Europe was not prepared for the most recent crises, particularly regarding protection and support of younger populations. The negative health consequences have been amply documented for the COVID-19 crisis [3, 4] while other crises are less well investigated. For a prepared and sustainable society, public health decision-making processes are needed that 1) are more inclusive to any vulnerable group, such as children and adolescents, 2) systematize in a transparent way the best available knowledge from all disciplines on all consequences (i.e., effects and side effects; short and long-term impacts) of potential public health decisions, 3) consult the younger populations (and guardians) as any other stakeholder and, 4) provide public services that protect fundamental rights of children and youth, e.g., safety from violence, having a home and minimal financial support, remain available in times of crises and anticipate emerging needs.

Effective, evidence-based interventions supporting child health and development as well as child healthcare delivery need to be scaled up. For this, and further to capture the relevance of any shifts at policy level, in health systems, or health and health behaviors of children and adolescents, data and evidence on social and environmental health determinants, child health outcomes and effective interventions are needed [5]. This means several critical points: 1) disaggregating the data to capture the developmental issues of childhood and adolescence; 2) adapting survey instruments to the targeted population to make sure the youngest as well as those with limited literacy or learning disorders can accurately give their true opinions; 3) including children and adolescents in building questionnaires and in choosing relevant topics from their perspective; 4) sharing the results with young people (and guardians) in a meaningful way.

All crises have affected, and will continue to affect, vulnerable and marginalized populations more strongly, and further exacerbate health inequalities. Inequalities in child and adolescent health are best addressed by focusing on social determinants of health, proportionate universalism (i.e., delivery of universal services at a scale and intensity proportional to the degree of need), and by using a multisectoral approach based on the principle of “Health in all Policies.” Furthermore, more equitable fiscal and labor market policies, which were proven to decrease inequality [6], are necessary to address the growing economic inequality in Europe and to lift up the 24.4% of children who were at risk of poverty and social exclusion across the European Union in 2021 [7]. It is likely that their number has increased further since the beginning of the war in Ukraine, and the associated cost-of-living crisis across the continent.

In children, infant and under-5 mortality rates are typically utilized to monitor and assess population health; data are usually available and of high quality. However, child health determinants and outcomes in ages above 5 are most often not equitably assessed. The comparatively low infant and under-5 mortality rates in Europe can lead decision-makers to the conclusion that: “All is well with child health.” Advocacy for child health from 0–18 years is thus crucial to ensure decision-makers are aware of child and adolescent health issues, the long-term relevance, as well as of their responsibility to develop and implement policies and programs and to provide available services with sufficient funding. Advocacy should similarly focus on creating healthy environments for families and community support and to inform the public and opinion leaders about child and adolescent health and wellbeing issues and needs [8].

A growing body of evidence is showing that increasing child and adolescent participation in public health research, policies, decisions and actions yields more positive and sustainable health outcomes, enhances participants’ empowerment and satisfaction, and also increases evidence due to improved data collection and dissemination of results [9]. Empowerment and participation of younger generations in public health actions and policy must guarantee diversity among the representatives, e.g., in terms of gender, age, cultural, socioeconomic and migrant backgrounds, cognitive and physical disabilities as well as sexual expression, and thus contribute to the development of a robust child and adolescent community. Participation trains young people to engage in decisions that matter to them with benefits in self-efficacy and self-worth [9], and also challenges and educates the adult community working in public health in terms of accepting shifting power dynamics.