This project built on our ongoing collaborative work with Public Health Wales and the Wales Health Impact Assessment Unit. For several years we have supported this wider work on climate change which has mainly focused on the necessary work of undertaking what we believe are some of the first Health Impact Assessments on climate change and topics like circular economy at a whole population / whole country scale. It also built on our internal R&D on geospatial data for climate vulnerability. [Download link at bottom of page.]
Adaptation to climate change is a vital part of planning for the effects of climate change. Adaptation can be: planned, reactive, anticipatory, or spontaneous (UKCIP, 2013). And unsurprisingly taking planned action before you are forced into reactive response is lest costly and can be better planned and targeted to reduce inequalities.
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.
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.
COVID-19
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?
Assessment
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
The final published reports are now available via the following links:
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.
Feedback:
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
This case study of the Dyfi Biosphere was prepared in support of Public Health Wales’ health impact assessment (HIA) of the impact of climate change in Wales. The study area is Wales’ only biosphere and offers a unique learning site for sustainable development, demonstrating a variety of communities, landscapes, and ecosystems.
Upland sheep farming and forestry
With such diverse features that are all in some way potentially affected by climate change, this area offered valuable insights about the impacts on health and wellbeing of climate change. The study area was scoped to include the community of Fairbourne on the edge of the Biosphere that some media reports have described as potentially Britain’s first climate refugees. This case study however sought to take a holistic view of the Dyfi Biosphere through a public health lens considering the many different communities both on the coast and inland and how they will be affected by broad ranging climate change impacts.
Methods were primarily desktop based. Whilst the project scope did not include stakeholder interviews Urban Habitats was nonetheless able to incorporate conversations with certain key stakeholders and local organisations supplemented with site visits conducted of course by train and bicycle! Whilst not formally involved in the study both the Dyfi Biosphere and the Centre for Alternative Technology, where Mark Drane is a visiting lecturer kindly provided invaluable insights including access to previous studies which were invaluable. Systems mapping was also undertaken as part of this brief and included obtaining feedback at a stakeholder event associated with the main HIA.
What this study contributed was to place a public health lens on the questions of climate change including considering population groups across different community profiles and settlement typologies such as coastal or inland and of varying sizes. There were many practical examples of communities taking action already such as the Talybont Floodees responding to inland surface water flooding and Greener Tywyn seeking to encourage sustainable living in coastal town.
Climate change is a problem that presents new challenges for public health requiring us to extend the lens of research. At the same time it is essential to value community knowledge and experience and whilst this study was not participatory care was nevertheless taken to carefully represent the available views of communities.
What we learned
The village and beach at Fairbourne
It was invaluable to find out more about the varied ecosystems of the Dyfi biosphere and the huge value that they have including to address climate change.
We were forced to think about how to break down the enormous topic of climate change into manageable chunks. System mapping helped but also demonstrated the complexity of the situation even tracing one issue through a web of connections. And as with any HIA the evidence base is constantly developing which simply highlights the need for continuous and ongoing work in this area.
We also enjoyed cycling around the Biosphere – albeit in torrential rain!
Report: findings from the HIA will inform Public Bodies across Wales and will be contained in a Public Health Wales report for publication in 2022.
Feedback
This relatable case study with real world examples from the Dyfi Biosphere is an important component of this health impact assessment (HIA) of climate change in Wales and is included as a case study. Urban Habitats developed our early concept with the suggestion and opportunity to consider a range of communities across the Biosphere and the potential health and wellbeing impacts of climate change on them.
This was also clearly informed by the practice’s ethical approach to their work – valuing the knowledge of communities and taking a sensitive approach to understanding the experiences of people who are living with the impacts of climate change today.
Knowledge of the issues, the geography, and a willingness to get out in the rain on a bike and understand the context on the ground were all equally important ways of working that Mark Drane and Urban Habitats brought to the work!
Liz Green, Consultant in Public Health, Policy and International Health / Programme Director for Health Impact Assessment, Public Health Wales
Want to know more?
A are you keen to think about health & wellbeing in your community, work, or organisation? We love to listen! get in touch
Cardiff Council in Wales has an ambitious policy to make every street for every citizen a healthy street: working in collaboration with Living Streets this project looked at making that a reality.
Rolling out a ‘streets for health’ initiative across the city, to enable all streets to be reclaimed as public spaces and become healthy, green, safe, child friendly, to encourage walking and cycling, with high quality pedestrian crossings, biodiversity, planting and sustainable urban drainage systems (SUDS), and provide improved access for everyone, particularly those with restricted mobility.
Urban Habitats worked in collaboration with Living Streets on this commission to provide a team that integrated Urban Habitats’ community health knowledge with Living Streets’ expertise in community engagement and co-production.
Activities included:
Approach to prioritising investment by health need.
A community health profile of a pilot area.
Community drop-in sessions.
A pop up parklet at a community market.
Community survey.
Street audits with residents and stakeholders.
A capacity building workshop with about 50 local authority staff.
A report & recommendations to the local authority.
A range of sources of data including public health data and participatory community events were used to provide a range of evidence sources including the lived experience of community members.
The approach included understanding the health priorities for the city of Cardiff and using public health and other relevant sources to develop a method for prioritising street level interventions for health and wellbeing impact considering where the greatest need was. To our knowledge this is a novel approach to prioritising funding for interventions.
Capacity building and understanding for the Streets for Health initiative within the local authority was also important: a half-day participatory workshop was undertaken with about 40 staff from a range of services including transport policy, play services, highways, and others.
From this initial data gathering a draft prioritised list of interventions was proposed and one of these in the Plasnewydd area was developed in more detail. An approach of community asset mapping was used, including listening to the lived experience of community members. This comprised a series of public drop in events including at a Saturday market, community street audits, and school street audits with a local primary school. Living Streets expertise in community and school engagement was supported by Urban Habitats to frame questions and activities to health and wellbeing outcomes.
The learning and engagement from these events were an important outcome. Findings were also presented to Cardiff Council as a joint written report combining both health and wellbeing context and goals alongside actionable street audit findings.
As a legacy for this project Living Streets Cymru supported the establishment of a grassroots Living Streets Local Group of residents which is now active in promoting walking and healthy streets in the area.
What we learned
This was a valuable opportunity to bring together Living Streets expertise in working with communities and street audit with Urban Habitats focus on wellbeing and health outcomes. So for example it was really valuable to integrate our understanding of pathways to health impact into the community survey.
This project involved taking an adopted policy and then turning that into actionable guidance. The work highlighted the importance of this being a systemic and ongoing series of activities to bring policy into reality on the ground. Community discussions and valuing lived experience are important outcomes and can provide a quick way to start to make progress in health impact even if physical changes take longer to implement.
Our mapping technique developed existing approaches using stickers with relatable questions and statements was very successful and worked well for starting discussions.
Supporting thinking about a long term masterplan investment, Urban Habitats planned and facilitated a day workshop with teams from across the Sheffield Hallam University to consider health and wellbeing links to the masterplan principles and strategies.
This work aimed to build capacity within the University team across faculties and professional services divisions. The workshop led participants through a series of hands on exercises to consider a wider determinants definition of health; understand better who the University population are; and develop through ideation methods a series of about 15 proposals. These practical proposals were mapped against timescale and the University’s masterplan principles.
The workshop supported a strong ambition “to make a real difference and impact with our proposals… through early thinking in the right way, great healthy and well design does not need to cost a lot or get value engineered out.” (SHU, Director of Estates)
The workshop was successful particularly in bringing together people from different areas of the university together: for example an estates mechanical engineer and human resources manager who had not previously met worked together to develop complementary proposals for freeing up public realm space taken up with services infrastructure and then adopting this as space for wellbeing spaces for mindfulness, reading, and hobbies. A key output was getting to know colleagues better and the internal assets already within the organisation.
From this day a workshop write up included a series of collated ideas that had been analysed against wellbeing benefits and also for consistency with the masterplan principles. This was done using a framework / checklist that could be adopted by individuals responsible for delivering projects and programmes in future.
What we learned from this work is the value of allowing time to discuss terms and ideas that are new and potentially challenging: population groups and how health impact is unequally felt by different groups in particular is a public health approach but for those not used to thinking in this way the language can be challenging. In particular language is constantly changing to be inclusive and whilst important to consider unequal impacts it is also important to avoid stigmatising groups.
Penderry is a community on the edge of Swansea city centre. The community has faced a number of challenges but also has significant resilience and is situated amongst some valuable natural resources including common land and a historic woodland with rich biodiversity which is an important part of creating wellbeing in the future with the community.
