.

From measurement to implementation

The discussion focused on a recurring weak point in public health policy: implementation. While the evidence on cardiovascular prevention and care is strong, most strategies fail in execution, noted Dr Héctor Bueno, co-leader of JACARDI’s Work Package on data and scientific coordinator of the Cardiovascular Health Strategy of Spain’s National Health System. The key is a clear vision, participation of patients and citizens, as well as political ownership.

Plans only deliver results when they are operational, measurable and realistic, stressed Dr Bueno. Measurement “is essential for visibility and accountability: without indicators, progress cannot be tracked”. 

He described how the Spanish strategy is built on a broad indicator framework covering prevention, primary care, acute and chronic care, gender aspects and education, supported by a core set of priority measures. Digital integration, interoperable registries and automated data systems are critical to make monitoring sustainable. Dr Bueno also underlined that aligning scientific evidence, political commitment and citizen engagement is as important as funding when moving from strategy to practice.

JACARDI’s cross-sector contribution to the Safe Hearts Plan

Dr Benedetta Armocida, coordinator of JACARDI, highlighted how the joint action supports the Safe Hearts Plan through cross-sector and patient-journey approaches that connect health literacy, risk awareness, screening and prevention with long-term care pathways. “Cardiovascular prevention is not only a health system responsibility but a societal one, requiring coordinated action across sectors,” Dr Armocida noted, reflecting a Health in All Policies approach. 

JACARDI pilots already include early-life interventions to improve children’s understanding of cardiovascular risk and workplace-focused prevention models, alongside broader work on food literacy, healthy environments and equitable access. Digital health and AI tools can accelerate impact, she added, “but only if they are properly integrated into routine care, trusted by users and supported through professional training”. 

The overall conclusion was clear: Europe now has stronger data, shared metrics and a dedicated policy framework through the Safe Hearts Plan. With its indicator frameworks, cross-sector pilots and implementation focus, JACARDI is helping to transform evidence and ambition into tangible improvements in cardiovascular health. 

References:

OECD (2025), The State of Cardiovascular Health in the European Union, OECD Publishing, Paris 

EU Safe Hearts Plan (pdf)

The State of Cardiovascular Health in Europe Dashboard, OECD

The Cardiovascular Health Strategy (CVHS) of Spain’s National Health System, Ministry of Health, Spain (pdf)

Call for papers: join the scientific debate on cardiovascular disease and diabetes

The current policy landscape offers unique momentum for strengthening collective action on noncommunicable diseases. To stimulate discussion on the challenges and opportunities related to cardiovascular disease and diabetes, the International Journal of Public Health and Public Health Reviews have opened a joint call for papers.

Authors are invited to submit Original Articles, Theory and Concept papers, Reviews, and Policy Briefs for the special issue “Strengthening the public health response to cardiovascular diseases and diabetes”. The call for papers is open until 15 January 2027. Submissions will be reviewed by an editorial board that includes two experts from JACARDI, Yhasmine Hamu and Edwin Wouters.

Developed in line with the JACARDI mission, the special issue seeks to foster actionable knowledge that advances effective, equitable, and sustainable responses. Its aim is to support healthier lives, more resilient health systems, and stronger commitment to tackling noncommunicable diseases.

Topics of interest, identified in collaboration with JACARDI, include:

• Primary prevention, including health literacy, awareness, and health promotion
• Screening of high-risk populations
• Integrated health pathways, including health care organization, patient self-management, and reintegration into the workforce
• Data infrastructure and digital technologies as drivers of evidence-informed decision-making and innovation
• Health system strengthening, with a focus on governance, financing, and service delivery
• Strategies to reduce health inequities and ensure that populations living in vulnerable situations are not left behind

Accepted papers will be published on a rolling basis in the online special issue.

Be part of the call and support the creation and dissemination of knowledge that strengthens our public health response to cardiovascular disease and diabetes!

For more information on the call visit the website of the International Journal of Public Health.

A historic step for global health: UN adopts declaration on NCDs and mental health

The Eightieth United Nations General Assembly (UNGA) has adopted a landmark global political declaration to tackle noncommunicable diseases (NCDs) and mental health in an integrated way, recognising that conditions like cardiovascular disease, diabetes, cancer, chronic respiratory illnesses and mental health disorders are now the leading causes of death, disability and lost opportunity worldwide.

This declaration marks a pivotal shift in global health policy, setting concrete, measurable targets for 2030 and calling on governments to act with urgency, equity and accountability.

The first-ever global outcome targets set out by the declaration to be achieved by 2030 include:

• 150 million fewer tobacco users;
• 150 million more people with hypertension under control;
• 150 million more people with access to mental health care.

The declaration goes beyond health systems, addressing the wider determinants of health – such as air pollution, unhealthy diets, harmful marketing practices, and digital harms – and emphasises that NCDs and mental health must be tackled together, through whole-of-government and whole-of-society collaboration.

This is a huge opportunity to reset global efforts and accelerate progress on the Sustainable Development Goals, especially on reducing premature deaths and promoting well-being for all.

Where JACARDI fits in

JACARDI’s mission aligns directly with this global vision. By advancing evidence-based, integrated prevention and care models for cardiovascular disease and diabetes – key components of the NCD burden – JACARDI helps translate these high-level political commitments into action on the ground.

Our work in harmonising data, strengthening health pathways, supporting policy implementation, and fostering cross-country learning directly contributes to the declaration’s ambitions of measurable impact and equity. With its emphasis on collaboration, scalability, prevention and inclusion, JACARDI is uniquely positioned to support Member States in meeting these targets, bridging research, policy and practice for lasting change.

Slovenia’s breakthroughs in the fight against diabetes

This year’s National Diabetes Conference in Slovenia placed a strong spotlight on JACARDI and the country’s three national pilot projects addressing diabetes. These initiatives are designed to:

• Identify individuals with undiagnosed type 2 diabetes or intermediate hyperglycemia, especially among vulnerable groups who rarely access preventive services.
  
• Increase participation in primary-care education programs among people already diagnosed with type 2 diabetes or intermediate hyperglycemia.
  
• Boost attendance in the national diabetic retinopathy screening program, a crucial step in preventing diabetes-related blindness.

Slovenia is well aware of its key challenges in diabetes care and is actively addressing them through the nearly complete CARE4DIABETES project and its ongoing work within JACARDI. Both efforts are fully aligned with the country’s National Diabetes Plan, ensuring that strategic intent is translated into concrete action.

Why JACARDI matters for Slovenia

In an interview conducted during the conference, Dr Jelka Zaletel (NIJZ Slovenia) explained why JACARDI is uniquely important for the country. Slovenia knows its main barriers in managing the diabetes burden: many individuals with type 2 diabetes remain undiagnosed; those who would benefit most from preventive visits or early detection often do not enter the healthcare system; and attendance in primary-care education programs remains lower than expected.

The JACARDI pilot projects help tackle these issues head-on:

• Pilot 1: Developing new, community-based approaches to reach people unlikely to attend preventive check-ups.
  
• Pilot 2: Understanding and addressing why individuals with type 2 diabetes do not participate in primary-care education programs—and redesigning these programs accordingly.
  
• Pilot 3: Improving uptake of the national diabetic retinopathy screening program. Although 30,000 people currently attend screenings, an estimated 150,000 Slovenians live with diabetes. JACARDI helps uncover where the gaps lie and how to close them.
  

A fourth pilot: Strengthening cardiovascular care

These efforts are embedded in Slovenia’s National Diabetes Plan, supported by clear action plans. The National Diabetes Conference, held every November, is one such action, providing an annual moment to share progress and results from JACARDI.

Slovenia is also implementing a fourth JACARDI pilot project focused on cardiovascular health. It aims to harmonize approaches across rehabilitation centers treating patients after acute coronary events—an area where attendance is also suboptimal. This work aligns with the Ministry of Health’s decision to develop a National Strategy for Cardiovascular Health, reinforcing how JACARDI can support strategic planning beyond diabetes.

Relive the Conference

A mood video from the event captures the atmosphere at the venue. Although only speakers and roundtable participants were physically present, the online turnout was impressive, with more than 170 remote attendees.

You can also watch the full interview with Dr Jelka Zaletel, where she explores in more depth how Slovenia leverages JACARDI to address long-standing gaps in diabetes and cardiovascular care.

Mitja Lainscak: My hope is that we can intervene earlier for more patients

“It’s important that the JACARDI initiative and its outcomes gain visibility within the scientific community”, stresses Mitja Lainscak, Professor of Internal Medicine at the University of Ljubljana and member of JACARDI’s Scientific Advisory Board. As a clinical practitioner and researcher, he anticipates that collaboration will be one of the most important positive outcomes of the project, along with effects going from the regional or national level to the international level.

What significance does JACARDI hold for you and your organization?

I think that the organisations involved really appreciate being part of such a large initiative, trying to bring together efforts in the field of cardiovascular medicine and diabetes and to stimulate some potential cross-talk between the partners. The consortium is hosting more than 140 pilot projects with some of them related within or across the field.

One of the main benefits of an initiative like this, is that people talk to each other and realise that they can collaborate, so that their efforts can be transferred from the regional or national level to the international level.

How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular disease and diabetes in Europe?

Our society is aging and that’s an unavoidable reality. Advances in medicine have played a significant role in this trend. In addition, improvements in detection tools and the capabilities of our healthcare system have enhanced our ability to identify patients more effectively.

I hope we will identify more people at risk, as well as those with single or multiple conditions. Early detection is crucial because it allows us to start treatment earlier in the course of the disease, rather than waiting until it has progressed and caused irreversible damage. My hope is that we can intervene earlier for more patients.

How do you think JACARDI will influence future collaboration on cardiovascular disease and diabetes prevention in Europe?

JACARDI is a Joint Action, supported by the European Union and recognised by the scientific community. In a previous newsletter, I read a message from Professor Thomas F. Lüscher, the President of European Society of Cardiology highlighting the importance of JACARDI in shaping the future of cardiovascular disease and diabetes management through collaborative, data-driven care for the benefit of patients. I believe a similar message will come from the diabetes community. So, as said previously, having like-minded experts in the same room encourages discussion and cross-fertilisation of ideas. I anticipate that participants will begin to collaborate outside of the JACARDI framework, which I see as a positive outcome.

The European Society of Cardiology and the diabetes associations are already aligned, and I believe JACARDI has a crucial role to play in promoting future collaboration.

It’s important that the JACARDI initiative and its outcomes, such as pilot results, gain visibility in the scientific community. Researchers need to present their findings at conferences and submit their work for publication. This is essential to demonstrate that the funding received has been used effectively. Ultimately, it’s important to ensure that the investments made produce tangible results.

Based on your experience as a cardiologist, what do you consider the most critical factors in improving data-driven healthcare outcomes?

This is an extremely important question. Speaking from a national perspective, as someone from Slovenia, I’d like to extend this to an international context.

I believe that the lack of IT support for collecting data is a crucial issue. Slovenia is a small country with 2 million inhabitants and 14 hospitals, but we lack a unified IT system across these institutions. Although all hospitals are publicly owned and we have a single insurance provider, we struggle to collect comprehensive epidemiological data. We have a national hospitalization database, but it doesn’t give you the granularity of patient data.

The first necessary step would be the development of IT solutions, possibly using artificial intelligence, to extract the necessary data from medical records, particularly in terms of epidemiology. In my opinion, we still lack accurate figures for many diseases, both in Slovenia and across Europe.

Without this data, we cannot fully understand the scope of the problem, making it difficult to effectively allocate resources for patient management. I believe that the JACARDI pilots will showcase best practices in addressing this epidemiological data gap.

In terms of how JACARDI’s research and initiatives could support lasting, practical changes in clinical practice across Europe, particularly in Slovenia, I anticipate that most findings will primarily reflect the pilot country’s specific context . However, some lessons can be adapted across borders. Each country involved will focus on its specific challenges, but I believe that through meetings like this, where participants are encouraged to share their work, others can identify relevant lessons.

The perspective of the Advisory Board members is crucial in this process, as we aim to integrate ideas from different work packages that may not always communicate effectively with each other. This collaboration is essential.

Dr. Mitja Lainscak is a Professor of Internal Medicine at the University of Ljubljana and conducts clinical practice and research at the Department of Internal Medicine, General Hospital Murska Sobota, Slovenia. He is the Director of the Slovenian Research Agency and his clinical and research interest is cardiovascular medicine with particular emphasis on heart failure, pharmacotherapy, and metabolism with body composition. He has published more than 170 papers and holds an Executive Committee member position at the Heart Failure Association of the ESC.  

Learn more about Mitja Lainscak and his work and connect on LinkedIn.

A model of excellence in the Marche Region: turning a regional best practice into a shared European achievement

The Marche Region stands as a European model of excellence in managing diabetes. Its participation in JACARDI builds on more than a decade of coordinated innovation, legislation, and stakeholder engagement.

The foundation was laid with Regional Law No. 9/2015, which established a network of Diabetes Centres connected by a shared electronic record and coordinated through the Regional Diabetes Committee. Led by the Marche Regional Health Agency (Agenzia Regionale Sanitaria – ARS), this committee unites specialists, family doctors, pediatricians, and patient associations to ensure equal access and consistent quality of care. Recognized by the European Commission’s Best Practice Portal and the Italian National Agency for Regional Healthcare Services (Agenzia Nazionale per i servizi sanitari Regionali – AGENAS), this network became a reference model for chronic disease management.

When the European Union launched JACARDI, the Marche Region’s mature system made it a natural choice for leadership. The region now co-coordinates the work on patient self-management and runs five pilot projects that align with prevention, early diagnosis, and integrated care. All activities are co-designed with professionals and patient associations, ensuring that regional strengths feed into European innovation while new knowledge returns to improve local services.

As highlighted by Flavia Carle, Director of the Regional Health Agency, participating in a European Joint Action offers “two main benefits: contributing our experience to the development of guidelines and organizational models, and learning from other European countries to guarantee equity across our region.”

Digital innovation plays a central role. As Massimiliano Petrelli notes, the region’s electronic medical records now allow real-time data access, enabling faster and more precise interventions. JACARDI provides new resources to expand this capacity and strengthen digital health literacy among professionals and patients alike.

Beyond technology, JACARDI promotes a cultural shift toward shared responsibility. The projects now implemented in all the Health Authorities of the Regional Healthcare system will enhance health literacy, empowering citizens to make informed decisions about their care.

As highlighted by Paolo Muratori, President of the Marche Federation of Diabetic Associations, patient associations act as vital bridges between institutions and the community, ensuring that patient voices help shape regional policies.

In just two years, the Marche JACARDI team has launched pilot projects in almost all Diabetes Centres, produced educational materials, and trained healthcare staff, embedding these innovations into the regional system.

The Marche Region’s journey—from pioneering legislation to European leadership—shows how consistent collaboration and commitment to equity can turn a regional best practice into a shared European achievement. JACARDI is not just a project but a collective investment in knowledge, empowerment, and health for all.

New online risk test by the Finnish Diabetes Association garners over 120,000 users in just one month

A groundbreaking new digital health initiative in Finland is empowering individuals to assess their risk of developing some of the country’s most common chronic illnesses, all from the comfort of their homes. This tool has been developed as part of a pilot program within JACARDI’s Work Package on screening by the Finnish Institute for Health and Welfare (THL) and the Finnish Diabetes Association.

The new online risk test has already garnered over 120,000 users in just one month, signaling a widespread public interest. In fact, drawing from extensive population-level health data, the tool estimates a person’s likelihood of developing: type 2 diabetes, cardiovascular diseases, and memory disorders (such as dementia). The risk for type 2 diabetes and heart disease is projected over 10 years, while memory disorders are evaluated over a 20-year timeline.

The test was developed by a team of experts, including Prof. Jaana Lindström, Research Manager at THL and Sari Koski, Director of Diabetes Courses and Knowledge Production at the Finnish Diabetes Association, under JACARDI’s Work Package on Screening, led by Hanna Tolonen from THL. It does not function as a diagnostic tool, yet it offers a general risk assessment based on an individual’s lifestyle and health background, providing valuable insights even before symptoms emerge. It is especially helpful for individuals who may not yet have access to clinical testing or regular medical evaluations.

The test is available online and can be completed in minutes, anonymously and free of charge. It is designed for adults of all ages and is especially relevant for those who are unaware of their risk factors. It can be used independently at home.

Each user receives a personalized summary of their risk, along with science-backed lifestyle suggestions. These include advice in areas, such as diet and nutrition, physical activity, sleep and recovery, and stress management.

By taking the test, individuals are encouraged to make small but impactful changes to their daily habits, changes that could significantly reduce their chances of developing chronic illnesses in the future.

Since its launch in late May 2025, the test has exceeded expectations; the section related to memory disorders has seen particularly high engagement.

This level of adoption underscores a growing interest among the Finnish population in self-directed health promotion and self-care. The success of the initiative also reflects how digital tools can complement traditional healthcare services by raising awareness, prompting early action, and reducing long-term healthcare costs.

Health authorities are enthusiastic about the test’s potential. Prof. Jaana Lindström, from THL, emphasized its preventive power, stating that recognizing risk is key to taking action in time.

Sari Koski, representing the Finnish Diabetes Association, highlighted the importance of modest lifestyle adjustments by saying that even small changes can lead to significant health benefits over time.

This perspective is supported by stark national statistics. Every year in Finland:

• Approximately 23,000 people are diagnosed with type 2 diabetes
• Around 22,000 with coronary artery disease
• About 23,000 begin experiencing memory-related disorders

These figures underline the urgent need for tools that enhance citizens’ awareness of chronic disease risk factors and promote early detection and lifestyle interventions.

For this reason, the launch of this new test quickly gained widespread attention, as the campaign was covered extensively by both major national and local media outlets across Finland. Leading publications highlighted the test’s potential to empower individuals to take control of their health. Regional news platforms played a key role in disseminating the information, ensuring that citizens across the country, from urban centers to rural municipalities, were informed about the tool.

The risk test serves not only as a personal wellness tool but also as a potential model for broader public health efforts. This strategy is not only beneficial for the individual but also contributes to the sustainability of the healthcare system.

Moreover, initiatives like this one are economically sensible: they help curb the rising costs of treating chronic conditions and allow more people to stay healthier and more productive for longer.

Finland’s new online risk test represents a timely and impactful tool for public health promotion. While not a replacement for medical diagnosis, it opens the door to greater personal responsibility and awareness. By bridging digital innovation with health promotion, it empowers citizens to act before illness strikes, and that might just be the key to a healthier future for all.