Public Health Professionals Research Articles

Public Health Literacy: a concept to develop – Qualitative study among public health professionals

Abstract Background Health literacy can be defined as individuals’ motivation and skills to access, understand, evaluate, and utilize information to make decisions about their health. Despite Sorensen’s widely used definition encompassing both individual and population levels, also known as Public Health Literacy, it remains poorly detailed and is rarely taken into account by measurement tools. As evidenced by the Covid-19 health crisis, limited public health literacy impacts reluctance to accept government recommendations, vaccine hesitancy, and fosters mistrust of science and conspiracy theories in the health field. The main objective of this study was to derive specific public health knowledge and skills from public health professionals for the general population constituted the first step of the development of a public health literacy measurement tools. Methods A qualitative study, based on ten semi-structured interviews with public health professionals from various settings (academic, hospital, health prevention, and promotion), working across various public health fields (nutrition, sexual health, mental health), has been conducted since March 2024. Results Preliminary analysis identified three main themes: (1) fundamental concepts including identification of health determinants, epidemiology and the purpose of public health interventions, (2) critical skills including the assessment of the level of evidence and reliability of public health information, and (3) civic orientation including environmental impact on health and community approach to interventions. Conclusions These detailed insights will guide the creation of a valid measurement tool for public health literacy. This will facilitate the investigation of specific impacts on people’s adherence to public health interventions or messages and the development of actions targeting literacy in a more holistic manner. Key messages • Specific public health dimensions have been identified to enrich the existed definition of health literacy. • Public health concepts, reliability of public health information and community approach constitute the core of public health literacy.

Enhancing Interprofessional Skills with SKY Campus: A Pilot Study on Mental Well-being at UCD

Abstract Background Public health professionals and students face increasing mental health challenges. Sudarshan Kriya Yoga (SKY), known for its mental health benefits such as stress reduction and improved emotional regulation, offers a promising strategy for enhancing well-being in public health education. Objectives To evaluate the immediate effects of a three-day participatory SKY workshop on mental well-being of Master of Public Health students at University College Dublin, Ireland. Methods A non-randomized, controlled pilot study will involve MPH students at UCD. Participants, aged 18 and above, enrolled in the MPH programme, will provide informed consent to attend a three-day SKY workshop in September 2024. The workshop, delivered by certified trainers, includes three sessions of three hours each. Standardised and validated Patient-Reported Outcome Measures (PROMs) such as the Perceived Stress Scale (PSS-10) and WHO-Five Well-being Index (WHO-5) will be used to assess perceived stress and mental wellbeing at baseline and immediately after the workshop. Results Based on previous literature, it is hypothesized that participants will show a significant reduction in perceived stress and improvement in mental wellbeing scores. Data will be analysed using descriptive statistics and Wilcoxon signed-rank tests to evaluate changes in PROM scores. Conclusions This pilot study aims to provide preliminary evidence on the effectiveness of SKY in improving mental wellbeing among public health students. Successful outcomes could support integrating SKY into the public health curriculum, promoting its adoption across other institutions, and enhancing the professional skills development of future public health professionals. This component is proposed in the ASPHER core curriculum programme for public health as an important cross curricular subject area Key messages • Integrating SKY Campus workshops into public health education enhances interprofessional skills and mental well-being, offering a holistic approach to professional development in global health. • This study uses standard PROMs to assess the SKY workshop’s impact, aiming for significant improvements in stress and mental well-being to shape global public health curricula.

Training and capacity building on the effects of climate change on health: a need to up-scaling

Abstract The need to develop training on the effects of climate change on health is obvious, as the awareness on this topic is growing but the knowledge is not enough disseminated. ASPHER has taken several initiatives to address this subject. Among them, three activities deserve to be highlighted: in cooperation with the GCCHE, we have set up an intensive online course with a great success (nearly 1.000 participants in each of the 10 sessions). With the same partner we have conducted a survey in all SPHs members of our network, to be able to map training activities in the European Region and follow their development. We also work with the European Observatory on climate change and health to reinforce capacity building at European level. But this is not enough and we have to go faster and further in several directions: - by linking more closely multidisciplinary research and training, as knowledge is evolving quickly; - by developing specific training for all public health trainees. This is why we need to incorporate this topic in public health core curriculum; - by having some modules tailored to different publics: public health professionals, health professionals, but also local, national and European decision-makers and stakeholders. To conduct these activities, we have to reinforce our different partnerships and create a powerful alliance at the European level.

E-Cigarettes in the Young Population

E-cigarettes have gained notable popularity among youth in recent years, posing a serious societal issue that has elicited much concern from public health professionals and legislators. The increase in e-cigarette consumption among adolescents can be ascribed to assertive marketing strategies employed by corporations that focus on appealing to young consumers through flavored offerings and aesthetically pleasing designs. This rise is concerning because of the possible long-term health ramifications linked to vaping, such as nicotine addiction and exposure to hazardous chemicals found in numerous e-cigarette formulations. The normalization of e-cigarette usage in social contexts may result in heightened peer pressure and the endorsement of detrimental conduct. To properly address this issue, government agencies must enforce stronger rules on e-cigarette sales and marketing directed at minors, while schools and community organizations should educate youth about the risks of vaping.

9.D. Practice session: Luton, a Marmot town – Lessons from using a whole-system approach to tackle health equity

Abstract Objective To share learnings from our Health Equity Town journey, including opportunities and challenges. To allow stimulating discussion on whole system approaches to health inequalities and the social determinants of health. To include discussion on where and how public health influences or leads, the importance of impact measures, and of shared vision. Added value Luton’s 2040 strategy, and being a health equity town, are long term visions. It has been 18 months since we launched Luton’s health equity ambition, and during that time we have taken great strides forward in how we deliver against the Marmot principles and create a movement around health equity in Luton. Organisations nationally and internationally are grappling with approaches to doing this. This workshop will provide an opportunity to discuss some of the key learnings, challenges and opportunities so far in taking this approach, and how to continue to maintain momentum and buy in across sectors at local level. The workshop will include discussion on the following: 1. Taking a whole-system approach to health inequalities - working across system leaders and strategic partners including health, care, voluntary sector, businesses, housing, police and others, as well as across the local authority departments. This takes clear articulation of the problem and actions, as well as clarity on where public health professionals are most effective to support, influence, and lead. 2. There is increasing recognition of the building blocks of health and the importance of ensuring action to improve health outcomes is taken across the whole system to tackle health inequalities - including employment, education, and housing. Discussion on specific actions being taken in some of these areas to tackle health inequalities as part of the health equity town approach. 3. Working with the community to understand health inequalities. 4. How we will measure progress. 5. The concept of proportionate universalism is now well known, however making this a reality is a challenge. 6. East London Foundation Trust, the mental health provider in Luton, is also embedding Marmot Policy objectives across the Trust, and is a key partner in Luton. Work is underway to establish projects with joint aims such as skills passport to increase employment in mental health service users. Format Presentation followed by opportunity for question and answer and discussion with panel. Key messages • Whole system approaches to tackling health equity are possible through shared vision and coordinated approach. • Action across the building blocks of health is vital, the complex and long term nature is challenging.

Self-reported health effects from wildfire smoke: A cross-sectional study in New York State

Abstract Background Wildfires and exposure to wildfire smoke (WFS) are forecasted to increase, in part driven by climate change. As witnessed in 2023, regions in Europe and North America are facing more sustained periods of poor air quality due to WFS. Growing evidence suggests average daily WFS correlates with morbidity and mortality, but the impact of prolonged WFS exposure remains understudied, especially in areas where WFS is a newer occurrence. We examine associations between consecutive days of WFS experienced and self-reported health symptoms in the northeastern United States. Methods This retrospective cross-sectional study explored New York State (NYS) residents’ experience with WFS in summer 2023 via an online survey. Participants reported the longest period of consecutive WFS days and symptoms experienced. Log-binomial regression models estimated prevalence ratios (PR) and 95% confidence intervals (CI). Results 553 NYS residents were included, representing a healthy, primarily female and White population, ranging from 18 to 86 years. 549 (99.3%) reported experiencing WFS, with the longest period of consecutive WFS days varying (≤3 days: n = 152; 4 to 6 days: n = 255; ≥7 days: n = 146). 490 (88.6%) reported ≥1 health symptom, with itchy/watery eyes, sore throat, and headache as the most frequent. Compared to ≤ 3 consecutive WFS days, symptom prevalence was 9.1% higher for those reporting 4 to 6 days (PR [95% CI]:1.09 [1.00, 1.19]) and 16.7% higher for ≥7 days (1.17 [1.07, 1.27]). The trend of increased symptom prevalence with longer WFS periods persisted and was pronounced for specific symptoms. Control for potential confounders did not appreciably change estimates. Conclusions Our findings suggest longer sustained WFS exposure associates with higher symptom prevalence, which may be precursors to more serious health conditions. As global populations face more WFS with climate change, public health professionals should prioritize strategies to mitigate prolonged exposure. Key messages • In a convenience sample of 553 primarily healthy New York State residents, 99.3% reported experiencing wildfire smoke and 88.6% reported at least 1 symptom of poor health during summer 2023. • Associations between consecutive days of wildfire smoke experienced and prevalence of any and specific symptoms tended to vary in a dose-response manner.

Strengthening public health professionals in policymaking in the Eastern WHO European region

Abstract Background The collaborative research between EUPHA and WHO aimed to explore factors impacting public health professionals’ (PHP) involvement in health policy processes in the Eastern WHO European Region, addressing barriers, enablers, and capacity-building needs. Methods Utilizing a mixed methodology, the study employed document analysis, scoping review, and interviews to triangulate data, with the document analysis focusing on 4 published Essential Public Health Operations Self-Assessment Reports, the scoping review analysing 15 key articles, and 5 semi-structured interviews providing additional insight from key country stakeholders. Results Core findings revealed significant barriers impeding PHPs' participation in policy processes. Among others, these included limited intersectoral collaboration, shortage of skilled public health (PH) personnel, financial resource constraints and inadequate governance structures. Conversely, several enablers were identified, such as a positive trend in increased intersectoral collaboration and innovative governance structures during Covid-19, the development of more trained PHPs and the utilization of International Health Organisations. The two main capacity building needs reported were the importance of modernizing PH education and promoting intersectoral collaboration. Conclusions This study offers a preliminary overview of how PHPs' involvement in health policy processes in these countries can be enhanced: More intersectoral collaboration, updated PH education curricula and trainings, and governance re-design building on positive trends seen during the pandemic. Following actions are recommended: Creation of an international platform for cross-sectoral PH communication & exchange, direct support for universities and PH researchers, development of comprehensive PH trainings, assistance in forming or strengthening national public health associations and identification & sharing of effective local governance practices. Key messages • This research identifies barriers to PHPs’ participation in Eastern WHO European Region's health policy processes, while highlighting enablers like increased collaboration during Covid-19 to build on. • Recommendations to harness the enablers include clear actions such as creating an international public health platform for interaction and exchange or build-up of national public health associations.

5.C. Scientific session: Strengthen resilience against emerging vector-borne diseases through the ECDC Fellowship Programmes

Abstract Over the past decade, climate change has impacted the transmission of a wide range of vector-borne diseases (VBDs) in Europe, where locally transmitted outbreaks have occurred. It has been implicated in the observed expansion of competent disease vectors in Europe such as Aedes albopictus, which transmits diseases such as Zika, Dengue and Chikungunya. Climate may influence the life cycle of vectors, and the reproduction rate of viral particles inside vectors and human hosts, which means that upsurges in temperature can reduce the incubation period of these pathogens and the life cycle of vectors, thus boosting transmission risk through elevated vector populations. Moreover, globalization and international air travel contribute to pathogen and vector dispersion internationally. Risk mapping suggests further expansion of the species in northern Europe due to climate change. The above underscores the necessity for more proactive measures, such as developing an effective vector control program by monitoring the density and distribution of hosts and pathogens at urban, national, and cross-border levels. Additionally, establishing early warning systems based on integrated human and zoonotic and entomological surveillance is crucial to detect alerts promptly and comprehend where and when infections may emerge or spread. Furthermore, cross-border collaboration and harmonization of vector-borne surveillance systems across European countries may improve preparedness, control and response to mosquito-borne diseases. Preparedness and response require significant efforts from EU Member States and neighbouring countries. Only through a multidisciplinary approach, involving multiple sectors, can we truly prepare to address public health threats. To contribute to strengthening resilience against cross-border public health and emerging health threats in EU Member States and neighbouring countries, the European Centre of Disease Prevention and Control (ECDC) has established three fellowship training programmes. These programmes aim to create and maintain a network of highly qualified epidemiologists, microbiologists and public health professionals and strengthen the public health epidemiology workforce at EU and neighbor countries. This workshop will offer attendees a comprehensive overview of the ECDC’s fellowship programmes, describe how they function and explain their role in preparing for health threats. It will provide examples of three projects carried out by fellows on the implementation of preparedness, response and control measures for emerging vector-borne diseases in European countries at local, national and multinational levels. Those will set the scene for an in-depth analysis of the key challenges faced and can help promote awareness that integrated, multidisciplinary interventions are both feasible and effective in reducing the threat of vector-borne infectious diseases spreading in Europe and neighboring countries. Key messages • ECDC fellowship programmes aim to strengthen resilience against emerging public health threats in EU Member States and neighboring countries. • Fellows are engaged in national and cross-border integrated and multidisciplinary interventions to strengthen preparedness and mitigate the spread of emerging vector-borne diseases.

Investigating Transmission Patterns and Genome Sequencing of SARS-CoV-2 in University College Dublin

Abstract Background This study describes the investigation and management of multiple outbreaks of SARS-Cov2 during the second and third wave of the pandemic at University College Dublin, Ireland from September 2020 to September 2021. Methods Relevant data were gathered as part of the public health outbreak investigations led by the UCD Internal Covid Control Team (ICCT) in collaboration with the public health teams of the Health Service Executive (HSE). Results are presented for PCR (polymerase chain reaction) confirmed cases and their close contacts, reported to the UCD ICCT between September 2020 to September 2021. Results There were 214 cases notified to ICCT. Among these, 153 cases were in residence on-campus cases. 73 epidemiologically linked clusters identified, where the number of cases linked with each cluster varied between 1 to 27. Additional cases during this period had no obvious epidemiological link to the identified clusters. Of 902 close contacts with PCR test results, 31.5% (n = 284) tested positive. 77% (n = 219) self-reported with mild to moderately symptoms while 23% (n = 65) self-reported as asymptomatic. Retrospective Whole Genome Sequence (WGS) analysis was undertaken after the outbreaks had subsided. The test positive cases were grouped into 6 clusters, and it was shown that many of the apparent sporadic cases were included in these clusters. Conclusions The proportion of close contacts testing positive varied significantly throughout the pandemic, with testing policy and type of exposure having the greatest impact. Whole genome sequencing can give a better understanding of webs of transmission to complement epidemiological investigations. It is now possible to undertake sequencing in real time where it can make a contribution to outbreak control and resolution. Public Health professionals should become familiar with WGS and bioinformatics as useful tools in their armory for the control of all communicable diseases not only SARS-CoV-2. Key messages • Combined epidemiological investigations and Whole Genome Sequencing (WGS) provide crucial insights into campus COVID-19 outbreaks, guiding effective control measures. • WGS integration enhances understanding of transmission patterns, identifies clusters, and equips public health professionals with data-driven approaches for outbreak management beyond SARS-CoV-2.

A long journey from telemedicine to digital (public) health: the vision of different stakeholders

Abstract The healthcare system willingly adopts new innovative means of communication and solutions offered by computer science. Telemedicine was one of the first terms used in this context. It was initially associated with providing medical services but quickly extended to other areas of health-related activities, including public health. The growth of the global web yielded new prospects for the provision of health services, also resulting in new terms to name the use of information and telecommunication technologies in healthcare. E-health, stemming from the end of 90ies in the 20th century, was initially defined as a new domain strongly associated with public health, especially in the context of access to health information. Quickly, its understanding was extended to all health-related interventions based on innovative digital technologies. Today, digital health and digital public health have emerged as the key terms, signifying the next phase of emerging applications that leverage the advancements made on the technical front. The medical community is probably more inclined to use the former term, while public health professionals are dedicated to the latter. But do these terms carry distinct meanings? Or is it merely a matter of the professional group’s background? Is the focus on individual or population health a differentiating factor? In the meantime, business and technical communities have developed the concept of Health 4.0. This concept emphasizes using technologies like the Internet of Things, cloud computing, big data, and artificial intelligence. However, digital (public) health benefits hugely from these solutions. One can ask whether every professional community needs other concepts and new terms for naming fields, resulting from the multidisciplinary effort. And where are the plain people in this landscape? Do they have sufficient digital and health literacies to accept new modes of health service delivery?

Realising the health benefits of City Development Plan in Ireland: The process and influence of HIA

Abstract Background The built environment is a major determinant of health. This research examined the process of implementing a health impact assessment (HIA) of a city development plan, using HIA guidance developed by Institute of Public Health Ireland. HIA is an established approach to facilitate a Health for All Policy approach and is a practical tool used to appraise the potential health effects of a policy, programme or project prior to implementation. Methods This mixed methods study underpinned by action research and implementation science frameworks, explored the process and experiences of undertaking an HIA on the Cork City Development Plan (2022-2028). A total of 36 stakeholders across a variety of institutions, sectors, and including members of the public, were involved in the HIA. Results We found there was an appetite for HIA’s use to facilitate cross sectoral working to identify, mitigate, and address health inequalities. Data derived from interviews, surveys and workshops indicate that while most stakeholders involved saw the value HIA could bring to their work, further efforts are required to realise the benefits of HIA as a decision-support tool. Barriers included lack of familiarity of HIA across sectors, and for those involved in carrying out the HIA, lack of adequate training, time and access to local data. Conclusions HIA can contribute to embedding a Health for All Policies approach, however, greater effort from the public health professionals is required to advocate for HIA as a tool to influence policy. Our results suggest that its practical application requires (i) intersectoral training on HIA that supports a broader understanding of the social determinants of health, (ii) knowledge of the purpose and remit of the policy, plan or programme being appraised and (iii) ensuring a broad range of relevant expertise and experience on the steering group tasked with leading the HIA. Key messages • HIA can contribute to embedding a Health for All Policies approach. • Stakeholders do see the value that HIA can bring to their work, however, further efforts are required to realise the benefits of HIA as a decision-support tool.

Evaluating Accuracy of AI-Generated Travel Vaccine Recommendations: GPTs in Public Health

Abstract Introduction Artificial intelligence (AI), particularly generative pre-trained transformers (GPTs), holds promise for enhancing public health strategies like travel vaccine recommendations. This pilot study evaluated GPTs’ accuracy in delivering tailored vaccine advisories compared to standards set by public health professionals. Integrating AI’s data analysis capabilities into healthcare decision-making could improve recommendation precision and personalization. Methods This retrospective study analyzed GPT travel vaccine recommendation accuracy against a gold standard from health professionals for 90 travelers visiting various countries. Sociodemographic data and vaccine recommendation outcomes were examined. Accuracy assessments were stratified by age, sex, country of travel, duration of travel, type of travel, and specific vaccines. Results Preliminary results showed an 77.43% overall accuracy across all vaccine recommendations. Specific vaccine accuracies varied, with 97.78% alignment for hepatitis A, 93.51% for typhoid fever and 89.36% for rabies. However, lower accuracies were observed for cholera (33.33%) and encephalitis (56.25%). Moderate accuracies were noted for yellow fever (75%), 74.07% for malaria prophylaxis, diphtheria and tetanus (63.33%), and dengue (57.58%). Stratified analyses are expected to provide more realistic results and highlight discrepancies in certain groups. Conclusions This pilot demonstrates GPTs can be a valuable tool for supporting international vaccination professionals, but they are still not a substitute for these professionals, achieving 77.43% overall accuracy. Recommendations include: a) Educate health professionals in the use of GPTs, b) Developing guidelines for ethical and accurate AI use in public health, c) Using AI to strengthen surveillance and response systems. Combining AI with traditional strategies aims to optimize international traveler health outcomes. Key messages • Using artificial intelligence can optimize and facilitate the task of clinical consultancy in traveler’s advice. • It is necessary to establish guidelines for AI use to ensure ethical and accurate applications.

Exploring Health Professionals’ Views on Hive: A Digital collaborative space for Health Emergencies

Abstract Background The rapidly changing media landscape has significantly affected how information is consumed, particularly during health emergencies. Conflicting information shared or information lacking in scientific rigour can be exploited nefariously online to undermine the health response and damage trust. Digital platforms have become increasingly vital for facilitating communication, and in response, the WHO developed the Hive digital space to provide a safe environment for public health professionals to convene, share information, ask questions, and learn from each other. This study aims to explore the experiences of public health professionals in health emergencies to assess the added value of the Hive platform to coordinate and connect health expertise globally. Methods This study uses a cross-sectional online survey distributed to Hive users focusing on their experiences of working in health emergencies. The responses will undergo descriptive and thematic analysis, as well as inferential statistics such as one-way ANOVA and post-hoc analysis. The survey will emphasize the practical application, value, satisfaction, perceptions, and strategy for the Hive platform to be utilised for global health emergency coordination. Expected Outcomes Insights from this study will delineate how the Hive platform is used by public health experts at all levels in emergency management. It will also highlight the challenges, needs and demands for digital tools to connect skills, experience and knowledge in one place. These insights will demonstrate how the Hive can streamline these processes and provide a safe space for information exchange for a coordinated response to health emergencies. Conclusions Understanding the needs and perceptions of Hive users involved in health emergency prevention, preparedness, response, and resilience will provide critical insights into optimizing the platform’s usability, connectiveness across emergency teams and sustainability of the platform. Key messages • Connecting communities, fostering collaboration and co-creation for improved health emergency management. • Hive enhances collaboration among health professionals, providing a safe environment for knowledge and information sharing.

Harnessing social marketing for interdisciplinary health management: enhancing public health outcomes

Abstract Social marketing in health leverages the principles of traditional marketing to influence behaviours that benefit individuals and communities. It involves using marketing techniques to promote public health initiatives, aiming to change attitudes and behaviours towards healthier choices. By strategically framing health messages, social marketing can effectively reach diverse populations, encouraging them to adopt practices that enhance their wellbeing. This approach not only increases awareness about health issues but also empowers people to take proactive steps in managing their health, ultimately leading to improved public health outcomes. Showcasing a forward-thinking approach to public health management, this plenary session seeks to shed light on the transformative role of interdisciplinary collaboration in enhancing health outcomes. Recognising that health and wellbeing are influenced by a myriad of actors beyond the healthcare sector, there is a growing imperative to empower professionals from diverse disciplines with health management principles. By effectively ‘social marketing’ health management to those outside the traditional health sector, such as in architecture, urban planning, construction, education, transportation, and manufacturing, health-oriented decision-making can be seamlessly integrated across these fields. The session will highlight innovative approaches for engaging non-health stakeholders in decision-making processes, leveraging the expertise of health management and public health professionals. By facilitating a dialogue between health professionals and experts from other sectors, the session will explore the potential and challenges of intersectoral partnerships, and challenge policymakers, health managers, and stakeholders in the health sector to actively engage non-health professionals in their pursuit of improved health outcomes for European citizens. Case studies from across Europe where interdisciplinary collaborations have led to social programming and infrastructure developments that enhance health and wellbeing will be presented. The case study ‘Compassionate leadership’ will delve into how organisation leaders can harness their health management capacity to foster a supportive environment that prioritises wellbeing. ‘Health-centric design in public spaces’ will demonstrate the impact of designing public areas with a focus on health, showcasing how thoughtful urban planning can significantly enhance community health. The third case study, ‘Architecture for better health and healing’ will highlight the role of architectural design in promoting health and recovery, emphasising the importance of creating spaces that support healing. Finally, ‘Educating to health’ will underline the significance of educating young people to healthy habits, sustainability, and physical and mental wellbeing, illustrating how this can lead to healthier communities. By fostering broader interdisciplinary collaboration, it is possible to unlock innovative solutions to health challenges and ultimately create healthier, more resilient communities across Europe. Moderator Tiago Correia Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal, and Board Member of the EHMA Speakers/Panellists Marina Macchiaiolo Rare Diseases and Medical Genetics Unit, Bambino Gesù Children’s Hospital, Italy, and President of the Italian Committee for the United World Colleges Stefano Capolongo Department of Architecture, Construction Engineering and Built Environment (ABC), Politecnico di Milano, Italy

Legal perspectives on climate change and inequalities

Abstract In many areas of public health policy, litigation has delivered significant, long-lasting impacts. Examples include tobacco control, increasing access to treatments for HIV, and addressing air pollution and climate change. Litigation is an established part of public health’s advocacy toolbox in national courts, and increasingly in international courts and tribunals. In responding to climate change, in addition to potential policy and law reform, climate change litigation creates opportunities for public scrutiny and debate by raising awareness of inaction or harm caused by governments or private sector polluters, and sparking wider community mobilisation for climate action. Where climate change litigation is based on human rights claims, credible science-based evidence of the health and other human rights impacts of climate change is essential. Public health professionals are increasingly involved in assembling and presenting such evidence, often focusing on vulnerable populations. However, the multiple intersecting identities of vulnerable populations have not been sufficiently explored. For example, how does intersectional disadvantage influence the ways in which evidence of the impact of climate change is assembled and assessed? How are these issues addressed in the courts? Examples include older women (KlimaSeniorinnen v. Switzerland), young people, from both the global South and global North, in urban or remote areas, or with different pre-existing health conditions (Sacchi et al. v. Argentina et al), and Indigenous people, including women and children (Daniel Billy and others v. Australia; Teitiota and others v. New Zealand). Multiple identities can compound vulnerability. For example, young people may be more vulnerable both due to their physical immaturity and due to eco-anxiety and other mental health impacts. This presentation will explore these issues, and the critical role of public health professionals in legal action to address climate change.

1.G. Scientific session: Forecasting dietary habits trends, human and planetary health

Abstract Extensive research has elucidated that dietary factors are pivotal in influencing both human health and the ecological stability of the planet. Suboptimal dietary patterns are implicated in over 10 million annual fatalities attributable to non-communicable diseases. Concurrently, the agricultural sector, a major component of food production, contributes significantly to environmental degradation. This sector is responsible for more than a quarter of global greenhouse gas emissions and utilizes approximately 50% of the planet’s habitable land. Moreover, it accounts for over 70% of global freshwater consumption and is a primary contributor to marine ecosystem disruption through nutrient runoff leading to ocean eutrophication. Despite these critical linkages, current global trends related to dietary practices show little alignment with the improvements needed to achieve the Sustainable Development Goals set for 2030. The existing policy framework and interventions lag considerably in addressing these concerns. Historical and ongoing discussions have repeatedly highlighted these issues, yet the allocation of resources necessary to counteract the pervasive influence of industry-driven marketing promoting less healthful dietary choices remains markedly inadequate. There is an urgent need to intensify dialogues and enhance the conceptual framework regarding the role of diet in sustaining global health and environmental integrity among public health professionals. Such measures are crucial for facilitating a shift towards more sustainable and health-promoting dietary habits globally. The EUPHA Food and Nutrition Section, the Chronic Diseases Section, in collaboration with the World Health Organization (WHO) Regional Office for Europe, aim to propose a joint workshop to share innovative research and activities held in the context of diet and environment. The workshop aims to provide new findings and stimulate the debate about the projections for the future of human and planetary health. Key messages • Human health and environmental preservation require an adaptation of dietary habits globally: are we going in the right direction? • Current evidence suggests that there is an wide area of intervention to improve actual dietary habits, reduce the environmental impact, and improve human health.

5.B. Round table: Improving digital health literacy in the era of generative artificial intelligence

Abstract Improved access to generative Artificial Intelligence (AI) platforms and technologies has prompted greater awareness of their potential application in health communication. This workshop will examine this potential alongside the practical challenges and risks of using generative AI in health communication in the broader context of the European Union AI Act. The workshop will explore the implications for the concept of digital health literacy in ways that reduce or mitigate existing digital health inequities across and within Europe. Chatbots and conversational AI platforms such as ChatGPT have opened opportunities for people to find, understand and use health information in significantly different ways. Public health professionals are already using these technologies to simplify health and medical information and to make it available in different languages. AI assisted technologies are also being used to create interactive and engaging learning experiences that provide the public with real-time feedback and insights about their health as well as prompting and reinforcing actions they can take to improve health. These developments have fundamental implications for our understanding of digital health literacy and the methods we use to support people in optimising the potential benefits of AI. Different communities in Europe vary considerably in their - access to digital technology, - skills to discriminate the accuracy and reliability of information, and - trust and responsiveness to what digital technologies have to offer. Building these fundamental digital health literacy skills is a critical priority if we are to ensure that all people benefit equitably from the potential offered by AI. Those of us engaged in improving health literacy have an important role to play in influencing the future direction of AI in health communication, including and especially by engaging in research and development activities that build evidence of effectiveness and support the development of digital health literacy skills in parallel with the expansion of access to AI-assisted digital technologies. The workshop chairs will provide introductory and summary remarks, moderate the panel discussion, and facilitate audience participation in the workshop. The individual panel members will make 3-minute introductions to key issues from different perspectives on the emerging practical applications of generative AI in health communication as well as the implications for strategies to improve digital health literacy in different population groups. The panel is made up of individuals in different roles and at different career stages who can offer complementary perspectives on these issues. Following the presentations, the co-chair will present some follow-up questions to the Panel before engaging directly with the workshop attendees for an open but structured discussion scheduled to last for 30 minutes of the Workshop. Key messages • We will examine how generative artificial intelligence has opened new both new opportunities and risks in the ways people find, understand and use health information. • We will consider how we can optimise the benefits of generative AI in a way that is equitable through the development of digital health literacy within and between communities in Europe. Speakers/panelists Catherine Jenkins London South Bank University, London, UK Diane Levin-Zamir Tel Aviv University, Tel Aviv, Israel Christopher Le Inland Norway University of Applied Sciences, Innlandet, Norway Miguel Telo de Arriaga Direção-Geral da Saúde, Lisbon, Portugal

From the first European Climate Risk Assessment to action in policy and practice

Abstract The first European Climate Risk Assessment (EUCRA), produced by the European Environment Agency in March 2024, engaging nearly 100 authors across Europe, highlights health among the most at-risk sectors. According to the structured risk assessment that was conducted to support the transparent identification of priorities for policy action, more and urgent action is needed to reduce health risks from heat indoors and outdoors; from wildfires and outbreaks of vector- and water-borne diseases. The responsibility for managing risks lies both with the EU and Member States, and the policy readiness varies depending on the risk. The European Climate and Health Observatory, set up to better understand, anticipate and prevent climate risks to human health in Europe, in the most recent report ‘Responding to climate change impacts on human health in Europe: focus on floods, droughts and water quality’ provides in-depth analyses of some climate-related risks to health and presents examples of responses to them in both policy and practice. Both assessments emphasise that without fast and systemic action to increase societal resilience, the health impacts of the changing climate will worsen, affecting already disadvantaged or vulnerable groups the most. Health and health-determining sectors have the opportunity to address the health impacts of climate change by, among others, increasing the climate resilience of health systems; developing, updating and implementing national health adaptation plans; and supporting the education and training of public health and healthcare professionals on climate change threats. At the same time, addressing health impacts from climate extremes requires responses across sectors, actors and spatial scales.

5.D. Scientific session: Climate Change and Inequalities: Addressing Intersections and Impacts

Abstract Climate change poses one of the greatest challenges of our time, with far-reaching implications for environmental sustainability, social equity, and economic development. In recent years, growing attention has been paid to the intersecting dynamics between climate change and inequalities, recognizing that vulnerable populations are disproportionately affected by climate-related risks and impacts. This workshop aims to explore the multifaceted relationship between climate change and inequalities and examine the root causes of disparities. In this workshop we will explore intersectionality by examining how climate change intersects with various forms of inequality, including socio-economic and health status, gender, age, indigenous status, and geography, shaping differential vulnerabilities and experiences of climate impacts. This workshop aims to facilitate dialogue, knowledge exchange, and collaboration among public health researchers and professionals. We offer a unique opportunity to deepen our understanding of the complex interplay between climate change and inequalities, shedding light on overlooked aspects [?]. By bringing together diverse perspectives and expertise, the workshop aims to generate actionable insights and solutions that promote social justice, sustainability, and human rights in the face of climate change. The presentations in this workshop are thematically interconnected, addressing key aspects of climate change and inequalities from multiple angles. Topics include: Gender and climate justice, Climate change adaptation equity, Legal perspectives on climate change and inequalities and Climate Change Impacts on Respiratory Health. In conclusion, this workshop serves as a critical platform for advancing understanding, dialogue, and action on the intersection of climate change and inequalities. Key messages • Climate change interacts with socio-economic, health, gender, age, indigenous status, and geography, influencing vulnerabilities and impacts. • Vulnerable populations bear a disproportionate burden of climate change effects, including individuals with pre-existing lung conditions and children.

1.Y.2. Children’s mental health problems explode. Can exposome research offer a solution?

Abstract Background A week-long, multidisciplinary workshop at the Lorentz Institute explored the expectations of exposome research on child health. Exposome research investigates how combined exposures affect health. Currently we see an increase in adolescent mental health problems in Europe. We explore at the workshop if and how exposome research can be part of the solution to tackle this health issue. Findings The workshop aims were to analyze how monitoring data from exposome research can be best used for improving health policy in relation to improving (environmental) health policy in relation to children’s health. By taking a deep dive into solution-finding, we explored creative solutions to better utilize existing exposome data from digital data platforms, such as cohort data. And to facilitate working across disciplines using innovative tools of working transdisciplinary across research, policymakers and other professionals. Furthermore, we study how to enhance, harmonize and interpretation of data on child health. Furthermore, we look how child health depends not only on the quality of a healthcare system, but also on the magnitude of negative or positive influencing factors, such as social and environmental factors. Identifying such stressors and reducing their impact through adequate policies can improve child health on local, national, or even global scales. One innovative way of identifying such stressors is the exposome approach. The exposome approach is the characterization of the non-genetic drivers of health and disease. The exposome comprises aspects of the Built environment (characteristics of where we live); the Social environment (with whom we interact, social networks and income); the Physio-Chemical environment (chemical and environmental factors exposure) and the Lifestyle/Food environment (what we eat, how much we exercise) over the entire life-course. Workshop aims: - Provide a background on the urgency of adolescent mental health problems in Europe. - Compare approaches of stakeholders and researchers: stakeholders’ input from the practical field can shape the approach of the research process. The second benefit is to derive implications for creating effective interventions and policies to prevent adverse effects of environmental exposures and to foster positive health in children and later in life. - Explore existing interventions on child health for issues, experiences and possible solutions to the governance and organization of health adaptation in urban and social planning. - How to act in the process of research to intervention to public policies. The workshop consists of three short presentations followed by interactive panel discussions. We end with the audience actively engaging in the debate, as well as entering their questions. The workshop will end by identifying the current and future necessary roles, responsibilities, capacities of the public health researchers, policymakers, and professionals for child health protection in complicated exposure settings. Key messages • Child mental health issues are increasing in an unexplainable way. • Engaging stakeholders into an exposome research process can help to form a child health strategy in Europe.