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.

Authors: Kathryn Ashton, Aimee Challenger+ 4 more
, Andrew Cotter-Roberts, Christie Craddock, Jordan Williams, Liz Green
The Social Return on Investment of Physical Activity and Nutrition Interventions - a Scoping Review

The Social Return on Investment of Physical Activity and Nutrition Interventions – a Scoping Review

Scarcity of resources for public health and mounting pressures on health systems such as the Covid-19 pandemic, make it vital to evaluate public health interventions and move away from traditional evaluation methods. This is important to understand not just the financial value of public health interventions, but also the wider social, environmental and economic value. This review aims to present the existing evidence base on the Social Return on Investment of physical activity and nutrition interventions, demonstrating the wider social and environmental benefits of these interventions.

Authors: Anna Stielke, Kathryn Ashton+ 2 more
, Andrew Cotter-Roberts, Mariana Dyakova

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
Journal article first page: Advancing the Social Return on Investment Framework to Capture the Social Value of Public Health Interventions: Semistructured Interviews and a Review of Scoping Reviews

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.

Authors: Kathryn Ashton, Andrew Cotter-Roberts+ 3 more
, Timo Clemens, Liz Green, Mariana Dyakova

Welsh Health Equity Solutions Platform Animation: How to use the Solutions Platform

The Welsh Health Equity Solutions Platform (WHESP) animation provides an overview of the functionality of the platform, guiding the user page-by-page through each section and tool. It showcases the easy-to-use Data Tool and Report Generator, that can both be tailored to a desired area of interest to produce outputs to inform work and frame insights.

Authors: Rebecca Hill, Jo Peden+ 7 more
, Lauren Couzens (née Ellis), Mariana Dyakova, Daniela Stewart, James Allen, Golibe Ezenwugo, Anna Stielke, Kathryn Ashton

Social Return on Investment (SROI) of mental health related interventions—A scoping review

Social Return on Investment (SROI) is a methodological approach which incorporates all three aspects for evaluating interventions. Mental health problems are one of the leading causes of ill health and disability worldwide. This study aims to map existing evidence on the social value of mental health interventions that uses the SROI methodology. This scoping review is a first of its kind to focus on SROI of mental health interventions, finding a good number of SROI studies that show a positive return on investment of the identified interventions. This review illustrates that SROI could be a useful tool and source of evidence to help inform policy and funding decisions for investment in mental health and wellbeing, as it accounts for the wider social, economic, and environmental benefits of public health interventions.

Authors: Rajendra Kadel, Anna Stielke+ 3 more
, Kathryn Ashton, Rebecca Masters, Mariana Dyakova

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.

Authors: Liz Green, Kathryn Ashton+ 3 more
, Mark Bellis, Timo Clements, Margaret Douglas

Toward an economy of wellbeing: The economic impact of the Welsh healthcare sector

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.

Authors: Timotej Jagrič, Christine Brown+ 6 more
, Dušan Fister, Oliver Darlington, Kathryn Ashton, Mariana Dyakova, Mark Bellis, Vita Jagrič

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.

Authors: Liz Green, Kathryn Ashton+ 4 more
, Lee Parry-Williams, Mariana Dyakova, Timo Clemens, Mark Bellis

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.

Authors: Kathryn Ashton, Liz Green+ 4 more
, Timo Clemens, Lee Parry-Williams, Mariana Dyakova, 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

‘Health in All Policies’—A Key Driver for Health and Well-Being in a Post-COVID-19 Pandemic World

The COVID-19 pandemic has raised the profile of public health and highlighted the links between health and other policy areas. This paper describes the rationale for, and principles underpinning, HiAP mechanisms, including HIA, experiences, challenges and opportunities for the future.

Authors: Liz Green, Kathryn Ashton+ 3 more
, Mark Bellis, Timo Clemens, Margaret Douglas

Using health impact assessment (HIA) to understand the wider health and wellbeing implications of policy decisions: the COVID-19 ‘staying at home and social distancing policy’ in Wales

This paper focusses on a HIA of the ‘Staying at Home and Social Distancing Policy’ or ‘lockdown’ in response to the COVID-19 pandemic in Wales conducted by the Welsh national public health institute. It describes the process and findings, captures the learning and discusses how the process has been used to better understand the wider health and well-being impacts of policy decisions beyond direct health harm. It also examines the role of public health institutes in promoting and using HIA.

Authors: Liz Green, Kathryn Ashton+ 4 more
, Sumina Azam, Mariana Dyakova, Timo Clemens, Mark Bellis

Adult support during childhood: a retrospective study of trusted adult relationships, sources of personal adult support and their association with childhood resilience resources

Adverse childhood experiences (ACEs) can affect health and well-being across the life course. Resilience is an individual characteristic that is known to help negate the effect of adversities and potentially transform toxic stress into tolerable stress. Having access to a trusted adult during childhood is critical to helping children build resiliency. This paper aims to understand the relationship between always having access to trusted adult support and childhood resilience resources, and examine which sources of personal adult support and the number of sources of adult support, best foster childhood resilience.

Authors: Kathryn Ashton, Alisha Davies+ 4 more
, Karen Hughes, Kat Ford, Andrew Cotter-Roberts, Mark Bellis

Welsh Health Equity Status Report – WHESRi

This report aims to help inform and support a sustainable response and recovery from Coronavirus (COVID-19) in Wales, placing health equity at its heart.
It reinforces our understanding of how interdependent individual and societal well-being, and the wider economy are, towards achieving prosperity for all. The report also contributes to strengthening the leading role of Wales at the forefront of the health equity and sustainable development agenda in Europe and globally.

Authors: Mariana Dyakova, Lauren Couzens (née Ellis)+ 10 more
, James Allen, Mischa Van Eimeren, Anna Stielke, Andrew Cotter-Roberts, Rajendra Kadel, Benjamin Bainham, Kathryn Ashton, Daniela Stewart, Karen Hughes, Mark Bellis

Process, Practice and Progress: A Case Study of the Health Impact Assessment (HIA) of Brexit in Wales

In 2018, the Health impact assessment (HIA) support unit in Wales carried out a comprehensive and unique HIA on the impact of Brexit in Wales. The aims were to understand the differential impacts that Brexit would have on the health and well-being of the population and to provide evidence to inform decision makers across a range of public bodies. This paper reflects on the process of carrying out the HIA and the methods used. It discusses the stages of the HIA, and shares the findings and reflections of implementation which will be beneficial to other HIA practitioners and policy makers.

Authors: Liz Green, Kathryn Ashton+ 2 more
, Nerys Edmonds, Sumina Azam

Health Impact and Social Value of Interventions, Services, and Policies: A Methodological Discussion of Health Impact Assessment and Social Return on Investment Methodologies

Assessing the positive and negative impact of policies, services and interventions on health and well-being is of great importance to public health. Health Impact Assessment (HIA) and Social Return on Investment (SROI) are established methodologies which assess potential effects on health and well-being, including social, economic and environmental factors, indicating synergies, and cross-over in their approach. Within this paper, we explore how HIA and SROI could complement each other to capture and account for the impact and social value of an assessed intervention or policy.

Authors: Kathryn Ashton, Lee Parry-Williams+ 2 more
, Mariana Dyakova, Liz Green

How to Make the Case for Sustainable Investment in Well-being and Health Equity: A Practical Guide

Health inequities are not inevitable. Coordinated policy action on the determinants of health combined with well designed and implemented governance approaches have a dual effect on reducing the health gap and improving overall population health. This guide is the first product developed under Public Health Wales’ WHO Collaborating Centre (WHO CC) on Investment for Health and Well-being work programme and outlines four key phases on how to synthesize, translate and communicate public health economics evidence into policy and practice. The interrelated four phases guide the reader through the process of developing evidence-informed products, which are context and target audience specific. The guide aims to (i) prevent disinvestment in health; (ii) increase investment in prevention (public health); and (iii) and mainstream cross-sectoral investment to address the wider determinants of health and equity, driving sustainable development for  prosperity for all. It has been developed based on a mixed-method approach including an evidence review, interviews with national and international experts, and a multisectoral stakeholder consultation which ensured relevance and transferability across sectors, contexts, settings and countries.

Authors: Mariana Dyakova, Kathryn Ashton+ 2 more
, Anna Stielke, Mark Bellis

Driving Prosperity for All through Investing for Health and Well-being – An Evidence Informed Guide for Cross-sector Investment

This guide identifies ten key evidence-informed policy opportunities for investment in Wales. Opportunities identified in the report address areas of high burden and cost in Wales, delivering economic as well as social and environmental returns, and supporting sustainable inclusive economic growth. The guide will help decision-makers to implement the Welsh Government’s Prosperity for All national strategy.

Authors: Mariana Dyakova, Mark Bellis+ 4 more
, Sumina Azam, Kathryn Ashton, Anna Stielke, Elodie Besnier

Do emotions related to alcohol consumption differ by alcohol type? An international cross-sectional survey of emotions associated with alcohol consumption and influence on drink choice in different settings

This article examines the emotions associated with drinking different types of alcohol, whether these emotions differ by socio demographics and alcohol dependency and whether the emotions associated with different drink types influence people’s choice of drinks in different settings.

Authors: Kathryn Ashton, Mark Bellis+ 3 more
, Alisha Davies, Karen Hughes, Adam Winstock

Developing a framework for managing the night-time economy in Wales: a Health Impact Assessment approach

This case study outlines the approach of a prospective Health Impact Assessment (HIA) to re-develop an existing reactive framework for managing the night-time economy in Wales. Inclusion of a range of stakeholders in the process enabled the reformulation of realistic proactive objectives which account for both health and well-being. This article highlights the benefits of HIA and can be used to inform future policy developments.

Authors: Kathryn Ashton, Janine Roderick+ 2 more
, Lee Parry-Williams, Liz Green

A Framework for Managing the Night Time Economy in Wales

The night time economy in Wales concerns the economic activity occurring between the hours of 6pm to 6am. This encompasses a range of activities from restaurants and establishments serving food, the on and off trade sale of alcohol, music venues and clubs with dancing and entertainment, cinemas and other leisure activities.

Authors: Kathryn Ashton, Janine Roderick+ 2 more
, Lee Parry-Williams, Liz Green

Investment for health and well-being: A review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020

There are growing public health, inequality, economic and environmental challenges across the WHO European Region that require urgent and priority-focused investment if sustainable development (meeting current needs without compromising the ability of future generations to meet their needs) is to be achieved and health and well-being ensured for present and future generations.

Authors: Mariana Dyakova, Christoph Hamelmann+ 6 more
, Mark Bellis, Elodie Besnier, Charlotte Grey, Kathryn Ashton, Anna Schwappach, Christine Charles