Cross-cutting integration of equity and diversity lens in public health: a novel approach of JACARDI

Abstract Issue/Problem Health inequities persist across European countries, impacting the distribution, prevention, and management of non-communicable diseases. With increasing population diversity and improved understanding of the intersectional nature of drivers of health inequities, narrowing inequities calls for systematic integration of diversity perspectives into equity-driven policy and practice. Description of the problem The EU-co-funded Joint Action on CVDs and diabetes (JACARDI, 11/2023-10/2027) project with 76 partners from 21 countries and 142 national-level projects (later pilots), applies a structured approach for integrating equity and diversity perspectives within all project structures. This is achieved through design of a common methodological framework and terminology glossary for all thematic work packages (WPs) and their pilots, which are further supported through capacity building sessions and consultations. Results The “4Cs” framework (Critical reflection; Context and data; Co-design; and inclusive and accessible Communications) for integrating equity and diversity principles in JACARDI was developed based on results of focus group interviews with WP leaders (n = 24) and review of previous literature. This framework was applied as a lens to be applied in the planned activities by WPs and pilots, elaborated in an equity and diversity maturity matrix aligned with the XV methodological steps for pilot implementation. Additionally, equity and diversity indicators were integrated into harmonized context analysis questionnaires for national focal points of each partner country, as well as into the methodology for pilot assessment and reporting. Lessons Equity and diversity perspectives should be integrated into the core structures of project implementation, supported by practical tools, trainings and practical consultations to improve adherence and collaborative understanding across project partners. Key messages • Equity and diversity integration into core structures are essential for tackling health inequities and the NCD-related social gradient in Europe. • Encouraging critical reflection among JACARDI partners is pivotal for initiating a paradigm shift towards equity and diversity inclusion.