Equity Lens: Antiracism is integral to reducing health inequalities      

Considering the words we use, the decisions we make, and the attitudes we hold, along with recognising discriminatory practices in everyday healthcare settings, are crucial steps public health professionals can take to address health disparities among ethnic minorities. As part of JACARDI’s Equity Lens series, this article examines differences in treatment and care for ethnic minorities, the importance of building trust, and concrete actions professionals can take to achieve more equitable health outcomes.

Since racism directly affects health outcomes, adopting an antiracist approach is integral to quality care, emphasizes Dr. Najma Yusuf, a medical doctor and an antiracism educator for the JACARDI Masterclass titled “Antiracism is care: Advancing Equity in Healthcare”. It is vital to recognize harmful structures, deconstruct them, and avoid past mistakes, especially in the current political climate.

Understanding structural racism and historical context

Racism in healthcare has been well documented and is rooted in structural issues. Studies show that patients from ethnic minorities may receive different treatment than the majority population. This discrepancy is visible even in common medical tests; for instance, in the case of pulse oximetry, which can lead to significant delays in initiating therapy. Diagnosis and treatment decisions made by healthcare professionals can also be influenced by cultural biases.

Dr. Yusuf shed light on the controversial history of medicine, noting that unethical medical experiments conducted on ethnic minorities were a regular occurrence not too long ago. The enduring effects of this history mean that certain minority groups remain wary of healthcare professionals today. Consequently, building trust must begin from the very start, which requires time.

From race-based to race-conscious medicine

A key concern is that race is still used as a risk factor for disease in health research. This persists despite the fact that it has been well-established that race is a social construct, rather than a biological risk factor.

Dr. Yusuf argued that, instead of relying on biology, race should be defined as a social and power construct. This approach allows practitioners to understand and see the effect that race has on an individual’s health and wellbeing. Moving away from race-based medicine toward race-conscious medicine will eventually lead to the reduction of racial health inequalities.

Five concrete ways to promote active antiracism

Antiracism requires active action, and there are concrete ways to promote it within healthcare and healthcare research. Dr. Yusuf presented five actions that professionals can take:

1. Admitting the existence of structural racism
2. Having active plans to reduce structural racism
3. Meeting patients without prejudice
4. Disaggregating data in health research for equity monitoring (by country of birth, language, ethnicity)
5. Using participatory approaches involving affected communities

Resources:

• Online course on anti-racism for professionals (videos are in Finnish with English subtitles)
• The Moni Suomi Study
• Pulling at the heart: COVID-19, race/ethnicity and ongoing disparities by Chin-Hong, P et al.
• From race-based to race-conscious medicine: how anti-racist uprisings call us to act
• Tackling structural racism and ethnicity-based discrimination in health

About Dr. Najma Yusuf

As a physician specializing in emergency medicine, and an anti-racism expert at the University of Helsinki, Dr. Yusuf has a demonstrated history of working in healthcare, biomedical sciences, and public health. Beyond her medical practice, she is actively engaged in advancing equity and inclusion, serving as a Board Member of the Finnish-Somalia Association (FSA) and as a trainer for doctors in Finland, contributing to a JACARDI pilot program developing antiracist training for healthcare professionals.

About the JACARDI Equity Lens Series:

Throughout this series, we share why equity and diversity are not optional add-ons but core components of truly equitable healthcare as well as a shared responsibility for everyone working in the field. To share the knowledge generated within JACARDI, the Equity Lens article series draws on the JACARDI Equity Masterclass series that provides an in-depth look into matters related to equity and diversity for JACARDI pilot teams conducting 143 healthcare interventions across Europe. The article series offers insights shared by a diverse pool of public health professionals within the consortium. By looking through an equity lens, we can build a more inclusive system for everyone. Join us in learning how an equity lens can shape daily practice and drive meaningful change.

Read the first article in the series: JACARDI’s 4Cs framework for advancing equity and diversity

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.

Can artificial intelligence help shape smarter cardiovascular policies across Europe?

What if policymakers across Europe had faster, clearer and more reliable data to guide decisions in cardiovascular health? Addressing that challenge, one of JACARDI’s pilot teams from CNIC presented their work at the ESC Digital & AI Summit 2025, showcasing AI innovations designed to turn evidence into actionable policy.

At the European Society of Cardiology Digital & AI Summit 2025, researchers Fatima Sanchez-Cabo, Juan Ignacio Alvarez Arenas, Daniel Jiménez Carretero, from the Computational Systems Biomedicine group at CNIC (Spanish Cardiovascular Research Center), and active members of JACARDI’s Working Group on Data Availability, Quality, Accessibility and Sharing, presented their poster: CARMINA: Optimizing low-parameter language models for high-quality cardiovascular research assistance. The work was featured in the session From bench to bedside: the potential roles of large language models in cardiovascular medicine, moderated by Professor Lis Neubeck, from Edinburgh Napier University; and Associate Professor Johan Verjans MD PhD FESC FRACP, from the University of Adelaide.

Why does this matter?

Within JACARDI’s Pilot 57, CNIC is developing EUROCARDIAB, a pioneering federated data platform integrating cardiovascular health indicators from across Europe. One of its key features is a CVD impact simulator that models how changes in risk factors could reduce event prevalence, providing policy makers with reliable, data-driven scenarios for national planning.

A dedicated web front-end will share these insights and will also host CARMINA (Cardiovascular And Research-driven Molecular Insight with Novel Assistant), an AI-powered research assistant designed to support specialized cardiovascular research. CARMINA will orchestrate the Intelligent Policy Agent (IPA), enabling autonomous trend analysis, computational modeling of interventions, and the creation of clear, actionable policy briefings for decision-makers in cardiology and diabetology.

This year’s ESC Digital & AI Summit motto, “Prepare for the next frontier in cardiovascular care”, aligns strongly with JACARDI’s overarching mission: accelerating patient outcomes and transforming clinical workflows across Europe through better data, smarter tools and more equitable care pathways.

Today, accurate, comparable and timely data on cardiovascular disease and diabetes remain limited, yet this information is essential for developing targeted policies that reduce disease burden, improve healthcare for all citizens and help close persistent inequalities.

The ESC Digital & AI Summit remains a key meeting point for global leaders, innovators and technology experts shaping the digital transformation of cardiovascular care, and pilots like this one from CNIC demonstrate how JACARDI is already turning that vision into meaningful, data-driven progress across Europe.

Learn more about CARMINA here.

More than cancer: The silent epidemic in Europe 

“I almost didn’t see my daughter graduate.” Alice, a 45-year-old mother of two, was the picture of health, or so she thought. Until one day, a sudden heart attack left her in the ICU, fighting for her life. Like many others, Alice was unaware of her cardiovascular risk factors. Her story is a stark reminder of the silent epidemic plaguing Europe: cardiovascular disease (CVD). Historically, CVD has been the leading cause of death in the European Union, claiming over 1.8 million lives annually and affecting more than 60 million people. [1],[2] Recent improvements in cardiovascular care in some countries highlight progress, but the burden of CVD remains unparalleled.

Despite its massive toll, CVD lacks the policy attention it deserves. Rising obesity and diabetes rates, particularly among younger populations, are fueling this crisis, while the decline in mortality rates has slowed alarmingly. Marleen Kestens, Manager of CVD Prevention Policies at the European Heart Network (EHN), underscores this urgency:

“CVD remains the leading cause of death in the EU, surpassing cancer and diabetes, yet it has long lacked the policy attention it urgently requires. The progress achieved through Europe’s Beating Cancer Plan presents a clear opportunity: its lessons, good practices, and even its unimplemented measures on prevention and nutrition can help shape an effective Cardiovascular Health (CVH) Plan. With up to 80% of premature CVD deaths being preventable through public health measures and/or preventative treatment, the time to act is now to make the healthy choice the default choice.” 

A blueprint for action

The success of Europe’s Beating Cancer Plan, reflected in the fact that over 90% of its actions are completed or well underway. Council Recommendations on cancer screening, on vaccine-preventable cancers, and on smoke- and aerosol-free environments provide recommendations to Member States and are extending access to important tools such as cancer screening, Human Papillomavirus and Hepatitis B vaccination, and strengthening protection from cancer risk factors such as tobacco. [3] 

These principles are equally vital for tackling CVD. JACARDI is committed to building on this momentum. By collaborating with organizations like EHN and supporting the European Alliance for Cardiovascular Health (EACH)’s roadmap, JACARDI aims to promote preventative care and education, advocate for evidence-based policy changes, and foster partnerships to enhance cardiovascular health across Europe.

For the Coordination Team of JACARDI, “the current policy momentum presents a pivotal opportunity to advance the development and implementation of a dedicated EU Cardiovascular Health Plan. Building on the achievements and lessons of Europe’s Beating Cancer Plan, such a framework must be tailored to the distinct complexities of cardiovascular disease prevention, early detection, and integrated care. We strongly endorse this strategic direction. We are firmly committed to contributing to and advocating for a comprehensive, equity-driven EU response.”

Central to JACARDI’s mission is the promotion of equity and diversity inclusion, grounded in gender-responsive and context-specific approaches. “We believe that only by embedding these principles at every level of policy and practice can we truly reduce the burden of cardiovascular diseases and diabetes, and ensure that no one is left behind,” explain the members of JACARDI’s Coordination Team.

Aligned with JACARDI’s vision, EACH envisions a future where, by 2030, premature and preventable deaths from CVD are reduced by one-third [4]. This ambitious goal aligns with Sustainable Development Goal Target 3.4 and prioritizes access to high-quality risk assessments, personalized care pathways, and reduction of health inequalities across Europe.

Turning vision into reality

Alice’s story, though fictional, represents the reality faced by millions. CVD is a silent epidemic, but it doesn’t have to remain that way. By learning from the successes of Europe’s Beating Cancer Plan and implementing a robust Cardiovascular Health Plan, fewer lives will be lost to preventable cardiovascular conditions. Together, we can make cardiovascular health a priority across Europe and create a future where the healthy choice becomes the default choice.

About the CVH Plan

The European Commission is currently developing the European Cardiovascular Health Plan (CVH Plan) to address Europe’s leading cause of death. In parallel, the European Alliance for Cardiovascular Health (EACH) has published A European Cardiovascular Health Plan: The Roadmap, which sets out a shared vision and concrete recommendations to reduce premature and preventable cardiovascular deaths by one third by 2030. Together, these efforts aim to ensure universal access to risk assessments, patient-centred care, and comprehensive strategies for prevention, diagnosis, treatment, and rehabilitation. Learn more.

Sources: 

[1] Fighting cardiovascular disease – a blueprint for EU action, June 2020. European Heart Network and the European Society of Cardiology. https://ehnheart.org/about-cvd/eu-action-on-cvd/ 

[2] Samuel Chin Wei Tan, Bin-Bin Zheng, Mae-Ling Tang, Hongyuan Chu, Yun-Tao Zhao, Cuilian Weng, Global Burden of Cardiovascular Diseases and its Risk Factors, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021, QJM: An International Journal of Medicine, 2025; hcaf022, https://doi.org/10.1093/qjmed/hcaf022

[3] Europe’s Beating Cancer Plan: a comprehensive action plan working hand in hand with the Cancer Mission. European Observatory on Health Systems and Policies: Domenico Fiorenza Glanzmann, Vittoria Carraro, Philippe Roux; CC BY-NC-SA 3.0 IGO. 12 March 2025, https://iris.who.int/bitstream/handle/10665/380751/Eurohealth-31-1-6-eng.pdf?sequence=1 

[4] A European Cardiovascular Health Plan: The need and the ambition, May 2022. European Alliance for Cardiovascular Health (EACH). https://www.cardiovascular-alliance.eu/wp-content/uploads/2022/05/EACH-Plan-Final_130522.pdf 

Bridging Borders: promoting public health across cultures

Katarzyna Brukało is an Assistant Professor at the Faculty of Public Health, Medical University of Silesia (SUM) in Katowice, Poland. She is a public health and dietetics specialist with over 15 years of academic and research experience. Her current work focuses on innovative approaches to NCD prevention, health promotion, and evidence-based policy. She is actively involved in EU and WHO projects such as JAHEE, Best Re-MaP, Health4EUkids, JACARDI, and JA PreventNCD.

You lead 15 very diverse pilot projects in JA PreventNCD, all centered around the concept of healthy living environments. Why is working at the local level so important, and what impact do you hope these pilots will have?

Our work package is very broad, because we have 15 pilot projects that are all very different. For example, we are adapting breastfeeding best practices from our Norwegian partners and implementing them in Greece. These are two very different contexts, with different conditions, and we also have pilots that promote drinking tap water, among many other activities.

What’s important is that all of these are implemented at the local level. This means we are close to the communities, close to the citizens, and that’s where we can make the biggest impact. Local governments and local structures have real power, and when we use this effectively, we can build on this work to make an impact on national policies as well. It’s like a puzzle: each pilot is one piece, and together they create the bigger picture.

Looking at the bigger picture, what is your dream result at the end of this project journey?

Our vision is not that Norway should become like Greece, or Greece like Norway. Instead, the real goal is that we learn from one another, build a good professional relationship with the facilitators, understand each other’s barriers, and use this knowledge to build responsible, community-based public health initiatives based on peer learning.

SUM University is also active in JACARDI. How do JACARDI and Prevent NCDs complement each other, and what added value do they bring when combined?

It’s very valuable that we are part of both Joint Actions, which we often call sister actions. JACARDI focuses mainly on cardiovascular diseases and type 2 diabetes, while Prevent NCDs addresses non-communicable diseases more broadly, including cancer.

Together, they allow us to tackle the full spectrum of non-communicable diseases. Only by acting together can we make a real impact, not just at the national level but also internationally.

You are known as an engaging communicator. How would you inspire others to make public health messages resonate?

For me, the key in communicating about public health is to be clear and responsible. We need to stand behind every word we say, because mistakes can lead to misinformation or even fuel fake news.

It’s also important to stay open to discussion, even engage in difficult debates and tough questions. Hard questions mean people are listening, reflecting, and engaging with what we say. That is, after all, why it is called public health, because it is for the public, and it must involve the public. Communication is central to this: raising awareness, building health literacy, and empowering people to understand their options.

About the JACARDI & JA PreventNCD collaboration:

The two projects are part of a broader network of European Union initiatives aimed at tackling non-communicable diseases (NCDs) and promoting public health. They work together to share knowledge, strategies, and resources, thereby amplifying their impact across the EU. By harnessing the synergies of these collaborative efforts, we can enhance the effectiveness of our initiatives, ensuring a more comprehensive approach to NCD prevention-and management, as well as health promotion.Explore more about the work of PreventNCDs here.

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.

“There is a positive story to be told here” — what we learned at the DigiCare4You Workshop

In line with HaDEA’s commitment to foster synergies and share knowledge across EU health initiatives, JACARDI actively engages with a wide portfolio of projects – from Joint Actions and EU4Health grants to Horizon-funded interventions. JACARDI team members recently attended the DigiCare4You Capacity Building and Recommendations Development Workshop with International Stakeholders, held in Lisbon during the annual ICIC conference.

The event underscored how ongoing stakeholder engagement is vital to disseminate results, explore upscaling opportunities, develop evidence-based national policies and lay the groundwork for future cross-country collaborations. We invite readers to learn more about this ambitious intervention – running in parallel to our own pilot implementations – which is already demonstrating early results, implementation insights, and an inspiring commitment to meaningful change in health self-management.

A people-centric, digital health solution for preventing and managing diabetes and hypertension

The Horizon2020-funded DigiCare4You project offers a new model for the early prevention and management of type 2 diabetes (T2D) and hypertension (HTN) by engaging schools, communities, and healthcare systems in an intersectoral approach. At its core, the project empowers families and connects health and education sectors, equipping individuals with digital tools to better manage their health.Building on the evidence-based Feel4Diabetes study, DigiCare4You is being implemented in two high-income (Greece, Spain) and two middle-income countries (Albania, Bulgaria), targeting over 10,000 families across socio-economic groups.

Screen, support, empower – the DigiCare4You approach

DigiCare4You applies a two-step screening model leveraging existing child growth monitoring activities in schools and health centers through which parents and caregivers are approached to complete the FINDRISC questionnaire as the first screening step. Adults identified as at risk are then referred for a second screening, which includes anthropometric and clinical assessments to detect conditions such as prediabetes, type 2 diabetes, or hypertension.

Those confirmed at risk are subsequently invited to join the DigiCare4You two-year, mHealth-supported intervention programme, focused on lifestyle change, self-management, and family support. A multilingual mobile app offers access to health data, tracking tools, and educational resources and even recipies. Importantly, the intervention supports healthier behaviors in both adults and children through school and community-based activities.

DigiCare4You combines digital innovation, equity-driven outreach, and participatory research, while integrating into existing systems and investing in health professional training – ensuring sustainable, real-world impact.

Early results revealed: first findings inspire confidence

The Capacity Building and Recommendations Development (CBRD) Workshop gathered international experts at the midpoint of project implementation to review progress and shape the upcoming Roadmap for Scale-Up.Prof. Brian Oldenburg elevated the spirit of the event stating that: “Early findings are promising enough to say that there is a positive story to be told here.” Indeed, early results are compelling:

• Fewer adults with intermediate hyperglycaemia progressed to T2D; many returned to normal glucose levels.
• Participants with T2D improved their HbA1c.
• Adults with obesity experienced weight loss, BMI reduction, and lower cholesterol—without increased medication reliance.

From research to real-world impact

The workshop emphasized the transition from effectiveness to implementation research – examining how interventions work in real-life conditions. Dr Rajesh Vedanthan facilitated a compelling discussion in which implementers candidly shared successes and challenges.

Key takeaways from country implementers:

• Strong consensus: “Yes, we would start and do it again.”
• Motivation stems from seeing behavior change within families—especially when children and caregivers reinforce each other’s progress.
• Burnout among healthcare staff is a concern—but aligning DigiCare4You with existing systems proved an effective strategy.
• Local ownership and trust, especially through primary care systems and schools, were pivotal.
• Participants emphasized the importance of engaging families holistically, with one Bulgarian team member noting how “changing the behavior at home” can be one of the most lasting outcomes.

Additionally, one noted barrier to engagement was previous unsuccessful attempts at weight control, highlighting the need for tailored motivational support.

Cost-effectiveness, scalability, and the road ahead

Preliminary analyses suggest strong cost-effectiveness, especially when targeting adults with intermediate hyperglycaemia in MICs. A Scalability Decision Support Tool was developed to assess implementation readiness across five domains: NCD care context, digital literacy, support systems, screening capacity, and digital integration. These insights inform the forthcoming Roadmap for Scale-Up.

JACARDI Relevance

The presence of experts involved in both JACARDI and DigiCare4You highlights the existence of a vibrant, cross-country network of professionals dedicated to cardiovascular and diabetes care. The workshop featured members of the JACARDI Stakeholder Advisory Board, including a policy advisor from the European Diabetes Federation, epidemiologist and researcher from EUPHA, healthcare professionals involved in the pilot implementation in Portugal, representatives from the industry developing digital tools, and communication experts. Together, these individuals demonstrate the strength of this interconnected community.

Such events provide valuable opportunities to learn, grow and exchange knowledge, and have the potential to shape and enhance the quality of ongoing interventions. Given the different timelines of these projects, the initial findings of the DigiCare4You project can provide valuable insights for the JACARDI teams, given that the implementation of the pilots has only just begun.

Looking ahead

In its final year, DigiCare4You will focus on completing the intervention, finalizing cost-effectiveness studies, and refining its scalability tools. A second CBRD workshop will present final results and a full Roadmap for Scale-Up, providing a concrete guide for policy and replication.

As the burden of type 2 diabetes (T2D) in Europe is expected to reach 72 million people by 2050, DigiCare4You is emerging as a promising prevention model. “We design a programme, and when we start to implement it, we are confronted with the reality on the ground. Reality is revealed, and we act according to people’s needs,” said Prof. Yannis Manios, Project Coordinator. Meeting people where they are – with empathy, innovation and commitment – may be the most powerful intervention of all.

Discover more about the DigiCare4You project here.

JACARDI’s voices on the scientific stage across Europe

The first half of 2025 has been a busy and productive time for JACARDI, with consortium members sharing key findings and pilot implementation highlights at leading scientific conferences across Europe. These contributions, spanning health literacy, integrated care, biomarker-based screening, and health economics, demonstrate the depth and scope of the work underway across multiple work packages.

Spotlight on ICIC25 – Lisbon, Portugal | May 14–16, 2025

JACARDI had a strong presence at the 25th International Conference on Integrated Care (ICIC25) with three distinct contributions representing different work packages:

Irati Erreguerena (Work Package 6 – Health literacy) delivered an oral presentation on a co-designed health literacy program for adolescents in the Basque Country, Spain. Her talk highlighted how WHO’s Health Literacy Development Model, and the Ophelia (Optimising Health Literacy and Access) co-design methodology were applied to empower younger populations with knowledge and tools for chronic disease prevention.

Yhasmine Hamu (Work Package 9 – Integrated care pathways) presented on the implementation of a value-based integrated care model, sharing strategies to address care fragmentation and improve outcomes for people with chronic conditions.

Gergely Varga (Representing both Work Package 9 – Integrated care pathways and Work Package 5 – Methodological framework) contributed a poster that outlined a situational analysis methodology designed to support integrated care.

Faculty of Public Health Summer Scientific Meeting – Dublin, Ireland | May 20–21, 2025

Sonja Moore (Work Package 8 – Screening) presented findings from a scoping literature review on the use of natriuretic peptides in cardiovascular risk stratification and management. Her poster focused on current strategies and approaches for using these biomarkers in patient populations without diagnosed heart failure, a topic gaining traction in preventive cardiology. The review aimed to inform more targeted screening protocols and identify gaps in clinical practice across Europe.

COMET Conference – Poznań, Poland | June 25–27, 2025

Richard Osborne (Work Package 6 – Health Literacy) represented JACARDI at the 23rd International and Interdisciplinary Conference on Communication, Medicine, and Ethics (COMET). His oral presentation focused on scaling up health literacy development as a strategy to prevent and manage non-communicable diseases. The talk stressed the need for strategic investment in communication and co-design at the system level.

1st European Public Health Economics Conference
– Palermo, Italy | June 26–27, 2025

Katie Ellwood (Work Package 8 – Screening) presented a pilot study from JACARDI aiming to establish the most cost-effective threshold for using NT-proBNP blood marker in cardiovascular disease (CVD) risk stratification. The analysis models the impact of different thresholds over a 30-year horizon in a large population cohort. This pioneering work within JACARDI bridges clinical practice with health economics, helping to inform sustainable, evidence-based screening strategies.

These scientific initiatives reflect JACARDI’s commitment to knowledge-sharing, collaboration, and measurable impact. Consortium members not only showcased research but also engaged with policymakers, practitioners, and academics, advancing the mission to improve cardiovascular and diabetes outcomes across Europe. The autumn season offers a variety of relevant conferences, kicking off right at the end of summer with the Congress of the European Society of Cardiology, taking place from 29 August to 1 September.