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

Maximising opportunities for health and wellbeing for people and communities experiencing socio-economic disadvantage: A guide to using the Socio-economic Duty in policy and practice in Wales

Achieving a More Equal Wales is one of the seven goals set out in the Well-being of Future Generations (Wales) Act 2015. The act provides public sector bodies in Wales with the five ways of working that will support us to make better decisions today for a More Equal Wales tomorrow. The Welsh Government’s Socio-economic Duty came into force in 2021 and aims to deliver better outcomes for those who experience socio-economic disadvantage.
The aim of this Guide is to help public bodies in Wales apply the Socio-economic Duty so that it can act as a powerful lever to improve the health outcomes for people and communities who experience socio-economic disadvantage. Public bodies have an opportunity to embed the Duty into their systems and approaches to ensure that the Duty makes a systematic difference and is not just a tick-box exercise.
An accompanying animation is also available via the links below.

Authors: Sara Elias, Lewis Brace+ 1 more
, Jo Peden

Is parental unemployment associated with increased risk of adverse childhood experiences? A systematic review and meta-analysis

Unemployment has adverse consequences for families and can put children at risk of harm. This review examines associations between parental unemployment and adverse childhood experiences (ACEs). Findings highlight that increasing employment opportunities and parental support interventions may help break multigenerational cycles of ACEs.

Authors: Natasha Judd, Karen Hughes+ 3 more
, Mark Bellis, Katie Hardcastle, Rebekah Amos

International Horizon Scanning and Learning Summary Calendar 2022/23

This International Horizon Scanning and Learning Summary Calendar is the third in the series, following the Summary Calendars from 2020/21 and 2021/22. This Summary Calendar has collated, synthesised, and presented a clear and concise synopsis of the five International Horizon Scanning Reports over the past year, since April 2022 through to March 2023. In addition, the two summary reports (published in 2022) are included. The International Horizon Scanning and Learning work stream has proved to showcase informative and impactful research whilst collating data from other countries and has provided guidance, recommendations, and useful insights regarding the evolving nature and uncertainties of emerging public health topics, which has sought to improve and inform such actions and approaches in Wales.

The summary aims to inform a succinct overview of comprehensive, coherent, inclusive and evidence-informed policy action, which has supported and continues to support the national strategies towards a healthier, more equal, resilient, prosperous and globally responsible Wales. This calendar includes key messages and key recommendations from the high level synthesis pages of each International Horizon Scanning report.

Themes include:
• Intermediate care
• The cost of living crisis
• COVID-proofing the educational environment: 4-18 years
• Early childhood education and care
• Communication campaigns for vaccine acceptance
• The impact of COVID-19 on mental health and increasing vulnerability
• The impact of COVID-19 on increasing the health gap and vulnerability

Authors: Mariana Dyakova, Emily Clark+ 14 more
, Andrew Cotter-Roberts, Abigail Malcolm (née Instone), Golibe Ezenwugo, Leah Silva, Anna Stielke, Sara Cooklin-Urbano, Lauren Couzens (née Ellis), James Allen, Aimee Challenger, Claire Beynon, Mark Bellis, Mischa Van Eimeren, Angie Kirby, Benjamin Bainham

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.

Authors: Liz Green, Mariana Dyakova+ 2 more
, Laura Holt, Kit Chalmers

Time to Talk Public Health: February – March 2023 Panel Survey Findings

Time to Talk Public Health is a new nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice. This report presents findings from the February – March 2023 survey, covering issues including screening, sustainability, campaigns and current concerns. The following topics were also asked in the survey: food environments, healthy weight and Healthy Weight Healthy You campaign, however, their findings will be reported internally initially and published at a later date.

Authors: Catherine Sharp, Karen Hughes

Wales Without Violence: A Shared Framework for Preventing Violence among Children and Young People

Preventing violence among children and young people requires collective and coordinated action.

The Wales Without Violence Framework outlines the key elements needed to successfully develop primary prevention and early intervention strategies to end violence among children and young people through a public health, whole-system approach.

Authors: Alex Walker, Bryony Parry+ 2 more
, Emma Barton, Lara Snowdon

Comparing relationships between single types of adverse childhood experiences and health related outcomes across the life course: a combined primary data study of eight surveys

Adverse childhood experiences (ACEs) show strong cumulative associations with ill-health across the life course. Harms can arise even in those exposed to a single ACE type but few studies examine such exposure. For individuals experiencing a single ACE type, we examine which ACEs are most strongly related to different health harms.

Authors: Mark Bellis, Karen Hughes+ 2 more
, Katie Cresswell, Kat Ford

International Horizon Scanning and Learning Report: Communication campaigns for vaccine acceptance

The International Horizon Scanning and Learning reports were initiated as part of the COVID-19 public health response, to support dynamic response and recovery measures and planning in Wales. In spring 2022, the scope of the reports was expanded to cover priority public health topics, including in the areas of health improvement and promotion, health protection, and health care public health.

In focus: Communication campaigns for vaccine acceptance

Authors: Abigail Malcolm (née Instone), Leah Silva+ 6 more
, Lauren Couzens (née Ellis), Golibe Ezenwugo, Sara Cooklin-Urbano, Aimee Challenger, Emily Clark, Mariana Dyakova

Tackling Adverse Childhood Experiences (ACEs) State of the Art and Options for Action

This new report brings together what is known about ACEs across Europe and internationally, showing the on-going toxic impact that ACEs can have across the life course and how ACEs and their consequences can be prevented. The report supports the development of a trauma-informed society that is invested in action to prevent ACEs and better support those affected by them.

Authors: Sara Wood, Mark Bellis+ 3 more
, Karen Hughes, Zara Quigg, Nadia Butler

Time to Talk Public Health: January 2023 Panel Survey Findings

Time to Talk Public Health is a new nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice.
This month’s survey covered mental well-being, vaccines, risk-taking behaviour and health inequalities.

Authors: Catherine Sharp, Karen Hughes

Gambling Health Needs Assessment for Wales

This health needs assessment aims to review the needs of people experiencing harms from gambling to inform a public health approach to reducing gambling harm in Wales. It includes the epidemiology of harmful gambling, a summary of the evidence base around preventative and treatment interventions, a summary of existing services, and themes identified from qualitative research, which explored in detail the views of people with lived experiences of harmful gambling, service providers and stakeholders.

Authors: Annie Ashman, Claire Beynon

Time to Talk Public Health: Panel Recruitment Survey

Time to Talk Public Health is a new nationally representative panel of Welsh residents established by Public Health Wales to enable regular public engagement to inform public health policy and practice.
This report presents the demographics of the 2,000 panel members recruited during the first stage of the project. Findings from the initial recruitment survey, focusing on cost of living, coronavirus and priorities for Public Health Wales, are also reported.

Authors: Catherine Sharp, Karen Hughes

Be the Change – Procurement that doesn’t cost the earth

Procurement is costly. Welsh public sector spends £7 billion on procurement. A huge 62% of the 2018/19 carbon footprint for NHS Wales was from procurement.
Sustainable procurement can mean considering not buying things at all, buying energy and resource efficient goods, ethical goods such as Fairtrade coffee, or locally sourced products and services which support local businesses. It can also support the delivery of organisational priorities and well-being objectives, and ultimately improve the economic, environmental, social, and cultural well-being of Wales.
The e-guide gives advice for anyone buying goods and services on ways we can take action by thinking about what we need, where it comes from, how long it will last and the impact it has on people, nature and planet.

Authors: Tracy Evans, Eurgain Powell

Biodiversity and Resilience of Ecosystems Duty Report 2022

The first Public Health Wales’ ‘Biodiversity Duty report’ was published in 2019, in response to the enhanced biodiversity and resilience of ecosystems duty under Section 6 of the Environment (Wales) Act 2016. The duty requires public authorities to “maintain and enhance biodiversity (so far as is consistent with the proper exercise of their functions) and in doing so promote the resilience of ecosystems”.
In 2023 we have published an updated Biodiversity and Resilience of Ecosystems Duty Report outlining the steps Public Health Wales is taking to promote biodiversity, highlighting progress made between 2019 and 2022 including against actions identified in our Biodiversity Action Plan, Making Space for Nature.

Authors: Eurgain Powell

International Horizon Scanning and Learning Report: Early childhood education and care

The International Horizon Scanning and Learning reports were initiated as part of the COVID-19 public health response, to support dynamic response and recovery measures and planning in Wales. In spring 2022, the scope of the reports was expanded to cover priority public health topics, including in the areas of health improvement and promotion, health protection, and health care public health.

In focus: Early childhood education and care

Authors: Abigail Malcolm (née Instone), Leah Silva+ 5 more
, Lauren Couzens (née Ellis), Golibe Ezenwugo, Sara Cooklin-Urbano, Emily Clark, Mariana Dyakova

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

Cold homes and their association with health and well-being: a systematic literature review

As part of a wider project to determine whether current indoor temperature standards for households in Wales are optimal for people’s comfort, health, and well-being, this review aims to identify and appraise the current evidence on the association between cold homes and health and well-being.

Authors: Hayley Janssen, Ben Gascoyne+ 4 more
, Kat Ford, Rebecca Hill, Manon Roberts, Sumina Azam

Associations between Adverse Childhood Experiences (ACEs) and Lifetime Experience of Car Crashes and Burns: A Cross-Sectional Study

Using a UK general population sample, this study has identified relationships between exposure to ACEs and lifetime experience of car crashes and burns; two major markers of unintentional injury. Findings highlight the need for effective interventions to prevent ACEs and reduce their impacts on health and well-being. A better understanding of the relationships between ACEs and unintentional injury, and the mechanisms that link childhood adversity to injury risks, can benefit the development of multifaceted approaches to injury prevention.

Authors: Kat Ford, Karen Hughes+ 3 more
, Katie Cresswell, Nel Griffith, Mark Bellis

Responding to the climate crisis: applying behavioural science

The climate crisis presents a persistent and growing environmental burden of disease with significant public health consequences. Addressing the crisis via mitigation and adaptation methods requires changing our behaviour. This guide is for professionals/practitioners working on policy, services or communications to tackle the climate crisis, offering useful tips on incorporating behavioural insights and increasing the likelihood of a change in behaviour being adopted.

Authors: Oliver Williams, Ashley Gould

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

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

Improving health and wellbeing: A guide to using behavioural science in policy and practice

This guide for practitioners and policy makers provides a brief introduction to behavioural science and a step-by-step process for developing behaviour change interventions – whether policy, service or communications. It’s designed to support topic-matter experts to optimise their interventions – helping to ensure we more often ‘get what we aim for’. Improving health and wellbeing: a guide to using behavioural science in policy and practice

Authors: Robert West, Ashley Gould