Patient safety is often associated with what happens inside healthcare services: avoiding medical errors, reducing harm and ensuring safe treatment. While these are essential priorities, patient safety begins long before a person enters the healthcare system. It starts with prevention, health promotion and creating the conditions that help people stay healthy throughout life.
This year's World Patient Safety Day offers an opportunity to highlight a broader perspective on safety: preventing disease before it occurs, ensuring people can understand and use health information, and addressing the social inequalities that continue to shape health outcomes across Europe.
Non-communicable diseases (NCDs), including cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, account for around 80% of the disease burden in Europe. Much of this burden is preventable. Tobacco use, physical inactivity, unhealthy diets, alcohol consumption and air pollution remain among the leading drivers of disease, alongside the broader social and environmental conditions that influence health throughout life.
"Patient safety does not begin in the consultation room," says Linda Granlund, Project Coordinator of JA PreventNCD and Director of Public Health at the Norwegian Directorate of Health. "It begins much earlier, with our ability to prevent disease and promote health throughout life."
A healthy population is essential not only for individual wellbeing, but also for societal resilience. People who remain healthy for longer are better able to participate in education, work, family life and their communities. In an increasingly uncertain world, good population health is also an important part of preparedness and sustainability.
However, the burden of disease is not shared equally. Social inequalities are reflected in both health outcomes and people's ability to prevent and manage illness.
"People with higher levels of education and income are generally more likely to report good physical and mental health, stronger social functioning and greater confidence in managing chronic conditions," says Granlund. "This highlights how social and economic factors shape people's opportunities to stay healthy, prevent disease and benefit from healthcare."
In other words, the opportunities to benefit from prevention and healthcare are not equally distributed.
Addressing these challenges requires cooperation, learning and action across borders.
Through JA PreventNCD, partners across Europe are working together to strengthen health promotion and disease prevention and to translate knowledge into practical actions that can improve health and reduce inequalities.
A key part of that effort is strengthening health literacy.
Health literacy refers to people's ability and opportunity to find, understand, assess and use health information in order to make informed decisions about their health and healthcare. But health literacy is not only an individual responsibility. It also depends on how healthcare systems communicate and whether services are designed in ways that people can understand, access and use.
"Health literacy is not only about people's abilities," says Granlund. "It is also about the healthcare system's ability to make information and services understandable, accessible and usable for everyone, regardless of language, digital skills or prior knowledge."
Limited health literacy is associated with poorer health outcomes, greater difficulty managing illness and an increased risk of misunderstanding health information and treatment. This makes health literacy not only a public health issue, but also a patient safety issue.
As healthcare becomes increasingly person-centred, people are expected to take a more active role in managing their health. This creates a shared responsibility between individuals, healthcare providers and health systems.
"We must strengthen people's ability to understand and manage their own health," says Granlund. "At the same time, we must make healthcare systems easier to navigate and services easier to use. We must do both."
Safe healthcare is not only about delivering the right treatment at the right time. It is also about ensuring that everyone has a genuine opportunity to understand, access and benefit from care.
Because patient safety starts long before treatment begins. And achieving good health and good lives for all requires that no one is left behind.