bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scaling up joint efforts to tackle cardiovascular diseases and diabetes in Europe
Authors: Armocida B 
Published: October 2024

Abstract
JACARDI, a Joint Action on cardiovascular diseases (CVD) and diabetes (DM), aims to support EU countries in reducing the burden of CVD and DM and related risk factors, both at individual and societal levels, while ensuring health systems sustainability and equity. In particular, JACARDI aims to implement best practices and pilot testing of innovative practices throughout the entire patient journey. Commencing by improving health literacy and raising awareness among general and target populations, moving through primary prevention and screening of CVD and DM among high-risk populations, and then address people living with CVD and DM and their health service providers, through the improvement of service paths and (self) management, including through digital tools, and completing the path by supporting and encouraging the labour participation of people living with these diseases. With 21 European countries and 76 partners engaged, JACARDI undertakes 142 pilot projects, promising to advance CVD and DM care for millions across Europe. In particular, through an innovative Work Package on methodology, JACARDI will develop and implement a methodological framework to guide all the pilot projects in the design, preparation, implementation, monitoring, reporting, and assessment processes. This framework will encompass transversal and intersectional aspects, ensuring a harmonized and efficient approach for all JA activities. Through rigorous and multidimensional evaluation, JACARDI aims to uncover new approaches to enhance healthcare systems, grounded in evidence-based practices and current needs, while adopting the lens of equity and sustainability throughout the entire methodological and implementation process.
7.L. Practice session: Is there an investment case for health at older ages?
Authors:   Organised by: European Observatory on Health Systems and Policies,   Chair persons: Jonathan Cylus (WHO)
Published: October 2024

Abstract

The global demographic landscape is undergoing significant transformation due to increases in longevity and declining birth rates. According to the United Nations, the world’s population aged 65 and over is projected to more than double, reaching over 1.5 billion by 2050, while global fertility rates are expected to decline to 2.4 births per woman by 2030 and continue decreasing to 2.2 births per woman by 2050. Ageing populations have frequently concerned decision-makers due to the potential implications of changes in population age-mix for labour markets and the economy, as well as for the sustainability of public programs and spending, particularly the health sector. For example, as the share of the population at older age increases, there are concerns over how to cope with the possible economic implications of having a smaller share of people at traditional working age (with potentially more people obtaining income security through both public and private pensions) and how to respond to greater health and long-term care needs. Without appropriate policy responses, there are worries that demographic changes will have inevitable consequences for households, public finances and possibly for economic growth and development. To support policy decisions related to population ageing it is important to have informative evidence and modelling tools that allow policymakers to better understand both the implications of population ageing as well as the consequences of policy action or inaction. To this end, this session presents three recently developed modelling tools that aim to address a number of policy relevant questions related to ageing:
1) How does ageing affect health financing and are health systems unsustainable?
2) How does ageing affect economic objectives and does health at older ages matter?
3) Can we develop economically relevant measures of health at older ages if older people do not have formal ties to the labour force?
Using data and analyses from a range of European countries, we will demonstrate empirically that the way ageing affects health financing systems, economies, and societies more broadly reflects policy choices and is not an inevitable consequence of demographic changes.

Key messages
• Policymakers must prioritize informed policies to comprehensively understand the impact of aging on health financing and economies, facilitating the development of sustainable solutions.
• Immediate action is imperative to address the implications of aging on labor markets and public spending, ensuring future economic stability and safeguarding societal well-being.
Health, an ageing labour force, and the economy: Does health moderate the relationship between population age-structure and economic growth?
Authors: Cylus J 
Published: October 2024

Abstract
Research often suggests that population ageing will be detrimental for the economy due to increased labour market exits and lost productivity, however the role of population health and disability at older ages is not well established. Identifying whether the health of older people affects economic outcomes is challenging due to methodological issues. Using country-level panel data, we estimate the relationship between the size of the older working age population (aged 55-69) and economic growth across 180 countries from 1990 to 2017. We run models using annual data and 5-year moving averages of real per capita GDP growth as dependent variables. This enables us to quantify the gains in real per capita GDP growth associated with a healthy older working-age population on a country-by-country basis. The initial models confirm an inverse-U or hump-shaped relationship between population age groups and economic growth. In the 5 year average GDP growth model, the coefficient for the inverse of YLDs among 55-69 year olds is positive and significant at p &lt; 0.01. The interaction term is significant at p &lt; 0.001 in the same model. Across all countries, a 5% improvement in YLDs is associated with at minimum 0.3% predicted additional annual real per capita GDP growth. While a larger share of the older working-age population at ages 55-69 has historically been associated with slower real per capita GDP growth, low levels of disability in this age group can reduce or even eliminate these adverse economic effects. We consistently find a significant positive interaction between disability and the share of the population at ages 55-69, suggesting that adverse economic effects are amenable to policy intervention.
Equity and diversity maturity matrix for structured diversity inclusion in the EU JACARDI project
Authors: Skogberg N , Spadea T , Armocida B , Zaletel J , Formenti B , Di Girolamo C , Onder G , Osborne R 
Published: October 2024

Abstract

Issue
There is increasing awareness on the importance of integration of cultural and ethnic diversity perspectives to reduce prevailing health inequities effectively and sustainably. There is, however, limited experience and practical tools for systematic integration of these perspectives in public health.

Description of the problem
The EU Joint Action for Cardiovascular Diseases and Diabetes (JACARDI) project, conducted 11/2023-10/2027 has developed a structured and systematic approach for integrating equity and diversity perspectives in all its 142 pilots across 21 European countries.

Results
Equity and diversity perspectives are embedded in the harmonized stepwise methodology for pilots, supported with a practical Equity and diversity maturity matrix. The maturity matrix is based on the JACARDI 4Cs Equity and diversity explanatory framework (Critical reflection; Context and data; Co-design; inclusive and accessible Communications). The content of the matrix is divided into concrete steps related to pilot’s planning and implementation, each with three levels of maturity that aim at gauging how equity and diversity perspectives are applied in practice: Approaching, Meeting, Exceeding. Pilots are encouraged to strive for any of these three levels, considering their available resources and previous experiences in diversity inclusion.

Lessons
Effective and sustainable change toward more equitable and diversity inclusive practice requires seamless integration of these perspectives in other routine activities. Training and continued practical and motivational support are key for adherence to novel approaches. In addition to being a practical tool, the Equity and diversity matrix acts as a structured self-evaluation tool to monitor how equity and diversity principles are translated into practice.
Key requirements for achieving EU-wide programme change
Authors: Osborne R 
Published: October 2024

Abstract

Issue
Across the world, thousands of projects aim for equitable improvement in health for people who are experiencing ongoing avoidable stigma, discrimination and disadvantage however very little change is often achieved.

Description of the problem
In this presentation we explore key requirements for project-level change to ensure EU-wide programme change is achieved.

Results
The two most common causes of project failure are a) the innovation is not suitable, needed or wanted (also called theory failure) or b) implementation failure. This presentation shares strategies to mitigate risks of project failure through co-design processes and communication, drawing from 30 years of experience from the entire implementation process from ideation to scale up. These experiences include projects from over 30 countries, including partnerships with the World Health Organization, governments and industry focused on health literacy, self-management, care pathways, workplace health, hospital services redesign, First Nations health and migrant health. Common success factors include balancing top-down needs with co-designed inputs and with previous preferred or good practice (which may have come from controlled trial evidence generated in different contexts). The intervention must co-implemented to serve stakeholder’s needs at all levels, from citizens to decision makers.

Lessons
The United Nations (UN) and private sector apply system-wide approaches to affect large scale change. This knowledge is valuable for large public health programmes aiming to integrate equity and diversity in project processes to minimize implementation failure.
The EU-funded action to strengthen health information systems
Authors: de Barros J 
Published: October 2024

Abstract
The European Commission initiative to build a European Health Union recognizes the need to address in a coordinated fashion the effects of the pandemic in health and social sectors and to strengthen the resilience, accessibility and effectiveness of health systems through co-operation, best practice exchange, training schemes, technical support and improved data and knowledge management. To make the most of the potential of health data, the European Health Data Space (EHDS) is being established as one of the central building blocks of a strong European Health Union. The EHDS sets out rules, common standards, infrastructures and a governance framework for the use of electronic health data for healthcare, research, innovation and policy making. In line with these policy goals, the European Commission is funding the Action ‘Supporting Member States in the WHO European Region in strengthening health information systems and boosting health data governance’. This Action will be implemented by WHO Regional Office for Europe and aims to boost the use and reuse of health data, including by promoting, where possible, the principles and solutions developed and implemented for the EHDS. It will also contribute to the objectives of the EU Global Health Strategy to improve global health security and deliver better health for all in a changing world. In addition, the Action is designed to strengthen countries’ capacity across critical programmatic areas of health data and digital health such as data quality (including appropriate data management and analytics) and digital health literacy across the 53 Member States in the WHO European region. The main objectives of the Action are to establish a Health Information Network for strategic guidance; and develop and implement tools and capacities to strengthen health information systems, health data governance, data quality and interoperability in countries.
8.C. Scientific session: Health system resilience: A Planetary Health perspective
Authors:   Organised by: EUPHA-ENV,   Chair persons: Andrea Schmidt (Austria), Angelique Mavrodaris (UK)
Published: October 2024

Abstract

Planetary Health is a collective and unifying approach to balance the interlinkages between human health, political, economic and social systems as well as the natural systems of our planet, the importance of which is growing in the context of climate change in European countries and beyond. Yet, there is a dearth of of research linking Planetary Health to health systems’ resilience, particularly from a public health lens. With the number of studies growing regarding impacts of climate change on health, the question remains how health systems need to be prepared, focusing for example on the emergence of infectious diseases as well as the triple crises of biodiversity loss, pollution and climate change. In addition, tools to assess climate-related risks developed at international level, such as the vulnerability, adaptation and capacity assessment developed by the World Health Organization (WHO) have rarely been piloted in European countries. In this workshop, firstly evidence is presented on the status quo of how climate change impacts health and emerging infections in Europe and at global level. Secondly, the workshop provides insights into how tools to assess vulnerability and resilience of health systems in the context of climate change may be used in the European context. Thirdly, resilience is assessed against evidence emerging from the triple environmental crises of biodiversity loss, pollution and climate change.

Key messages
• In a planetary health lens, using mixed methods to consider climate change vulnerability of different population groups and adaptation potentials are key to address current complex health challenges.
• Synergistic solutions and joint working across climate and health offer opportunities for greater health system resilience and population health impact.
Climate change and emerging infections: Risks, adaptation and response
Authors: Mavrodaris A 
Published: October 2024

Abstract

Background
Weather and changing climate are key drivers of the emergence, re-emergence and spread of infectious diseases globally. However, approaches to emerging infections and climate strategies are still largely being developed separately missing the opportunities for integrated climate adaptation actions to address infectious diseases.

Description
To inform the development of the UK national emerging infectious diseases plan, a literature review of the current and projected risks from extreme weather events and climate change on emerging infections in the UK is currently underway. This will support further work examining and co-designing adaptation options in the context of preparedness and response to emerging infections.

Results
Key preliminary findings from the literature review have indicated risks predominantly from evolving patterns of vector borne diseases as climatic conditions and habitat suitability of pathogens change. Changing temperatures and hotter summer temperatures have been associated with changing food-borne infection patterns. Further risks driven by extreme weather, including flooding and droughts, could perpetuate changes in water-borne infection patterns. Adaptation actions focussed on these infectious disease groups are currently under review and will cover risk assessment, data and surveillance, preparedness and response.

Lessons
This work integrates climate action with action on emerging infectious diseases. By examining the evidence on climate sensitive infections and co-designing solutions across teams, awareness is being raised and relationships and infrastructures built to better prepare and respond to both fundamental global public health challenges.
Climate change and health vulnerability assessments to increase regional climate resilience
Authors: Durstmueller F , Horváth I , Brugger K , Schmidt A E 
Published: October 2024

Abstract

Background
The impacts of climate change on health and healthcare systems exhibit complex interrelationships, varying across time and space. Population groups already disadvantaged due to their demographics, health, socioeconomic status, or geographical location tend to be particularly vulnerable to climate-related health risks. Our work aims to develop a method for a systematic quantitative vulnerability assessment to make regional vulnerabilities comparatively measurable.

Methods
Building on the WHO framework on Climate Change and Health Vulnerability and Adaptation Assessment (2021) a data mapping process was carried out to identify and validate vulnerability factors and quantitative indicators on a small-scale spatial resolution for the five dimensions: demographic, socioeconomic, biological/health, sociopolitical, and geographic/climate. Regional vulnerability scores for each indicator were calculated and visualized as geographic maps and circular barplots to allow for easily understandable interpretation.

Results
A set of 25 quantitative vulnerability indicators from a multitude of data sources - combining register data, survey data, and geospatial data - was compiled. Main challenges were the identification of sociopolitical vulnerability factors suitable for Austria and data availability on a small-scale level. The indicator set was used to identify regions that are particularly vulnerable due to their population composition, disease burden, and geographical location (e.g. regions in Eastern Austria with high shares of persons &lt; 65 years of age, unemployment, and heat days).

Conclusions
Systematically assessing vulnerabilities in key dimensions is central to identifying regionally specific pressure points, allowing for a quantitative baseline to derive adequate and tailored climate change adaptation measures to sustain future health. Systematic assessment provides essential insights for policymakers, public health officials, and disaster management agencies.
Whole of prison approach to vaccination: co-development of information materials for people living in prison
Authors: Plugge E , Laryea-Adekimi F , Harper J , Gleave M , Harriott P 
Published: October 2024

Abstract
Enhancing vaccination literacy is pivotal in addressing hesitancy, especially among incarcerated populations who may lack regular access to health information, thus ensuring health equity. Supported by the European Union, the RISE-Vac project endeavours to bolster vaccine literacy, accessibility, and uptake within European prisons. To discern vaccination knowledge gaps and preferences for information dissemination, consultations were conducted with incarcerated individuals in the United Kingdom (via the Prisoner Policy Network), France, and Moldova. A total of 344 responses were garnered: 224 from the UK, 70 from France, and 50 from Moldova. In addition a focus group was conducted in the UK. The key themes that emerged were common across the 3 participating countries: views of vaccination, prior knowledge about vaccines, areas of appetite for learning, availability of reliable information, and preferred mechanism for information sharing. Participants were particularly interested in learning about the effectiveness, side effects, and manufacturing of vaccines. Their invaluable input informed the creation of educational materials, notably a brochure slated for pilot testing in European prisons and a video clip. Notably, individuals with lived prison experience were actively engaged at every phase of this initiative, ensuring its relevance and efficacy.
Introducing vaccination services in prison settings: case study from Moldova
Authors: Barbiros I , Busmachiu V , Doltu S , Jignea Suveica L 
Published: October 2024

Abstract
Introducing vaccination services within prison settings presents a multifaceted challenge and opportunity, particularly evident in the case of Moldova. This Eastern European nation grapples with various socio-economic and healthcare disparities, with its prison population often experiencing heightened health vulnerabilities. Amidst such complexities, the implementation of vaccination services emerges as a crucial strategy not only to safeguard the health of incarcerated individuals but also to contribute to broader public health goals. Moldova’s journey in this regard reflects a commitment to advancing preventive healthcare within its correctional facilities. The introduction of vaccination services in prisons necessitated a comprehensive approach, encompassing policy development, infrastructure enhancement, staff training, and community engagement. Infrastructure enhancement was imperative to ensure the provision of vaccination services in a safe, efficient, and dignified manner within prison settings. This involved the establishment of designated vaccination areas equipped with the necessary medical supplies and equipment. Staff training emerged as a cornerstone of the initiative, empowering healthcare professionals working within prisons with the knowledge, skills, and confidence to deliver vaccination services effectively. Training programs encompassed various aspects, including vaccine administration, adverse event management, and communication strategies tailored to the specific needs of incarcerated individuals. Collaboration with people living in prison facilitated the dissemination of accurate information, addressed concerns, and encouraged participation in vaccination programs. During the period 2021-2023 7454 doses of antiCOVID-19, 1298 doses of anti-Flu vaccine, 3083 doses of anti-HBV vaccines were administered.
Advancing Public Health Equity through Expanded Vaccination Services in prison: case studies from Italy and France
Authors: Cocco N , Ranieri R , Polidoro M , Murauer E , Meauset A , Meroueh F 
Published: October 2024

Abstract
In Montpellier prison in France and San Vittore remand house in Italy, the provision of expanded, age-appropriate, coercion-free, and tailored vaccination services to PLP has emerged as a cornerstone in improving health outcomes within prison settings. The implementation of life course vaccination programs required the full integration of prison health into public health systems building on existing vaccination services covering HBV, flu and COVID-19. In San Vittore, a vaccination clinic aimed at people living in prison was set-up. Universal vaccination status assessment and vaccination catch-up was introduced targeting people admitted into prison. The vaccination clinic-related activities included information and awareness sessions on vaccination and health literacy offered regularly to PLP: increased vaccination knowledge is effective to enhance uptake. The vaccination clinic team consisted of infectious diseases physicians and a health assistant with an anthropological background, who ran the information and awareness sessions combining and adapting core content on vaccination with individual and community social and cultural contexts. Besides seasonal flu vaccination and anti-SARS-CoV-2 immunisation campaigns, vaccinations against pneumococcal pneumonia and herpes zoster were also offered to older and fragile individuals as per national immunization plan. One of the priority objectives of the vaccination clinic was the increase in vaccination coverage against HBV and HPV, not only as a tool for the prevention of infectious diseases, but as an innovative and effective tool of cancer prevention. As part of a more ambitious program to protect sexual health in prison and related to updated screening tools for the early diagnosis of lesions due to HPV infection, vaccination against HPV was also offered as part of a health empowerment project tailored to women in detention, with the aim of building self-awareness of their own health needs.