Resources

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.

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).

Analysing the value, benefits and barriers to stakeholder and community participation in health impact assessments (HIAs) in Wales from 2005 to 2020

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.

Self-administered sexual health testing in an open prison setting: a pilot health impact assessment and social return on investment analysis

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.

Successfully creating the conditions for Health Impact Assessment in Wales: a case study. In: Impact Assessment Outlook Journal Volume 21: July 2024. Impact Assessment Frontiers Part 2: People, Health and Equality. Thought pieces from UK and International practice

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.

Charter for International Health Partnerships in Wales: An Implementation Toolkit

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.

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.

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.

Self-administered sexual health testing in an open prison setting in Wales: A Health Impact Assessment and Social Return on Investment analysis

This report outlines findings from a study that aims to understand the health impacts and social return on investment of a self-sampling service for Sexually Transmitted Infections (STIs) in an open prison setting in Wales. The study applies an innovative approach by using a Health Impact Assessment (HIA) lens and approach, in combination with the Social Return on Investment (SROI) framework.

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.

Advancing the Social Return on Investment Framework to Capture the Social Value of Public Health Interventions

Investment in public health has far-reaching impacts, not only on physical health but also on communities, economies, and the environment. There is increasing demand to account for the wider impact of public health and the social value that can be created, which can be captured through the use of the social return on investment (SROI) framework. This study aims to explore the application of SROI and identify areas of advancement for its use in public health.

Public Health Wales: Our International Health Strategy 2023-2035

Public Health Wales has updated its 2017 International Health Strategy to better reflect the significant changes in the global landscape and to enable Public Health Wales’ new Long-Term Strategy.

Health Impact Assessment for Climate Adaptation: Examples from Practice

This briefing focusses on adaptation to address climate change and the application of Health Impact Assessment (HIA) as a process that can support policy makers to maximise wellbeing benefits, minimise harm to health, and avoid widening health inequalities when designing adaptation policies. It contains five case studies – two international and three from Wales, and provides action oriented examples of putting HIA into practice.

Climate Change in Wales: Health Impact Assessment

This health impact assessment (HIA) is a strategic and comprehensive appraisal of the potential implications of climate change on population health in Wales. It provides robust evidence to inform public bodies, agencies and organisations in their preparations for, and responses to, climate change and climate change events. It aims to support adoption of policies and plans that can promote and protect health and wellbeing for all in Wales and in those population groups and geographical areas particularly at risk of negative impacts.

The outputs of the HIA available to download here are:

• An evidence based HIA Summary report
• Individual chapters on the evidence of impact of climate change on the wider determinants of health and population groups in Wales
• A set of 4 infographics
• A PowerPoint slide deck
• A Technical Report

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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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.

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.