Loneliness, social isolation and social connection

Loneliness, social isolation and social connection in Wales: A public health perspective

Loneliness and social isolation are increasingly being recognised as public health challenges. This report aims to present loneliness, social isolation and social connection in Wales from a public health perspective. Intended for professionals, policymakers and other individuals working directly or indirectly in the field of social connection, it includes data and evidence on: the prevalence of loneliness, social isolation and social connection in Wales and the population groups most affected; factors that increase the risk of loneliness and social isolation; impacts on health and well-being; evidence on solutions; examples of good practice in Wales; and key areas for future action.

Authors: Sara Wood, Carys Dale+ 1 more
, Karen Hughes

Time to Talk Public Health October 2025 Survey Findings

Time to Talk Public Health is a nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice. The panel is designed to be broadly representative of the Welsh population by age, sex, deprivation, ethnicity and health board. This report presents findings from the October 2025 survey covering: Source of Health Information, Health Policy, Health and Well-Being After Pregnancy, Ageism, and Public Health Wales.

Authors: Catherine Sharp, Karen Hughes+ 1 more
, Carys Dale
Front cover of International Health Newsletter 9: February 2026

International Health Newsletter Issue 9: February 2026

The International Health Coordination Centre’s (IHCC) International Health Newsletter promotes and shares international news, events and initiatives with partners across Wales and beyond.

The newsletter was piloted in May 2023, thereon issued quarterly.

View the latest issue here.

Authors: Laura Holt, Jo Harrington+ 5 more
, Karen Hughes, Sara Wood, Joanne C. Hopkins, Keira Charteris, Liz Green

Rapid Participatory Health Impact Assessment (HIA) of the Introduction of a National Lung Cancer Screening Programme in Wales

This HIA report was undertaken by the Lung Cancer Screening Project Team, consisting of representatives from across the NHS, which was supported by the Wales Health Impact Assessment Support Unit (WHIASU), through the facilitation of a HIA participatory workshop. The project team was established in April 2024, with the final report being published in September 2025. The rapid participatory HIA, concentrated on gathering Welsh stakeholder knowledge and insight into the proposed introduction of a national lung cancer screening programme from the perspective of both the service users and those involved with the delivery of the service.

This report gives a background to the project and to HIA itself, before looking at the Participatory HIA workshop in more detail, which was carried out in October 2024, showing what population groups were identified and the determinants of health individually, using WHIASUs Population Groups and Determinants of Health checklists. The report suggests that the National Lung Cancer Screening Programme has the potential to highly benefit the population of Wales, by identifying lung cancers early and through the integrated promotion of smoking cessation services. In addition, the report also highlights the work necessary to ensure that an accessible and equitable screening programme is delivered.

Authors: Catrin Lyddon, Jen Sharp

Safer inhalation devices: a rapid Health Impact Assessment of a harm reduction pilot for people who smoke crack cocaine

This study explores how a Health Impact Assessment (HIA) was used to evaluate a proposed harm reduction pilot programme in Wales providing safer inhalation devices (SIDs) for people who smoke crack cocaine, a group facing significant health risks and lacking targeted harm reduction services. Through stakeholder engagement, including people with lived experience, the HIA identified potential benefits such as reduced risk of infections, safer equipment use, and improved engagement with services, alongside challenges like resource pressures and access issues.

Overall, the findings highlight that an SID pilot could help reduce health inequalities and stigma, while demonstrating the value of HIA in shaping inclusive, evidence-informed public health interventions and guiding future implementation and evaluation.

Authors: Kathryn Ashton, Benjamin J. Gray+ 3 more
, Rick Lines, Daniel Harman, Liz Green
Engaging Men as Prosocial Bystanders in Nightlife Settings

Engaging Men as Prosocial Bystanders in Nightlife Settings: Behavioural Insights for Sexual Harassment Prevention

This article explores how men can be effectively supported to intervene as prosocial bystanders in incidents of sexual harassment within South Wales’ nighttime economy. Using interviews and focus groups with men aged 18–54, the research developed five behavioural “personas” that capture the diverse psychological perspectives influencing decisions to step in.

Through the COM-B model, the study identifies common barriers—particularly limited knowledge of safe intervention techniques and uncertainty around legal implications—as well as important motivational and contextual factors. The persona-based approach demonstrates that men cannot be treated as a single audience; instead, tailored strategies are needed to meet different support needs.

Authors: Emma Barton, Bryony Parry+ 1 more
, Lara Snowdon

Engaging women in health and justice research: A North Wales multi-agency approach

This social innovation narrative presents a collaborative, trauma-informed research model designed to engage women at risk of entering the criminal justice system in North Wales. The narrative draws on empirical research originally conducted by the Women’s Justice Blueprint and ACE Hub Wales, which explored women’s physical and mental health, substance use, and the barriers they face when seeking support. This narrative reframes this work through a methodological lens, illustrating how innovative, multi-agency approaches enabled deeper understanding and participation. 

By demonstrating how collaborative research infrastructures can enhance access, voice, and data quality, this narrative shows how methodological innovation can support more effective and inclusive responses to women’s health and justice. 

Authors: Connie Williams, Joanne C. Hopkins
Journal of Community Safety and Wellbeing - Building a Wales without violence

Building a Wales Without Violence: Using Behavioural Science to Implement a Public Health Approach

This social innovation narrative presents how the Violence Prevention Team and Behavioural Science Unit collaborated on the development of an implementation plan for the Wales Without Violence Framework (2023). By applying behavioural science—and specifically the COM-B model—the Violence Prevention Team worked with professionals across sectors to explore what supports and influences their ability to embed the framework’s nine principles of violence prevention into everyday practice.

The article outlines key insights into the behaviours, barriers, and facilitators identified by practitioners, and highlights how understanding capability, opportunity, and motivation can strengthen the adoption of a public-health approach across sectors. It also reflects on how this process helped the Violence Prevention Team clarify its role within the wider prevention landscape in Wales, supporting more effective coordination and resource use.

Authors: Bryony Parry, Lara Snowdon+ 5 more
, Emma Barton, Alex Walker, Joanne C. Hopkins, Alice Cline, Nicky Knowles
The front cover has the title of the report - Biodiversity and Resilience of Ecosystems Report - and a photo of a Welsh mountain landscape with heather and mountains

Biodiversity and Resilience of Ecosystems Report 2025

This report summarises the work undertaken by Public Health Wales (PHW) to support biodiversity over the last three years. Section 6 of the Environment (Wales) Act 2016 requires public authorities to ‘seek to maintain and enhance biodiversity and promote the resilience of ecosystems’ ensuring biodiversity is considered in business planning, policies, plans and projects.

Authorities are required to report on progress every three years. PHW has published reports in 2019 and 2022, and this report highlights progress made between 2023 and 2025.

Authors: Helen Bradley, Eurgain Powell

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

Planning Healthy Places: A guide for local authorities in Wales for embedding health in planning policy

This guidance aims to support those working across urban and rural local authorities in Wales to consider, include and promote health and wellbeing through Local Development Plans (LDPs) and the planning system. It provides evidence and guidance about how this can be achieved and why the links between planning and health are so important. The guide can form the basis of an evidence background paper for LDPs or supplementary planning guidance (SPG) and includes five sections.

Authors: Cheryl Williams, Sue Toner+ 1 more
, Liz Green

Urgent care components and their effectiveness: A rapid review of evidence and international insights

This report explores how different components of urgent care services can help reduce pressure on emergency departments and support patient independence. Drawing on the latest research through a systematic rapid review and international insights, it highlights best practices from across the UK and globally to inform urgent care service design in Wales. The review covers a range of urgent care service components, including:
• Task shifting strategies to optimise workforce capacity and efficiency
• Improved access to diagnostic services, such as radiology
• Smart tools like digital triage and decision-support systems for staff
• Expansion of urgent care/treatment centres for timely, appropriate care
• Virtual urgent care, including phone and video consultations for urgent advice
The findings suggest that well-designed urgent care services can deliver safer, faster, and more effective care. While further research is needed, the evidence highlights a promising opportunity to ease pressure on hospitals and ensure patients receive the right care, in the right place, at the right time.

About the review:
This work is a collaboration between the Evidence Service (Research, Data and Digital Directorate) and the International Health Insights team (Policy and International Health Directorate, WHO Collaborating Centre on Investment for Health and Wellbeing) within Public Health Wales.

Authors: Anamica Patel, Keira Charteris+ 8 more
, Kate Shiells, Laura Johnson, Helen Morgan, Hannah Shaw, Daniela Stewart, Zuwaira Hashim, Kirsty Little, Mariana Dyakova

Better Health Through Behavioural Science: An Enabling Plan for Wales

This plan describes a route map of important actions that can secure the conditions to enable the more routine and systematic use of behavioural science in services, improvement and innovation, communications, policy and systems approaches that that are aiming for better health and wellbeing.

Developed with a technical and strategic advisory group, and input from our Behavioural Science Community for Wales, the plan draws on regional and international approaches to behavioural science application in health and wellbeing, and describes how, through applying behavioural science in our work, we can get what we aim for more often, and in doing so realise a behavioural dividend that optimises our impact for better health and equity.

Authors: Ashley Gould, Jonathan West

Childhood Poverty and ACEs

This study, published in the journal BMC Public Health, examined the role of adverse childhood experiences (ACEs) and childhood poverty in life course health and prosperity.

Using a sample of 5,330 adults from five local authorities in England, the study found that ACEs were significantly related to childhood poverty. Both ACEs and childhood poverty were associated with poorer life outcomes, including for self-rated health, chronic health conditions, mental well-being, employment and income.

The findings underscore the need for investment in interventions and policies to prevent intergenerational cycles of abuse and poverty.

Authors: Mark Bellis, Karen Hughes+ 4 more
, Kat Ford, Nadia Butler, Charley Wilson, Zara Quigg

Delivering public health and well-being priorities through Local Development Plans (LDPs) in Wales

This report presents a summary of the methods and key findings of a review of how health is included in case study Local Development Plans (LDPs) in Wales and the effectiveness of LDPs in supporting the delivery of health and well-being priorities. The report is intended to inform and support the Wales Health Impact Assessment Support Unit.

Authors: Neil Harris, Andrew Ivins+ 3 more
, Matthew Wargent, Liz Green, Cheryl Williams

Winter well-being: shared actions and impact

A new report by Public Health Wales brings together the latest evidence, behavioural insights and practical tools to support health and care colleagues and services in preparing for the winter months.

The report, Winter Well-being: Shared Actions and Impact, is designed to complement existing NHS and Welsh Government winter planning frameworks. It provides actionable guidance and checklists to help teams strengthen system resilience, maintain population health, and ease demand on services.

The report also highlights the importance of prevention, including protecting against winter viruses by getting vaccinated against flu, RSV and COVID-19, staying active, eating warm meals, checking in on neighbours, and taking vitamin D daily to stay healthy through the colder months.

Authors: Ashley Gould, Kat Ford+ 7 more
, Elizabeth Augarde, Karen Hughes, Natasha Judd, Alice Cline, Molly Bellis, Carys Dale, Sumina Azam

Strengthening Health with Equitable International Partnerships: Key Learning and Best Practices

Wales has an enabling legislative and policy context for international health partnerships, illustrated by the Well-being of Future Generations Act goal of creating a ‘globally responsible Wales’.

This discussion paper explored how Welsh and international communities’ benefit from collaborative partnerships through a scoping review. The objectives were to identify current knowledge, evaluate advantages, and determine best practice.

Authors: James Rees, Joshua Yawo Malcolm+ 2 more
, Jo Peden, Zuwaira Hashim
Welsh Health Equity Solutions Platform - acronym WHESP

Tackling Child Poverty: A Scottish Policy Model

Child Poverty rates in the UK have worsened in recent years, exacerbated by the cost-of-living crisis.

Scotland is the only nation in the UK where average year-on-year poverty rates are improving, with progress being underpinned by strategies that incorporate income, employment, and social protection, supported by targeted policy and investment.

This spotlight feature explores Scotland’s approach to solution-based action, combining policy, investment, and a public health perspective. Its experience offers valuable lessons for Wales and other countries.

Authors: Lewis Brace

Time to Talk Public Health – June 2025 Survey Findings

Time to Talk Public Health is a nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice. The panel is designed to be broadly representative of the Welsh population by age, sex, deprivation, ethnicity and health board. This report presents findings from the June 2025 Survey covering: Type 2 diabetes, use of gloves in healthcare settings, incontinence, dental health, climate change and public health policy.

Authors: Catherine Sharp, Karen Hughes+ 1 more
, Carys Dale
Factors associated with childhood out-of-home care entry and re-entry in high income countries A systematic review of reviews

Factors associated with childhood out-of-home care entry and re-entry in high income countries: A systematic review of reviews

Out-of-home care placements can profoundly impact children, families, and society. This systematic review synthesises findings from existing reviews on factors associated with entry and re-entry into out-of-home care.

The evidence highlights key factors associated with out-of-home care entry, including child-level factors (ethnicity, health, behaviour), family-level factors (parental socioeconomic adversities, substance use), community-level factors (neighbourhood conditions), and system-level factors (prior child welfare involvement). The review also identifies several factors associated with children remaining with their birth families and not entering out-of-home care.

Factors associated with childhood out-of-home care entry are multi-faceted and complex. There is opportunity for policymakers and practitioners to adopt preventative and holistic interventions to promote the wellbeing and stability of children and families.

Authors: Richmond Opoku, Natasha Judd+ 10 more
, Katie Cresswell, Michael Parker, Michaela James, Jonathan Scourfield, Karen Hughes, Jane Noyes, Dan Bristow, Evangelos Kontopantelis, Sinead Brophy, Natasha Kennedy

Comparative relationships between physical and verbal abuse of children, life course mental well-being and trends in exposure: a multi-study secondary analysis of cross-sectional surveys in England and Wales

This study examined relationships between physical and verbal abuse in childhood and adult mental well-being. The study, published in the journal BMJ Open, used data from surveys conducted in Wales and England between 2012 and 2024. It found that childhood verbal abuse was associated with similar increases in risk of low mental well-being as childhood physical abuse. The study also measured trends in self-reported physical and verbal abuse across birth cohorts.

Authors: Mark Bellis, Karen Hughes+ 4 more
, Kat Ford, Zara Quigg, Nadia Butler, Charley Wilson

Shaping the future of healthy housing for children and families in Wales: A summary of stakeholder engagement

Our homes can significantly shape our physical and mental health and well-being.
This paper sets out the work that Public Health Wales has conducted alongside other housing stakeholders to envision a future of healthier of homes, especially for those living in poverty. It summarises insights drawn from stakeholder conversations and a futures-focused workshop, held in November 2024.
This work builds on two previous reports from Public Health Wales – an overarching report, homes for health and well-being, and a second on affordability. Here we go further and shine a light on housing quality, affordability, and security, and the impact this has particularly on the well-being of children and families.

Authors: Joe Rees, Menna Thomas

Health in Planning: The role of health in Local Development Plans in Wales

The planning system in Wales operates at three levels: national, regional, and local. Local Development Plans (LDPs) guide land use and development at the local authority level. This report, commissioned by Public Health Wales, Wales Health Impact Assessment Support Unit (WHIASU), presents a summary review of how health is included in Local Development Plans (LDPs) across Wales. The primary aim of this report is to inform WHIASU’s approach to supporting local governments in integrating health considerations into LDPs. The findings will also add value for other stakeholders working to improve health and wellbeing as it highlights opportunities for strengthening the inclusion of health in local plans. The review of Local Development Plans across Wales revealed several opportunities to strengthen their role in promoting population health and reducing health inequities. Currently, most LDPs address health-related factors indirectly through planning policies such as housing, transportation, and environmental quality. Few plans explicitly define health or health inequalities, and none include specific health indicators or measures. While all LDPs incorporate elements that influence social determinants of health, such as access to services and quality of housing, these connections to health outcomes are often implicit rather than clearly articulated. Our analysis found that LDPs already contain many elements that can support population health and wellbeing. By making these health implications explicit, defining key health concepts clearly, and incorporating measurable health indicators, LDPs could more effectively advance their potential to improve health outcomes and reduce health inequities across Welsh communities.

Authors: Fiona Haigh, Amber Murphy+ 3 more
, Jinhee Kim, Liz Green, Cheryl Williams