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circular economy | health impact assessment

A health impact assessment commissioned by Public Health Wales, part of NHS Wales: Circular economies and sustainable health and well-being: the public health impact of public bodies refocusing on waste reduction and reuse in Wales.

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Moving toward a circular economy

Beyond recycling is Welsh Government’s plan to keep resources in use and avoid waste with an aim to reach zero waste by 2050.  This has the opportunity to create profound environmental, social, and economic benefits.  Circular economy approaches have been developed and championed by both the Ellen MacArthur Foundation and Kate Raworth in her book Doughnut Economics.  This assessment set out with a public health lens to investigate the health and well-being benefits that circular and doughnut approaches can help create.

Health impact assessment (HIA)

HIA is an approach that considers how the health and wellbeing of populations may be affected by a suggested action, in this case the introduction of a circular economy approach to waste reduction. HIA approaches are used to improve health and reduce inequalities throughout plans and projects but also policies and programmes.  Urban Habitats was commissioned by the Welsh Health Impact Assessment Unit at Public Health Wales, a leading centre of expertise on HIA globally, and part of the WHO Collaborating Centre on Investment for Health and Well-being. Urban Habitats’ role was to develop an initial draft HIA and edit this into a final report including through Public Health Wales’ peer review process.


Initial evidence searches and assessment had been conducted prior to the COVID-19 pandemic which had a huge impact on waste collection services both in terms of keeping them running and front line workers finding themselves faced with potentially infectious waste.  Urban Habitats was also tasked therefore to undertake a rapid review of a range of peer reviewed and grey literature and assess this evidence for impacts.

Impact framework

An impact framework was prepared, whilst not a requirement of the protocol, it is the case that with environmental determinants of health form a complex web of interconnections so use of systems mapping approaches can be invaluable to assessing pathways to impact – in other words like a spider’s web, if you pull one thread, what else is affected?


A comprehensive and concurrent assessment of circular economy approaches including waste reduction, reuse, and recycling in Wales was undertaken.  Evidence sources were synthesised and impacts assessed previously by Public Health Wales through workshops and interviews were further interrogated by Urban Habitats and then through an assessment workshop working with second and third reviewers / assessors.  Due to the timing of the assessment, Urban Habitats was able to incorporate a new preliminary assessment of the COVID-19 pandemic in this area, highlighting the impacts this had on existing waste reduction approaches.

Report – Final Report Now Published

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The final published reports are now available via the following links:

Executive Summary


Summary Report

Supporting Information Report

What we learned:

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Image credit: Alexander Andrews, Unsplash

It is no exaggeration to say that the HIA protocols developed by Public Health Wales are a leading example internationally of how to undertake HIA in an ethical, participatory, and evidence informed way and make the gaps in some other approaches manifest.  These methods are clearly aligned to Urban Habitats’ values and build on our experience of integrating both full HIA and parts of HIA into much of our work.

This project provided an opportunity for a deep dive into the topic of circular economy.  This included enhanced understanding of the evidence base and also emphasised for us the huge positive potential of circular economy approaches to address climate, nature, and biodiversity crises whilst also addressing issues of equity and population health.


This assessment is the second in a series that develops Public Health Wales’ work on the health and wellbeing impacts of climate change on people and communities of Wales.  It is an important step and will help inform public health orientated action in Wales to address the climate, nature, and biodiversity emergencies and mobilise ‘health in all policies’ approaches.

Mark Drane and the Urban Habitats team brought an approach to their work clearly driven by their values as well as an approach that combined both rigour and a collaborative approach.  This support has been invaluable during the COVID-19 pandemic when other team members were moved to frontline health protection roles.

We are very pleased with this work and it has helped to develop and refine the final output to include the very latest literature on circular economy and incorporated a rapid review of COVID-19 impacts.

Liz Green, Consultant in Public Health, Policy and International Health / Programme Director for Health Impact Assessment, Public Health Wales

Want to know more?

Are you keen to think about health & wellbeing in your community, work, or organisation?  We love to listen!  get in touch