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Health Economics

Overview

Health inequities have significant social and economic costs to individuals and societies. In Wales, the Socio-economic Duty highlights the Welsh Government’s commitment to safeguarding equality and human rights, and places tackling inequality at the heart of decision-making.

Reducing health inequalities is an important policy objective, from a social justice perspective. An economic argument can potentially add weight to the objective of reducing health inequalities.

Health economics is about using resources efficiently to improve the population’s health. It focuses on equity, efficiency, effectiveness, values and behaviours for the allocation of healthcare resources to meet the health needs of the population it serves.

Economic evaluation compares the costs and consequences of alternative courses of action and provides evidence to inform decisions on how to allocate limited healthcare provision. Decisions on the allocation of resources need to be made in such a way that achieves effective and equitable outcomes and value for money.

There is growing economic evidence underpinning public health interventions. Evidence suggests that local and national public health interventions are highly cost-saving, and that cuts to public health budgets in high income countries are likely to generate billions of pounds of additional costs to health services and the wider economy.

The Five Essential Conditions

This section contains examples of resources on the nature and impacts of health inequalities, linking to the Five Essential Conditions for health. These resources include:

  • An interactive dashboard
  • Reports
  • Guides
  • Research articles

Stay up to date. The Welsh Health Equity Solutions Platform is continuously updated with the latest resources and materials, including data, policies, reports and case studies. Contact us to be notified of updates to the Solutions Platform.

Get in touch to get involved. We are working with stakeholders and users to update and expand the Solutions Platform with projects, case studies and spotlight features focused on health equity. Contact us to share your projects and success stories, to feature on the platform.

Health and Health Services

Resources

REPORT

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

This report by Public Health Wales estimates 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.

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


GUIDE

Cost of Health Inequality to the NHS in Wales: Interactive Dashboard

This interactive dashboard by Public Health Wales accompanies the ‘Cost of health inequality to the NHS in Wales’ report. The dashboard allows users to select how the data are displayed and to select outcomes and healthcare settings of interest.

Cost of Health Inequality to the NHS in Wales: Interactive Dashboard


REPORT COVID

Economic Consequences of COVID-19 Pandemic Outbreak on Health Indicators and Health Service Use in Wales: Longstanding Illness Projection 2020/21 – 2022/23

This report by Public Health Wales forecasts the potential economic consequences of COVID-19 on Longstanding Illness (LSI), taking into account the relationship between change in unemployment rate and LSI.

Economic Consequences of COVID-19 Pandemic Outbreak on Health Indicators and Health Service Use in Wales: Longstanding Illness Projection 2020/21 – 2022/23


REPORT

Our Programme for Transforming and Modernising Planned Care and Reducing Waiting Lists in Wales

This plan by Welsh Government sets out four clear commitments to people in Wales to help them access the health advice and services they need. These are to: increase health service capacity; prioritise diagnosis and treatment; transform the provision of planned care; and provide better information and support to patients.

Our Programme for Transforming and Modernising Planned Care and Reducing Waiting Lists in Wales


REPORT

What’s next? Key issues for the Sixth Senedd

This report by the Welsh Parliament Senedd Research explores the challenging social, economic and public policy issues of the day in Wales, including hospital waiting times and the backlog in ‘routine’ healthcare created by COVID-19.

What’s next? Key Issues for the Sixth Senedd


REPORT

The Costs and Consequences of Violence to the Healthcare System in Wales

This report by Liverpool John Moores University identifies and measures the costs of violence to the healthcare system in Wales, using cost-of-illness (COI) methods. It concludes that violence imposes a large economic burden on the healthcare system in Wales, with an estimated £46.6 million spent on addressing the short-term consequences of violence in 2018/19.

The Costs and Consequences of Violence to the Healthcare System in Wales


GUIDE

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

This practical guide by Public Health Wales outlines a step-by-step process of how to synthesise, translate and communicate public health and health economics evidence into policy and practice, making the case for sustainable investment in well-being and health equity. The guide argues that population health is an economic asset and a productive good. It is intended to help key stakeholders, advocates for health and equity, civil servants and other health and non-health professionals who have a role in informing, influencing or shaping national and subnational policy and practice.

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


GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investment in the health sector, a life-course approach to health and social care, and early access to mental health services. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


ARTICLE

Return on Investment of Public Health Interventions: A Systematic Review

This systematic review explores the return on investment (ROI) of public health interventions delivered in high income countries with universal healthcare, including ROIs in relation to healthcare public health interventions (e.g. disease management or medication adherence for high-risk patients) and health protection and health promotion interventions, as well as wider determinants and legislative interventions.

Return on Investment of Public Health Interventions: A Systematic Review


PAPER

The Relationship Between Social Care Resources and Healthcare Utilisation by Older People in England: An Exploratory Investigation

The aim of this report is to provide an overview and informed critique of models that have been used in the UK and internationally to project healthcare demand, and assess their applicability for different projection scenarios. We provide a comparison of the projection approaches and highlight their benefits and limitations, as well as their suitability depending on research objectives and use.

The Relationship Between Social Care Resources and Healthcare Utilisation by Older People in England: An Exploratory Investigation


PAPER

Is an Ounce of Prevention Worth a Pound of Cure? Estimates of the Impact of English Public Health Grant on Mortality and Morbidity

In this paper, researchers examined the availability of a funding formula for the public health grant to investigate the relationship between such expenditure and mortality. Most previous attempts to estimate the marginal productivity of English health care expenditure have employed instruments that rely on statistical tests alone for their justification. A new approach to instrumentation has proposed the use of ‘funding rule’ variables as instruments, which can be justified on theoretical grounds. Although there have been many studies of the impact of specific health promotion activities on outcomes, there have been no successful attempts to relate English public health expenditure to mortality. Moreover, by converting healthcare (treatment) expenditure to a local authority geography, it is possible to estimate an outcome specification that includes both treatment (healthcare) and prevention (public health) expenditure. Consequently, it is possible to identify the relative contribution of both types of expenditure to reductions in mortality.

Is an ounce of prevention worth a pound of cure? Estimates of the impact of English public health grant on mortality and morbidity


PAPER

Approaches to Projecting Future Healthcare Demand

Since 2010, adult social care spending has fallen significantly in real terms whilst demand has risen. Reductions in local authority budgets are expected to have had spill over effects on the demand for healthcare in the English NHS. The study explores the effects of changes in local authority social care resources on older people in terms of healthcare utilisation and the use of NHS Continuing Care (NHS CHC). The paper contributes to a growing literature exploring the interdependencies between social care and healthcare.

Approaches to Projecting Future Healthcare Demand


LEAFLET

Sustainable Investment in Population Health and Well-being: Towards a Value-Based Public Health

The World Health Organization (WHO) Collaborating Centre on Investment for Health and Well-being (WHO CC) at Public Health Wales is progressing a pioneering programme of work, applying a Social Value approach towards building a ‘Value-Based Public Health’ and an Economy of Wellbeing in Wales.

Sustainable Investment in Population Health and Well-being: Towards a Value-Based Public Health


ARTICLE

Toward an Economy of Well-being: The Economic Impact of the Welsh Healthcare Sector

Population health and well-being 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.

Toward an Economy of Well-being: The Economic Impact of the Welsh Healthcare Sector


Health and Income Security and Social Protection

Resources

PEER REVIEWED ARTICLE

Social security cuts and life expectancy: a longitudinal analysis of local authorities in England, Scotland and Wales

This study investigated the correlation between the full implementation of the UK Government's 'welfare reform' program reductions in social security payments by 2016 and life expectancy across local authorities in England, Scotland, and Wales.

Social security cuts and life expectancy: a longitudinal analysis of local authorities in England, Scotland and Wales


PEER REVIEWED ARTICLE

Population mortality impacts of the rising cost of living in Scotland: scenario modelling study

This study used scenario modelling to examine the effects of recent inflation on household incomes in Scotland. It assessed the efficacy of mitigation measures and explored the impact on mortality outcomes and associated inequalities in the evolving economic context. The analysis compared outcomes under recent inflation without intervention to a scenario with inflation mitigated by UK Government support policies. 

Population mortality impacts of the rising cost of living in Scotland: scenario modelling study


PEER REVIEWED ARTICLE

Is austerity a cause of slower improvements in mortality in high-income countries? A panel analysis

This study investigates the impact of austerity measures on mortality trends in 37 high-income countries from 2000 to 2019, considering various economic indicators. The research aims to discern the association between austerity policies implemented after the 2007–08 financial crisis and the slowed rate of mortality improvement observed in many high-income countries since 2010.

Is austerity a cause of slower improvements in mortality in high-income countries? A panel analysis


PEER REVIEWED ARTICLE

Knowing the goal: an inclusive economy that can address the public health challenges of our time

This article is a rapid review of grey and peer-reviewed literature to identify the attributes of an inclusive economy to enable public health professionals to influence an inclusive economic recovery.

Knowing the goal: an inclusive economy that can address the public health challenges of our time


PEER REVIEWED ARTICLE

How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis

This study synthesised evidence from studies measuring the impact of changes in individual and household income on mental health and wellbeing outcomes in working-age adults (aged 16–64 years).

How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis


PEER REVIEWED ARTICLE

The Geneva Charter—Realising the potential of a well-being society

This article presents the   Geneva Charter for Well-being and discusses the well-being concepts and ideas, relevant to policy-making. It also presents four case studies bridging the concepts with policy and political realities

The Geneva Charter—Realising the potential of a well-being society


PEER REVIEWED ARTICLE

How to measure progress towards a wellbeing economy: distinguishing genuine advances from ‘window dressing’

This article examined approaches by which to measure wellbeing economy for nations and proposed a series of criteria by which judgement can be made on whether progress towards a wellbeing economy is occurring. 

How to measure progress towards a wellbeing economy: distinguishing genuine advances from ‘window dressing’


REPORT

A Taxing Issue? The Tax System and Healthier Lifestyles in Wales

This report by Public Health Wales focuses on contemporary population health concerns related to diets where taxation has been considered or implemented elsewhere, and/or is a viable innovation within the Welsh context. It aims to increase knowledge and understanding of the range of taxation options available to promote health and influence change in unhealthy behaviours; and to provide Welsh policy makers with current health evidence related to these options, detailing why fiscal measures are a mechanism for improving health.

A Taxing Issue? The Tax System and Healthier Lifestyles in Wales


REPORT

The Health and Well-being Impact of Regional Funding in Wales: Working Towards more Resilient, Equal and Prosperous Communities

This report by Public Health Wales focuses on the health and well-being impact of the loss of European Union (EU) Structural Funds and the risks and opportunities presented by a replacement scheme. It aims to inform national, regional and local decision makers in Wales, particularly those involved in the allocation and management of future regional funding schemes. The report contains key insights on the current importance of the EU Structural Funds for the health and well-being of local areas with a focus on different population groups. It discusses the potential impact on health and well-being once EU funding ceases and identifies priority areas for future regional funding.

The Health and Well-being Impact of Regional Funding in Wales: Working Towards more Resilient, Equal and Prosperous Communities


REPORT COVID

What’s next? Key issues for the Sixth Senedd

This report by the Welsh Parliament Senedd Research explores the challenging social, economic and public policy issues of the day in Wales, including poverty and supporting low-income households and the impact of the COVID-19 pandemic on low-income households. It also includes a look at public finance including the pressures facing local government, a focus on taxation, and trends in Welsh budgets over the previous Senedd and Wales’ funding framework.

What’s next? Key issues for the Sixth Senedd


GUIDE

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

This practical guide by Public Health Wales outlines a step-by-step process of how to synthesise, translate and communicate public health and health economics evidence into policy and practice, making the case for sustainable investment in well-being and health equity. The guide argues that population health is an economic asset and a productive good. It is intended to help key stakeholders, advocates for health and equity, civil servants and other health and non-health professionals who have a role in informing, influencing or shaping national and subnational policy and practice.

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


GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in universal social protection. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


ARTICLE

Economic Influences on Population Health in the United States: Toward Policymaking Driven by Data and Evidence

This review explores the influence of economic factors on population health in the United States. The review concludes that there is growing evidence to suggest that fading economic opportunities and rising economic insecurity have played an important role in the deteriorating health outcomes and rising mortality rates experienced by working-age individuals. It also suggests that policymakers need to consider and rigorously evaluate new approaches, such as basic income grants or job guarantee programs.

Economic Influences on Population Health in the United States: Toward Policymaking Driven by Data and Evidence


REPORT COVID

Modelling the Impact of COVID-19 on the UK Economy: An Application of a Disaggregated New-Keynesian Model

This report by the National Institute of Economic and Social Research sets out a framework that can be used to evaluate policies intended to mitigate the economic effects of Covid-19. The report shows that policies such as the furlough scheme can prevent the sharp rises in unemployment that might arise in the absence of the scheme, and illustrate how such policies can be evaluated using the framework.

Modelling the Impact of COVID-19 on the UK Economy: An Application of a Disaggregated New-Keynesian Model


REPORT

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.

Social Return on Investment (SROI) of Mental Health Related Interventions: A Scoping Review


REPORT

The Cost-of-Living Crisis: Implications for Public Health and the Identification of Solutions report

The report summarises learning from the World Health Organization (WHO) All-Regions for Health Network (RHN) webinar facilitated by the WHO Collaborating Centre at Public Health Wales on the 21st of September 2022.

The Cost-of-Living Crisis: Implications for Public Health and the Identification of Solutions report


Health and Living Conditions

Resources

REPORT

What’s Next? Key Issues for the Sixth Senedd

This report by the Welsh Parliament Senedd Research explores the challenging social, economic and public policy issues of the day in Wales, including the challenge of ending homelessness and issues of public transport, farming and nature.

What’s Next? Key Issues for the Sixth Senedd


REPORT

The Costs and Consequences of Violence to the Healthcare System in Wales

This report by Liverpool John Moores University identifies and measures the costs of violence to the healthcare system in Wales, using cost-of-illness (COI) methods. It concludes that violence imposes a large economic burden on the healthcare system in Wales, with an estimated £46.6 million spent on addressing the short-term consequences of violence in 2018/19.

The Costs and Consequences of Violence to the Healthcare System in Wales


REPORT

Gambling as a Public Health Issue in Wales

This report by Bangor University and Public Health Wales explores the financial, health and social impacts of gambling, which groups are more vulnerable to gambling harms, and what can be done to prevent gambling harms in Wales.

Gambling as a Public Health Issue in Wales


REPORT

Gambling-related Harms Evidence Review: The Economic and Social Cost of Harms

This report by Public Health England estimated the excess direct cost to government and the excess cost to wider society associated with at-risk and problem gamblers in England.

Gambling-related Harms Evidence Review: The Economic and Social Cost of Harms


GUIDE

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

This practical guide by Public Health Wales outlines a step-by-step process of how to synthesise, translate and communicate public health and health economics evidence into policy and practice, making the case for sustainable investment in well-being and health equity. The guide argues that population health is an economic asset and a productive good. It is intended to help key stakeholders, advocates for health and equity, civil servants and other health and non-health professionals who have a role in informing, influencing or shaping national and subnational policy and practice.

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


GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in universal social protection. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


REPORT

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.

Circular Economies and Sustainable Health and Well-being


Social and Human Capital

Resources

PEER REVIEWED ARTICLE

Economic relationships and health inequalities: improving public health recommendations

This article recognizes the economic relationships between social groups that face health inequalities. This article particularly looks at rent, interest, capital gains, profit, monopoly and speculation and their impact on health inequalities. 

Economic relationships and health inequalities: improving public health recommendations


GUIDE

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

This practical guide by Public Health Wales outlines a step-by-step process of how to synthesise, translate and communicate public health and health economics evidence into policy and practice, making the case for sustainable investment in well-being and health equity. The guide argues that population health is an economic asset and a productive good. It is intended to help key stakeholders, advocates for health and equity, civil servants and other health and non-health professionals who have a role in informing, influencing or shaping national and subnational policy and practice.

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


GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in quality early education and care, life-long learning opportunities and job training and supporting adult learning and health literacy. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


REPORT

The Health and Well-being Impact of Regional Funding in Wales

This report focuses specifically on the health and well-being impact of the loss of European Union (EU) Structural Funds and the risks and opportunities presented by a replacement scheme. It aims to inform national, regional and local decision makers in Wales, particularly those involved in the allocation and management of future regional funding schemes. The report contains key insights on the current importance of the EU Structural Funds for the health and well-being of local areas with a focus on different population groups.

The Health and Well-being Impact of Regional Funding in Wales


ARTICLE

Cost of health inequality to the NHS in Wales

There are wide inequalities in health and healthcare use between people living in more deprived neighbourhoods and those living in less deprived neighbourhoods 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.

Cost of health inequality to the NHS in Wales


Health and Employment and Working Conditions

Resources

REPORT

What’s next? Key issues for the Sixth Senedd

This report by the Welsh Parliament Senedd Research explores the challenging social, economic and public policy issues of the day in Wales, including issues of employment, furlough, productivity and the number of claimants in Wales. It also explores opportunities to support the recovery of sectors disproportionately impacted by the COVID-19 pandemic and change how the Welsh economy works.

What’s next? Key issues for the Sixth Senedd


REPORT

Wellness in work: The economic arguments for investing in the health and wellbeing of the workforce in Wales

This report by Bangor University brings together evidence of the economic case for investing in the health and wellbeing of the workforce in Wales. The report highlights the high cost of productivity losses in Wales due to addiction and health harming habits and its impact on employment, and suggests that workplace interventions to prevent ill health can generate a positive return on investment for employers in Wales.

Wellness in work: The economic arguments for investing in the health and wellbeing of the workforce in Wales


GUIDE

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

This practical guide by Public Health Wales outlines a step-by-step process of how to synthesise, translate and communicate public health and health economics evidence into policy and practice, making the case for sustainable investment in well-being and health equity. The guide argues that population health is an economic asset and a productive good. It is intended to help key stakeholders, advocates for health and equity, civil servants and other health and non-health professionals who have a role in informing, influencing or shaping national and subnational policy and practice.

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


GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in improving working lives and mental health in the workplace. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


Policy

Overview

Wales is a small nation, yet it has a proud history of being outward and forward-looking, and committed to achieving sustainable development and prosperity for all within and beyond Welsh borders. The ground-breaking Well-being of Future Generations (Wales) Act 2015, implemented in synergy with a number of modern Welsh laws, positions Wales at the forefront of the sustainability agenda and enables transformative cross-sector work that benefits the people, the economy and the planet. It places an explicit commitment on public bodies towards achieving a healthier and more equal Wales. More recently, the Socio-economic Duty 2020 cements a commitment to safeguarding equality and human rights, and places tackling inequality at the heart of decision-making.

The concept of Health in All Policies (HiAP) is increasingly accepted by governments and the scientific community as an important pre-condition for improved population health and an overall fairer and more cohesive society. HiAP entails working synergistically across sectors to take account of the health implications of decisions, aims to avoid health harm and rebalance social and health equity. To accelerate progress in reaching those being left behind because of poor health, and in preventing others from falling behind, policy action is required that reaches not only the most vulnerable but also those disproportionally at risk of avoidable poor health.

The WHESRi and the Solutions Platform can help bring health and equity in all policies in Wales and beyond, through informing and supporting policies, plans and investment prioritisation across different sectors and key stakeholders, in order to accelerate action and progress towards closing the health gap and achieving healthy prosperous lives for all in Wales and beyond.

The Five Essential Conditions

Many policies or legislation adopted in Wales help to reduce inequity and create a more sustainable and fairer Welsh society.

Stay up to date. The Welsh Health Equity Solutions Platform is continuously updated with the latest resources and materials, including data, policies, reports and case studies. Contact us to be notified of updates to the Solutions Platform.

Get in touch to get involved. We are working with stakeholders and users to update and expand the Solutions Platform with projects, case studies and spotlight features focused on health equity. Contact us to share your projects and success stories, to feature on the platform.


Health and Health Services

Resources

GOVERNMENT POLICY

Charter for unpaid carers

Charter explaining the legal rights of unpaid carers in Wales under the Social Services and Wellbeing (Wales) Act 2014.

Charter for unpaid carers


GOVERNMENT POLICY

National framework for social prescribing

A description of social prescribing in Wales and a plan of how to provide it throughout the country.

National framework for social prescribing


STRATEGY

Digital and data strategy for health and social care in Wales

To improve the way we deliver modern health and care services through technology and use of data.

Digital and data strategy for health and social care in Wales


STRATEGY

The role of outpatients in transforming planned care in Wales

This strategy and action plan sets out the Welsh Governments' intentions to recover, reset and transform planned care services whilst reducing variation across health boards and deliver consistent and equitable services for all.

The role of outpatients in transforming planned care in Wales


GUIDE

Promote, prevent and prepare for planned care

Empowering people waiting for treatment to optimise their health and well-being. The 3Ps Policy outlines at a strategic level the underpinning principles, characteristics and functions of services supporting those waiting for treatment in Wales.

Promote, prevent and prepare for planned care


GUIDE

The Primary Care (E-Prescribing Pilot Scheme) Directions 2023

Directions to local health boards as to the Primary Care (E-Prescribing Pilot Scheme) Directions 2023.

The Primary Care (E-Prescribing Pilot Scheme) Directions 2023


STRATEGY

Strengthening our community care system

What the Welsh Government plans to do to help older and vulnerable people.

Strengthening our community care system


LEGISLATION

Social Services and Well-being (Wales) Act 2014

An Act of the National Assembly for Wales providing the legal framework for improving the well-being of people who need care and support, and carers who need support, and for transforming social services in Wales.

Social Services and Well-being (Wales) Act 2014


LEGISLATION

Coronavirus Act 2020 (Commencement No.1) (Wales) Regulations 2020

The Regulations bring into force Coronavirus Act 2020 provisions relating to the Mental Health Review Tribunal for Wales and local authorities' duties under the Social Services and Well-being (Wales) Act 2014.

Coronavirus Act 2020 (Commencement No.1) (Wales) Regulations 2020


STRATEGY

Substance Misuse Delivery Plan 2019-2022

The Welsh Government delivery plan aims to reduce the harms associated with substance misuse during and following the COVID-19 pandemic.

Substance Misuse Delivery Plan 2019-2022


GUIDE

Free Prescriptions

The Welsh Government guidance on claiming free prescriptions in Wales.

Free Prescriptions


LEGISLATION

Health and Social Care (Quality and Engagement) (Wales) Act: Summary

The Welsh Government law to improve quality and public engagement in health and social care.

Health and Social Care (Quality and Engagement) (Wales) Act: Summary


STRATEGY

COVID-19 Vaccination Equity Strategy for Wales

The Welsh Government strategy to ensure that everyone has fair access to a COVID-19 vaccination and a fair opportunity to receive it.

COVID-19 Vaccination Equity Strategy for Wales


STRATEGY

Dementia Action Plan 2018 to 2022

The Welsh Government action plan to improve diagnosis, care and support for people with dementia.

Dementia Action Plan 2018 to 2022


STRATEGY

Together for Mental Health Delivery Plan 2019-2022

The Welsh Government delivery plan to improve the mental health and wellbeing of the population in Wales.

Together for Mental Health Delivery Plan 2019-2022


STRATEGY

Age Friendly Wales: Our Strategy for an Ageing Society

The Welsh Government strategy for an ageing society.

Age Friendly Wales: Our Strategy for an Ageing Society


STRATEGY

Healthy Weight: Healthy Wales Obesity Strategy

The Welsh Government strategy sets out what is doing to support people to make healthier choices and lead more active lives, including a 'Healthy NHS' and how success of the strategy can help to make a substantial cost saving to the future of NHS services and will improve outcomes for people’s long-term health and wellbeing.

Healthy Weight: Healthy Wales Obesity Strategy


STRATEGY

COVID-19 Reconstruction: Challenges and Priorities

The Welsh Government document sets out priorities to help stabilise Wales as we continue to live with coronavirus, prevent longer-term damage and plan to build a new future, including supporting the NHS to make up lost ground in terms of treatment of non-coronavirus-related conditions.

COVID-19 Reconstruction: Challenges and Priorities


STRATEGY

A Healthier Wales: Long-term Plan for Health and Social Care

The Welsh Government plan sets out a long term future vision of a whole system approach to health and social care, focused on health and wellbeing and on preventing illness, including new community-based models of health and social care.

A Healthier Wales: Long-term Plan for Health and Social Care


POLICY

Programme for Government 2021 to 2026

The updated Welsh Government programme for government, including the commitment to provide effective, high quality and sustainable healthcare.

Programme for Government 2021-2026


STRATEGY

Together for a Safer Future: Wales’ Long-term COVID-19 Transition from Pandemic to Endemic

The Welsh Government plan for long-term COVID-19 transition from pandemic.

Together for a Safer Future: Wales’ Long-term COVID-19 Transition from Pandemic to Endemic


STRATEGY

Transforming and Modernising Planned Care and Reducing NHS Waiting Lists

Welsh Government programme for transforming and modernising planned care in Wales and reducing waiting lists.

Transforming and Modernising Planned Care and Reducing NHS Waiting Lists


STRATEGY

Winter Respiratory Vaccination Strategy: Autumn and Winter 2022-2023

How Welsh Government will protect those who are most vulnerable from COVID-19 and influenza

Winter Respiratory Vaccination Strategy: Autumn and Winter 2022-2023


STRATEGY

A Smoke-free Wales: Our Long-term Tobacco Control Strategy

The Welsh Government long-term plan towards a smoke-free Wales by 2030.

A Smoke-free Wales: Our Long-term Tobacco Control Strategy


STRATEGY

Directed Enhanced Service: Hormone Treatment for Adult Patients with Gender Dysphoria

Outlines specialised services provided by general medical services for adults with gender dysphoria.

Directed Enhanced Service: Hormone Treatment for Adult Patients with Gender Dysphoria


STRATEGY

Directed Enhanced Service: Homelessness

Outlines specialised services provided by general medical services for homelessness.

Directed Enhanced Service: Homelessness


STRATEGY

Directed Enhanced Service: Asylum Seekers and Refugees

Outlines specialised services provided by general medical services for asylum seekers and refugees.

Directed Enhanced Service: Asylum Seekers and Refugees


STRATEGY

More Than Just Words: Welsh Language Plan in Health and Social Care

How Welsh Government will embed the Welsh language in health and social care so that people can access the care that they deserve and require.

More Than Just Words: Welsh Language Plan in Health and Social Care


STRATEGY

Learning Disability Delivery and Implementation Plan 2022-2026

What Welsh Government are doing to support people with learning disabilities.

Learning Disability Delivery and Implementation Plan 2022-2026


Health and Income and Social Protection

Resources

GUIDE

Childcare Offer Wales

The Welsh Government Childcare Offer for Wales sets out help with childcare costs for working parents of 3 to 4 year olds.

Childcare Offer Wales


STATEMENT

Warm Homes Programme

The Welsh Government statement on the Warm Homes Programme Annual Reports

Warm Homes Programme


GUIDE

Discretionary Assistance Fund

The Welsh Government guidance on eligbility and applying for the Discretionary Assistance Fund

Discretionary Assistance Fund


GUIDE

Flying Start

The Welsh Government guidance for local authorities, professionals and parents.

Flying Start


GUIDE

Families First

The Welsh Government guidance for local authorities about planning and providing services funded by Families First.

Families First


STATEMENT

Youth Homelessness Innovation Fund

The Welsh Government press release on projects to tackle homelessness among young people.

Youth Homelessness Innovation Fund


STRATEGY

Tackling Fuel Poverty 2021 to 2035

The Welsh Government plan to support people struggling to meet the cost of their domestic energy needs.

Tackling Fuel Poverty 2021 to 2035


STRATEGY

Equality Plan and Objectives: 2020 to 2024

The Welsh Government plan sets out aims, objectives and actions to tackle inequality and make our society fairer and more inclusive, including the long-term aim to eliminate inequality caused by poverty

Equality Plan and Objectives: 2020 to 2024


STRATEGY

Raising Awareness of Children’s Rights

The Welsh Government plan to raise awareness of the 'United Nations Convention on the Rights of the Child' in Wales until the end of 2023.

Raising Awareness of Children’s Rights


STRATEGY

Childcare Offer for Wales: National Digital Service Assisted Digital Strategy

The support arrangements to help people who are unable to use the Childcare Offer digital service unaided.

Childcare Offer for Wales: National Digital Service Assisted Digital Strategy


STRATEGY

UK Strategy for Financial Well-being: Delivery Plan for Wales

What Welsh Government is doing to help people make the most of their money now and in the future.

UK Strategy for Financial Well-being: Delivery Plan for Wales


LEGISLATION

Tertiary Education and Research (Wales) Act

The Act will establish a new body responsible for the oversight, strategic direction and leadership of the Post-Compulsory, Education & Training (PCET) sector.

Tertiary Education and Research (Wales) Act


STRATEGY

Welsh Government Budget Improvement Plan 2023 to 2024

Welsh Governments plan to improve the budget using the Well-being of Future Generations Act and the 5 ways of working.

Welsh Government Budget Improvement Plan 2023 to 2024


POLICY

Our National Mission: High Standards and Aspirations for All

Welsh Government's national mission is to achieve high standards and aspirations for all by tackling the impact of poverty on educational attainment and supporting every learner.

Our National Mission: High Standards and Aspirations for All


Health and Living Conditions

Resources


POLICY

New Warm Homes Programme: policy statement

Statement on Welsh Government long-term ambition to improve the energy efficiency of Welsh homes.

New Warm Homes Programme: policy statement


GUIDE

Climate Action Wales: Public engagement strategy 2023 to 2026

This Strategy sets out a framework for the Welsh Government and its partners to work together to support and engage the people and communities of Wales in action on the climate and nature emergencies.

Climate Action Wales: Public engagement strategy 2023 to 2026


GUIDE

Welsh Housing Quality Standard

The Welsh Government guidance sets out that houses owned by housing associations and local authorities have to be in good condition as part of the housing quality standard.

Welsh Housing Quality Standard


STRATEGY

An Active Travel Action Plan for Wales

The Welsh Government action plan to enable people to walk and cycle more.

An Active Travel Action Plan for Wales


STRATEGY

Clean Air Plan for Wales: Healthy Air, Healthy Wales

The Welsh Government plan to improve air quality and reduce the impacts of air pollution on human health, biodiversity, the natural environment and our economy.

Clean Air Plan for Wales: Healthy Air, Healthy Wales


STRATEGY

Prosperity for All: A Climate conscious Wales

The Welsh Government 5 year plan to adapt to the impacts Wales may face from climate change.

Prosperity for All: A Climate conscious Wales


STRATEGY

Violence Against Women, Domestic Abuse and Sexual Violence: National Survivor Engagement Framework

The Welsh Government proposals for a survivor framework to ensure that survivors, witnesses and affected others inform and influence Government work related to violence against women, domestic abuse and sexual violence.

Violence Against Women, Domestic Abuse and Sexual Violence: National Survivor Engagement Framework


STRATEGY

Low Carbon Delivery Plan

This Plan sets out the Welsh Government’s approach to cut emissions and increase efficiency in a way that maximises wider benefits for Wales, ensuring a fairer and healthier society.

Low Carbon Delivery Plan


STRATEGY

Social House Building Strategy

The Welsh Government strategy sets out how modern methods of construction can build better homes more quickly.

Social House Building Strategy


STRATEGY

Violence Against Women, Domestic Abuse and Sexual Violence: National Advisers Annual Plan 2021 to 2022

The Welsh Government annual plan sets out work to prevent violence and to support and protect people who have experienced violence.

Violence Against Women, Domestic Abuse and Sexual Violence: National Advisers Annual Plan 2021 to 2022


STRATEGY

Homelessness Strategy

The Welsh Government strategy for preventing and ending homelessness.

Homelessness Strategy


STRATEGY

National Strategy for Flood and Coastal Erosion Risk Management in Wales

The Welsh Government strategy sets objectives and measures to manage the risks from flooding and coastal erosion across Wales.

National Strategy for Flood and Coastal Erosion Risk Management in Wales


LEGISLATION

Housing (Wales) Act 2014

The Act of the National Assembly for Wales includes: Regulation of Private Rented housing; Homelessness; Gypsies and Travellers; Standards for Social Housing; Housing Finance; Allowing fully mutual Housing Associations to grant Assured Tenancies; Council Tax for certain types of dwelling; Amendment of Leasehold Reform, Housing and Urban Development Act 1993.

Housing (Wales) Act 2014


LEGISLATION

Environment (Wales) Act 2016

The Welsh Government Act provides an iterative framework that ensures that managing our natural resources sustainably will be a core consideration in decision-making.

Environment (Wales) Act 2016


STRATEGY

Cold Weather Resilience Plan

The Welsh Government Warm Homes plan for people at risk of living in a cold home.

Cold Weather Resilience Plan


STRATEGY

Healthy Weight: Healthy Wales Obesity Strategy

The Welsh Government strategy sets out what is doing to support people to make healthier choices and lead more active lives, including healthy communities.

Healthy Weight: Healthy Wales Obesity Strategy


STRATEGY

Ending Homelessness in Wales: A High Level Action Plan 2021 to 2026

The Welsh Government action plan to end homelessness over 2021-2026.

Ending Homelessness in Wales: A High Level Action Plan 2021 to 2026


STRATEGY

Regional Economic Frameworks

Regional economic frameworks on how each region of Wales is working towards a common set of economic priorities, including building resilient built and natural environments and responding to climate change.

Regional Economic Frameworks


STRATEGY

Towards Zero Waste: Our Waste Strategy

The Welsh Government strategy sets out long term aims for resource efficiency and waste managemen , including reducing our impact on climate change and sets out a long term framework for resource efficiency and waste management

Towards Zero Waste: Our Waste Strategy


STRATEGY

Equality Plan and Objectives: 2020 to 2024

The Welsh Government plan sets out aims, objectives and actions to tackle inequality and make our society fairer and more inclusive, including the long-term aim to build cohesive communities that are resilient, fair and equal.

Equality Plan and Objectives: 2020 to 2024


STRATEGY

COVID-19 Reconstruction: Challenges and Priorities

The Welsh Government document sets out priorities to help stabilise Wales as we continue to live with coronavirus, prevent longer-term damage and plan to build a new future, including stepping up construction of council and social housing, providing better access to open spaces, creating remote working hubs, pursuing a strong decarbonisation agenda, managing our land for the benefit of rural communities and future generations and protecting and enhancing our natural resources.

COVID-19 Reconstruction: Challenges and Priorities


STRATEGY

Future Wales: The National Plan 2040

The Welsh Government development plan for Wales, influencing all levels of the planning system in Wales and helping to shape Strategic and Local Development Plans prepared by councils and national park authorities, including achieving decarbonisation and climate-resilience, developing strong ecosystems and improving the health and well-being of our communities.

Future Wales: The National Plan 2040


STRATEGY

A Healthier Wales: Long Term Plan for Health and Social Care

The Welsh Government plan sets out a long term future vision of a whole system approach to health and social care, focused on health and wellbeing and on preventing illness, including supporting people to remain active and independent, in their own homes, for as long as possible.

A Healthier Wales: Long Term Plan for Health and Social Care


POLICY

Programme for Government 2021 to 2026

The updated Welsh Government programme for government, including commitents to build a stronger, greener economy and make our cities, towns and villages even better places in which to live and work.

Programme for Government 2021 to 2026


STRATEGY

Working Together to Reach Net Zero: All Wales Plan

The Welsh Government plan to work with partners so that Wales can meet the challenge of climate change and deliver a greener and fairer future

Working Together to Reach Net Zero: All Wales Plan


STRATEGY

Welsh Government Net Zero Strategic Plan

The plan to make Welsh Government net zero by 2030.

Welsh Government Net Zero Strategic Plan


Health and Social and Human Capital

Resources

GOVERNMENT POLICY

Children and young people's plan

The Plan set out the promises Welsh Government has made to support children and young people.

Children and young people's plan


GOVERNMENT POLICY

Charter for unpaid carers

Charter explaining the legal rights of unpaid carers in Wales under the Social Services and Wellbeing (Wales) Act 2014.

Charter for unpaid carers


GOVERNMENT POLICY

Anti-racist Wales Action Plan

The An Anti-racist Wales Action Plan (the Plan) builds on previous Welsh Government initiatives on race equality.

Anti-racist Wales Action Plan


STRATEGY

Strengthening our community care system

What the Welsh Government plans to do to help older and vulnerable people.

Strengthening our community care system


REPORT

Social services national outcomes framework

A report on the well-being of people who receive care and support and unpaid carers who receive support

Social services national outcomes framework


STRATEGY

Strategy for an ageing society: delivery plan progress May 2023

How the Welsh Government intends to meet targets outlined in the strategy for an ageing society delivery plan.

Strategy for an ageing society: delivery plan progress May 2023


STRATEGY

Strengthening our community care system

What the Welsh Government plans to do to help older and vulnerable people.

Strengthening our community care system


STRATEGY

Together for Mental Health Delivery Plan 2019-2022

The Welsh Government plan to improve the mental health of the nation.

Together for Mental Health Delivery Plan 2019-2022


STRATEGY

Youth Engagement and Progression Framework

The Welsh Government implementation plan to reduce the number of 11 to 25 year olds who are not engaged in education, employment or training (NEET)

Youth Engagement and Progression Framework


REPORT

Reducing Infant Class Sizes Grant

The Welsh Government report sets out information on the progress it is making to reduce infant class sizes in grant-funded schools.

Reducing Infant Class Sizes Grant


STRATEGY

Supporting Young People in the Justice system

The Welsh Government Youth Justice Implementation Plan to support young people in or at risk of entering the criminal justice system.

Supporting Young People in the Justice system


STRATEGY

Healthy Weight: Healthy Wales Obesity Strategy

The Welsh Government strategy sets out what is doing to support people to make healthier choices and lead more active lives, including healthy childcare settings, schools, and higher, further and other educational settings.

Healthy Weight: Healthy Wales Obesity Strategy


STRATEGY

Equality Plan and Objectives: 2020 to 2024

The Welsh Government plan sets out aims, objectives and actions to tackle inequality and make our society fairer and more inclusive, including the long-term aim that everyone in Wales is able to participate in political, public and everyday life.

Equality Plan and Objectives: 2020 to 2024


STRATEGY

COVID-19 Reconstruction: Challenges and Priorities

The Welsh Government document sets out priorities to help stabilise Wales as we continue to live with coronavirus, prevent longer-term damage and plan to build a new future, including ensuring that young people do not lose educationally or economically

COVID-19 Reconstruction: Challenges and Priorities


STRATEGY

Digital Strategy for Wales

The Welsh Government document sets out priorities to help stabilise Wales as we continue to live with coronavirus, prevent longer-term damage and plan to build a new future, including ensuring that young people do not lose educationally or economically

Digital Strategy for Wales


POLICY

Programme for Government 2021 to 2026

The updated Welsh Government programme for government, including a commitent to continue its long-term programme of education reform, and ensure educational inequalities narrow and standards rise.

Programme for Government 2021 to 2026


STRATEGY

Cymraeg 2050: Our Plan for 2021 - 2026

The Welsh Government work programme 2021 to 2026 to help achieve a million Welsh speakers and double the daily use of Welsh by 2050.

Cymraeg 2050: Our Plan for 2021 - 2026


STRATEGY

Violence Against Women, Domestic Abuse and Sexual Violence: Strategy 2022 to 2026

How Welsh Government will work with other organisations to tackle violence against women, domestic abuse and sexual violence.

Violence Against Women, Domestic Abuse and Sexual Violence: Strategy 2022 to 2026


STRATEGY

Equality, Race and Disability Evidence Units Strategy

Describes the scope and emerging priorities of the Equality, Race and Disability Evidence Units.

Equality, Race and Disability Evidence Units Strategy


STRATEGY

Anti-racist Wales Action Plan

What Welsh Government are going to do to make Wales anti-racist.

Anti-racist Wales Action Plan


STRATEGY

LGBTQ+ Action Plan for Wales

Welsh Governments plan to make Wales the most LGBTQ+ friendly nation in Europe.

LGBTQ+ Action Plan for Wales


STRATEGY

Period Proud Wales Action Plan

Welsh Governments plan to end period poverty and achieve period dignity in Wales.

Period Proud Wales Action Plan


STRATEGY

Strategy for an Ageing Society: Delivery Plan

How Welsh Government intend to meet the targets outlined in the 'Age friendly Wales: our strategy for an ageing society’

Strategy for an Ageing Society: Delivery Plan


STATEMENT

The Quality Statement for Women and Girls’ Health

The quality statement by Welsh Government describes what good quality women's health services look like.

The Quality Statement for Women and Girls’ Health


STRATEGY

Delivering Justice for Wales

Welsh Government approach to reforming the justice system, and delivering better outcomes for the people of Wales.

Delivering Justice for Wales


STRATEGY

Well-being of Future Generations: Continuous Learning and Improvement Plan for 2023 to 2025

Deepening the understanding and application of the sustainable development principle at the heart of how Welsh Government works.

Well-being of Future Generations: Continuous Learning and Improvement Plan for 2023 to 2025


Health and Employment and Working Conditions

Resources

STRATEGY

Cross-Government Employability Plan

The Welsh Government plan to tackle unemployment and economic inactivity.

Cross-Government Employability Plan


STATEMENT

Working Wales

The Welsh Government press release on the Working Wales service providing simpler support for individuals looking to get into work.

Working Wales


GUIDE

Parents, Childcare & Employment (PaCE)

The Welsh Government guidance on support for childcare whilst training and gaining skills to get a job.

Parents, Childcare & Employment (PaCE)


STRATEGY

Workforce Equality, Diversity and Inclusion Strategy: 2021 to 2026

The Welsh Government strategy sets out ambitious plans and targets for shaping Welsh Government for the future.

Workforce Equality, Diversity and Inclusion Strategy: 2021 to 2026


STRATEGY

Stronger, Fairer, Greener Wales: A Plan for Employability and Skills

The Welsh Government plan to help people upskill, access fair work and thrive, for a more equal Wales.

Stronger, Fairer, Greener Wales: A Plan for Employability and Skills


STRATEGY

Regional Economic Frameworks

Regional economic frameworks on how each region of Wales is working towards a common set of economic priorities, including sustainable jobs and fair work.

Regional Economic Frameworks


STRATEGY

COVID-19 Reconstruction: Challenges and Priorities

The Welsh Government document sets out priorities to help stabilise Wales as we continue to live with coronavirus, prevent longer-term damage and plan to build a new future, including reducing unemployment and giving everyone the best chance to find and keep decent work with long term prospects

COVID-19 Reconstruction: Challenges and Priorities


STRATEGY

Digital Strategy for Wales

The Welsh Government strategy on using digital, data and technology to improve the lives of people in Wales, including creating a workforce that has the digital skills, capability and confidence to excel in the workplace and in everyday life.

Digital Strategy for Wales


POLICY

Programme for Government 2021 to 2026

The updated Welsh Government programme for government, including a commitent to build an economy based on the principles of fair work, sustainability and the industries and services of the future.

Programme for Government 2021 to 2026


STRATEGY

Healthy Weight: Healthy Wales Obesity Strategy

The Welsh Government strategy sets out what is doing to support people to make healthier choices and lead more active lives, including healthy workplaces.

Healthy Weight: Healthy Wales Obesity Strategy


STRATEGY

National Occupational Standards Strategy 2022 and Beyond

The strategy sets out the vision for helping the workforce gain the transferable skills most critical to the economy of the future.

National Occupational Standards Strategy 2022 and Beyond


UK and International

Overview

Long-standing and persistent health inequity is as evident in Wales as it is across Europe and the rest of the world.

The United Nations 2030 Agenda for Sustainable Development sets 17 Sustainable Development Goals (SDGs, or Global Goals) with Goal 10 explicitly focusing on reducing inequalities; and all other Goals having a direct or indirect impact on people’s wellbeing and the health gap. Particularly relevant Goals are Goal 1 No poverty; Goal 2 Zero hunger; Goal 3 Good Health and Well-being; Goal 4 Quality education; Goal 5 Gender Equality and Goal 8 Decent work and economic growth.

SDGs explicitly related to improving health and equity

Improving health and well-being for all, reducing health inequities and ensuring no one is left behind can bring wider economic, social and environmental benefits to populations, contributing to inclusive economic growth and sustainable development.

However, progress towards the SDGs across the world has been stalled by the Coronavirus pandemic.

Aligned with the SDGs, the WHO’s Thirteenth General Programme of Work 2019–2025 aims to ensure healthy lives and promote well-being for all at all ages. To drive and facilitate implementation, the WHO European Office for Investment for Health and Development in Venice, Italy, developed the Health Equity Status Report initiative (HESRi) looking into the key challenges, opportunities and options to: a) remove the barriers that are holding people back in health and in life; and b) create the conditions for all people to prosper and flourish in health and in life. It also provides a cutting-edge methodology and a suite of tools to promote and support policy action for health equity and well-being.

Following from this, the first Resolution on Accelerating progress towards healthy, prosperous lives for all, increasing equity in health and leaving no one behind in the WHO European Region was adopted, recognising that reducing and eradicating health inequities are a necessary contribution to inclusive growth and sustainable development.

The WHO European Programme of Work, 2020–2025 “United Action for Better Health in Europe” has put a strong emphasis on ‘leaving no one behind’ to address the persistent challenge of health inequities across the European Region. In the UK, the UCL Institute of Health Equity has been leading and collaborating on work to address the social determinants of health and improve health equity, developing and supporting reviews, approaches and capacities.

There has been a long-standing collaboration between Wales and the WHO, strengthening know-how, capacity and international partnership for improving well-being and health equity, preventing and tackling threats to people and society; and achieving sustainable development. The WHO Collaborating Centre on Investment for Health and Well-being (WHO CC) at Public Health Wales has been working closely with the WHO Regional Office for Europe and the European Office for Investment for Health and Development in Venice, Italy to strengthen Wales’ leading role in driving sustainable investment in population well-being and health equity, and supporting prosperity for all. Through establishing the WHESRi, Wales has been recognised as a global influencer and a live innovation site for health equity, providing an example and inspiration for other countries and regions; as well as learning from international best practice, expertise and innovative approaches.

Initiated to inform and support the COVID-19 pandemic response and recovery, the Public Health Wales’ International Horizon Scanning and Learning reports provide extensive international evidence on the health, well-being, social and economic impacts of COVID-19. These impacts have not been felt equally and have led to increased health gaps and vulnerabilities, bringing new and unprecedented challenges for populations, health systems and governments worldwide. They have further exposed social inequities, discrimination and health gaps within and between countries, leading to calls to ‘build back fairer’. The reports have now expanded in scope to include priority public health topics.

The Five Essential Conditions

This section contains examples of resources on the nature and impacts of health inequalities, linking to the Five Essential Conditions for health. These resources include:

  • An interactive dashboard
  • Reports
  • Guides
  • Research articles

Stay up to date.

The Welsh Health Equity Solutions Platform is continuously updated with the latest resources and materials, including data, policies, reports and case studies. Contact us to be notified of updates to the Solutions Platform.

Get in touch to get involved.

We are working with stakeholders and users to update and expand the Solutions Platform with projects, case studies and spotlight features focused on health equity. Contact us to share your projects and success stories, to feature on the platform.

Useful resources:

RESOURCE

World Health Organization Health Equity Status Report Initiative

Aiming to shift political and policy focus from describing the problem to capturing progress and enabling action to increase equity in health.

World Health Organization Health Equity Status Report initiative


RESOURCE

World Health Organization Social Determinants of Health

Presenting information on inequities in health and how they are socially determined, preventing poorer populations from moving up in society and making the most of their potential.

World Health Organization Social determinants of health


RESOURCE

World Health Organization The WHO Global Webinar Series on Equity, COVID-19 and the Social Determinants of Health

Exploring the disproportionate impacts that the COVID-19 pandemic is having on more disadvantaged population groups, with a focus on how it is widening health inequities.

World Health Organization The WHO Global Webinar Series on Equity, COVID-19 and the Social Determinants of Health


RESOURCE

Joint Action Health Equity Europe (JAHEE)

Contributing to efforts to achieve greater equity in health outcomes across all groups in society in participating countries and in Europe at large and to reduce inter-country heterogeneity in tackling health inequalities.

Joint Action Health Equity Europe (JAHEE)


RESOURCE

The Centre for Global Health Inequalities Research (CHAIN)

Bringing together researchers from global regions and different research disciplines to advance the current state-of-the-art by offering new insights from social, laboratory-based and natural experiments into the casual mechanisms linking socioeconomic status and health.

The Centre for Global Health Inequalities Research (CHAIN)


RESOURCE

EuroHealthNet Health Inequalities Portal

An information hub on health inequalities in Europe providing information on a range of areas, such as finance, data, initiatives and tools.

EuroHealthNet Health Inequalities Portal


RESOURCE

The Lancet Group Advancing Equity, Diversity, and Inclusion

Advancing equity, diversity, and inclusion (EDI) as a commitment to health for all.

The Lancet Group Advancing Equity, Diversity, and Inclusion


RESOURCE

The Health Foundation Evidence Hub: What Drives Health Inequalities?

Providing data, insights and analysis exploring how the circumstances in which we live shape our health.

The Health Foundation Evidence Hub: What Drives Health Inequalities?


RESOURCE

University College London Institute of Health Equity

Supporting greater health equity by building the evidence base, influencing action that works, and building capacity.

University College London Institute of Health Equity


RESOURCE

Ensuring SDG Progress Amid Recurrent Crises

Focused on the cumulative effect of COVID, Ukraine conflict and Climate crisis in an economic context. This United Nations report looks at the disproportionate impact upon the most vulnerable and has a solutions focus through inclusion of a ‘roadmap to accelerate progress of the Sustainable Development Goals’

Ensuring SDG Progress Amid Recurrent Crises


RESOURCE

Cost of Living Crisis: How it Affects Children in Europe and What Governments Need to do

Looking at the child poverty crisis in Europe caused in part by the COVID pandemic and the Ukraine conflict, this Save the Children report provides insights from 12 European countries show the impact of the cost-of-living crisis on children/families. Solutions focused in that it provides information and examples of government interventions and provides recommendations.

Cost of Living Crisis: How it Affects Children in Europe and What Governments Need to do


RESOURCE

Addressing the Cost-of-Living Crisis in Developing Countries: Poverty and Vulnerability Projections and Policy Responses

This United Nations report explores the impact of the cost-of-living crisis on the global economy, looking at the impacts of this on changes to poverty and vulnerability to poverty. Solutions focus through inclusion of policy responses.

Addressing the cost-of-living crisis in developing countries: Poverty and vulnerability projections and policy responses


GUIDE

How to Equity Proof Your Policies and Interventions: A Resource Guide for Planners and Policy Makers to Leave No-one Behind

This toolkit provides complementary resources to the Health Equity Status Report Initiative. It offers user-friendly guidance on developing inclusive, participatory approaches to policy-making that reaches groups that are not represented in the available data.

How to Equity Proof Your Policies and Interventions: A Resource Guide for Planners and Policy Makers to Leave No-one Behind


Health and Health Services

Resources

Policies that aim to ensure availability, accessibility, affordability and quality of preventative and health care services and interventions.

REPORT COVID

International Horizon Scanning and Learning: Summary Report On the impact of COVID-19 on Increasing the Health Gap and Vulnerability

This report by Public Health Wales brings together international evidence and insights on inequalities from the International Horizon Scanning Learning Report series. It focuses on vulnerable groups and the unequal distribution of indirect impacts resulting from the COVID-19 pandemic, including disruption to health services, and the effects of the pandemic on mental health and issues of vaccine equity.

International Horizon Scanning and Learning – Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability


REPORT

Inequalities in Health Care for People with Depression and/or Anxiety

This long read report by The Health Foundation describes the health care use of people with depression and/or anxiety across primary and secondary care in England prior to the COVID-19 pandemic, and highlights the broader health needs of these patients and longstanding variation in use of health care by level of socioeconomic deprivation.

Inequalities in Health Care for People with Depression and/or Anxiety


PAPER

Health Systems Resilience During COVID-19: Lessons for Building Back Better

This health policy series by the European Observatory on Health Systems and Policies provides national policy-makers with evidence from other countries to assess their own responses to COVID-19 and incorporate adjustments that are appropriate for their national contexts, supporting the transition from managing the crisis to achieving more resilient health systems and societies.

Health Systems Resilience During COVID-19: Lessons for Building Back Better


PAPER

How will COVID-19 Impact Fertility?

This technical brief by the United Nations Population Fund highlights the crucial importance of classifying sexual and reproductive health (SRH) services as ‘essential services’ during the pandemic, and underscores the responsibility of governments to assure that all persons can exercise their reproductive rights, even during a global pandemic.

How will COVID-19 Impact Fertility?


BRIEFING

European Support for Improving Health and Care Systems

This policy brief by the World Health Organization and European Observatory on Health Systems and Policies maps the many European tools that can help to improve health and care systems and how they relate to the challenges faced by health policy-makers in Member States.

European Support for Improving Health and Care Systems


ARTICLE

Economic Vulnerability and Unmet Healthcare Needs Among the Population Aged 50 + years During the COVID-19 Pandemic in Europe

This research article points towards the existence of significant differences in accessing healthcare during the pandemic according to economic vulnerability.

Economic Vulnerability and Unmet Healthcare Needs Among the Population Aged 50 + years During the COVID-19 Pandemic in Europe


ARTICLE

Global Prevalence and Burden of Depressive and Anxiety Disorders in 204 Countries and Territories in 2020 due to the COVID-19 Pandemic

This research article estimates an increase in cases of major depressive disorder and of anxiety disorders globally due to the COVID-19 pandemic.

Global Prevalence and Burden of Depressive and Anxiety Disorders in 204 Countries and Territories in 2020 due to the COVID-19 Pandemic


BRIEFING

Unmet Needs for Health Care: Comparing Approaches and Results from International Surveys

Looking into reported levels of ‘unmet needs’ relating to healthcare based upon information gathered across international surveys. This OECD report highlights that unmet needs are greater among the poor across all international surveys.

Unmet Needs for Health Care: Comparing Approaches and Results from International Surveys


REPORT

Health for Everyone?: Social Inequalities in Health and Health Systems

Analysing inequalities in health and health systems across 33 OECD & EU countries, focussing on risk factors to health, health status, the utilisation of health services, unmet health care needs and coverage. Solutions focused in that it seeks to provide a discussion of how societies can becomes more inclusive.

Health for Everyone?: Social Inequalities in Health and Health Systems


BRIEFING

Health Care Financing in Times of High Inflation

Focusing on the current economic climate and the challenges this brings to health systems. The briefing discusses the limit of overall government spending on healthcare and the need for increases to be implemented across OECD countries.

Health Care Financing in Times of High Inflation


Health and Income and Social Protection

Resources

Policies that aim to provide economic security and support to reduce the health and social consequences of poverty and low income throughout a person’s life.

REPORT COVID

International Horizon Scanning and Learning: Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability

This report by Public Health Wales brings together international evidence and insights on inequalities from the International Horizon Scanning Learning Reports published between May 2020 and August 2021. It focuses on vulnerable groups and the unequal distribution of indirect impacts resulting from the COVID-19 pandemic, including impacts on low-income workers.

International Horizon Scanning and Learning – Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability


PAPER

Inequality and the COVID Crisis in the United Kingdom

This working paper by the Institute for Fiscal Studies reports that job-support programmes combined with the expanded welfare system meant that disposable income inequality fell during the COVID-19 pandemic but that rising house prices benefited people in particular around the middle of the wealth distribution.

Inequality and the COVID Crisis in the United Kingdom


REPORT COVID

Inequality in the Time of COVID-19: All Metrics Are Not Equal When it Comes to Assessing The Pandemic’s Unequal Effect

This report by the International Monetary Fund examines income inequality and points to international evidence of the effectiveness of social protection policy responses such as income transfers targeted to poor and vulnerable workers.

Inequality in the Time of COVID-19: All Metrics Are Not Equal When it Comes to Assessing The Pandemic’s Unequal Effect


ARTICLE

COVID-19 and Global Income Inequality

This research article explores the impacts of the COVID-19 pandemic on global income inequality.

COVID-19 and Global Income Inequality


ARTICLE

Food Insecurity and COVID-19 Risk in Low- and Middle-income Countries

This research article assesses whether knowledge of a person infected with COVID-19 is associated with food insecurity, job loss and business closures, and coping strategies to smooth consumption.

Food Insecurity and COVID-19 Risk in Low- and Middle-income Countries


PAPER

Income Security During Periods of Ill Health: A Scoping Review of Policies, Practice and Coverage in Low-income and Middle-income Countries

This scoping review aims to map the range, features, coverage, protective effects, and equity of policies that aim to provide income security for adults whose ill health prevents them from participating in gainful work in low-income and middle-income countries. It concludes that scaling up and diversifying the range of income security interventions is crucial for improving coverage and equity, and that to achieve these outcomes, illness-related income protection must receive greater recognition in health policy and health financing.

Income Security During Periods of Ill Health: A Scoping Review of Policies, Practice and Coverage in Low-income and Middle-income Countries


ARTICLE

Health Inequalities in Europe: Does Minimum Income Protection Make a Difference?

This research article investigates how minimum income protection is associated with socio-economic health inequalities.

Health Inequalities in Europe: Does Minimum Income Protection Make a Difference?


REPORT

Brief Report: A Comparison of Child Mental Health Inequalities in Three UK Population Cohorts

This brief report reveals that the mental health gap between advantaged and disadvantaged children in the UK has not reduced over the last 20 years and may be getting worse.

Brief Report: A Comparison of Child Mental Health Inequalities in Three UK Population Cohorts


ARTICLE

Economic Influences on Population Health in the United States: Toward Policymaking Driven by Data and Evidence

This research article explores economic influences on population health in the United States and suggests that policymaker consensus around the value of data—and the political will to act on it—will be critical for translating evidence into improvements in population health.

Economic Influences on Population Health in the United States: Toward Policymaking Driven by Data and Evidence


ARTICLE

Geographic and Socio-demographic Predictors of Household Food Insecurity in Canada, 2011–12

This research article reports a graded relation between income and food insecurity in Canada, with every $1000 increase in income associated with 2% lower odds of marginal food insecurity, 4% lower odds of moderate food insecurity, and 5% lower odds of severe food insecurity.

Geographic and Socio-demographic Predictors of Household Food Insecurity in Canada, 2011–12


BRIEFING

What Triggers Economic Insecurity and Who is Most At Risk?

This policy brief by the United Nations Department of Economic and Social Affairs suggests that full recovery from the pandemic crisis is not possible without addressing economic security and reducing inequality.

What Triggers Economic Insecurity and Who is Most At Risk?


WEBINAR COVID

Confronting Poverty and Income Insecurity During COVID-19 Through Strengthening Social Protection

This WHO Global Webinar Series on Equity, COVID-19 and the Social Determinants of Health (SDH) discusses the disproportionate impacts that the COVID-19 pandemic is having on more disadvantaged population groups, with a focus on how it is widening health inequities.

Confronting Poverty and Income Insecurity During COVID-19 Through Strengthening Social Protection on


BRIEFING

The Inequality Virus: Bringing Together a World Torn Apart by Coronavirus Through a Fair, Just and Sustainable Economy

This briefing paper by Oxfam International notes that hundreds of millions of people were being forced into poverty during the COVID-19 pandemic.

The Inequality Virus: Bringing Together a World Torn Apart by Coronavirus Through a Fair, Just and Sustainable Economy


REPORT

2022 Global Report on Food Crises

Focuses on current situation regarding the food crises, taking global, regional and country specific views. Included information relating to vulnerable groups including pregnant women, children, refuges etc. Solutions focused in that it contains information on data and ‘know-how to change the course’.

2022 Global Report on Food Crises


ARTICLE

The Association Between Food Insecurity and Mental Health During the COVID-19 Pandemic

Examining the association between food insecurity and mental health amongst low-income Americans during the COVID pandemic. Solutions focused in that public health recommendations are included to reduce the impacts of food insecurity.

The Association Between Food Insecurity and Mental Health During the COVID-19 Pandemic


BRIEFING

Impact of the Socio-Economic Crisis on FEBA Members

Looking at evidence-based insights into the repercussions of the cost-of-living crisis, on the operations of Food Banks and on the profile of end beneficiaries supported through charitable organisations across member countries within Europe. Illustrates increasing need for Food Banks and also increasing vulnerability to food insecurity including groups most vulnerable to this.

Impact of the Socio-Economic Crisis on FEBA Members


ARTICLE

Energy Poverty Policies and Measures in 5 EU Countries: A Comparative Study

Looking into the impacts of energy poverty including the physical and mental health impacts upon energy poor individuals across 5 EU countries (Cyprus, Spain, Portugal, Bulgaria and Lithuania). Solutions focused in that an overview of selected policies and measures are analysed and recommendations are made on how to utilise policy tools and provide the most efficient support to energy poor households.

Energy Poverty Policies and Measures in 5 EU Countries: A Comparative Study


Health and Living Conditions

Policies that aim to ensure opportunities for, and access and exposure to living conditions and environments that have a positive influence on people’s health and well-being.

Resources

REPORT COVID

International Horizon Scanning and Learning: Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability

This report by Public Health Wales brings together international evidence and insights on inequalities from the International Horizon Scanning Learning Reports published between May 2020 and August 2021. It focuses on vulnerable groups and the unequal distribution of indirect impacts resulting from the COVID-19 pandemic, including the impact on family, sexual and gender-based violence and food poverty.

International Horizon Scanning and Learning: Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability


PAPER

Inequality and the COVID Crisis in the United Kingdom

This working paper by the Institute for Fiscal Studies reviews the effects of the COVID-19 pandemic on inequalities including household living standards in the UK.

Inequality and the COVID Crisis in the United Kingdom


REPORT

Overcoming Health Inequalities in ‘Left Behind’ Neighbourhoods

This report by the All-Party Parliamentary Group (APPG) for left-behind neighbourhoods describes the impact of poor health for those living in deprived areas and 'left behind' neighbourhoods in England and provides a number of policy recommendations for reducing health inequalities at the neighbourhood and community level.

Overcoming Health Inequalities in ‘Left Behind’ Neighbourhoods


ARTICLE

Falling Living Standards During the COVID-19 Crisis: Quantitative Evidence from Nine Developing Countries

This research article presents evidence from nine developing countries that household coping strategies and government assistance were insufficient to sustain pre- COVID-19 living standards, resulting in widespread food insecurity and poor economic conditions.

Falling Living Standards During the COVID-19 Crisis: Quantitative Evidence from Nine Developing Countries


GUIDE

WHO Housing and Health Guidelines: Recommendations to Promote Healthy Housing for a Sustainable and Equitable Future

This report by WHO explores key health risks and the burden of disease related to housing, and provides evidence summaries on household crowding, indoor temperatures, injury hazards, housing accessibility and more.

WHO Housing and Health Guidelines: Recommendations to Promote Healthy Housing for a Sustainable and Equitable Future


ARTICLE

Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities

This systematic review presents results that suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.

Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities


REPORT

Environmental Health Inequalities in Europe: Second Assessment Report

This report by the WHO documents the magnitude of environmental health inequalities within countries through 19 inequality indicators on urban, housing and working conditions, basic services and injuries.

Environmental Health Inequalities in Europe: Second Assessment Report


BRIEFING

Building for a Better Tomorrow: Policies to Make Housing More Affordable

This OECD report focusses on housing affordability across OECD countries and key drivers of the increasingly tight housing market and the impacts of this on those most vulnerable, including low-income households, youth or seniors. Solutions focused in that sets out a series of recommendations for governments to make housing more affordable.

Building for a Better Tomorrow: Policies to Make Housing More Affordable


Health and Social and Human Capital

Policies that aim to develop and strengthen social relations and community assets, including education, skills, community resources and meaningful social interactions to promote learning, and protect and promote health and wellbeing throughout a person’s life.

Resources

REPORT COVID

International Horizon Scanning and Learning – Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability

This report by Public Health Wales brings together international evidence and insights on inequalities from the International Horizon Scanning Learning Reports published between May 2020 and August 2021. It focuses on vulnerable groups and the unequal distribution of indirect impacts resulting from the COVID-19 pandemic, including impacts on education and childcare.

International Horizon Scanning and Learning – Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability


REPORT COVID

The State of the Global Education Crisis: A Path to Recovery

This report by The World Bank spotlights how COVID-19 has deepened the education crisis. It also charts a course for creating more resilient education systems for the future, including how to build on the investments made and the lessons learned during the pandemic to accelerate learning recovery and emerge from the crisis with increased education quality, resilience, and equity in the longer term.

The State of the Global Education Crisis: A Path to Recovery


PAPER

Youth in Europe: Effects of COVID-19 on their Economic and Social Situation

This study explores the effects of the COVID-19 pandemic on youth in Europe, including the impacts of school closures, restrictions on training opportunities and early school leaving. It also includes actions taken to tackle the effects of COVID-19, including improving digital skills and quality traineeships.

Youth in Europe: Effects of COVID-19 on their Economic and Social Situation


ARTICLE

Modifying the School Determinants of Children’s Health

This commentary explores how the school determinants of children’s health can be modified to improve population outcomes and outlines a proposal for the next generation of health promoting schools.

Modifying the School Determinants of Children’s Health


REPORT

Education in the Digital Age

This OECD report looks into the role of education in supporting emotional and physical wellbeing of children, specifically looking at intersectionality between education, wellbeing and digital technologies. Solutions focused in that the report details the efforts of specific countries to tackle inequalities and protect and empower students.

Education in the Digital Age


REPORT

UNESCO Strategy on Education for Health and Well-being

The strategy presents UNESCO’s vision for better health and education outcomes for all learners, looking at issues impacting this, including gender-based violence, gender inequality, HIV and AIDS, sexually transmitted infections (STIs), unintended pregnancies, and violence and discrimination highlighting the unmet need for mental health services in and around learning institutions.

UNESCO Strategy on Education for Health and Well-being


REPORT

Ready to Learn and Thrive: School Health and Nutrition Around the World

This UNESCO report focuses on education, health and nutrition as rights and ends in themselves, whilst also being an investment in a country’s future and in the capacity of its people to lead productive and fulfilling lives. Solutions focused in that the report illustrates the feasibility of school health and nutrition programmes across the globe.

Ready to Learn and Thrive: School Health and Nutrition Around the World


STRATEGY

Every Child Learns: UNICEF Education Strategy 2019-2030

The UNICEF strategy supports every child’s right to quality education, focusing on inequalities through children excluded on the basis of gender, children with disabilities, the poorest, ethnic and linguistic minorities, and children affected by emergencies.

Every Child Learns: UNICEF Education Strategy 2019-2030


Employment and Working Conditions

Policies that aim to improve the health impact of employment, working conditions and workplace equality. 

Resources

REPORT COVID

International Horizon Scanning and Learning: Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability

This report by Public Health Wales brings together international evidence and insights on inequalities from the International Horizon Scanning Learning Reports published between May 2020 and August 2021. It focuses on vulnerable groups and the unequal distribution of indirect impacts resulting from the COVID-19 pandemic, including impacts on employment.

International Horizon Scanning and Learning: Summary Report On the impact of COVID-19 on increasing the Health Gap and Vulnerability


PAPER

Inequality and the COVID Crisis in the United Kingdom

This working paper by the Institute for Fiscal Studies reviews the effects of the COVID-19 pandemic on inequalities in the UK including labour market inequalities, and identifies that increased rates of working from home appear likely to persist which may increase some inequalities and decrease others.

Inequality and the COVID Crisis in the United Kingdom


ARTICLE

Emotional and Financial Health During COVID-19: The Role of Housework, Employment and Childcare in Australia and the United States

This research article identifies feelings of anxiety and financial worry about employment and domestic changes, particularly among American mothers, during the COVID-19 pandemic, potentially exacerbating gender inequality in emotional health.

Emotional and Financial Health During COVID-19: The Role of Housework, Employment and Childcare in Australia and the United States


PAPER

Youth in Europe: Effects of COVID-19 on their Economic and Social Situation

This study explores the effects of the COVID-19 pandemic on youth in Europe, including the development of youth employment and unemployment and the impact on young people not in employment, education or training. It also includes actions taken to tackle the effects of COVID-19, including quality traineeships, effective apprenticeships and the growing importance of career guidance.

Youth in Europe: Effects of COVID-19 on their Economic and Social Situation


ARTICLE

COVID-19 and the Immediate Impact on Young People and Employment in Australia: A Gendered Analysis

This research article suggests that young people in Australia have been significantly impacted by COVID-19 compared to their older counterparts, with young women in particular exposed to the economic fallout.

COVID-19 and the Immediate Impact on Young People and Employment in Australia: A Gendered Analysis


REPORT

Working Conditions and Workers' Health

This report by the European Foundation for the Improvement of Living and Working Conditions (Eurofound) uses European Working Conditions Survey data and describes findings that the emotional demands of work have increased, underlining the growing importance of psychosocial risks at work. It also reveals that changes over time suggest that although the risk of poor health is concentrated in certain occupations, those occupations traditionally considered to be protected are increasingly exposed to risks that are likely to affect workers’ health and well-being.

Working Conditions and Workers' Health


ARTICLE

Is There an Association Between Working Conditions and Health?: An Analysis of the Sixth European Working Conditions Survey Data

This research article on European working conditions presents results that show that encouraging working conditions, work environment, and job support are associated with both better self-assessed health and better objective health.

Is There an Association Between Working Conditions and Health?: An Analysis of the Sixth European Working Conditions Survey Data


ARTICLE

The Contribution of Employment and Working Conditions to Occupational Inequalities in Non-Communicable Diseases in Europe 

This research article concludes that employment and working conditions are important determinants of occupational inequalities in non-communicable diseases (NCDs) and recommends consideration of labour market regulations be considered in the formulation of NCD prevention.

The Contribution of Employment and Working Conditions to Occupational Inequalities in Non-Communicable Diseases in Europe 


ARTICLE

Informal Employees in the European Union: Working Conditions, Employment Precariousness and Health

This research article concludes that informal employment in the EU-27 is characterised by worse working conditions and employment precariousness than the conditions for formal employees. Also, that there is no evidence that being in informal employment implies better health outcome compared to permanent employees.

Informal Employees in the European Union: Working Conditions, Employment Precariousness and Health


REPORT

OECD Employment Outlook 2022

Looking at labour market recovery from the pandemic and how this has been further impacted by the Ukraine conflict; reviewing the key labour market and social challenges for a more inclusive post-COVID 19 recovery. Focuses upon vulnerability through attention given to frontline workers and groups lagging behind in labour market recovery (young people, workers with less education, and racial/ethnic minorities). Solutions focused through the examination of policies to address these challenges and the outlook ahead.

OECD Employment Outlook 2022


Vulnerability and Unmet Needs

Overview

The differences that create health gaps undermine health equity. They arise from a range of factors, including the circumstances in which we are born and live, such as our housing, education and work. They are often made worse by discrimination, stereotyping, and prejudice based on individual-level factors, many of which are protected characteristics under the Equality Act 2010, such as our sex, race, gender or age. Each of these factors can lead to health gaps on their own, but they can also overlap and, in turn, create multiple disadvantages and deepen health inequities.

Health inequities have long been linked to processes and conditions that systematically prevent or restrict population groups from gaining economic, social, political and cultural inclusion. More recently, the COVID-19 pandemic has worsened existing health inequities, drawing further attention to structural disadvantage and discrimination. The pandemic has also led to new gaps in areas such as the ability to work from home and digital access, creating emerging drivers of vulnerability and unmet needs. Furthermore, cost of living pressures are having significant impacts that can undermine health inequity, particularly on the poorest households in Wales.

The Five Essential Conditions

This section provides examples of resources exploring health inequalities in the context of vulnerability and unmet needs, aligned to the five essential conditions. The resources cover a range of the protected characteristics, including where they overlap and lead to multiple disadvantage, sometimes referred to as the ‘intersectionality’ of protected characteristics. Other circumstances that are not considered protected characteristics, such as deprivation and homelessness, are also covered.

Featured resources include reports, policy briefs, research briefs and research articles in peer-reviewed academic journals. All resources focus on health inequalities in Wales (see UK and international for non-Wales resources).

Stay up to date. Come back to this page for spotlight features focusing on health equity and the protected characteristics.The Welsh Health Equity Solutions Platform is continuously updated with the latest resources and materials, including data, policies, reports and case studies. Contact us to be notified of updates to the Solutions Platform.

Get in touch to get involved. We are working with stakeholders and users to update and expand the Solutions Platform with projects, case studies and spotlight features focused on health equity. Contact us to share your projects and success stories, to feature on the platform.

Health and Health Services

Resources

REPORT

The Health Experiences of Asylum Seekers and Refugees in Wales

This technical report provides insights into asylum seekers’ and refugees’ experiences of health in Wales. It suggests that a compassionate, non-judgemental approach to providing care supports people seeking sanctuary to access healthcare with potential to reduce health inequities.

The Health Experiences of Asylum Seekers and Refugees in Wales


REPORT

Brexit and Poverty in Wales: A Public Health Lens

This report by Public Health Wales seeks to strengthen knowledge and understanding of the implications of the United Kingdom’s exit from the European Union – ‘Brexit’ - on poverty, and health and well-being in Wales, including a focus on public services including health and care provision. Policy and decision makers, those who are part of the public health system, and stakeholders across sectors, can use the evidence presented to understand the opportunities and risks for communities in Wales, and identify actions to help build a fairer future.

Brexit and Poverty in Wales: A Public Health Lens


REPORT

Towards a Healthy and Sustainable Workforce for The Future: The Current Health and Well-being of the Nursing and Midwifery Workforce in Wales

This report by Public Health Wales provides an indication of the challenges some staff are facing in our health and social care services. The findings are relevant to those who have responsibilities for the management of staff or are involved in redesigning our services for the future.

Towards a Healthy and Sustainable Workforce for The Future: The Current Health and Well-being of the Nursing and Midwifery Workforce in Wales


REPORT

The Right to Adequate Housing in Wales: The Evidence Base

This independent research report by Alma Economics, commissioned by Tai Pawb, the Chartered Institute of Housing Cymru and Shelter Cymru, explores housing and housing inequality in Wales. The report looks at the costs of inadequate housing, including to health and social care, and presents international examples of other countries that have some form of the right to adequate housing.

The Right to Adequate Housing in Wales: The Evidence Base


GUIDE

A More Equal Wales: The Socio-economic Duty: Examples of Inequalities of Outcome Due to Socio-economic Disadvantage and COVID-19

This guidance document by Welsh Government presents examples of inequalities of outcome which arise from socio-economic disadvantage and where these have been exacerbated as a result of COVID-19, including impacts on health outcomes. The guidance is intended to be a useful starting point for policy makers in their consideration of inequality of outcomes arising from socio-economic disadvantage.

A More Equal Wales: The Socio-economic Duty: Examples of Inequalities of Outcome Due to Socio-economic Disadvantage and COVID-19


REPORT COVID

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19

This report by Welsh Government explores the impact of the COVID-19 pandemic on disabled people in Wales, including evidence on the disruption to disabled people’s access to on-going medical treatment and health services.

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19


REPORT COVID

Health of Individuals with Lived Experience of Homelessness in Wales During the COVID-19 Pandemic

This report by Public Health Wales demonstrates that healthcare needs are greater in those with lived experience of homelessness. It reinforces the need to reduce barriers to access to healthcare and improve preventative care and management of long-term health conditions in individuals with insecure housing arrangements.

Health of Individuals with Lived Experience of Homelessness in Wales During the COVID-19 Pandemic


REPORT COVID

COVID-19 in Wales: The Impact on Levels of Health Care Use and Mental Health of the Clinically Extremely Vulnerable

This report by Public Health Wales reveals marked declines in planned and emergency care for clinically extremely vulnerable and general populations in Wales during 2020 and suggests this unmet need is likely to cause a considerable backlog in demand for mental health and physical health services, and translate to increased service use over time.

COVID-19 in Wales: The Impact on Levels of Health Care Use and Mental Health of the Clinically Extremely Vulnerable


REPORT

The Mental Health Measure Ten Years On

The Mental Health Measure (the Measure) is a key piece of Welsh mental health law. Since its implementation, ten years ago, it has provided a legal framework for improving mental health services and formed a central part of the Welsh Government’s ten year Together for Mental Health Strategy. A decade on from the implementation of the Measure, this report by Mind Cymru looks at how it has changed people’s experiences of accessing support.

The Mental Health Measure Ten Years On


REPORT

A Perfect Storm: The Funding Crisis Pushing the Welsh Violence Against Women, Domestic Abuse and Sexual Violence (VAWDASV) Sector to the Brink

This report by Welsh Womens Aid explains how factors such as Covid-19, Brexit, the Cost-of-Living crisis, high service demand, and a lack of sustainable funding are impacting frontline workers and the women and children in need of specialist VAWDASV support in a way that could bring the sector into irreversible decline.

A Perfect Storm: The Funding Crisis Pushing the Welsh Violence Against Women, Domestic Abuse and Sexual Violence (VAWDASV) Sector to the Brink


STRATEGY

Learning Disability Services, Our Plans for 2022 to 2026

This Easy Read document covers the areas Welsh Government want to work on. It explains what they plan to do to support people with learning disabilities and when.

Learning Disability Services, Our Plans for 2022 to 2026


Health and Income and Social Protection

Resources

REPORT

A Basic Income to Improve Population Health and Well-Being in Wales?

This report by Public Health Wales presents learning related to health and the wider determinants of health from basic income schemes implemented around the world.

A Basic Income to Improve Population Health and Well-Being in Wales?


GUIDE

A More Equal Wales: The Socio-economic Duty - Examples of Inequalities of Outcome due to Socio-economic Disadvantage and COVID-19

This guidance document by Welsh Government presents examples of inequalities of outcome which arise from socio-economic disadvantage and where these have been exacerbated as a result of COVID-19, including impacts on health outcomes. The guidance is intended to be a useful starting point for policy makers in their consideration of inequality of outcomes arising from socio-economic disadvantage.

A More Equal Wales: The Socio-economic Duty - Examples of Inequalities of Outcome due to Socio-economic Disadvantage and COVID-19


REPORT COVID

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19

This report by Welsh Government explores the impact of the COVID-19 pandemic on disabled people in Wales, including how disabled people have disproportionately fallen behind with household bills during the pandemic, because of their position in the labour market and increased costs associated with being disabled.

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19


REPORT

Emerging Drivers of Vulnerability to Health Inequity in the Context of COVID-19: Perspectives and Response from the Voluntary and Community Sector in Wales

This report by Public Health Wales sets out qualitative research with participants recruited from a range of Voluntary and Community Sector (VCS) organisations in Wales. The report identifies key emergent needs related to the pandemic, including economic insecurity due to strained household finances and job loss, as well as worsening mental health due to anxiety and loneliness, digital exclusion, loss of face-to-face services and limitations in the statutory response.

Emerging Drivers of Vulnerability to Health Inequity in the Context of COVID-19: Perspectives and Response from the Voluntary and Community Sector in Wales


Health and Social and Human Capital

Resources

REPORT

Resilience: Understanding the Interdependence Between Individuals and Communities

This report by Public Health Wales brings together evidence from published literature on the interdependence between individual and community resilience, and provides an overview of existing programmes to strengthen resilience.

Resilience: Understanding the Interdependence Between Individuals and Communities


REPORT

The Right to Adequate Housing in Wales: The Evidence Base

This independent research report by Alma Economics, commissioned by Tai Pawb, the Chartered Institute of Housing Cymru and Shelter Cymru, explores housing and housing inequality in Wales. The report presents evidence suggesting a direct link between inadequate and unaffordable housing and education.

The Right to Adequate Housing in Wales: The Evidence Base


GUIDE

A More Equal Wales: The Socio-economic Duty - Examples of Inequalities of Outcome Due to Socio-Economic Disadvantage and COVID-19

This guidance document by Welsh Government presents examples of inequalities of outcome which arise from socio-economic disadvantage and where these have been exacerbated as a result of COVID-19, including issues of education and digital exclusion. The guidance is intended to be a useful starting point for policy makers in their consideration of inequality of outcomes arising from socio-economic disadvantage.

A More Equal Wales: The Socio-economic Duty - Examples of Inequalities of Outcome Due to Socio-Economic Disadvantage and COVID-19


REPORT COVID

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19

This report by Welsh Government explores the impact of the COVID-19 pandemic on disabled people in Wales, including evidence around increased exclusion, loneliness, isolation and declining mental health and barriers to accessing on-line services.

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19


REPORT COVID

Emerging Drivers of Vulnerability to Health Inequity in the Context of COVID-19: Perspectives and Response from the Voluntary and Community sector in Wales

This qualitative research by Public Health Wales draws on insights from the Voluntary and Community Sector (VCS) in Wales to help understand how the COVID-19 pandemic has affected vulnerability. It found that during the pandemic, vulnerability rapidly arose and was often exacerbated when individuals were unable to access support from particular resources, services and local infrastructure.

Emerging Drivers of Vulnerability to Health Inequity in the Context of COVID-19: Perspectives and Response from the Voluntary and Community sector in Wales


REPORT COVID

Children and Young People’s Mental Well-Being During the COVID-19 Pandemic

This report prepared for Public Health Wales reports that spending time outside, keeping physically active, engaging in creative activities and hobbies, establishing routines, maintaining contact with friends online and being aware of the nature of Coronavirus and how to prevent its spread, helped reduce the negative mental health impacts of the pandemic.

Children and Young People’s Mental Well-Being During the COVID-19 Pandemic


REPORT

Human Rights are Lifetime Rights

Age Cymru was funded from January to July 2022 to deliver a human rights project in partnership with the Welsh Government. The purpose of this project was to raise awareness of human rights, and to engage with older people across Wales to embed the message that older people are citizens and participants in society, who should expect to have their human rights upheld.

Human Rights are Lifetime Rights


REPORT

Coronavirus: The Consequences for Mental Health in Wales

This Mind Cymru report describes the ongoing impact of the coronavirus pandemic on people with mental health problems across Wales.

Coronavirus: the consequences for mental health in Wales


REPORT

Attitudes and Disability: The Experiences of Disabled People in 2022

Changing attitudes is a topic that is consistently raised by disabled people as a top priority, and Scope UK believes negative attitudes and stereotypes are a root cause of the inequality faced by disabled people today. Building on previous attitudes research carried out 5 years ago, the research seeks to understand what attitudes disabled people face, and the effect that has on their work, education, and social lives.

Attitudes and Disability: The experiences of disabled people in 2022


Health and Employment and Working Conditions

Resources

REPORT

Inequality in a Future Wales: Areas for Action in Work, Climate and Demographic Change

This report explores how three key trends – changes to how we work, climate change and demographic change – may affect inequalities in a future Wales. It identifies that preparations for a changing future of work should focus on job redesign and training and that new policies, such as Universal Basic Income (UBI) and remote working, need to consider equality.

Inequality in a Future Wales: Areas for Action in Work, Climate and Demographic Change


REPORT COVID

A COVID-19 Pandemic World and Beyond: The Public Health Impact of Home and Agile Working in Wales Summary Report

This Health Impact Assessment summary report identifies a broad range of positive and negative implications from home and agile working for the workforce in Wales, both in the short and longer term, and identifies actions that could be adopted to promote individual, community and societal well-being which also meet the needs of organisations and employers.

A COVID-19 Pandemic World and Beyond: The Public Health Impact of Home and Agile Working in Wales Summary Report


PAPER

Refugee Employment and Skills Support Study

This independent study looks at the employment aspirations, skills and experience of refugees and asylum seekers and the barriers they face in funding employment.

Refugee Employment and Skills Support Study


REPORT

The Right to Adequate Housing in Wales: The Evidence Base

This independent research report by Alma Economics, commissioned by Tai Pawb, the Chartered Institute of Housing Cymru and Shelter Cymru, explores housing and housing inequality in Wales. The report presents evidence that has explored associations between unaffordable housing with productivity losses and economic impact.

The Right to Adequate Housing in Wales: The Evidence Base


GUIDE

A More Equal Wales: The Socio-economic Duty - Examples of Inequalities of Outcome Due to Socio-Economic Disadvantage and COVID-19

This guidance document by Welsh Government presents examples of inequalities of outcome which arise from socio-economic disadvantage and where these have been exacerbated as a result of COVID-19, including issues of sector shutdowns, younger workers and lower earners. The guidance is intended to be a useful starting point for policy makers in their consideration of inequality of outcomes arising from socio-economic disadvantage.

A More Equal Wales: The Socio-economic Duty - Examples of Inequalities of Outcome Due to Socio-Economic Disadvantage and COVID-19


REPORT COVID

COVID-19 and Employment Changes in Wales: What We Know About Current and Future Impacts

This report presents evidence that certain population groups have been more affected by the COVID-19 pandemic than others, including young people, women, black and minority ethnic groups, low income families and single parents.

COVID-19 and Employment Changes in Wales: What We Know About Current and Future Impacts


ARTICLE

Characteristics of Those Most Vulnerable to Employment Changes During the COVID-19 Pandemic: A Nationally Representative Cross-sectional Study in Wales

This research article reveals that a number of vulnerable population groups experienced detrimental employment outcomes during the initial stage of the COVID-19 pandemic in Wales. It recommends that to ensure that health and wealth inequalities are not exacerbated by COVID-19 or the economic response to the pandemic, interventions should include the promotion of secure employment and target the groups identified as most susceptible to the emerging harms of the pandemic.

Characteristics of Those Most Vulnerable to Employment Changes During the COVID-19 Pandemic: A Nationally Representative Cross-sectional Study in Wales


REPORT COVID

COVID-19 and Employment Changes in Wales: Insights for Policy, Young People, Employment and Health

Public Health Wales commissioned Beaufort Research to explore perspectives on employment challenges faced by young people (with and without dependent children) related to the pandemic; and what could be done to mitigate the impact of COVID-19 related employment changes on young people.

COVID-19 and Employment Changes in Wales: Insights for Policy, Young People, Employment and Health


REPORT COVID

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19

This report by Welsh Government explores the impact of the COVID-19 pandemic on disabled people in Wales, including how experiences of work and employment have contributed to the disadvantages disabled people have experienced during the pandemic.

Locked Out: Liberating Disabled People’s Lives and Rights in Wales Beyond COVID-19


REPORT COVID

Emerging Drivers of Vulnerability to Health Inequity in the Context of COVID-19: Perspectives and Response from the Voluntary and Community Sector in Wales

This report by Public Health Wales sets out qualitative research with participants recruited from a range of Voluntary and Community Sector (VCS) organisations in Wales. The report identifies key emergent needs related to the pandemic, including economic insecurity due to strained household finances and job loss, as well as worsening mental health due to anxiety and loneliness, digital exclusion, loss of face-to-face services and limitations in the statutory response.

Emerging Drivers of Vulnerability to Health Inequity in the Context of COVID-19: Perspectives and Response from the Voluntary and Community Sector in Wales


REPORT

Survey Results 2020: Fertility Matters at Work

Survey results from the 2020 survey looking into women's fertility experiences within the workplace, including any relevant policy in place, support offered, and impacts this may have had upon their career trajectory.

Survey Results 2020: Fertility Matters at Work


REPORT

Manifesto for a Gender Equal Wales

In this Manifesto, Chwarae Teg sets out their vision for how the next Welsh Government can deliver a gender equal Wales where all women, of all backgrounds, can fulfil their potential and achieve equal outcomes.

Manifesto for a Gender Equal Wales


REPORT

Tackling Sexual Harassment in the Workplace

The project by Chwarae Teg, funded by Rosa: Now’s The Time Challenge , has undertaken research on how employers, managers, and women view current experiences of sexual harassment and identifies five key requirements to create a workplace that does not tolerate sexual harassment: culture; policy; training; reporting mechanisms; and the way employers respond to reports.

Tackling Sexual Harassment in the Workplace


Solutions

Overview

Health inequities are the result of many and varied factors that are often outside people’s direct control. It is not enough to identify the big issues that need addressing but to identify a range of tools, actions, investments, policies and practical solutions for improving health and well-being and reducing inequalities. 

Health inequities are not inevitable; they can be reduced or prevented. Solutions are required that address the unmet needs of populations made vulnerable by systemic inequity. Real health benefits can be attained at an affordable cost and within resource constraints if effective strategies are adopted. 

Healthcare alone cannot close the health inequity gap. Health inequities are multi-faceted, often demonstrating the interlinked nature of multiple factors, not least avoidable social inequalities in factors such as where we live, our household earnings, and our opportunities for good work. 

This complexity means there is no simple ‘one size fits all’ solution to reduce health inequities. Rather, efforts to reduce health inequities requires action on all the social determinants of health – the five essential conditions – across the life course. As such, actions in all areas of government policy affect health.

Coordinated policy action on the determinants of health, combined with well-designed and implemented governance and policy approaches can have effect on 1) reducing the health gap; 2) improving overall population health and well-being; and 3) achieving inclusive and sustainable economic growth and prosperity for all.

Ongoing challenges – not least the COVID-19 pandemic, the cost of living crisis and climate change – emphasise that we live in an increasingly changing and globalised world, posing both challenges and opportunities. Despite its catastrophic consequences, the pandemic has opened a window of opportunity to adopt and accelerate new approaches and solutions to achieve healthier and more resilient people, societies and economies. As well as potential solutions to ‘build back fairer’ from the pandemic, there is also potential for a ‘green recovery’ by identifying opportunities to support population health through sustainable means and to put health in all policies to identify and influence the health and equity impacts of policy decisions. 

The Programme for Government commits the Welsh Government to ‘move to eliminate inequality in all its forms’. Making the case and advocating for investment in well-being and health equity are essential to enable evidence-informed, sustainable and fair policy and action for the benefit of people, communities, societies, the economy and the planet. The scale and nature of the challenge calls for a co-ordinated, whole-sector response, making a strong case for community-centred approaches to public health and whole-system approaches to health equity. 

How public policy and decision making responds to persistent and new challenges in uncertain times will rely heavily on the ability to shape responses to big trends. The challenge is how to implement change across a complex system so that it endures over time

Futures work is about thinking and planning for the long term. It can help when considering the challenges we are likely to face in Wales that could influence and shape the future, as well as those that are unforeseen or uncertain, while supporting the development of policies or strategies that will prove robust in the face of many different futures. The Future Trends Report 2021 and associated Evidence Pack can support decision-makers understand Wales’ future better and make more informed decisions for current and future generations. The Three Horizons Toolkit can also help public bodies to think and plan for the longer term. Efforts to consider what inequality in a future Wales might look like can be supported by the framework established by the Well-being of Future Generations (Wales) Act 2015, which compels us to think differently about our approach to health inequalities. The Future Generations Commissioner has set out case studies and big ideas from Wales and further afield on what individuals, communities and public bodies are doing to meet the well-being goals

The Five Essential Conditions

Understanding ‘what works’ can inform decisions about public services. There are many tools, resources, practical frameworks and software applications to help measure and understand health inequalities. Also, the WHO Europe Health Equity Status Report Initiative (HESRi) has brought together case studies of success stories, promising practices and lessons learned from the local, national and European levels. The case studies show how countries have overcome the challenges related to disinvestment in policies and approaches that impact on health equity, and maximised new opportunities for advancing objectives to increase equity in health.

This section brings together information on potential solutions and good practice, and directs those attempting to tackle health inequalities to reports, practical guides, toolkits and techniques that have been implemented. Different tools and techniques are appropriate at different stages of development. For example, when a new service is being planned it might be relevant to undertake a Health Impact Assessment, whereas if services have been in place for some time but are under review, tools such as Multi-Criteria Decision Analysis or Programme Budgeting and Marginal Analysis may be more appropriate. 

The solutions-focused resources in this section are presented within a broader context, which acknowledges the underlying factors driving health equity. The WHO Regional Office for Europe report Driving forward health equity – the role of accountability, policy coherence, social participation and empowerment, suggests that evidence increasingly demonstrates that addressing one or a combination of the conditions that are crucial to giving people an equal chance in life (e.g. living environment, education, employment) in isolation from broader social and institutional factors in society has led to progress not being as fast as expected. Rather, to scale up action on health equity and enable the conditions necessary to lead healthy and prosperous lives, action needs to be taken on underlying factors driving health equity. The report presents the findings of a scientific expert review that identified four key drivers of health equity – accountability, policy coherence, social participation and, underlying them, empowerment – as social and institutional factors that drive health equity on their own, but are also dynamic and interact with each other. Work on these drivers has informed the Health Equity Status Report initiative and has resulted in independent companion papers each elaborating further on accountability, policy coherence and social participation as drivers of health equity. A further policy brief presents evidence showing that political participation, representation, accountability and transparency are also important preconditions for health equity.

The role of behavioural science in addressing health inequalities

Increasing health equity requires both the social and behavioural causes of health inequalities to be addressed in parallel. Behavioural science, the scientific study of behaviour, provides evidence-based approaches to understanding and influencing behaviour in specific populations in a given context. This scientific approach ensures an accurate understanding of behaviours and what drives them rather than relying on assumptions of what is believed to influence behaviour. It also facilitates consideration of both conscious and automatic processes that have an influence on our behaviour.

Behavioural science methods support the identification of populations/sub populations most at risk of, or affected by, health inequalities and provides evidence base frameworks for exploring the determinants of behaviour from the perspective of the population of interest. This enables targeted intervention for segments of the population experiencing health and/or social inequalities. The systematic approach offered by behavioural science prompts consideration of equity at every stage in process of developing and implementing policies, services, and communications.

A guide to using behavioural science, which comes from a Public Health Wales and UCL Centre for Behaviour Change partnership, Improving health and well-being: a guide to using behavioural science in policy and practice offers an introduction to behavioural science and a step-by-step process for developing/optimising interventions (policy, service or communications) designed to start, stop, continue or change behaviours.

Stay up to date. Come back to this page for spotlight features on practical, sustainable health equity solutions. The Welsh Health Equity Solutions Platform is continuously updated with the latest resources and materials, including data, policies, reports and case studies. Contact us to be notified of updates to the Solutions Platform.

Get in touch to get involved. We are working with stakeholders and users to update and expand the Solutions Platform with projects, case studies and spotlight features focused on health equity. Contact us to share your projects and success stories, to feature on the platform.

Health and Health Services

The Inverse Care Law describes the relationship between the need for health care and how it is used, acknowledging that often, people who are in most need of health care are the least likely to receive it. Throughout the COVID-19 pandemic it was noted that those living in more disadvantaged areas had worse outcomes, once again shining the spotlight on inequalities. 

When there is acute demand (e.g. hospital waiting lists following the pandemic) it can be difficult to allocate spend to prevention, but this is the only way to reduce further acute demand at a later time point. Tools such as Return on Investment and Social Return on Investment can be helpful. 

When planning and delivering healthcare services, there are many tools and techniques that can be applied to reduce inequalities. These include the use of health impact assessment, health needs assessment, and economic assessments

Decisions on services are based on data: information from the people in need (e.g. health needs assessment and epidemiological data), where it is best to spend resources (e.g. NICE guidelines or return on investment studies) and data on reducing inequalities (e.g. health impact assessment or integrated impact assessment). Investment is often driven by need and data but this is not always the case.  

Multi-criteria Decision Analysis and Programme Budgeting and Marginal Analysis

As a tax-funded system, the NHS is under constant strain as the demand for healthcare is close to infinite, whilst healthcare resources are finite. To create a balance between finite resources and infinite wants and needs, choices are necessary and consequently costs and benefits must be compared. Prioritisation is also required to assist this decision-making so resources are used in a way that maximises their benefit. 

Multi-criteria Decision Analysis (MCDA) and Programme Budgeting and Marginal Analysis (PBMA) are tools that aid decision-making and resource allocation so that benefits are maximised. They offer a framework to identify interventions that are cost-effective and address socio-economic equity, that improve productivity and keep people in work in Wales (e.g. addressing musculoskeletal issues and mental health). These frameworks require information on quantifiable indicators for interventions, for example how many people access services; what services cost; their reach; whether they are evidence-based and cost-effective; their benefits (e.g. how many people quit smoking as a result of the intervention). These frameworks can also assist in the development of key performance indicators prior to undertaking an evaluation.


Useful Resources

GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investment in the health sector, a life-course approach to health and social care, and early access to mental health services. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


GUIDE

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

This practical guide by Public Health Wales is a tool to improve governance, investment and accountability for health and equity. The guide is intended to help the development of evidence-informed, context-tailored advocacy reports and other relevant documents and tools, enabling healthy policy- and decision-making across different sectors, levels of government and country settings. It aims to prevent disinvestment in health, increase investment in prevention (public health), and mainstream cross-sectoral investment to address the wider determinants of health and equity.

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


REPORT COVID

Placing Health Equity at the Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives For All in Wales

This report by Public Health Wales places health equity at the heart of a sustainable response and recovery to the COVID-19 pandemic. The report explores the impact of the pandemic on health services in Wales and the opportunities to adopt and accelerate new approaches and solutions to achieve healthier and more resilient people, societies and economies.

Placing Health Equity at the Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives For All in Wales


REPORT

Making the Difference: Tackling Health Inequalities in Wales

This short paper by the Welsh NHS Confederation outlines ideas on ways of working that would ensure collective impact in addressing health inequalities, including an example of approaches to transform the way people access and rely on health and care by integrating community development initiatives with established services.

Making the Difference: Tackling Health Inequalities in Wales


REPORT

Reducing Health Inequalities Through New Models of Care: A Resource for New Care Models

This report by the Institute for Health Equity provides an analysis of the opportunities for new models of care and place-based health systems to improve health and reduce health inequalities in England. The report describes the opportunities for healthcare organisations to do more to improve population health and reduce inequalities in health. In particular, that healthcare services must integrate with other sectors to form place-based health systems that influence wider community, social and economic drivers of health, in addition to providing equitable access to treatments.

Reducing Health Inequalities Through New Models of Care: A Resource for New Care Models


STRATEGY

Health Systems Resilience During COVID-19: Lessons for Building Back Better

This health policy series book by the WHO European Observatory on Health Systems and Policies sets out that health systems resilience – defined as the ability to absorb, adapt, and transform to cope with shocks – is needed to ensure sustained performance of health system functions. The book identifies 20 key strategies, grouped according to the health systems functions that have been found as enhancing health systems resilience in the face of COVID-19. The strategies describe how to secure and (re)allocate financing while leaving no one behind, and emphasize the importance of governance and the need for more health workers who are fit for the job and well supported.

Health Systems Resilience During COVID-19: Lessons for Building Back Better


GUIDE

Improving the Quality of Health Services: Tools and Resources

This compendium by the World Health Organization describes tools and resources for WHO Member States aiming to improve the quality of service delivery. The compendium includes tools and resources on quality improvement and provides examples of how the tools and resources have been applied in country settings. It covers a range of technical areas from hospital management and emergency care to primary care and person-centered care.

Improving the Quality of Health Services: Tools and Resources


STATEMENT

The Path to Global Equity in Mental Health Care in the Context of COVID-19

This comment published in The Lancet suggests that efforts to achieve equity in mental health should address: involvement of people with lived experience; collection and integration of social determinants data to inform healthcare system responses; implementation of services responsive to population needs; leveraging care providers proportionate to population need; creating innovative and accessible services; incorporating equity objectives into global health policy activities and inter-sectoral programmes; and measuring cost-effectiveness.

The Path to Global Equity in Mental Health Care in the Context of COVID-19


Health and Income and Social Protection

In order to live a healthy and happy life people need economic security. In Wales, the Socio-economic Duty came into force on 31 March 2021. Public bodies subject to the Duty must, when making decisions of a strategic nature about how to exercise their functions, have due regard to the desirability of exercising them in a way that is designed to reduce the inequalities of outcome which result from socio-economic disadvantage. The Welsh Government has published a progress tracker to support public bodies in meeting the requirements of the Duty. Public Bodies should use the progress tracker for benchmarking how requirements of the Duty are being met; understanding how to take forward improvements to effect meaningful culture change, beyond the requirements of the Duty; and for encouraging reflection and the recording of progress. 

Many organisations have explored potential solutions to the issue of income security and social protection. The Institute of Fiscal Studies produced a report exploring income inequalities in the UK. The report presents options for addressing the effects of rising unemployment, namely reducing the cost of employing people using the tax system; raising public service expenditure and public sector employment; increased funding of (re-)training programmes; boosting out of work benefits; or more fundamental changes to introduce more social insurance into the welfare system. 

The Welsh Government has outlined plans to extend support for care-leavers through a Basic Income pilot in Wales. The pilot is designed to extend support for care-leavers and will provide a test for the stated benefits of basic income, such as addressing poverty and unemployment and improving health and financial well-being. Public Health Wales has produced a Basic Income report which considers a range of evidence and explores the potential impacts on health and well-being. It also looks into the different approaches to policy design and implementation internationally. The report identifies options for policy-makers who are thinking about basic income, such as carrying out economic modelling, placing health and well-being as a core aim of any scheme, and carrying out feasibility studies to understand how basic income could be introduced in Wales.


Useful Resources

GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in universal social protection. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


GUIDE

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

This practical guide by Public Health Wales is a tool to improve governance, investment and accountability for health and equity. The guide is intended to help the development of evidence-informed, context-tailored advocacy reports and other relevant documents and tools, enabling healthy policy- and decision-making across different sectors, levels of government and country settings. It aims to prevent disinvestment in health, increase investment in prevention (public health), and mainstream cross-sectoral investment to address the wider determinants of health and equity.

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


REPORT

A Basic Income to Improve Population Health and Well-being in Wales?

This report by Public Health Wales is aimed at decision-makers considering basic income in Wales. The report introduces the concept of basic income, appraises the existing evidence from pre-existing schemes and trials, and explores what steps Wales would need to consider in developing a basic income proposal that has improving health and wellbeing as a key objective. This report does not make formal recommendations; rather, it aims to provide evidence to inform the debate, to support future decision-making, and shape thinking for further research.

A Basic Income to Improve Population Health and Well-being in Wales?


PAPER

Universal Basic Income Policies and Their Potential for Addressing Health Inequities: Transformative Approaches to a Healthy, Prosperous Life for All

This discussion paper by WHO Europe is based on a broad literature review, including academic literature, policy documents, impact evaluations from Universal Basic Income (UBI) pilot approaches, and other similar programmes. The paper explores the context factors shaping the case and conditions for basic income reform, and discusses some of the controversies and challenges around UBI as concrete policy measures.

Universal Basic Income Policies and Their Potential for Addressing Health Inequities: Transformative Approaches to a Healthy, Prosperous Life for All


REPORT COVID

Placing Health Equity at the Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives for All in Wales

This report by Public Health Wales places health equity at the heart of a sustainable response and recovery to the COVID-19 pandemic and explores the impact of the pandemic on the socio-economic gap and different sectors in Wales.

Placing health equity at the heart of the COVID-19 sustainable response and recovery


WEBINAR COVID

Confronting Poverty and Income Insecurity During COVID-19 Through Strengthening Social Protection

This webinar is part of a global webinar series by the World Health Organization on the COVID-19 pandemic’s impact on equity and the social determinants of health. The webinar includes discussions on the global evidence on the role of social protection in mitigating the health inequity impacts arising from poverty and income insecurity caused by the COVID-19 pandemic.

Confronting Poverty and Income Insecurity During COVID-19 Through Strengthening Social Protection


REPORT

The Cost-of-Living Crisis: A Welsh Action Plan

This short report sets out the Bevan Foundation’s proposals for action in the next 6-12 months that will ease the pressure of the cost-of-living crisis for the least well-off. It recommends action on the three areas that are the biggest pinch-points in households’ budgets: housing, energy and food. It focuses on action that is deliverable in the short term, using existing devolved grants and allowances and by working with community organisations, and makes recommendations about using them effectively.

The Cost-of-Living Crisis: A Welsh Action Plan


Health and Living Conditions

A number of the wider determinants of health derive from our health and living conditions; for example, housing. The need for security in relation to having and keeping a home and being surrounded by a safe and consistent home environment, and its impact on both physical and mental health and well-being, has long been recognised.

Public Health Wales has produced a number of reports that highlight the issues of poor quality housing and its impact on health. These reports include potential solutions, including the case for investment in housing which outlines the need to tackle housing as a fundamental determinant of health and presents solutions including: eliminating cold damp and mouldy homes; improving ventilation; energy efficiency measures and fuel poverty schemes; support for vulnerable households instead of area-based interventions. 

In Europe, a project mapping trends and policies to tackle homelessness in Europe. This has included setting out recommendations to address homelessness, including the right to adequate housing for all (vulnerable) people in Europe and the integration of health services within housing solutions.

During times of uncertainty, such as the COVID-19 pandemic, a home can provide a secure and stable base for individuals and households. A health impact assessment of the impact of COVID-19 on housing was undertaken by Public Health Wales, and made further recommendations for the future including: investment in affordable, safe and sustainable housing as part of a ‘green’ pandemic recovery, and support for sustainable place-making as outlined in Planning Policy Wales; encouragement of longer-term tenancies to give tenants greater security and greater protection from eviction- balancing this with the needs of landlords, to reduce barriers to gaining future secure accommodation. 

Useful Resources

GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in spatial and urban planning initiatives, supportive and resilient communities, greener and safer communities, and multifaceted housing interventions. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


GUIDE

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

This practical guide by Public Health Wales is a tool to improve governance, investment and accountability for health and equity. The guide is intended to help the development of evidence-informed, context-tailored advocacy reports and other relevant documents and tools, enabling healthy policy- and decision-making across different sectors, levels of government and country settings. It aims to prevent disinvestment in health, increase investment in prevention (public health), and mainstream cross-sectoral investment to address the wider determinants of health and equity.

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


REPORT

Making a Difference - Housing and Health: A Case for Investment Main Report

This report by Public Health Wales presents the case for investing in health and housing in Wales. The report outlines the costs of inadequate housing to the NHS and to society, including evidence on particular population groups including older people and people with a disability and evidence on homelessness. The report also identifies priority areas for preventative action, evidence on effective housing interventions, and case studies of actions taken in Wales to address housing quality, unsuitable homes and homelessness.

Making a Difference - Housing and Health: A Case for Investment Main Report


REPORT COVID

Placing Health Equity at the Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives for All in Wales

This report by Public Health Wales places health equity at the heart of a sustainable response and recovery to the COVID-19 pandemic and explores the impacts of the pandemic on the housing system, homelessness, access to blue and green spaces, crime and domestic violence in Wales.

Placing Health Equity at the Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives for All in Wales


REPORT COVID

Maximising Health and Well-being Opportunities for Spatial Planning in the COVID-19 Pandemic Recovery

This report by Public Health Wales sets out the evidence on the impact of COVID-19 on communities in Wales, including housing, healthy food environments, local foundational economies, transportation, and green and blue infrastructure. The report advocates for public health and health care and planning systems to come together to enable effective and sustainable land use planning and placemaking approaches in building sustainable places that improve health and well-being.

Maximising Health and Well-being Opportunities for Spatial Planning in the COVID-19 Pandemic Recovery


GUIDE

Health Impact Assessment (HIA) and Local Development Plans (LDPs): A Toolkit for Practice

This toolkit by Public Health Wales outlines the context and policy levers for HIA and land use planning and practical advice and resources which can be used as an accessible reference when required during the development of local development plans (LDPs), strategic development plans (SDPs) and supplementary planning guidance (SPGs). The Toolkit aims to support the ongoing collaboration between the planning and public health sectors in Wales in order to maximize positive health and well-being outcomes through land use planning policies that create healthy, equitable and cohesive communities.

Health Impact Assessment (HIA) and Local Development Plans (LDPs): A Toolkit for Practice


REPORT

Planning and Enabling Healthy Environments

This report by Public Health Wales promotes a better understanding of the broader environmental and social barriers that impact on health, well-being and inequalities. The report enables policies and plans that can ripple out to benefit individual physical and mental well-being, community and environmental health. The report is supplemented by a case studies resource with examples from Wales and the United Kingdom in relation to: investment in town centres and the high street, town regeneration, hot food takeaways, residential developments, green infrastructure, and areas for play.

Planning and Enabling Healthy Environments


REPORT COVID

No Place Like Home? Exploring the Health and Well-being Impact of COVID-19 on Housing and Housing Insecurity

This report by Public Health Wales is based on a comprehensive and participatory Health Impact Assessment (HIA) explores the health and well-being impact of COVID-19 on housing and housing insecurity. The report sets out actions to promote individual, community and societal well-being. The evidence in this report can assist policy and decision-makers when considering the impact of the pandemic on housing and housing insecurity, so that potential inequalities and negative impacts can be reduced, and future opportunities for positive health and well-being maximised.

No Place Like Home? Exploring the Health and Well-being Impact of COVID-19 on Housing and Housing Insecurity


REPORT

Making a Difference: Reducing Health Risks Associated with Road Traffic Pollution in Wales

This report by Public Health Wales outlines solutions that seek to reduce the emissions from road traffic and achieve positive public health impacts through developing a more sustainable economy, thriving society and optimum health and well-being for the present and future generations in Wales.

Making a Difference: Reducing Health Risks Associated with Road Traffic Pollution in Wales


REPORT

Preventing Youth Homelessness: An International Review of Evidence

This report by the Wales Centre for Public Policy is based on an international review. The report identifies evidence-based interventions, promising practices, youth-identified prevention priorities, and intersecting policy elements contributing to the prevention of youth homelessness. The evidence review was guided by questions including ‘Which policies and programmes are effective in preventing youth homelessness?’, and ‘What are the characteristics of effective strategies to prevent youth homelessness?’

Preventing Youth Homelessness: An International Review of Evidence


GUIDE

Reducing Homelessness Amongst Migrants, Refugees and Asylum Seekers: Good Practice Guide

This good practice guide by the Tai Pawb for the Welsh Local Government Association shares good practice examples from Wales and other nations on preventing and tackling homelessness among migrant populations.

Reducing Homelessness Amongst Migrants, Refugees and Asylum Seekers: Good Practice Guide


PAPER

Making the Difference: Tackling Health Inequalities in Wales

This short paper by the Welsh Confederation outlines ideas on ways of working that would ensure collective impact in addressing health inequalities, including the importance of good quality, affordable social homes and affordable green energy solutions.

Making the Difference: Tackling Health Inequalities in Wales


REPORT

Working Together to End Homelessness from Social Housing

This report by Shelter Cymru recognises the relationship between housing and physical and mental health. The report is informed by the experiences of some people who have been very close to losing their social homes, and the work of social landlords and other organisations in helping to prevent homelessness from social housing.

Working Together to End Homelessness from Social Housing


REPORT COVID

Addressing the National Syndemic: Place-based Problems and Solutions to UK Health Inequality

This report by Public Policy Projects and the Institute of Health Equity presents examples of what can be done to address health inequalities: by the health and care system, local and regional government, the voluntary and community sector, and business, working with individuals and communities.

Addressing the National Syndemic: Place-based Problems and Solutions to UK Health Inequality


REPORT

Levelling Up Health: A Practical, Evidence-based Framework

This report, co-led by the Universities of Cambridge and Newcastle (England), provides practical guidance on how to reduce health inequalities at local and regional level. The guidance is aimed at central and local government as well as other agencies with a stake in improving health. It includes case studies on models and approaches to design and shape new places so that they promote health and wellbeing, and services and programmes designed around the specific needs of places and communities based on good community engagement.

Levelling Up Health: A Practical, Evidence-based Framework


GUIDE

WHO Housing and Health Guidelines: Recommendations to Promote Healthy Housing for a Sustainable and Equitable Future

These guidelines by the World Health Organization provide evidence-based recommendations on conditions and interventions that promote healthy housing, and facilitates leadership in enabling health and safety considerations to underpin housing regulations. The guidance will enable health considerations to inform housing, energy, community development, and urban development policies.

WHO Housing and Health Guidelines: Recommendations to Promote Healthy Housing for a Sustainable and Equitable Future


REPORT

Health and Well-being Alliance: Mind the Gap: What’s Stopping Change? The Cost-of-living Crisis and The Rise in Inequalities in Wales

In this report, the Welsh NHS Confederation Health and Well-being Alliance examine the cost-of-living crisis and rise in inequalities in Wales. It calls on the Welsh Government to outline the action being taken across all government departments, setting out how success will be measured and evaluated through shared performance measures and outcomes for all public bodies in Wales, accompanied by guidance on how individual organisations should collaborate to reduce inequalities and tackle the cost-of-living crisis.

Health and Well-being Alliance: Mind the Gap: What’s Stopping Change? The Cost-of-living Crisis and The Rise in Inequalities in Wales


REPORT

Review of Poverty and Social Exclusion in Wales

The Wales Centre for Public Policy (WCPP) have prepared two reports on poverty and social exclusion in Wales as part of our work to deliver a review of international poverty and social exclusion strategies, programmes and interventions for the Welsh Government. One report focuses on quantitative evidence, and another focuses on secondary qualitative evidence relating to the lived experience of poverty and social exclusion in Wales.

Review of Poverty and Social Exclusion in Wales


REPORT

UK Poverty 2023

This is the second issue of Joseph Rowntree Foundation poverty report, which looks at trends in poverty across many important characteristics and impacts.

UK Poverty 2023


REPORT

Snapshot of Poverty

The Bevan Foundation’s Snapshot of Poverty report is divided into three sections. The first section sets out to provide an overview of how people in Wales are managing rising costs. The second section looks in greater detail at the experiences of the groups that are being most affected by rising costs. The final section explores the impact of the cost-of-living crisis on people’s health

Snapshot of Poverty


Health and Social and Human Capital

Human capital and social capital are known to have an impact on health and well-being. Evidence from Europe suggests that policy interventions targeted at improving individual social capital can directly improve individual health and contribute to community social capital, reinforcing the beneficial role of individual social capital.

Human Capital

Definitions of human capital encompass the notion that there are investments in people such as education, training or health, and that these investments increase an individual’s productivity. Human capital is the value of individuals’ skills, knowledge, abilities, social attributes, personality and health attributes. These factors enable individuals to work, and therefore produce something of economic value. It is measured as the sum of the total potential future earnings of everyone in the labour market. The Office of National Statistics (ONS) produces human capital estimates for the UK

Harvard University has produced a summary of how to boost human capital and the factors that are important, including: education; vocational training; a climate of creativity; and infrastructure. In the UK, the Chartered Institute of Personnel and Development (CIPD) has published widely on human capital. The CIPD technical report on human capital theory makes the case for investment in people as individuals and from the organisational level, and provides a series of recommendations for improving human capital including: formal training; mentoring; coaching; tracking mood and productivity; and talent management to retain human capital within an organisation or location. 

Social Capital

Social capital is the networks of relationships among people who live and work in a particular society, enabling that society to function effectively. Social capital arises from the human capacity to consider others, to think and act generously and co-operatively. There are three core aspects to social capital: social relationships; the quality of relationships and shared understanding. The ONS produces findings on social capital in the UK

A systematic review has presented strong evidence to suggest that people with a lower socio-economic status generally have lower levels of social capital, and that lack of social capital is related to socioeconomic inequalities in health. Further, that social capital between close relations or tight-knit communities can buffer some of the negative effects of low socio-economic status on health. 

Health literacy is a key feature of social capital. It is the social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health. Health literacy empowers people to make positive choices and is an enabler that supports the promotion of equity by improving people’s access to health information, and their capacity to use it effectively. Digital health advances have the potential to help increase access, decrease healthcare system costs and improve health outcomes. However, technology solutions to digital health literacy have the potential to both promote health literacy and be a barrier. Also, evidence on how various aspects of social capital affect different health outcomes for different actors remains unclear, and there is limited literature on the health benefits of social capital interventions.


Resources

GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in quality early education and care, life-long learning opportunities and job training and supporting adult learning and health literacy. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


GUIDE

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

This practical guide by Public Health Wales is a tool to improve governance, investment and accountability for health and equity. The guide is intended to help the development of evidence-informed, context-tailored advocacy reports and other relevant documents and tools, enabling healthy policy- and decision-making across different sectors, levels of government and country settings. It aims to prevent disinvestment in health, increase investment in prevention (public health), and mainstream cross-sectoral investment to address the wider determinants of health and equity.

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


REPORT COVID

Placing Health Equity at The Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives for All in Wales

This report by Public Health Wales places health equity at the heart of a sustainable response and recovery to the COVID-19 pandemic and explores the impacts of educational disruption, use of digital technology and social media, and volunteering in Wales.

Placing Health Equity at The Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives for All in Wales


REPORT

Participation as a Driver of Health Equity

This report by the WHO Regional Office for Europe sets out that the promotion of social participatory systems can be an efficient formula for reducing inequities in health.

Participation as a Driver of Health Equity


PAPER

Making the Difference: Tackling Health Inequalities in Wales

This short paper by the Welsh Confederation outlines ideas on ways of working that would ensure collective impact in addressing health inequalities, including approaches that prioritise the value of social connectedness alongside health.

Making the Difference: Tackling Health Inequalities in Wales


REPORT COVID

Tackling Loneliness in Wales Through the Pandemic and Beyond: Stakeholders’ Ideas for Action

This report by The Wales Centre for Public Policy (WCPP) sets out five areas of action for tackling loneliness, with a focus on technology, the role of communities, the experience of vulnerable groups, managing the transition from COVID-19, and improving collaboration and collective ways of working.

Tackling Loneliness in Wales Through the Pandemic and Beyond: Stakeholders’ Ideas for Action


REPORT

Supporting the Welsh Lifelong Learning System

This report by the Wales Centre for Public Policy sets out the benefits of adopting an all-age lifelong learning strategy. The report draws attention to how lifelong learning and skills acquisition can help find solutions which will aid the economy and the well-being of Welsh residents and suggests using learning to promote a preventative approach to health.

Supporting the Welsh Lifelong Learning System


GUIDE

Building Better Futures: Toolkit

This toolkit provides practical tools to help stretch the shared imagination about what might be possible in the future, and to support communities to identify a preferred future and to make specific plans to work towards that future. The toolkit was developed through a pilot community foresight exercise with voluntary and community groups across three different communities in Wales.

Building Better Futures: Toolkit


GUIDE

Digital Health Literacy: How New Skills Can Help Improve Health, Equity and Sustainability

This policy précis by EuroHealthNet explores digital health literacy and what it means for health equity. It also looks at promising practices from our members on the ground and how further progress can be made across Europe.

Digital Health Literacy: How New Skills Can Help Improve Health, Equity and Sustainability


Health and Employment and Working Conditions

Being in good employment is protective of health, while unemployment contributes to poor health. Ill health can also affect people’s participation in the labour market, with costs to the individual, families, communities, employers and public services; combined costs from worklessness and sickness absence amount to approximately £100 billion annually in the UK, presenting a strong economic case for action. 

There is growing evidence on what works to increase employment and improve working conditions. The National Institute for Health and Care Excellence (NICE) has produced guidelines and recommendations on workplace health. This guideline includes new and updated recommendations on: workplace culture and policies; assessing and certifying fitness for work; statement of fitness for work; making workplace adjustments; keeping in touch with people on sickness absence; early intervention; sustainable return to work and reducing recurrence of absence and how to support people with a health condition or disability who are not currently employed. In addition, NICE has produced a guideline on mental well-being at work that includes recommendations on: strategic approaches to improving mental well-being in the workplace, organisation-wide approaches and having a supportive work environment; external sources of support; training and support for managers; individual-level approaches, employees who have or are at risk of poor mental health and those in high-risk occupations; engaging with employees and their representatives; local and regional strategies and plans and considerations for small and medium-sized enterprises (including micro-enterprises).

In Wales, the Healthy Working Wales (HWW) programme aims to support and encourage employers to create healthy working environments, take action to improve the health and well-being of their staff, manage sickness absence well, and engage with employees effectively, all of which can help to achieve a range of positive business and organisational outcomes. HWW offers health advisor support, training events, workshops, information and guidance. The Welsh Local Government Association works with local authorities to assist them meet their health and safety requirements, and provides a broader skills and capacity role including support for development opportunities such as apprenticeships, work placements and graduate schemes and action to engage with and provide opportunities for those who are not in employment, education or training (NEET) and/or economically inactive. Also, the Equality Impact Assessment in Wales Practice Hub is a collective source of information and practice, with resources promoting and supporting the development of good quality, robust EIAs that meet the legal duties of the Equality Act 2010 and the Welsh Public Sector Equality Duties 2011.

During the COVID-19 pandemic it became even more evident that economic insecurity was not evenly distributed amongst the population in Wales, and inequalities widened. A report by Public Health Wales exploring the link between COVID-19 and employment changes in Wales highlighted the issues and identified potential solutions. Promising interventions for different groups included: investing in interventions that offer employment support, career guidance, vocational training and apprenticeships; job creation and job search assistance; education and training; employment protection legislation and more.  


Useful Resources

GUIDE

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

This guide by Public Health Wales suggests policy options for priority investment in Wales, based on the best available Welsh and European evidence. The policy options address areas of high burden and costs, as well as demonstrating co-benefits (returns) to the economy, society and the environment, including investing in improving working lives and mental health in the workplace. The guide can be used by policy- and decision-makers across national and local government, the health and social care service, and public bodies in all other sectors in Wales.

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


GUIDE

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

This practical guide by Public Health Wales is a tool to improve governance, investment and accountability for health and equity. The guide is intended to help the development of evidence-informed, context-tailored advocacy reports and other relevant documents and tools, enabling healthy policy- and decision-making across different sectors, levels of government and country settings. It aims to prevent disinvestment in health, increase investment in prevention (public health), and mainstream cross-sectoral investment to address the wider determinants of health and equity.

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


REPORT

Improving Health & Employment Outcomes through Joint Working

This report by the Public Policy Institute for Wales presents the literature and evaluation evidence on ‘what works’ in the field of health and work, and how health and employment interventions for people living with health conditions can be made to work more effectively.

Improving Health & Employment Outcomes through Joint Working


REPORT COVID

COVID-19 and Employment Changes in Wales: Promising Interventions to Improve Health and Health Equity

This report by Alma Economics and commissioned by Public Health Wales identifies and describes the evidence on labour market interventions that can be implemented to improve health and health equity outcomes for people in Wales, and protect them from the employment hardship caused by the COVID-19 crisis.

COVID-19 and Employment Changes in Wales: Promising Interventions to Improve Health and Health Equity


REPORT COVID

COVID-19 and Employment Changes in Wales: Insights for Policy – Young People, Employment and Health. Qualitative Research Findings

This report prepared for Public Health Wales provides population insights from organisations which support young people, young people aged 18-24 years (with and without dependent children) and policy influencers and decision-makers on COVID-19 related employment changes. The report presents their views on changes that would support young people in the future with opportunities for work, including ensuring the voice of young people is part of the process of co-producing solutions.

COVID-19 and Employment Changes in Wales: Insights for Policy – Young People, Employment and Health. Qualitative Research Findings


REPORT COVID

Placing Health Equity at the Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives for All in Wales

This report by Public Health Wales places health equity at the heart of a sustainable response and recovery to the COVID-19 pandemic and explores its impacts on unemployment, employment and working conditions in Wales.

Placing Health Equity at the Heart of the COVID-19 Sustainable Response and Recovery: Building Prosperous Lives for All in Wales


GUIDE

Health Labour Market Analysis Guidebook

This guidebook by the Health Workforce Department of the World Health Organization provides a comprehensive overview of the health labour market, offers guidance on how to analyse and understand its dynamics, and identifies key steps to undertake a health labour market analysis. It also facilitates the implementation of standardized health labour market analysis approaches in supporting countries to answer key policy questions relating to health and care workers.

Health Labour Market Analysis Guidebook


GUIDE

Delivering Fair Work for Health, Well-being and Equity

This guide is intended to support agencies in their existing efforts to improve health, well-being and equity through inclusive participation in fair work. This guide was informed by the work and recommendations of the Participation in Fair Work for Health, Well-being and Equity Expert Panel. Action on fair work supports a healthier, more equal and more prosperous Wales, and if done well, can support all seven well-being goals.

Delivering Fair Work for Health, Well-being and Equity


REPORT

Too Ill To Work, Too Broke Not To

Mental health problems in the workplace have garnered a lot of political attention in recent years. However, the focus has been primarily on prevention and support for people with mental health problems while they are well enough to work. Even with the best support, however, sometimes people will need to take time out of work as a result of their mental health. This Money and Mental Health Institute report looks at the financial costs of taking time out of work, the impact this has on mental health, and how it influences our ability both to return to work and to take time off when we need to.

Too Ill To Work, Too Broke Not To


REPORT

Cost of Living Crisis in Wales: A Public Health Lens

This report by Public Health Wales 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.

Cost of Living Crisis in Wales: A Public Health Lens


REPORT

International Horizon Scanning and Learning Report: The Cost-of-Living Crisis

The International Horizon Scanning and Learning reports, Public Health Wales, were initiated as part of the COVID-19 public health response, to support dynamic response and recovery measures and planning in Wales. This report focuses on the cost-of-living crisis, examining the impact of the COLC on health equity within Wales and the UK, before examining how other governments in other countries are attempting to mitigate the COLCs impact on health equity.

International Horizon Scanning and Learning Report: The Cost-of-Living Crisis