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Public health is a concern for people of all ages and from all communities. Despite increasing dialogue about the rates of child poverty, obesity, physical inactivity and harmful patterns of drug and alcohol consumption, there has been no notable improvement in the health of the nation. We continue to see worrying trends in the number of people living with preventable illnesses resulting from unhealthy lifestyles. Additionally, the gap between those with the best health and those with the worst health is widening.
The association between poverty and health outcomes is well known. For almost 25 years the level of poverty in Wales has been largely static- whilst other areas of the UK have managed to begin closing the poverty gap, Wales lags behind.
Even though a quarter of the Welsh population already live in poverty, The Institute for Fiscal Studies forecasts that child poverty in Wales could increase significantly by 2020. Some children’s charities expect poverty rates to reach a 30 year high within this time frame. Children in the most deprived areas of Wales are already almost twice as likely to die in a given year as those from the least deprived areas.
57% of adults are overweight or obese and rates of obesity in all age groups are growing. For people who are overweight and physically inactive, their risk of developing serious life threatening and chronic diseases is markedly increased. There are substantial health and social care costs associated with the treatment of obesity. Given current childhood obesity rates we can expect to see a situation where grandchildren die before their grandparents.
In terms of physical inactivity, people are becoming increasingly sedentary and this has obvious health implications. The financial cost of physical inactivity in Wales is estimated at about £650 million per year. This is at a time when many local authorities are struggling to maintain their current recreation services, let alone expand on them.
The rate of deaths in Wales from coronary heart disease has fallen by almost a quarter since 2001. Despite this, rates are still higher than that in many European countries and largely down to lifestyle.
In terms of quality of life, Wales has a much higher percentage of people reporting long-term limiting illness than England.
For older generations, the decision between heating and eating remains a very real choice for many. Cuts to community transport services and leisure provision continue to increase isolation, impact on mental health and affect wider health outcomes.
The Public Health (Wales) Bill had the potential to make a transformative difference to the way all public bodies plan for and challenge many of the key determinants of poor health outcomes.
Whilst we are heartened that the newly elected Welsh Government intends to bring forward new draft legislation on public health, it is essential that what they propose is sufficiently robust. The new law must provide appropriate levers to ensure that there is both a collaborative effort and a collaborative obligation amongst public bodies to address and overcome the socio-economic root causes of health inequalities in Wales.