Time to Talk Public Health is a nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice. The panel is designed to be broadly representative of the Welsh population by age, sex, deprivation, ethnicity and health board. This report presents findings from the August 2024 survey covering: Cardiovascular health, Non-Emergency Patient Transport Service, travelling to health appointments, healthy weight, mealtimes and vaccines.
‘The Country deep dive on the well-being economy: Wales’ is part of a series of country deep dives published under the WHO European Well-being Economy Initiative led by the WHO European Office for Investment and Development. Each publication in the series is developed by combining academic and grey literature with narratives from semi structured interviews conducted with key stakeholders in government and public health institutions, with the aim to demonstrate concrete country experiences in advancing and implementing well-being economies.
This deep dive focuses on the Welsh approach. It gives context for Wales’s commitment to the well-being economy agenda, and identifies key concepts and strategies, governance structures and mechanisms, the role of (public) health, and approaches to measuring and monitoring progress. It highlights both the drivers and barriers Wales has encountered on the path towards a well-being economy. While Wales’s experience is not representative or all-encompassing, countries that are considering or in the process of shifting to a well-being economy can look at these key findings and take-home policy messages for inspiration.
This publication focuses on the use of Health Impact Assessment (HIA) by public bodies in Wales as a process that can support policymakers and those involved in decision taking to maximise well-being benefits, minimise harm to health, and avoid widening health inequalities. It also supports public bodies in meeting duties under the Public Health (Wales) Act (2017).
The 20th anniversary of WHIASU marks two decades of advancing HIA as a vital tool for healthier decision-making and reducing health inequalities in Wales. Established in 2004, WHIASU has led the way in enabling the integration of HIA into policy at local, regional and national levels.
The timeline highlights key milestones, documents, and publications in WHIASU’s history and the practice of HIA in Wales. Looking ahead, WHIASU will continue to champion HIA and Health in All Policies (HiAP), supporting public bodies in implementing upcoming HIA regulations under the Public Health Act (Wales) Act 2017.
Authors: Michael Fletcher, Kathryn Ashton+ 7 more
, Laura Evans, Cheryl Williams, Abigail Malcolm (née Instone), Catrin Lyddon, Lee Parry-Williams, Nerys Edmonds, Liz Green
The report presents evidence that living in a colder home (at a temperature below 18°C) is linked with negative impacts on health and well-being, particularly for people who are older or who have health conditions or disabilities. The report also includes a set of recommendations on the satisfactory heating regime in Wales.
Authors: Rebecca Hill, Daniella Griffiths+ 5 more
, Hayley Janssen, Kat Ford, Nicholas Carella, Ben Gascoyne, Sumina Azam
The sexual health of the male prison population is often among the poorest in a country. This paper aims to identify the wider health impacts and social value of a sexual health self-sampling programme offered to male prisoners in an open prison setting in Wales.
This study applied a unique pilot approach of using Health Impact Assessment and Social Return on Investment Frameworks in tandem. Key stakeholder groups affected by the intervention were identified, and engaged with through workshops, interviews and questionnaires to identify and quantify the health impacts and wider outcomes. Outcomes were then valued using proxy financial values to present the overall estimated social value of the self-sampling service.
Based on a small sample, results indicate that for every £1 spent on the self-sampling service in the prison, a potential value of £4.14 was created. This resulted in a ratio of £4.14:£1. Approximately one-third of the value created (£1,517.95) was categorised as monetarily returnable, whereas the remaining value (£3,260.40) was purely illustrative social value, for example improved mental well-being.
This unique pilot study demonstrates the health impacts and wider social value of providing a self-sampling sexual health service to prisoners within an open prison setting. By innovatively testing the feasibility of using a Health Impact Assessment process alongside Social Return on Investment analyses, this paper has outlined how the frameworks can be used in synergy to illustrate not just direct return on investment but also the social value of providing such a service.
Authors: Kathryn Ashton, Aimee Challenger+ 6 more
, Christie Craddock, Timo Clemens, Jordan Williams, Oliver Kempton, Mariana Dyakova, Liz Green
Health Impact Assessments (HIA) are undertaken to inform decision-making processes by assessing the potential health and health equity impacts of a programme, policy, or project and developing appropriate responses to mitigate harms and maximize benefits. Stakeholder and community participation is central to the impact assessment process. This research explores the experiences of stakeholders and community members who participated in HIA workshops in Wales between 2005 and 2020. Data were gathered through a questionnaire at the end of each HIA workshop session with stakeholder and community participants from diverse backgrounds reporting on the experience of their participation. The analysis reveals a range of perceived benefits of participation in the HIA process. The identified benefits included the opportunity to be heard, networking, and a view of participation as a community service. These findings reinforce the importance of stakeholder and community participation in HIA, through the perspective of participants themselves. This study contributes to the understanding of community and stakeholder participation in impact assessment processes and offers recommendations for improving the practice and impact of HIA in policy development. These findings have the potential to be transferable to other types of impact assessments, and other forms of community and stakeholder participation.
Authors: Liz Green, Amber Murphy+ 3 more
, Kathryn Ashton, Christopher Standen, Fiona Haigh
The International Health Coordination Centre’s (IHCC) International Health Newsletter promotes and shares international news, events and initiatives with partners across Wales and beyond.
The newsletter was piloted in May 2023, thereon issued quarterly.
Like many areas across the UK, Coventry faces health inequalities, particularly among its most vulnerable communities. However, there has been notable progress. In this blog, we highlight the impactful work Coventry City Council has undertaken so far. A key initiative is the city’s Job Shop, which operates a Hub and Spoke model, offering personalised support in community locations to empower residents.This blog also explores how the Marmot Cities approach is making a difference and shares valuable lessons learned along the way.
Recognising the importance of involving everyone in the solution, the Wales Violence Prevention Unit (VPU) has launched the ‘Engaging Men and Boys in Violence Prevention Toolkit’, in partnership with Plan International UK. This Toolkit brings together academic evidence and professional expertise to support the development of inclusive, accessible and engaging programmes for men and boys.
As part of the implementation of the Wales Without Violence Framework, the Toolkit will continue to develop to provide a range of accessible information for understanding, supporting, and critically assessing the role that programmes designed to specifically support men and boys can play in preventing violence. At this stage, the toolkit consists of two reports and an infographic:
-“You’ve given me the courage to challenge how boys treat girls” Key Findings from ‘Test and Learn’ Projects in Wales- this report shares findings from focus groups with Plan International UK’s Test and Learn projects. Primarily, it explores evidence from practice and from literature on enablers and barriers to engaging men and boys in violence prevention.
-Investing in allies and ambassadors- Engaging men and boys in violence prevention: A Review of Programmes in Wales- this report showcases Welsh programmes that aim to engage men and boys in violence prevention. These programmes were identified by professionals as part of a survey, and this report provides considerations for practitioners, researchers, policy makers and commissioners on project development, including evaluation, and project delivery.
-An infographic which draws out the key considerations from both reports for designing and delivering programmes to engage men and boys in preventing violence.
To explore the Toolkit, click here: https://waleswithoutviolence.com/resources
Authors: Alex Walker, Lara Snowdon+ 4 more
, Shauna Pike, Bryony Parry, Emma Barton, Anne-Marie Lawrence
These case studies are co-produced with organisations and people across Wales who are leading initiatives at the community level which are already contributing to the vision for Wales to become a trauma-informed nation by working in a trauma-informed way. The purpose of these reports is to shine a light on the existing approaches, celebrate their work and continue to inform and support the implementation of the Trauma-informed Wales Framework and further development of our Trauma and Adverse Childhood Experiences (TrACE) informed organisational toolkit.
Spotlight on Anglesey explores the journey of Anglesey in becoming a trauma-informed island. Anglesey’s journey to becoming a trauma-informed island is founded on a strengths-based approach which creates a positive psychosocial environment and a high level of community resilience.
Spotlight on Home-Start Cymru showcases their brilliant work with families in communities throughout Wales, and how trauma –informed practice can change people’s lives through , collaboration trust and support. Their trauma-informed organisational approach is a strengths-based, whole systems approach which also supports their workforce and volunteers by acknowledging their mental health and well-being.
Exposure to adverse childhood experiences (ACEs) is recognised globally as a risk factor for health problems in later life. Awareness of ACEs and associated trauma is increasing within schools and educational settings, as well as the demand for supportive services to address needs. However, there is a lack of clear evidence for effective interventions which can be delivered by non-clinicians (e.g., the school staff themselves).
This systematic review of twenty-five studies revealed emerging evidence for non-clinician delivered interventions for enhancing mental health outcomes in school-age youth with exposure to ACEs; specifically, evidence for the effectiveness of CBT-based group and interventions involving caregivers.
This study explored the intergenerational continuity of adverse childhood experiences (ACEs) in a male justice-involved population. 294 fathers aged 18-69 years in a Welsh prison completed a questionnaire exploring their exposure to ACEs. The questionnaire also measured the ACE exposure of each child they had fathered. The study found evidence for the intergenerational continuity of ACEs. Paternal ACE exposure was found to increase the risk of child ACE exposure, both to multiple ACEs and individual ACE types.
Time to Talk Public Health is a nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice. The panel is designed to be broadly representative of the Welsh population by age, sex, deprivation, ethnicity and health board. This report presents findings from the May 2024 survey covering: Carbon Monoxide; Vaccines; Infections; and Health Stigma.
This piece of work focuses on the potential impacts of future trends on our social connectedness and community networks (our ‘social capital’) over the next fifty years. It aims to explore some of the factors which may support and strengthen social participation and networks in Welsh communities, as a central feature of a healthy and flourishing society, and those which may risk alienating, polarising and isolating individuals and groups. This report does not aim to predict the future but rather to prompt people to think about the longterm challenges, opportunities, and possibilities that future trends can present.
Working towards health equity is a challenging but crucial task. Public Health Wales is seeking to support you in this work, whatever your role, by compiling a range of national and international tools that have been developed to guide this work in different contexts.
Public Health Wales has published an overview of 22 health equity frameworks and tools to support governments, organisations, and individuals to work towards health equity. Frameworks and tools were identified through searches of key international and national resources.
Authors: Jo Peden, Rhiannon Griffiths+ 3 more
, Sara Southall, Rebecca Hill, Lauren Couzens (née Ellis)
Reflections from the Wales Health Impact Assessment Support Unit (WHIASU), Policy and International Health, World Health Organization (WHO) Collaborating Centre on Investment for Health and Well-being, Public Health Wales.
The aim of this review is to consolidate and enhance the evidence base on the prevention of, and response to, public sexual harassment and other forms of gender-based harassment in all public spaces, to understand prevalence, causes and effective interventions. It will directly inform the priority of the Blueprint work stream: Gender-based Harassment in all Public Spaces. The Blueprint approach has been adopted by Welsh Government and Policing in Wales to support delivery against the Wales Violence Against Women, Domestic Abuse and Sexual Violence (VAWDASV) strategy.
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: The Commercial Determinants of Health: Children and Young People
This summary calendar, the fourth to be published, presents a short and interactive overview of the five International Horizon Scanning Reports from 2023-2024, with themes including:
• Universal primary free school meals
• Mental health and well-being of refugees and asylum-seekers
• Five essential conditions for health equity
• Embedding prevention in primary and community care
• Impact of poverty on babies, children and young people
Trust in health and other systems can affect uptake of public health advice and engagement with health services. Adverse childhood experiences (ACEs) increase individuals’ risks of ill health, thus understanding how ACEs affect trust in sources of health advice and other support is important to inform engagement with this vulnerable group. This study examined associations between ACEs and trust in health advice, other information and public services in a nationally representative sample of 1,880 adults in Wales.
A toolkit is available to staff whose work involves international health and working with global stakeholders. The implementation toolkit helps staff in Health Boards and NHS Trusts translate the Charter for International Health Partnerships in Wales into operational practices.
Despite advancements in societal acceptance and legal rights, LGBTQIA+ individuals continue to face significant disparities in mental health, sexual health, and healthcare access. Health inequalities among the LGBTQIA+ communities in Wales present a pressing challenge.
This blog describes the challenges experienced by the LGBTQIA+ communities in Wales regarding health and social care. It features strategic policies that are making difference, ensuring fair health access for all. The blog also highlights transformative efforts that are not only reshaping public health but also setting precedents for inclusivity across the nation.
The International Health Coordination Centre’s (IHCC) International Health Newsletter promotes and shares international news, events and initiatives with partners across Wales and beyond.
The newsletter was piloted in May 2023, thereon issued quarterly.
In 2016, the United Kingdom voted to exit the European Union, which was surrounded by political and social uncertainty. The United Kingdom now negotiates its own trade agreements, and in March 2023, it agreed to join the Comprehensive and Progressive Trans-Pacific Partnership Agreement (CPTPP). A health impact assessment (HIA) was undertaken in 2022–23 to predict the potential impact of the CPTPP on the health and well-being of the Welsh Population. This paper explores the HIA findings and highlights the value of the approach in engaging with stakeholders and informing policymakers. This HIA followed a standard five-step approach which involved a literature review to identify potential health impacts, qualitative interviews with cross-sectoral stakeholders and the development of a community health profile. The HIA identified potential impacts across the wider determinants of health and specific vulnerable population groups. Investor state dispute settlement mechanisms, economic uncertainty and loss of regulatory policy space were identified as key pathways for health impacts. The findings have been beneficial in informing decision-makers to prepare for the CPTPP in Wales using an evidence-informed approach. This work has demonstrated the value of a HIA approach that uses a transparent process to mobilise a wide range of evidence, resulting in transferrable learning.
Authors: Liz Green, Kathryn Ashton+ 6 more
, Leah Silva, Courtney McNamara, Michael Fletcher, Louisa Petchey, Timo Clemens, Margaret Douglas
Adverse childhood experiences (ACEs) are stressful experiences during childhood such as child maltreatment and exposure to household difficulties including domestic violence, substance abuse, mental illness and family members being in prison. This study analysed data collected from 1,880 adult residents across Wales. It found that those who reported multiple ACEs in their childhood were significantly more likely to perceive they would be unable to cope financially during the cost-of-living crisis, independent of factors including household income level, employment status and residential deprivation.
Authors: Karen Hughes, Mark Bellis+ 4 more
, Katie Cresswell, Rebecca Hill, Kat Ford, Joanne C. Hopkins
Adverse childhood experiences (ACEs) are associated with poorer health outcomes yet their association with healthcare engagement remains relatively underexplored, particularly within the UK. This report presents the findings of an online survey with adults resident in Wales and England, developed to explore the association between ACEs and healthcare engagement, including comfort in the use of healthcare services.
Climate change is recognised as the biggest threat to global health of the 21st century and impacts on health and wellbeing through a range of factors. Due to this, the need to take action in order to protect population health and wellbeing is becoming ever more urgent.
In 2019, Public Health Wales carried out a comprehensive mixed-method Health Impact Assessment (HIA) of climate change. Unlike other risk assessments, it appraised the potential impact of climate change on health and inequalities in Wales through participatory workshops, stakeholder consultations, systematic literature reviews and case studies.
The HIA findings indicate potential impacts across the wider determinants of health and wellbeing. For example, air quality, excess heat/cold, flooding, economic productivity, infrastructure, and community resilience. A range of impacts were identified across population groups, settings, and geographical areas.
These findings can inform decision-makers to prepare for climate change plans and policies using an evidence-informed approach. The work has demonstrated the value of a HIA approach by mobilising a range of evidence through a transparent process, resulting in transferrable learning for others.
Authors: Liz Green, Kathryn Ashton+ 6 more
, Nerys Edmonds, Michael Fletcher, Sumina Azam, Karen Hughes, Phil Wheater, Mark A Bellis
The report highlights the highest carbon emission single-use plastic and waste items used in PHW’s Microbiology Laboratories and identifies recommendations to switch to more sustainable alternatives.
The solutions identified can be replicated across the wider healthcare sector.
Time to Talk Public Health is a nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice. Welsh residents were asked their views on a range of public health topics. The survey had a focus on topics relating to children’s health and well-being, including questions of specific relevance to parents. To increase participation of parents in the survey, a parent boost sample was recruited to take part in the survey in addition to the routine general population sample. The February survey focused on the following six topics: parenting information needs, perceptions of breastfeeding, role of education settings in child health, child behaviour strategies, mental well-being, and technology use with family and friends.
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