Another 2030 Agenda

A look at the Public Health Wales Long Term Health Strategy

Public Health Wales has a long-term health strategy 2018-2030 entitled, ‘Working to Achieve a Healthier Future For Wales’. It has seven strategic priorities:

• Influencing the wider determinants of health

• Improving mental well-being and resilience

• Promoting healthy behaviours

• Securing a healthy future for the next generation

• Protecting the public from infection and environmental threats to health

• Supporting the development of a sustainable health and care system focused on prevention and early intervention

• Building and mobilising knowledge and skills to improve health and well-being across Wales

It states in the introduction that it, ‘reflects the United Nations 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals’. The word ‘sustainability’ features repetitively throughout the strategy, as one might expect.

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The ‘challenges’ facing Wales, according to the text, include an ageing population, the rise in prevalence of long-term conditions, a growing disparity in wealth, the early impacts of climate change, emerging threats in infectious diseases, as well as the rise in violence and extremist behaviour. Brexit is also mentioned within the European context of challenges facing health.

It states that opportunities to improve health outcomes will include, ‘better use of genomics, data science, artificial intelligence and social media’.

One supporting resource for developing this Strategy was the, ‘Stay Well In Wales’ survey of 2017. If you are wondering why you have never heard of this, it’s because only 1001 people were interviewed after being invited by letter. Or to put it another way, 0.033% of the population.

Amongst the findings of this survey were:

1.    66% of people agreed that companies should be made to adopt behaviours to reduce climate change (10% disagreed)

2.    76% agree they support 20mph speed limits where they will reduce road traffic injuries (12% disagree)

3.    47% agreed the advertising of alcohol should be banned to reduce alcohol problems (26% disagreed)

4.    34% agreed their GP usually talks to them about how to live a healthier life (interestingly 50% disagreed).

Shockingly, there is no finding specifically on recreational drug misuse which has been causing additional fatalities year on year in Wales, with a record number in 2022.

The report examines each of the seven strategic priorities and goes into some detail of what each priority means and what difference will have been made by 2030.

For example, under the heading, ‘Improving mental health wellbeing and resilience, it states that by 2030 ‘we will be actively monitoring the mental wellbeing of the population’.

Under, ‘Promoting Healthy Behaviours’ it is stated that ‘By 2030 we will have changed social norms about the acceptability of a range of health harming behaviours’. Expect – given the 2017 survey mentioned – banning of alcohol advertising and wider restrictions regarding its sales. I wrote previously that Public Health Wales and the WHO collaborating centre had alluded to climate change being linked to higher alcohol consumption. It also referenced a 2018 Swedish paper which stated that increased alcohol intake would lead to increased alcohol related greenhouse gas emissions.

The ‘Protecting the Population from Infection and Environmental Threats to Health’ section states that ‘We expect to have new classes of treatments to replace antibiotics and fewer people will die as a result of resistance to antibiotics’. Public Health Wales also expects to have ‘the highest immunisation uptake possible across all sections of the population’.

Additionally, it states here that they expect to be ‘prepared for and be able to deal with the expected effects of climate change’ and to have ‘strengthened international collaboration on bio-security’.

By 2030, PHW expect to have ‘shifted the balance from hospital to community-based care’.

The final section is titled, ‘Building and mobilising knowledge and skills to improve health and well-being across Wales’; mobilising being a curious choice of word, having military connotations. It contains a word salad in its explanation of what this will entail, for example:

‘We will inform policy and practice through expert, impartial, trusted intelligence leading a whole-system, cross-sector approach for population health’.

This apparently includes ‘implementing a new health intelligence system’.

Public Health Wales will be ‘an international exemplar and trusted national resource in the use of evidence and intelligence to inform decision making for health’.

Given the current lack of trust in the NHS in Wales, PHW together with its national and international partners definitely has its work cut out. Perhaps they will further engage the services of Sheffield Hallam University’s Centre for Behavioural Science and Applied Psychology to nudge us all into good health, just as they tried with NHS staff and vaccine uptake in 2021.