Rural areas, which account for 88% of French municipalities and are home to 22 million people, have poorer health indicators than urban areas. For example, life expectancy at birth there is two years lower than in urban areas. Rural areas are indeed characterized by specific socioeconomic and demographic vulnerabilities. And “the countryside” is not spared from pollution: pesticides, industrial facilities, and road infrastructure expose residents to harm. Local agriculture, often geared toward exports, provides little benefit to residents. The lack of healthcare professionals limits access to care and preventive services, while mobility challenges weigh on education, employment, and social life, especially for young people. However, stakeholders—whether institutional or community-based, professionals or local elected officials—are committed to promoting health. In Puy-de-Dôme, a network of ambassadors works to combat isolation among the elderly. In Vercors, a mobile bus addresses mental health issues among 11- to 25-year-olds. In Lorraine, a regional food initiative promotes access to high-quality, locally sourced food for everyone. While these initiatives are promising, they would benefit from being more firmly grounded in scientific frameworks, just as the concept of health-promoting urban planning is beginning to inspire rural towns in their development projects. The rural world, through its diversity and capacity for innovation, offers valuable lessons and points the way toward public action that transforms living conditions, the environment, and the foundations of social cohesion.

• Read the issue

Today, well-known figures—artists, athletes, influencers—are speaking openly about their mental health struggles. This shows just how far we’ve come over the decades, when the “madman” was confined to the walls of psychiatric hospitals or kept hidden within families. This special report from La Santé en action sheds light on this major shift: mental health is no longer merely the absence of mental disorders; it is a broader concept that encompasses everyone’s emotional, psychological, and social well-being. This dynamic state is influenced throughout life by multiple social, economic, and cultural factors. To improve the mental health of the population—the deterioration of which the COVID-19 pandemic has revealed—it is important to address the underlying determinants proactively through intersectoral public policies. This issue explores possible paths for collective transformation, whether it involves creating cities conducive to the well-being of residents, workplaces where employees can thrive, or schools where young people feel comfortable and eager to learn. Beyond that, initiatives and tools exist to ensure that everyone is able to take care of their mental health, just as they do their physical health.

• Read the issue

The benefits of health promotion are now well documented. However, the interventions implemented among a target population or in specific settings, such as schools, must be effective. Many initiatives today rely on the goodwill of grassroots actors—whether from community organizations or institutions—who are feeling their way forward, improvising, and experimenting. But since the programs implemented are not always evaluated, it is difficult to know their actual impact, even if the beneficiaries report being satisfied. Based on this observation, this issue of La Santé en action advocates for the implementation of interventions proven to be effective in order to improve the prevention system. Impact assessment and cost-effectiveness analysis are crucial, even if they are perceived as complex and time-consuming. It is equally important to provide practitioners who design programs with validated resources that can be used in their professional context, encouraging them not to start from scratch. Access to this scientific knowledge—whether national or international—is now being organized in France across various fields, signaling the beginning of a shift toward evidence-based prevention.

• Read the issue

Citizen participation, which gives everyone a greater voice in the development of public policy through conventions, online consultations, and collaborative workshops, is gaining momentum in many areas. This issue of La Santé en action explores the various forms of health participation, which enable people to become more involved in decisions affecting not only their own physical and mental well-being but also that of their community. This engagement offers numerous benefits, both individual and collective: it improves the quality of care, promotes people’s autonomy and empowerment, helps reduce health inequalities, and more. Today, experiential knowledge is more widely recognized, and citizens are involved in the development of health surveys or prevention messages. However, designing health policies not only for populations but with them requires time and resources. And it faces a challenge: how can we ensure effective and inclusive participation?

• Read the issue

Five years after the onset of the COVID-19 pandemic, this issue of *La Santé en action* sheds light on social and regional health inequalities in light of research published on the health crisis. This period, and particularly the lockdowns, has exacerbated inequalities in living and working conditions across social groups, regions, women and men, and age groups. Initiatives taken by frontline workers to test and vaccinate have demonstrated the importance of outreach efforts to reach vulnerable populations, those most distant from the healthcare system. This is one of the lessons from this unprecedented crisis that calls for socially differentiated public policies that are more inclusive and protective.

• Read the issue

Making biodiversity conservation a public health issue is essential, because a “healthy” natural world is vital to human survival. Yet it is clear that contemporary societies, through their lifestyles and production methods, are mistreating nature and distancing themselves from it… This issue of La Santé en action sheds light on the many complex links between nature and individual health (both physical and mental) in light of scientific publications from recent years. A significant section is devoted to urban renaturation policies, which require cooperation within local governments between health and environmental departments, as well as medium-term planning tools. Finally, examples are provided, illustrating countless ways to reconnect with the benefits of nature—in daycare centers, schools, retirement homes, community gardens, and more.

• Read the issue
• English version

Sex education for young people remains a crucial issue, not only in the fight against sexism and sexual violence, but also in providing everyone with the tools for a fulfilling emotional, relational, and sexual life. This issue of Health in Action aims to demonstrate how sex education today is no longer based solely on risk prevention; rather, it is part of a comprehensive vision of health and well-being. This new, positive approach, guided by UNESCO’s international recommendations, emphasizes learning about one’s body and intimacy, as well as communicating about emotions, respecting oneself and others, and more. Consequently, a “comprehensive” sex education program—progressive and tailored to all ages—requires a multidisciplinary approach in interventions, both in and out of school. This represents a shift for stakeholders that must be supported.

• Read the issue