Reducing health inequalities

Why this theme?

Healthy and resilient natural resources underpin our health and well-being, as well as being an important part of our culture and economy. They provide our food, clean water, air, energy and protect us against hazards such as flooding and climate change. These are the natural benefits of a place.

There are stark differences in people’s health across South West Wales. The link between our health and the condition and accessibility of our natural environment has been recognised and reflected in the Public Services Board (PSB) well-being plans in Neath Port Talbot, Swansea, Carmarthenshire and Pembrokeshire.

We know that being active outdoors in a natural environment improves people’s physical health and mental well-being. Whether you live in the countryside or the city, it is important we all have easily accessible green space, e.g. woods, meadows and parks, and blue space, e.g. rivers, lakes and the sea. If communities use these 'outdoor gyms' there are benefits through improved health and well-being, as well as reduced healthcare costs . We all need to manage our natural resources in better, more sustainable ways so they are cleaner, greener, more accessible and maintain their natural beauty - bringing increased enjoyment and benefits to local people and visitors.

Top ‘national challenges and opportunities’ from the Natural Resources Policy addressed by this theme:

• Supporting preventative approaches to health outcomes, with a particular focus on key public health issues of transport related air and noise pollution, tackling physical inactivity and mental health
  
  
• Supporting action to tackle health and economic inequalities
  
  
• Supporting community cohesion
  
  
• Supporting climate change mitigation and adaptation through ecosystem approaches

Health in South West Wales

In Wales, on average, people are living longer than previously and living longer in good health. When we look at the those living in the least and most deprived areas of South West Wales, however, there are big differences in people’s health. Those living in deprived areas not only have lower life expectancy, they are also in less good health.

If we look at the information for those living in the most and least deprived areas in the county of Swansea, the difference in healthy life expectancy is 21.9 years for males and 16.3 years for females. Males living in the most deprived fifth of Wales not only have a shorter lifespan, but also spend less of it in good health (77%) compared to those living in the least deprived fifth (89%). The same is true of females (74% vs 86%). A correlation between higher overall deprivation and low physical health scores can be observed in urban areas and in the Welsh valleys, where the majority of areas in Swansea and Neath Port Talbot score low.

We have identified three key topics related to this theme:

1. Open green spaces and urban green infrastructure

There is a direct link between people’s good health and being surrounded by the natural environment. Our green and blue spaces, including parks, open spaces, playing fields, woodlands, wetlands, road verges, rivers, canals, allotments and private gardens are often referred to as green infrastructure. This living network not only defines and shapes the character of a place but also delivers multiple benefits for biodiversity, health and well-being.

By having an excellent living network in an urban area, it can help connect fragmented wildlife populations and habitats, linking urban areas with their surrounding environment. In other words, green infrastructure is good for people and for nature.

Low-income areas are associated with lower quality housing and education, poor diet, and less access to good quality green space. Living near areas of greenspace (such as parks or woodland) can improve health, regardless of social class.

Urban trees are an important component of green infrastructure. Some towns in South West Wales have notably low levels of tree cover (including Port Talbot at 7.5% and Gorseinon, Haverfordwest, Carmarthen and Llanelli at around 11%). Additionally, tree cover is not evenly distributed in these areas with deprived areas tending to have lower cover.

2. Recreation activities and use of green and blue active travel

The Active Travel (Wales) Act encourages more people to undertake regular journeys on foot and bicycle. Investment in an active travel infrastructure can result in significant economic benefits. The building of green active travel routes can result in multiple benefits for people and biodiversity.

The Area Statement work so far has identified that giving people access to recreational trails, as well as green/blue travel routes is an important priority. This is something also identified through our Public Services Board engagement and local plans (e.g. Pembrokeshire Well-being Plan and Pembrokeshire Coast National Park Draft Management Plan) for South West Wales in both rural and urban locations.

Outdoor recreation activities provide multiple benefits for people, the environment and the economy by encouraging environmentally friendly behaviours, contributing to health outcomes and through tourism. South West Wales has a lot to offer both in terms of locally accessible countryside and internationally renowned fisheries, mountain biking trails and bathing beaches.

Given this provision, we would like to work collaboratively to support nature-based activities and make the outdoors more accessible to all.

Image by Pippa Sabine

3. Protecting the environment for our well-being

Ensuring our natural resources are of high quality is key to our well-being. From the air we breathe and the waters we swim in, to managing the risk from the rivers and coast we live by, nature-based solutions can deliver multiple benefits for people and the environment. There is a strong connection between this topic and our land management theme.

The coastal zone around South West Wales is hugely important to support tourism and industry as well as providing human health benefits. Within this area we have 40 designated bathing waters (33 ‘Excellent’, 6 ‘Good’ & 1 ‘Sufficient’) which the tourism industry relies on for visitors.

The European Union has introduced significantly tighter water quality standards causing several bathing waters to be at risk of not meeting the new minimum requirements. Activities and discharges from the urban environment can have a detrimental effect on these waters which can have a significant impact on those enjoying them.

Climate change

It should be noted that, as a cross cutting theme, the considerations in our climate change section also apply here and vice versa. Unmanaged, the impacts of our changing climate will have potentially negative consequences for our future health and well-being and often these are hardest felt by the most vulnerable in society. Similarly, interventions to help improve health, e.g. accessible GI, can also help us manage and cope with the effects of climate change.

What would success look like?

A key part of the development of this Area Statement has been our engagement with stakeholders and we say more about this in the next section.

In the previous section we have described some of the main considerations and opportunities for improving health. Here we have set out ‘what success looks like’ as a series of you told us statements reflecting the general consensus from our engagement sessions; these sessions generated a wealth of information ideas and the following represents just a summary of the opportunities ahead of us (where there was general agreement among multiple stakeholders). If you feel that we have missed something, please don’t worry, we want to carry on the conversations we have started. Please see the section at the end of this theme which details how you can remain part of this process.

You told us that our urban communities should feature a network of high quality, well connected green infrastructure

• We need to work with local planners and developers to ensure that new developments provide green infrastructure
  
  
• We all need to involve local people in the decision-making process and enable them to manage their local environment. This includes opportunities for different management (e.g. community food growing) and use of public assets
  
  
• Existing developments should incorporate green infrastructure to help deal with issues such as poor air quality and urban run-off. We need to understand how residents currently use their urban space and what their relationship is with green spaces and address gaps

You told us that that communities should be well connected by green active travel routes, with easily accessible recreational green space

• Significant opportunities exist to make better use of the public sector estate for both formal and informal recreation. Use of these assets can be made easier by simplifying processes and paperwork. Partners and Public Services Boards should work together, including data and skills sharing, to explore health initiatives and to explore and remove barriers to healthy and active lifestyles
  
  
• Linked to this and our climate change theme we all need to change the way we travel. Schemes include:
  
  
  • Integrated public transport system: timetables linked-up with active travel routes and sharing schemes (bike and car sharing). We need to work with public sector body partners, industry and Welsh Government to ensure this is appropriately planned, considered and available to all
    
    
• Increase public awareness of green/blue spaces and biodiversity through:
  
  
  • Reviewing educational role of public sector organisations with staff empowered to promote local access whilst educating on more technical matters (such as biodiversity)
    
    
  • Working with educational facilities and the third sector to promote biodiversity through the school curriculum and on an individual school scale
    
    
  • Sponsorship programmes linking local businesses, communities and amenities to nearby blue or green spaces including promoting cultural activities with a strong emphasis on sustainability
    
    

Image by Pippa Sabine

You told us that everyone should enjoy clean air to breath and high quality bathing beaches and rivers:

• You place a high value on our coastal environment and our bathing beaches in particular. We will work with the water companies, local authorities and the third sector to manage river catchments as a whole (catchment-based approach) to safeguard these areas and the rivers which feed them. We will take an evidence led approach to identify the mitigation measures – including investigating the possibility of alternative funding sources. Build on examples such as the Green Seas Partnership as models of success.
  
  
  • Investigate the possibility of designating inland bathing waters (in docks, lakes and rivers) to encourage people to use the blue spaces on their doorstep
    
    
  • Changing behaviours is required to improve our air quality through the implementation of ‘air quality action plans’ and other actions. We need to target areas for collaboration (such as engine idling at schools or information screens to give live air quality and noise data to the general public)
    
    
• Ensure that communities are well protected and prepared against flooding. Inform and educate the public and local politicians on issues such as flood risk, including those responsible for making planning decisions. Engage with communities living in ‘at-risk’ areas to raise awareness. Utilise catchment restoration techniques (capturing water elsewhere before it floods an area), alongside ‘traditional’ flood risk management
  
  

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Who have we worked with to date?

In developing this Area Statement our aim has been to work collaboratively and represent the views and ideas from all stakeholders in South West Wales. Our goal has been to involve you in helping identify the key risks that we all face in managing our natural resources sustainably, as well as the opportunities.

This has required a different way of working.

We have undertaken a wide range of engagement activities, including targeted planning workshops with selected experts to larger multi-sectoral workshops. The latter have been well attended and included elected representatives, community groups, eNGOs, as well as officials from the public sector. We’ve also ensured that representative groups (such as farming unions, angling associations etc) have been included. The business sector has mainly been represented by larger industry.

As many different sectors have been included as possible to capture the widest range of views and expertise. 

Internally we have been working closely with our colleagues developing the South Central Wales, Marine and Mid Wales Area Statements to ensure that actions link up where appropriate. In particular, the coastal zone and marine environment are very important for us in South West Wales and we recognise that what happens on land often impacts the sea and vice versa.

What are the next steps?

We need your continued support to progress the opportunities and actions we set out earlier and in this section. We will be continuing our conversations with you on how best to take this forward – both in terms of delivery and in refining the detail where further work is needed. This is likely to involve more focused work on specific themes or around particular geographical areas (e.g. the opportunity catchments).

So, we encourage all stakeholders, existing and new, to get involved - further details on how to do this are in the next section.

Throughout this theme there are clear areas which you told us were important for implementing effective actions to improve health outcomes and reduce health inequalities. These include the development planning system, utilising the public sector estate, recreation and access, and environmental improvements (air and water quality).

Next steps:

Influence the planning system 

• Work with the local planning authorities to ensure that there is appropriate provision of greenspace and green infrastructure both at regional planning level and for individual developments
  
  
• Work with local groups to ensure that green infrastructure is considered and integrated into any regeneration projects planned

Improve recreation, access and tourism opportunities using Natural Resources Wales’ assets

• Work with Neath Port Talbot Council and local stakeholders to develop an Afan Forest recreation masterplan to improve access and visits
  
  
• Work with others to explore and maximise the community benefit of the Welsh Government Woodland estate (e.g. through Mynediad agreements)
  
  
• Support local access forums to help improve access networks
  
  
• Promote education and sustainable and appropriate recreation at our national nature reserves

Work with public sector partners to gain maximum well-being and biodiversity benefit from the public estate

• Work with Public Services Boards (PSBs) and third sector partners to promote and implement green infrastructure for people’s well-being
  
  
• Ensure that data and expertise are shared between partners to facilitate increased accessibility to and recreational use of green and blue spaces
  
  
• Provide support for communities to access and manage the natural environment

Ensure South West Wales has a high-quality environment

• Take a catchment-based approach to sustaining and improving the quality of bathing waters. Continue monitoring, maintain and improving bathing water status and investigate the possibility of designating inland bathing waters to encourage people to use the assets on their doorstep
  
  
• Support a programme of engagement with priority communities to raise people’s awareness of their flood risk and actions they need to take
  
  
• Support Welsh Government’s review of the short-term action plan for air quality in Port Talbot. Implement the Clean Air Plan in this area and work with experts in behaviour change techniques to make this happen

How does what we’ve proposed deliver Sustainable Management of Natural Resources?

By embracing the natural environment in South West Wales we can play our part in improving some of the chronic health conditions seen in the area – both in rural and urban settings. Ecosystems which are located near populations provide the best opportunity and should be managed in a way that maximises the benefits that they provide for physical and mental well-being.

In delivering any actions an integrated and collaborative approach will need to be taken, reflecting the principles of SMNR and incorporating the five ‘ways of working’ from the Well-being of Future Generations Act.

A vision for South West Wales:

• Our towns, cities and new developments embrace and enhance the natural environment with green infrastructure at the heart of decision-making
  
  
• High quality green and blue spaces (both urban and rural) are easy to access and appropriately used by all
  
  
• Communities, businesses, third sector and public sector are well informed about the natural environment and enabled to effectively manage their local spaces
  
  
• There are clean and healthy spaces to live, work and play in – from the air we breathe to the waters we bathe in
  
  

How can people get involved?

This theme is only the beginning of the journey as we work with people to improve the management of South West Wales’ natural resources. If you would like to be part of this process, please get in touch with us using the form below. Alternatively, please email us direct at: Southwest.as@cyfoethnaturiolcymru.gov.uk

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