Coordinating Efforts for Healthier Living Environments in Pula, Croatia

Between 26 and 28 May, multidisciplinary and cross-sector teams working on the transformation of Healthy Living Environments across Europe travelled to Croatia to pool their efforts and share their insights in the fight against non-communicable diseases (NCDs).

The JA PreventNCD Healthy Living Environments annual meeting, held in Pula, Croatia, and organised by the Croatian Institute of Public Health (CIPH), opened with a clear and inspiring message: preventing cancer and other non-communicable diseases requires healthier environments, stronger policy action, and a shared commitment to making prevention part of everyday life.

Over three days, participants discussed policies, interventions and research initiatives aimed at creating healthier places to live, learn, work and play. Through plenary sessions, thematic discussions and collaborative workshops, the meeting provided an opportunity to strengthen cooperation and advance a shared European agenda for prevention.

The opening session brought together voices from local government, public health and European policy, offering complementary perspectives on the challenges of and opportunities for prevention. Participants were welcomed by Pula Mayor, Peđa Grbin, who shared a personal reflection on how cancer had affected his own family, underlining prevention as both a public health priority and a deeply human issue connected to communities and everyday life.

The opening keynote by the First Lady of Croatia, Prof Sanja Musić Milanović, Head of the Health Promotion Division at CIPH, focused on obesity as one of the major public health challenges of our time and highlighted its links with several non-communicable diseases, including cardiovascular disease, diabetes, cancer and mental health disorders. Her presentation stressed that obesity is a complex multifactorial disease largely shaped by unhealthy environments disease Prof Musić Milanović highlighted the importance of political will in tackling childhood obesity and Croatia’s efforts in leading the way, as demonstrated through the Zagreb Declaration, adopted at the Summit of the Spouses of European Leaders in May 2023.

Building on these examples of national action, Prof Knut-Inge Klepp, the Scientific Coordinator of JA PreventNCD, connected the work of JA PreventNCD to major European prevention initiatives, including Europe’s Beating Cancer Plan, Healthier Together and the EU Safe Hearts Plan.

The session concluded with a presentation by Prof Romana Jerković, a Member of the European Parliament, Vice-Chair of the Committee on Public Health, who called for a new paradigm in European prevention policy. She argued that Europe must move beyond approaches focused mainly on individual responsibility and instead address the wider systems and commercial determinants that shape health behaviours and exposure to unhealthy products.

Prof Jerković highlighted several areas requiring stronger European action, including mental health, healthier school environments, nutrition education, physical activity promotion, tobacco and alcohol regulation, and the protection of children from unhealthy product marketing.

Altogether, the opening session provided an inspiring and meaningful starting point for collaborative work and detailed discussions that followed throughout the meeting. As Helena Križan, the co-leader of the Healthy Living Environments work package and representative of CIPH, noted:

“These energizing and inspiring messages at the beginning of the meeting set the tone for the very fruitful three days to come.”

Across the numerous sessions, participants worked not only on the core areas of the Healthy Living Environments work package — including increasing availability of healthier products and facilities, enhancing healthier urban environments, the promotion of environments free of unhealthy products and implementation of Baby-Friendly Communities and Health Services — but also on key transversal dimensions essential for effective implementation.

Angela Giusti from Istituto Superiore di Sanitá (ISS, Italy), leader of the Baby-Friendly Community and Health Services task, stated:

“during the discussions we've seen what the main barriers for the implementation from the commercial determinants of health perspective are, for instance, formulas and baby food marketing, and who the facilitators are, having already very well trained health personnel and active communities”.

A central focus was placed on strengthening methodological approaches for health promotion practice, with particular attention to harmonising monitoring tools and reflecting on their practical use in pilot settings. Experiences from ongoing implementations in schools, kindergartens and community contexts helped identify both barriers and facilitators, contributing to a shared reflection on how to improve and align the methodological framework across countries.

Communication and dissemination were also addressed as strategic levers for impact. Participants engaged in discussions on how to refine narratives around Healthy Living Environments, making them more community-oriented and accessible, while also exploring ways to better translate project results into meaningful public health impact through a more coordinated communication strategy.

Evaluation and sustainability were addressed as essential cross-cutting dimensions supporting the long-term relevance and effectiveness of the work, ensuring that results can be properly assessed and sustained beyond the duration of the Joint Action.

The encounter reaffirmed the importance of a coordinated, cross-sector approach to strengthening Healthy Living Environments across Europe. As the Joint Action moves forward, the insights gathered during the meeting will contribute to refining tools, improving implementation and ensuring the long-term sustainability of actions beyond the project’s lifetime.

As highlighted by participants, the meeting provided a valuable opportunity not only to review progress, but also to collectively identify remaining challenges and future priorities for action. In the words of Angela Giusti, ISS, the meeting “was great because we had the opportunity to discuss together what we still have to do by the end of the project and even beyond”.

Hosting the meeting in Pula also reinforced the importance of local engagement within a broader European framework. As pointed out by Helena Križan from CIPH, the meeting “was supported both by the host city mayor who himself attended,as well as important national and European level stakeholders.”

Looking ahead, participants emphasised the ongoing development of practical tools to support implementation at local level. As the task leader on Healthy Urban Environment, Nina Iszatt reflected,

“at the moment, we're midway in developing some tools to embed health into decision-making processes in municipalities”, but the senior researcher at the Norwegian Institute of Public Health expressed her confidence that “in the following months we’re going to have ready a healthy city toolbox useful for all kinds of local planning processes”.

Achieving truly Healthy Living Environments requires moving from progress to impact, ensuring that shared knowledge and collaboration are translated into concrete improvements in policies, practices and everyday settings across Europe.

Healthy Living Environments Communication Officer

Lluís Pascual i Vidal
Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (Fisabio), Spain

Croatia Communications Focal Point

Lucija Sironić
Croatian institute of Public Health (CIPH), Croatia