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

Beyond the present: How to apply long-term thinking to reduce health inequalities

This resource aims to inspire all of us to reduce health inequality in Wales and beyond in everything we do, by exploring methods to enable long-term thinking and sharing case studies which show how those approaches have been applied in Wales. It guides users through identifying relevant trends, generating a future vision, and setting a course for a desired future. Methods discussed include horizon scanning, the futures triangle, axes of uncertainty, and scenario planning, among others.

Authors: Petranka Malcheva, Louisa Petchey+ 1 more
, Sara Elias

Affordable homes for health and well-being

People’s homes can have a significant impact on their health and well-being.

This briefing follows our summary briefing ‘Homes for health and well-being’ on what a future of healthy homes in Wales should look like. It focuses on the importance of affordable homes for health and well-being.

We hope that by highlighting the links between housing affordability and health, and by sharing examples of what ‘good’ looks like, this briefing will help stakeholders in the housing system make progress towards a future where affordable homes help to protect and improve the health and well-being of everyone in Wales.

Authors: Manon Roberts, Louisa Petchey

How could international trade agreements help or hinder the well-being of future generations in Wales?

Now that the UK has left the European Union, the UK Government is negotiating international trade agreements on behalf of the rest of the UK for the first time in nearly half a decade. International trade agreements have the potential to impact positively and negatively on health, well-being, and equity in Wales.

Here we provide a visual methodology for exploring the ways in which specific international trade agreements may have this impact through the lens of the goals set out in the Well-being of Future Generations (Wales) Act 2015. In this infographic report, we summarise the potential impacts of the UK’s accession to the Comprehensive and Progressive Trans-Pacific Partnership (CPTPP) Free Trade Agreement.

Authors: Leah Silva, Louisa Petchey

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

Has Brexit changed detection and prevention of illicit trade in drugs, alcohol, and tobacco in Wales?

This briefing by Public Health Wales summarises the international systems the UK and Wales participated in to tackle illicit alcohol, tobacco, and drugs before Brexit. It will then explore how these have changed post-Brexit and what potential impact that may have on health and well-being in Wales.

Authors: Katie Cresswell, Louisa Petchey+ 1 more
, Leah Silva

Building the social relationships of older people in Wales: challenges and opportunities

Social capital is a protective factor for health and well-being, and differences contribute significantly to health inequalities in Wales. This paper provides a rapid review of older people’s social relationships and networks and how this has been impacted by the COVID-19 pandemic and more recent cost of living crisis. The report identifies policy and practice examples that can promote, sustain and strengthen older people’s social relationships and networks as a means of overcoming challenges and building the social capital of current and future older generations.

Authors: Menna Thomas, Louisa Petchey+ 2 more
, Sara Elias, Jo Peden

Cost of living crisis in Wales: A public health lens

The cost of living crisis is having, and will continue to have, wide-ranging and long-term impacts on the day-to-day lives of people in Wales.
This report summarises the ways in which the cost of living crisis can impact on health and well-being. It takes a public health lens to identify actions for policy makers and decision-makers to protect and promote the health and well-being of people in Wales in their response to the cost of living crisis, outlining what a public health approach to the crisis could look like in the short and longer-term.

Authors: Manon Roberts, Louisa Petchey+ 4 more
, Aimee Challenger, Sumina Azam, Rebecca Masters, Jo Peden

Has Brexit changed how Wales participates in global infectious disease prevention, preparedness and response?

The COVID-19 pandemic has pushed infectious diseases to the top of government agendas around the world. Simultaneously, Brexit has influenced how the UK, and therefore Wales collaborates with international partners on infectious diseases.
Timelines for Brexit and the COVID-19 pandemic overlapped, many post-Brexit arrangements were still in development. The next international public health emergency will test the new systems in Wales/the UK.
Brexit has been shown to have the potential to impact on the health and well-being of the Welsh population and is therefore a consideration in the context of infectious disease prevention, preparedness and response.
This briefing explores how the UK’s exit from the EU has changed its international relationships and processes for dealing with future infectious disease threats.

Authors: Katie Cresswell, Louisa Petchey

What could post-Brexit trade agreements mean for public health in Wales?

This briefing is for public health professionals and officials working on public health policy who are interested in how Brexit and trade agreements may affect their work, and for UK and Welsh officials working in trade policy to raise awareness of the relevance of trade to the health and well-being of the people of Wales.

Authors: Louisa Petchey, Katie Cresswell

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

Three Horizons Toolkit

The Horizon toolkit can help public bodies and people in general to think and plan for the longer term rather than being so stuck in the here and now that they miss the opportunities , don’t spot risks or make decisions that don’t stand the test of time.

Authors: Louisa Petchey

Young People and Brexit

In the years that have followed the European Union (EU) referendum in 2016, Brexit has seldom been out of the news. Despite considerable activity, there was still uncertainty around Brexit at the time of this research; not just around the logistics of if, when and how the UK might leave the EU but also what the implications of Brexit might be for the UK and for Wales – or even what effect the last few years might already have had.

Authors: Louisa Petchey, Angharad Davies+ 3 more
, Samuel Urbano, Sumina Azam, Alisha Davies

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