Unemployment has adverse consequences for families and can put children at risk of harm. This review examines associations between parental unemployment and adverse childhood experiences (ACEs). Findings highlight that increasing employment opportunities and parental support interventions may help break multigenerational cycles of ACEs.
This International Horizon Scanning and Learning Summary Calendar is the third in the series, following the Summary Calendars from 2020/21 and 2021/22. This Summary Calendar has collated, synthesised, and presented a clear and concise synopsis of the five International Horizon Scanning Reports over the past year, since April 2022 through to March 2023. In addition, the two summary reports (published in 2022) are included. The International Horizon Scanning and Learning work stream has proved to showcase informative and impactful research whilst collating data from other countries and has provided guidance, recommendations, and useful insights regarding the evolving nature and uncertainties of emerging public health topics, which has sought to improve and inform such actions and approaches in Wales.
The summary aims to inform a succinct overview of comprehensive, coherent, inclusive and evidence-informed policy action, which has supported and continues to support the national strategies towards a healthier, more equal, resilient, prosperous and globally responsible Wales. This calendar includes key messages and key recommendations from the high level synthesis pages of each International Horizon Scanning report.
Themes include:
• Intermediate care
• The cost of living crisis
• COVID-proofing the educational environment: 4-18 years
• Early childhood education and care
• Communication campaigns for vaccine acceptance
• The impact of COVID-19 on mental health and increasing vulnerability
• The impact of COVID-19 on increasing the health gap and vulnerability
Adverse childhood experiences (ACEs) show strong cumulative associations with ill-health across the life course. Harms can arise even in those exposed to a single ACE type but few studies examine such exposure. For individuals experiencing a single ACE type, we examine which ACEs are most strongly related to different health harms.
This new report brings together what is known about ACEs across Europe and internationally, showing the on-going toxic impact that ACEs can have across the life course and how ACEs and their consequences can be prevented. The report supports the development of a trauma-informed society that is invested in action to prevent ACEs and better support those affected by them.
Using a UK general population sample, this study has identified relationships between exposure to ACEs and lifetime experience of car crashes and burns; two major markers of unintentional injury. Findings highlight the need for effective interventions to prevent ACEs and reduce their impacts on health and well-being. A better understanding of the relationships between ACEs and unintentional injury, and the mechanisms that link childhood adversity to injury risks, can benefit the development of multifaceted approaches to injury prevention.
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.
Population health and wellbeing is both a result, as well as a driver, of economic development and prosperity on global, European, national and sub-national (local) levels. In this paper, the economic importance of the healthcare sector to the Welsh economy is explored. We use a large number of data sources for the UK and Welsh economy to derive an economic model for 2017. We estimate output, income, employment, value-added, and import multipliers of the healthcare sector. Results suggest that the healthcare sector has an above average contribution in four explored economic aspects of the Welsh economy (output, income, employment, value-added), according to its impact on the surrounding economic ecosystem.
The International Horizon Scanning and Learning reports were initiated as part of the COVID-19 public health response, to support dynamic response and recovery measures and planning in Wales. In spring 2022, the scope of the reports was expanded to cover priority public health topics, including in the areas of health improvement and promotion, health protection, and health care public health.
In focus: COVID-proofing the educational environment: 4-18 years
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.
In 2022, Wales joined the growing number of countries to ban physical punishment of children in all settings. Using data collected a year prior to legislative change, this study explores relationships between Welsh parents’ exposure to ACEs whilst growing up and their use of physical punishment towards children.
This report presents initial findings from a survey of adult residents in Wales on their perceptions of climate change and health. Whilst work to understand and mitigate climate change is gaining momentum in Wales, there remains a lack of information on population views and behaviours. Such data are critical for the co-creation of effective and acceptable approaches to climate change that help protect public health; the targeting of key messages and information; and the establishment of long-term solutions across Wales that will continue to be supported across multiple generations. To address this gap, a public survey was developed to seek the population’s views about climate change, its relationship with health, their current climate friendly behaviours, their willingness to engage in action, and views on policy solutions. This report presents initial findings from the survey, providing population-level views on climate change among adult residents in Wales.
There are wide inequalities in health and healthcare use between people living in more deprived neighborhoods and those living in less deprived neighborhoods in Wales. Tackling health inequality through a combination of health promotion and early intervention policies targeted toward deprived communities could yield substantial improvement in health and wellbeing, as well as savings for the Welsh NHS.
Social distancing measures have been effective in mitigating the spread of COVID-19; however, they have imposed a significant burden on population mental health and well-being. This study established an association between loneliness and self-reported worsening health during the pandemic, and identified factors increasing the risk of loneliness. The effect that social control measures have on loneliness should influence the design of future public health policy.
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.
Public Health Wales conducted a public engagement telephone survey to ask members of the public in Wales how coronavirus and related control measures are affecting their health and wellbeing. This report presents trends in responses to a selection of core questions over the two year period, including: worry about coronavirus; mental and physical health; worry about finances; and perceptions of the national response. It examines differences in responses by deprivation, gender and age.
The aim of this discussion paper is to help inform further policy action and potential solutions in order to reduce the health gap in Wales and beyond.
It provides a snapshot of the health inequalities experienced by different population groups in the years leading up to the Coronavirus (COVID-19) pandemic, applying an innovative statistical methodology, a ‘Decomposition analysis’.
The paper attempts to quantify the health gap in Wales, as well as to provide a better understanding of its main drivers across the five essential conditions for healthy prosperous lives for all, using a novel World Health Organization framework. It uses three measures of self-reported health: 1) the prevalence of fair/poor health; 2) the prevalence of low mental well-being; and 3) the prevalence of low life satisfaction, comparing these between:
• Those who are able to make a saving of at least £10/month and those who are not;
• Those who report being in material deprivation and those who do not; and
• Those who report a limiting longstanding illness, disability or infirmity and those who do not.
The analysis has generated an insight into the drivers of health inequities, identifying those which contribute the most, namely ‘Social and Human Capital’ and ‘Income Security and Social Protection’; while ‘Health Services’ has accounted the least. However, systematic differences are able to explain less than half (<50%) of the health gaps for the majority of the health outcomes, based on the statistical models.
The paper highlights the need for a basket of policy and investment decisions, prioritising the key drivers of health inequity, in consensus across sectors. Further exploration and engagement with experts, stakeholders, relevant groups and communities is essential to improve understanding of the health equity gap and its drivers.
It hopes to inform the following national and international stakeholders:
• Public health professionals
• Public policy makers and budget holders on national and local levels
• Statisticians, health scientists and data analysts
• All those who have a role in influencing the health equity gap in Wales and further afield
Improving understanding of risk factors for risky sexual behaviour is fundamental to achieve better population sexual health. This study explored associations between ACEs and poor sexual health outcomes in the UK. Findings highlight the need for effective interventions to prevent and ameliorate the lifelong effects of ACEs. Trauma-informed relationships and sex education, sexual health services, and antenatal/postnatal services, particularly for teenagers and young parents, could provide opportunities to prevent ACEs and support those affected.
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.
International Horizon Scanning and Learning: Summary Calendar UPDATE
This International Horizon Scanning and Learning Summary Calendar is an update from the previous Summary Calendar which can be found here and covered the period of April 2020 through to March 2021. This Summary Calendar has collated, synthesised and presented a clear and concise summary of the COVID-19 International Horizon Scanning Reports over the past year, since April 2021 through to March 2022. The International Horizon Scanning and Learning work stream has proved to showcase informative and impactful research whilst collating data from other countries and has provided guidance, recommendations and useful insights regarding the evolving nature and uncertainties of the COVID-19 pandemic, which has sought to improve and inform such actions and approaches in Wales. The summary aims to inform a succinct overview of comprehensive, coherent, inclusive and evidence-informed policy action, which has supported and continues to support the national strategies towards a healthier, more equal, resilient, prosperous and globally responsible Wales. This calendar includes key messages and key recommendations from the high level synthesis page of each International Horizon Scanning report.
Interpersonal violence has devastating implications for individuals, families, and communities across the globe, placing a significant burden on health, justice, and social welfare systems. Smartphone technology may provide a platform for violence prevention interventions. This paper explores the evidence on the availability and user experience of UK smartphone applications aimed to prevent violence and improve personal safety. The findings have implications for the development of policy on applications to improve personal safety, especially given recent national policy (e.g. UK) discussions about their utility.
The International Horizon Scanning and Learning work stream was initiated as a product of, and to inform upon, the evolving COVID-19 public health response and recovery plans in Wales. In spring 2022, the scope of the reports has been expanded to cover priority public health topics, including in the areas of health improvement and promotion, health protection, and health care public health. This report focuses on intermediate care.
These reports were used during the period of the Covid 19 pandemic in order to inform the Public Health Wales response and therefore only available in English.
This report seeks to explore, for the Bolton population, any association between ACE exposure and COVID-19 infection. It will also seek to identify if ACE exposure is associated with: trust in COVID-19 health information; attitudes towards, and compliance with COVID-19 restrictions (e.g. use of face coverings, social distancing); and attitudes towards COVID-19 vaccination. A better understanding of such relationships will help local services understand how they can encourage compliance with public health restrictions and vaccine uptake; information crucial for targeting health messaging and the management of threats to public health, including future pandemics.
This report focuses specifically on the health and well-being impact of the loss of European Union (EU) Structural Funds and the risks and opportunities presented by a replacement scheme. It aims to inform national, regional and local decision makers in Wales, particularly those involved in the allocation and management of future regional funding schemes. The report contains key insights on the current importance of the EU Structural Funds for the health and well-being of local areas with a focus on different population groups.
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.
Public Health Wales conducted a public engagement telephone survey to ask members of the public in Wales how coronavirus and related control measures are affecting their health and wellbeing. Survey reports aimed to provide data representative of the Welsh population and data are adjusted to represent the Welsh population by age, sex and deprivation.
The COVID-19 pandemic has posed challenges to societies, health systems and decision-makers worldwide and has resulted in long-term economic, social and health and well-being impacts. Mental health has been negatively affected across all-age groups exacerbating existing health inequalities.
This report reviews and summarises the international evidence from the International Horizon Scanning and Learning reports on the direct and indirect impact of COVID-19 on mental health, mental health services and increasing vulnerability.
In response to successive COVID-19 restrictions in Wales, the Welsh ACE Support Hub launched the #TimeToBeKind campaign in March 2021. The campaign used a short film broadcast on national television and promoted on social media to encourage behaviour change for kindness. This manuscript evaluates the #TimeToBeKind campaign film. Findings strongly indicated that film can be an effective tool to promote behaviour change for kindness and that even films that provoke strong emotional reactions can be positively perceived and lead to behaviour change. The findings of the evaluation are relevant to how public health messaging can adapt and utilise online space to target individuals and promote behaviour change.
This study examined the impacts of multi-component nightlife interventions – including community mobilisation, responsible beverage server training and law enforcement approaches – to reduce over-service of alcohol in four nightlife settings in England and Wales. It found that multi-component interventions were associated with significant increases in service refusal, with effects being stronger for interventions that included enhanced law enforcement, particularly if all intervention components were implemented.
The International Horizon Scanning and Learning work stream was initiated as a product of, and to inform upon, the evolving COVID-19 public health response and recovery plans in Wales. It focuses on COVID-19 international evidence, experience, measures and transition/recovery approaches, to understand and explore solutions for addressing the on-going and emerging health, wellbeing, social and economic impacts (potential harms and benefits).
Topics of focus are:
– COVID-19 vaccination equity
– COVID-19 excess mortality
These reports were used during the period of the Covid 19 pandemic in order to inform the Public Health Wales response and therefore only available in English.
Public Health Wales conducted a public engagement telephone survey to ask members of the public in Wales how coronavirus and related control measures are affecting their health and wellbeing. Survey reports aimed to provide data representative of the Welsh population and data are adjusted to represent the Welsh population by age, sex and deprivation.