As part of the JACARDI joint initiative among European member states, Santé publique France and its partners aim to design and implement a pilot intervention aimed at improving health literacy among women who have had a hypertensive disorder of pregnancy—that is, their ability to access, understand, evaluate, and use information to make the best decisions regarding their health. This intervention will be designed using the Ophelia method, which is internationally recognized and validated by the WHO, and aims to facilitate the development of practical, on-the-ground actions tailored to different populations. It emphasizes the co-creation of the intervention to reduce social health inequalities and include all stakeholders—including, for this pilot, the women themselves—in the design and implementation of the interventions.

The emergence and availability of the National Health Data System (SNDS)* in recent years has provided a powerful tool for research and epidemiological surveillance of diabetes in France. A diabetes surveillance system has been developed and has enabled the routine production, since 2010, of indicators of prevalence, incidence of pharmacologically treated diabetes, and incidence of complications. It also allows these indicators to be broken down by different geographic and socioeconomic levels.

However, this tool does not yet allow for the identification of individuals at high risk for diabetes, nor does it generate the clinical and biological data necessary for monitoring the main risk factors for complications, nor does it produce analyses stratified by type of diabetes.

Making new, accessible, relevant, and authoritative data available, along with strengthening the open data strategy, is a key driver of the agency’s work. That is why, as part of the Unknown DIAB, DIAB Lab, and DIAB Type 1 pilot projects, Santé publique France proposes to strengthen the National Health Data System (SNDS) in order to improve the diabetes surveillance system in France.

The objectives of these three pilot projects are, respectively:

• Develop an algorithm to identify individuals at high risk of undiagnosed diabetes and make the results, in the form of maps, available to local public health policymakers. This would allow for directly targeting high-risk individuals as well as their healthcare providers, and for planning a personalized prevention campaign using a proactive approach of “reaching out” and then “bringing back” to the healthcare system.

• Collect biological data directly from medical laboratories and establish a passive cohort (a group of individuals monitored without active solicitation, such as through questionnaires) using this data, combined with SNDS data, for a sample of people with diabetes in two French regions: Réunion and French Guiana. More generally, the project will also aim to test the feasibility and relevance of a surveillance system for risk factors of diabetes-related complications, based on linking biological data repositories with the SNDS.

• Develop an algorithm to identify cases of type 1 or type 2 diabetes in the SNDS in order to create a surveillance system specific to each type of diabetes, which will improve decision support for diabetes management and offer vast potential for diabetes research in France.

The SNDS is an anonymized medical-administrative database that includes, in particular, medical consultations, prescription drug dispensing, treatments fully covered by health insurance, and hospitalizations of individuals residing in France and covered by a health insurance plan.

Several countries have developed campaigns to raise awareness of high blood pressure (HBP) among the general public by combining a public awareness campaign with blood pressure screenings in public places (such as the “Know Your Numbers” campaign [Blood Pressure UK – United Kingdom] and “May Measurement Month” [International Society of Hypertension – World Health Organization]). Despite the proven benefits of prevention, screening, and management of high blood pressure, several indicators—such as prevalence, screening, and control—have not improved since 2006 in France, unlike in many other countries.

Santé publique France therefore proposes adapting this type of campaign to the French context by following the principles of improving health literacy and social marketing:

• a campaign to improve awareness of blood pressure readings among the general population at the subregional level, targeting volunteer regions particularly affected by hypertension;

• a campaign aimed at measuring blood pressure and offering hypertension screening primarily in pharmacies and other public places.