The health, well-being and equity impact of the Comprehensive and Progressive Trans-Pacific Partnership (CPTPP) Agreement on Wales

This report provides a short summary of the findings of a Health Impact Assessment (HIA) of the Comprehensive and Progressive Trans-Pacific Partnership (CPTPP) Agreement on Wales. This report is a high-level, evidence-based strategic overview. It summarises the main health, well-being and equity impacts that could potentially occur in the short and longer-term following the UK’s accession to the CPTPP.

Authors: Liz Green, Leah Silva+ 6 more
, Michael Fletcher, Louisa Petchey, Laura Morgan, Margaret Douglas, Sumina Azam, Courtney McNamara
Cartoon style image of health care workers smiling and taking care of young people, one of which is in a wheelchair

Welsh Health Equity Solutions Platform (WHESP)

The Welsh Health Equity Solutions Platform will act as a repository of information, case studies, and previous interventions used to help combat inequity and share good practice in Wales.
The platform features searchable data tools and a report-generating function which allows users to input their search terms and produce outputs related to those terms. The platform also offers a spotlight feature that can be used to highlight particular solutions or themes.
The team will develop the platform over time to add additional content and features.

Authors: Rebecca Hill, Jo Peden+ 12 more
, Lauren Couzens (née Ellis), Mariana Dyakova, Daniela Stewart, James Allen, Liz Green, Rebecca Masters, Leah Silva, Sara Cooklin-Urbano, Golibe Ezenwugo, Abigail Malcolm (née Instone), Jason Roberts, Rajendra Kadel

IHCC Progress Report 2018-22

This report outlines the International Health Coordination Centre’s (IHCC) progress in driving and enabling implementation of the Charter for International Health Partnerships in Wales (the Charter) across the NHS over the last four years. It also provides examples of international health partnership working from across the Health Boards and NHS Trusts. The report highlights the IHCC’s plans and aspirations for the future, in supporting a healthier, more equal, globally responsible, resilient and prosperous NHS in Wales.

The report highlights the IHCC’s role, achievements, ways of working, collaborative structures and activities; and outlines the evolution of the IHCC in relation to global, UK, national and local developments. These include challenges and opportunities such as the UK withdrawal from the European Union (‘Brexit’), the COVID-19 pandemic and the ‘cost of living’ crisis. It demonstrates the tools used to enable shared learning, facilitate cross-NHS and cross-sector synergies, and maximise benefits to the health and well-being of the people in Wales and beyond.

Authors: Liz Green, Mariana Dyakova+ 2 more
, Laura Holt, Kit Chalmers

Predicted and observed impacts of COVID-19 lockdowns: two Health Impact Assessments in Scotland and Wales

Health Impact Assessment is a key approach used internationally to identify positive or negative impacts of policies, plans and proposals on health and well-being. In 2020, HIAs were undertaken in Scotland and Wales to identify the potential health and well-being impacts of the ‘stay at home’ and physical distancing measures implemented at the start of the coronavirus disease (COVID-19) pandemic. There is sparse evidence evaluating whether the impacts predicted in HIAs occur following policy implementation. This paper evaluates the impacts anticipated in the COVID-19 HIAs against actual observed trends.

Authors: Liz Green, Kathryn Ashton+ 3 more
, Mark Bellis, Timo Clements, Margaret Douglas

Facilitators, Barriers and Views on the Role of Public Health Institutes in Promoting and Using Health Impact Assessment—An International Virtual Scoping Survey and Expert Interviews

Public health institutes have an important role in promoting and protecting the health and well-being of populations. A key focus of such institutes are the wider determinants of health, embracing the need to advocate for ‘Health in All Policies’ (HiAP). A valuable tool to support this is the health impact assessment. This scoping study aims to support public health institutes to advocate more successfully for the use of health impact assessments and HiAP in order to promote and protect health, well-being and equity. It highlights the enablers and barriers to the use of HIA in the contexts of the participants and suggests some actions which PHIs can take and Units they can learn from. The results from this study can serve as a platform to help build knowledge, networks and expertise, to help support a ‘Health in All Policies’ approach and address inequalities which exist in all societies.

Authors: Liz Green, Kathryn Ashton+ 4 more
, Lee Parry-Williams, Mariana Dyakova, Timo Clemens, Mark Bellis

Exploring the social value of Public Health Institutes: An international scoping survey and expert interviews

Making the case for investing in preventative public health by illustrating not only the health impact but the social, economic and environmental value of Public Health Institutes is imperative. This is captured by the concept of Social Value, which when measured, demonstrates the combined intersectoral value of public health. This research can inform future work to understand how to measure the holistic social value of Public Health Institutes, in order to strengthen institutional capacity and impact, as well as to achieve a more equitable society, and a more sustainable health system and economy, making the case for investing in public health, as we recover from COVID-19.

Authors: Kathryn Ashton, Liz Green+ 4 more
, Timo Clemens, Lee Parry-Williams, Mariana Dyakova, Mark Bellis

Protecting the mental wellbeing of our future generations: learning from COVID-19 for the long term

This comprehensive Mental Wellbeing Impact Assessment (MWIA) has been carried out by the Wales Health Impact Assessment Support Unit to identify the impacts of the COVID-19 pandemic, and associated policy responses, on the mental wellbeing of young people aged 10-24 in Wales.

The MWIA was carried out with the engagement of young people, teachers and lecturers and the support of a Strategic Advisory Group with representatives from a range of organisations in Wales.

The report aims to provide evidence and learning to inform cross-sector policy and practice directed at pandemic recovery, future emergencies and improving population mental wellbeing for the long term.

Authors: Nerys Edmonds, Laura Morgan+ 7 more
, Huw Arfon Thomas, Michael Fletcher, Lee Parry-Williams, Laura Evans, Liz Green, Sumina Azam, Mark Bellis

Circular Economies and Sustainable Health and Well-being

The report – ‘Circular Economies and Sustainable Health and Well-being: The public health impact of public bodies refocusing on waste reduction and reuse in Wales’, details how implementing policies to reduce and re-use waste, alongside recycling schemes will have possible significant positive impacts on health and well-being for the whole population of Wales. These include contributing to tackling the climate emergency and thereby reducing air pollution, reducing risk of extreme weather events, increased sustainable production of food and improved mental health and well-being.

Authors: Rachel Andrew, Mark Drane+ 3 more
, Liz Green, Richard Lewis, Angharad Wooldridge

Rising to the Triple Challenge of Brexit, COVID-19 and Climate Change for health, well-being and equity in Wales, Spotlight on: Rural Communities

A new report published by Public Health Wales highlights how the combined influences of Brexit, Coronavirus and climate change will potentially see rural communities in Wales experience a time of great change, with both opportunities and negative impacts to navigate.

Authors: Liz Green, Kathryn Ashton+ 7 more
, Michael Fletcher, Laura Evans, Tracy Evans, Lee Parry-Williams, Sumina Azam, Adam Jones, Mark Bellis

Maximising health and well-being opportunities for spatial planning in the COVID-19 pandemic recovery

The pandemic has explicitly exposed, and in some examples, exacerbated the health, well-being and inequalities impacts across the population which are derived from determinants such as the environment, land use, transport, economy and housing. This report aims to highlight the major positive and negative health impacts of spatial planning policies during the COVID-19 pandemic on the population of Wales, learn from these, any positive interventions and co-benefits in order to shape a healthier future environment for all.

Authors: Liz Green, Sue Toner+ 7 more
, Laura Evans, Lee Parry-Williams, Tom Johnson, Gemma Christian, Cheryl Williams, Sumina Azam, Mark Bellis

No place like home? Exploring the health and well-being impact of COVID-19 on housing and housing insecurity

This comprehensive and participatory Health Impact Assessment (HIA) explores the health and well-being impact of COVID-19 on housing and housing insecurity, and looks at the importance of having a consistent home that is of good quality, affordable, and feels safe. It also considers security of tenure in relation to stability, and being able to maintain a roof over one’s head and ultimately prevent homelessness. It is the third in a series, which focus on the impact of the COVID-19 pandemic on the population of Wales including the ‘Staying at Home and Social Distancing Policy’ and the impact of home and agile working. This report can be read in conjunction with these and the sections on housing and home working within them.

Authors: Louise Woodfine, Liz Green+ 9 more
, Laura Evans, Lee Parry-Williams, Christian Heathcote-Elliott, Charlotte Grey, Yoric Irving-Clarke, Matthew Kennedy, Catherine May, Sumina Azam, Mark Bellis

Health and wellbeing impacts of climate change Infographic

Public Health Wales has published a series of infographics highlighting the importance of climate change impact on the health and wellbeing of the population of Wales, and to support public bodies and businesses to take action to address any impacts.

Launched to coincide with the Council of Parties 26 (COP26), the infographics focus on the relationships between the natural environment and health, the population groups affected and some of the key health and wellbeing impacts of climate change and those population groups who could be affected.

Authors: Nerys Edmonds, Liz Green

Rising to the Triple Challenge of Brexit, COVID-19 and Climate Change for health, well-being and equity in Wales Spotlight on: Food Security

This paper highlights how the combined influences of Brexit, Coronavirus and climate change will potentially impact everyone through the food that is produced, accessed, available and consumed.

Authors: Liz Green, Kathryn Ashton+ 7 more
, Adam Jones, Michael Fletcher, Laura Morgan, Tom Johnson, Tracy Evans, Sumina Azam, Mark Bellis

Health Impact Assessment (HIA) and Local Development Plans (LDPs): A Toolkit for Practice

Public Health Wales has created a practical Health Impact Assessment (HIA) toolkit that will enable planners to easily integrate health into their development plans for the future.

Designed to help further the collaboration between planning and public health sectors in Wales the resource aims to maximise positive health and wellbeing outcomes through land use planning policies that create healthy, equitable and cohesive communities.

Please download Adobe Acrobat Reader before opening this resource in order for full functionality.

Authors: Liz Green, Lee Parry-Williams+ 1 more
, Edwin Huckle

Rising to the Triple Challenge of Brexit, COVID-19 and Climate Change for health, well-being and equity in Wales

This report provides a strategic overview of the impact, and interconnectedness, of the enormous events of Brexit, COVID-19
pandemic and climate change. It identifies the key determinants and population groups affected by the Triple Challenge and provides a key example against a determinant.

Authors: Liz Green, Kathryn Ashton+ 7 more
, Michael Fletcher, Adam Jones, Laura Evans, Tracy Evans, Lee Parry-Williams, Sumina Azam, Mark Bellis

Brexit and Poverty in Wales: A Public Health Lens

The aim of this report is to strengthen knowledge and understanding of the implications of the United Kingdom’s (UK) exit from the European Union (EU) – ‘Brexit’ – on poverty, and health and well-being in Wales.

Authors: Sumina Azam, Katie Hardcastle+ 6 more
, Laura Morgan, Rebecca Hill, Michael Fletcher, Tom Johnson, Liz Green, Mark Bellis

‘Health in All Policies’—A Key Driver for Health and Well-Being in a Post-COVID-19 Pandemic World

The COVID-19 pandemic has raised the profile of public health and highlighted the links between health and other policy areas. This paper describes the rationale for, and principles underpinning, HiAP mechanisms, including HIA, experiences, challenges and opportunities for the future.

Authors: Liz Green, Kathryn Ashton+ 3 more
, Mark Bellis, Timo Clemens, Margaret Douglas

Using health impact assessment (HIA) to understand the wider health and wellbeing implications of policy decisions: the COVID-19 ‘staying at home and social distancing policy’ in Wales

This paper focusses on a HIA of the ‘Staying at Home and Social Distancing Policy’ or ‘lockdown’ in response to the COVID-19 pandemic in Wales conducted by the Welsh national public health institute. It describes the process and findings, captures the learning and discusses how the process has been used to better understand the wider health and well-being impacts of policy decisions beyond direct health harm. It also examines the role of public health institutes in promoting and using HIA.

Authors: Liz Green, Kathryn Ashton+ 4 more
, Sumina Azam, Mariana Dyakova, Timo Clemens, Mark Bellis

All change. Has COVID-19 transformed the way we need to plan for a healthier and more equitable food environment?

This commentary aims to explore the post-pandemic role of spatial planning as a mechanism for improving public health by highlighting a whole system perspective on the food environment, referring to experiences in Wales as a case study, and concluding with observation on future consumer trends around access to food.

Authors: Michael Chang, Liz Green+ 1 more
, Steve Cummins

A COVID-19 pandemic world and beyond: The public health impact of Home and Agile Working in Wales

Due to the pandemic and policies such as the ‘Staying at Home and Social Distancing policy’, home and agile working has become necessary for many organisations and employees. This HIA aims to identify the impact of this shift in working practice and to articulate the differential impacts of such a change for organisations, the working population of Wales, their families and local communities.

Authors: Liz Green, Richard Lewis+ 5 more
, Laura Evans, Laura Morgan, Lee Parry-Williams, Sumina Azam, Mark Bellis

Process, Practice and Progress: A Case Study of the Health Impact Assessment (HIA) of Brexit in Wales

In 2018, the Health impact assessment (HIA) support unit in Wales carried out a comprehensive and unique HIA on the impact of Brexit in Wales. The aims were to understand the differential impacts that Brexit would have on the health and well-being of the population and to provide evidence to inform decision makers across a range of public bodies. This paper reflects on the process of carrying out the HIA and the methods used. It discusses the stages of the HIA, and shares the findings and reflections of implementation which will be beneficial to other HIA practitioners and policy makers.

Authors: Liz Green, Kathryn Ashton+ 2 more
, Nerys Edmonds, Sumina Azam

Health Impact Assessment (HIA): A Comparative Case Study of Sri Lanka and Wales: What Can a Developing Country Learn From the Welsh HIA System?

The health impact assessment (HIA) is increasingly recognized around the world as an effective governance tool to incorporate Health in All Policies to address the wider determinants of health. However, it is still poorly recognized and practiced in many developing countries, including Sri Lanka, where its applicability is most appropriate considering the complexity of social determinants of health and inequalities. This comparative case study aimed to explore the barriers for implementation of HIA in Sri Lanka in the areas of supportive policy framework, institutional infrastructure, capacity-building, and multisectoral collaboration and to compare them with a successful HIA system in a developed country (Wales) with a view toward identifying the “best practices” applicable in a developing country context.

Authors: Yasaswi N Walpita, Liz Green

A Health Impact Assessment of the ‘Staying at Home and Social Distancing Policy’ in Wales in response to the COVID-19 pandemic.

The HIA outlines the potential health and wellbeing impacts of the Staying at Home and Social Distancing Policy (commonly referred to as ‘Lockdown’) on the population of Wales in the short, medium and long term. It draws upon learning from international evidence, latest data and intelligence and the views of expert stakeholders.

Authors: Liz Green, Laura Morgan+ 5 more
, Sumina Azam, Laura Evans, Lee Parry-Williams, Louisa Petchey, Mark Bellis

Health Impact and Social Value of Interventions, Services, and Policies: A Methodological Discussion of Health Impact Assessment and Social Return on Investment Methodologies

Assessing the positive and negative impact of policies, services and interventions on health and well-being is of great importance to public health. Health Impact Assessment (HIA) and Social Return on Investment (SROI) are established methodologies which assess potential effects on health and well-being, including social, economic and environmental factors, indicating synergies, and cross-over in their approach. Within this paper, we explore how HIA and SROI could complement each other to capture and account for the impact and social value of an assessed intervention or policy.

Authors: Kathryn Ashton, Lee Parry-Williams+ 2 more
, Mariana Dyakova, Liz Green

The Public Health Implications of Brexit in Wales: A Health Impact Assessment approach – A Rapid Review and Update

This is a short supplementary follow up report and builds on a detailed analysis of The Public Health Implications of Brexit in Wales: A Health Impact Assessment Approach, originally published in January 2019, which examines the potential effects of Brexit on the short, medium and long-term health and well-being of people living in Wales.

Authors: Louisa Petchey, Liz Green+ 5 more
, Nerys Edmonds, Mischa Van Eimeren, Laura Morgan, Sumina Azam, Mark Bellis

Health Impact Assessment Training and Capacity Building Framework Technical Document

The Wales Health Impact Assessment Support Unit have published a framework for training and capacity building in HIA this week. The technical report sets out an underpinning framework for the WHIASU’s approach to the design, development, delivery and evaluation of training and capacity building for HIA over the next five years. The framework is the result of 18 months research, development and engagement. The technical document details a newly developed ‘Skills and Knowledge Framework for HIA’ and a ‘Development Pathway for HIA’ which can inform workforce development and capacity building. The framework has been developed with engagement and feedback from HIA practitioners from Wales and beyond. It has also been designed with the input of key stakeholders including Natural Resources Wales, Local Health Boards, planning officers, environmental health practitioners, and public health specialists.

Authors: Nerys Edmonds, Lee Parry-Williams+ 1 more
, Liz Green

The Public Health Implications of Brexit in Wales: A Health Impact Assessment Approach

The United Kingdom’s withdrawal from the European Union (EU) (informally referred to as “Brexit”) is an unprecedented event in UK history, and evidence of the impact of Brexit on a wide range of policy areas is either unknown or highly contested. The Wales Health Impact Assessment Support Unit, Public Health Wales, has carried out a Health Impact Assessment (HIA) to better understand the potential implications of Brexit for future health and well-being in Wales.

Authors: Liz Green, Nerys Edmonds+ 5 more
, Laura Morgan, Rachel Andrew, Malcolm Ward, Sumina Azam, Mark Bellis

Health in planning assessments

In the latest edition of Planning in London, Michael Chang (Town and Country Planning Association), Liz Green (WHIASU) and Jenny Dunwoody (Arup) provided an overview of opportunities to integrate health considerations in a range of assessments in the process. These include the Strategic Environmental Assessment, Environmental Impact Assessment and the Health Impact Assessment. This article is set in the context of the forthcoming London Plan, a statutory strategic planning document for whole of London, which will see Boroughs adopt the policy of using HIAs in the planning applications process. Many of the issues and themes set out in the article will also be relevant and of interest to practitioners in Wales. (pp52-53)

Authors: Michael Chang, Liz Green+ 1 more
, Jenny Dunwoody