Ahead of the conference, I spoke with Professor Manuel Franco, Chair of the 19th European Public Health Conference, physician and social and urban epidemiologist, and Research Professor at the Basque Centre for Climate Change (BC3), about the priorities shaping this year's program and the conversations he hopes the conference will stimulate.
- What are the main public health challenges shaping the scientific program for Bilbao 2026?
One of the things we agreed on when shaping the program was that urban health had never been the focus of the conference before. As urbanization continues to grow around the world, understanding what is happening in our cities, and how urban environments can either protect or harm health, has become increasingly important. By 2050, demographers estimate that two-thirds of the world's population will live in cities. Currently, 80% of Europeans live in urban settings. Urban public health can therefore be a powerful lever to improve the health of millions of people, particularly as cities face challenges such as growing inequalities, heatwaves, the urban heat island effect and are the main producers of greenhouse gas emissions.
The second main theme of the conference is the climate crisis. Although this is the European Public Health Conference, people from more than 80 countries will attend, making it a truly global forum for public health research and policy. Climate change must be understood as a planetary issue, and the relationship between the climate crisis and health is a very important one that has received increasing attention over recent decades.
The third main theme is health inequalities. We continue to see inequalities growing rather than shrinking, not only between countries but also within countries and cities. The gap in life expectancy between those who have and those who have not continues to grow, even in wealthy nations. It doesn't matter which health outcome you are interested in, whether cardiovascular disease, childhood obesity or infectious diseases, there is what we call the social gradient of disease. This issue of health inequalities is a very important one because we are not moving in the right direction.
- Which emerging public health issues do you think deserve greater attention from the European public health community?
I think the climate crisis is really in front of our eyes. It is very clear that our climate is changing, and it is not changing for the better. From a global point of view, we are seeing more wildfires, more heatwaves and more floodings. From a European perspective, Europe is the fastest-warming region in the world, and not everybody is aware of that. Within Europe, Southern European countries such as Spain, Italy and Greece are among those suffering the most. We are seeing heat-related mortality continue to grow and wildfires continue to escalate. Climate change is not really an emerging issue because it has been with us for a while, but its health effects is definitely a very important topic that deserves more attention.
Another important issue is how science and knowledge are understood and taken up by society. If more people in the media and on social media are denying science, data and serious analysis, and if disinformation continues growing, this becomes a public health threat. How are we going to translate science into policy if people deny science from the very beginning of the conversation? Science is about producing the best knowledge that can be translated into policies that protect our health. If the connection between science and policy is broken because of mistrust, disinformation or the rejection of scientific evidence, then we have a serious problem.
- How can bringing together researchers, practitioners and policymakers help translate research into public health policy and practice?
Urban health research means understanding how we live in cities. One of the main issues of the last decades is where people can live in those cities. The reality is that we do not live wherever we want, we live where we can. Segregation, gentrification and housing prices have become fundamental issues that shape where and how people live. The housing crisis is therefore a very important issue. These urban dynamics are very relevant to health and health-related policies. We often talk about problems such as violence, drugs or air pollution as city-wide issues, but they are not distributed equally. Some neighborhoods experience these problems much more than others. In Spain, housing has become such an important topic that it is influencing elections, public debate and even a general strike. What is happening in Madrid is also happening in many other cities in Spain, in Europe, around the world, showing how these local problems are also global problems.
That is why bringing together researchers, practitioners and policymakers is so important. Science by itself is not going to improve public health if the evidence does not reach technicians, practitioners, policymakers and the general public. For the first time, we have tried to open part of the conference to the city through what we call 'Science and Citizens' meetings. These discussions will focus on migration and health, climate change and health in cities, antimicrobial resistance, and social prescribing. Researchers will share their concerns with local councils, Non-Governmental Organizations (NGOs) and members of the public. Science needs to reach beyond academia if it is going to help improve health.
- What would be your key take-home message for delegates attending EPH 2026?
I hope the take-home message is that we have to understand social dynamics in order to understand health and protect health nowadays. Processes like housing prices, who gets to live where, migrations and the communication of science affect people´s health. Many of the challenges we face today, whether housing, migration, climate change or health inequalities, are not only local issues but also global ones.
Thank you to Professor Manuel Franco for sharing his insights ahead of EPH 2026.
I look forward to joining the public health community in Bilbao and hearing first-hand about the evidence, ideas and collaborations that will shape healthier cities and societies in the years ahead.