Welsh Health Equity Solutions Platform - acronym WHESP

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.

Authors: Rebecca Hill, Jo Peden+ 12 more
, Lauren Couzens (née Ellis), Mariana Dyakova, Daniela Stewart, James Allen, Liz Green, Rebecca Masters, Leah Silva, Sara Cooklin-Urbano, Golibe Ezenwugo, Abigail Malcolm (née Instone), Jason Roberts, Rajendra Kadel

Understanding health inequalities in Wales using the Blinder-Oaxaca decomposition method

Throughout Wales and the world, health inequality remains a problem that is interconnected with a wider and complex social, economic and environmental dynamic. Subsequently, action to tackle inequality in health needs to take place at a structural level, acknowledging the constraints affecting an individual’s (or community’s) capability and opportunity to enable change. While the ‘social determinants of health’ is an established concept, fully understanding the composition of the health gap is dependent on capturing the relative contributions of a myriad of social, economic and environmental factors within a quantitative analysis. The decomposition analysis sought to explain the differences in the prevalence of these outcomes in groups stratified by their ability to save at least £10 a month, whether they were in material deprivation, and the presence of a limiting long-standing illness, disability of infirmity. The analysis not only quantified the significant health gaps that existed in the years leading up to the COVID-19 pandemic, but it has also shown what determinants of health were most influential. Understanding the factors most closely associated with disparities in health is key in identifying policy levers to reduce health inequalities and improve the health and well-being across populations.

Authors: James Allen, Andrew Cotter-Roberts+ 4 more
, Oliver Darlington, Mariana Dyakova, Rebecca Masters, Luke Munford

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

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

Cost of health inequality to the NHS in Wales

There are wide inequalities in health and healthcare use between people living in more deprived neighborhoods and those living in less deprived neighborhoods in Wales. Tackling health inequality through a combination of health promotion and early intervention policies targeted toward deprived communities could yield substantial improvement in health and wellbeing, as well as savings for the Welsh NHS.

Authors: Rajendra Kadel, James Allen+ 8 more
, Oliver Darlington, Rebecca Masters, Brendan Collins, Joanna M. Charles, Miqdad Asaria, Mariana Dyakova, Mark Bellis, Richard Cookson

Influencing the Health Gap in Wales: Decomposition analysis discussion paper

The aim of this discussion paper is to help inform further policy action and potential solutions in order to reduce the health gap in Wales and beyond.
It provides a snapshot of the health inequalities experienced by different population groups in the years leading up to the Coronavirus (COVID-19) pandemic, applying an innovative statistical methodology, a ‘Decomposition analysis’.

The paper attempts to quantify the health gap in Wales, as well as to provide a better understanding of its main drivers across the five essential conditions for healthy prosperous lives for all, using a novel World Health Organization framework. It uses three measures of self-reported health: 1) the prevalence of fair/poor health; 2) the prevalence of low mental well-being; and 3) the prevalence of low life satisfaction, comparing these between:
• Those who are able to make a saving of at least £10/month and those who are not;
• Those who report being in material deprivation and those who do not; and
• Those who report a limiting longstanding illness, disability or infirmity and those who do not.

The analysis has generated an insight into the drivers of health inequities, identifying those which contribute the most, namely ‘Social and Human Capital’ and ‘Income Security and Social Protection’; while ‘Health Services’ has accounted the least. However, systematic differences are able to explain less than half (<50%) of the health gaps for the majority of the health outcomes, based on the statistical models.

The paper highlights the need for a basket of policy and investment decisions, prioritising the key drivers of health inequity, in consensus across sectors. Further exploration and engagement with experts, stakeholders, relevant groups and communities is essential to improve understanding of the health equity gap and its drivers.

It hopes to inform the following national and international stakeholders:
• Public health professionals
• Public policy makers and budget holders on national and local levels
• Statisticians, health scientists and data analysts
• All those who have a role in influencing the health equity gap in Wales and further afield

Authors: James Allen, Mariana Dyakova+ 4 more
, Andrew Cotter-Roberts, Oliver Darlington, Rebecca Masters, Mark Bellis

Cost of Health Inequality to the NHS in Wales. Report 1: Cost Associated with Inequality in Hospital Service Utilisation

This report aims to estimate the financial cost associated with inequality in hospital service utilisation to the NHS in Wales to help inform decision-making and resource prioritisation towards prevention and early intervention through an equity lens, contributing to COVID-19 sustainable and inclusive recovery.
The report is accompanied by an interactive dashboard, allowing users to explore in detail, the costs associated with inequality by service category, sex, age and level of deprivation.
Please note, the dashboard is optimised for use on desktop devices.

Authors: Rajendra Kadel, Oliver Darlington+ 5 more
, James Allen, Benjamin Bainham, Rebecca Masters, Mariana Dyakova, Mark Bellis