Trade, Trade Agreements and Tariffs and the Impact on Health, Well-being and Equity in Wales

This briefing paper, developed by the Wales Health Impact Assessment Support Unit (WHIASU), discusses the potential health, well-being and equity impacts of trade tariffs on the Welsh population. It is aimed at stakeholders in Wales working in the areas of trade, public health and health services to support them to better understand the potential impacts that trade tariffs can have on population health.

It begins with a brief introduction to trade agreements and to tariff and non-tariff barriers to trade. It then outlines the most recent trade deals the United Kingdom (UK) has signed up to before discussing how tariffs can affect population health, well-being and equity in Wales. It concludes with some options on how health and well-being can be better considered in trade agreements and identifying the impacts of tariffs. Finally, it presents two case study examples of how trade can impact the people and economy in Wales.

Authors: Michael Fletcher, Liz Green

Putting the Spotlight on Health, Well-being and Equity Using Health Impact Assessment: Case Studies from Public Bodies in Wales

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).

Authors: Mark Drane, Liz Green+ 3 more
, Kathryn Ashton, Michael Fletcher, Sumina Azam

20 years of the Wales Health Impact Assessment Support Unit (WHIASU) and the evolution of Health Impact Assessment (HIA) in Wales

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

Assessing public health implications of free trade agreements: The Comprehensive and Progressive Trans-Pacific Partnership Agreement

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 Wargent, Courtney McNamara, Michael Fletcher, Louisa Petchey, Timo Clemens, Margaret Douglas

Determining the Public Health Impact of Climate Change: A National Study Using a Health Impact Assessment Approach in Wales

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 Impact of the COVID-19 Pandemic on Women, Employment and Health Inequalities

The infographic summarises the findings, looking at the Population Groups and Determinants of Health impacted, along with the key statistics, mitigating actions and potential areas of future research. The Explanatory Note goes into further detail on the above, giving a breakdown of the evidence that informed our positive and negative findings on women, employment and health inequalities. It also offers readers the chance to see the HIA methodology that was used by the team.

Authors: Michael Fletcher, Laura Evans+ 3 more
, Lee Parry-Williams, Kathryn Ashton, Liz Green

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 Wargent+ 6 more
, Michael Fletcher, Louisa Petchey, Laura Morgan, Margaret Douglas, Sumina Azam, Courtney McNamara

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

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

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

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