Today, well-known figures—artists, athletes, influencers—are openly sharing their mental health struggles. This underscores 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 find fulfillment, 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.

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The benefits of health promotion are now well documented. However, the interventions implemented among target populations 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 recognized as 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.

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Citizen participation, which gives everyone a greater role in shaping public policy through conventions, online consultations, and collaborative workshops, is gaining momentum across a wide range of fields. This issue of *La Santé en action* explores the various forms of participation in health care, 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 designing 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?

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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 lockdowns in particular—has exacerbated inequalities in living and working conditions across social groups, regions, genders, and age groups. Initiatives taken by frontline workers to test and vaccinate have demonstrated the importance of reaching out to vulnerable populations, those furthest removed from the healthcare system. This is one of the lessons from this unprecedented crisis, calling for the implementation of socially differentiated public policies that are more inclusive and protective.

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Making biodiversity conservation a public health issue is essential, as a "healthy" natural environment is vital to human survival. Yet it is clear that contemporary societies, through their ways of life and production, are mistreating nature and drifting further away from it… This issue of La Santé en action sheds light on the multiple and complex links between nature and individual health (both physical and mental) in light of scientific publications from recent years. A significant chapter 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.

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Recent studies have highlighted this reality: the early years of a child’s life, including the prenatal period, are a pivotal time for their development. Thus, experiences at the very beginning of life—whether positive or negative—have a lasting impact on individuals’ physical and mental health, as well as on their social and emotional well-being. This issue of La Santé en action shares the latest scientific findings, particularly from the fields of psychology and neuroscience. It sheds light on interventions that support parents in building warm, stimulating interactions that meet the fundamental needs of young children. Indeed, children need to form a secure attachment bond with their caregivers—a bond that is essential for growing up with confidence and strengthening their ability to cope with adversity in the future.

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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 *La santé en action* aims to demonstrate how sex education today is no longer based solely on risk prevention; but 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, self-respect, and respect for others, among other things. 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 is a shift for stakeholders that must be supported.

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The concept of consent can be defined as "an act by which a person gives a decision—initiated by another—the personal approval necessary for it to be carried out." At every stage of life, individuals are called upon to give their consent and thus decide what they want. This applies, of course, to emotional and sexual life, where the concept of consent is indispensable. But it also applies to contraception, voluntary termination of pregnancy, medical consultations, medical procedures, all forms of care, end-of-life care, etc. This report analyzes the conditions that professionals in all fields—healthcare as well as education and social services—must meet, and all the questions they must ask themselves to obtain individuals’ consent before any action or procedure.

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Midlife—that is, the ages of 40 to 55—is a pivotal period for preventive care and promoting public health. It is pivotal yet underutilized because it is not recognized as a turning point in maintaining good health. Other life stages are much better defined: early childhood, adolescence, young adulthood, and later, middle age and older adults. This special issue presents the current state of scientific knowledge on the determinants and health status of people aged 40–55. It then explores what can be implemented to benefit the health of people in their 40s and 50s, those who are “invisible” in prevention and public health frameworks. Several innovative programs and initiatives aimed at improving the health of people in this age group are reviewed. Some thirty scientists and field professionals contributed to this special issue. What is striking in this assessment is the widening of social health inequalities: already at midlife, depending on their living conditions, there is a considerable gap between those who have benefited from favorable conditions and, conversely, those whose life course has been much harsher and whose health is already impaired.

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Physical activity is beneficial for the overall health—both physical and mental—of the entire population. The latest international scientific research has confirmed that it is equally beneficial for people with medical conditions.

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The COVID-19 pandemic is having a major negative impact on the mental health of the population, as evidenced by scientific studies and professionals working on the front lines. Some thirty experts and field professionals review the current state of knowledge and analyze the consequences of the pandemic on the mental health of the general population. They offer recommendations for action. This special issue focuses in particular on ethics and social and regional health inequalities.

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This is a new profession in the healthcare sector: health mediators help patients access care and help the general public access preventive services. The widening health inequalities currently underway, due to the COVID-19 pandemic—and the accompanying economic crisis—are now shining a spotlight on these “mediators” who serve as a bridge between vulnerable individuals and the healthcare system. Some thirty experts contribute to this special issue.

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It is a health determinant that is not sufficiently recognized: urban planning plays a crucial role in the quality of life, well-being, and thus the overall health of every individual. Four experts in health-promoting urban planning coordinated this special issue: Anne Roué Le Gall, Mathilde Pascal, Nina Lemaire, and Thierno Diallo. This issue presents a synthesis of knowledge and spotlights on health-promoting urban planning practices in France and abroad. Some twenty researchers and field professionals contributed to it. It includes a contribution from the World Health Organization (WHO), which highlights an urgent need—poor urban planning kills—and puts forward proposals.

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Health, social, and educational services alone are not enough to promote public health: some citizens are unable to access healthcare, treatment, and preventive care. If we want these populations to enjoy their fundamental rights, we must “reach out” to them. This special issue is entirely devoted to this approach: it summarizes the current state of knowledge and presents a variety of examples from across the country, including the overseas departments. Some thirty experts and practitioners in the field have contributed.

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