Addressing Health Inequalities Through Community Research
Health inequalities manifest at a local level despite national estimates. Research in Wales reveals the interplay between air pollution, deprivation, and health outcomes, highlighting the need for targeted interventions to reduce disparities. Public health plays a crucial role in managing air quality, advising stakeholders, and driving evidence-based policy. Legislative frameworks in Wales support sustainable approaches to address interconnected well-being priorities.
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Presentation Transcript
2017 IANPHI ANNUAL MEETING ISTITUTO SUPERIORE DI SANIT | ROME, ITALY
Health inequalities National-level burden estimates mask local variations Some people are more at risk than others Differential exposure vulnerability e.g. exposed to high air pollution concentrations Differential susceptibilities e.g. intrinsic factors (age, genetics) e.g. acquired (chronic illness, lifestyles and behaviours, multiple deprivation) Interaction with wider health determinants Triple jeopardy concept
Triple jeopardy in Wales Research carried out to explore relationships between linked air pollution, deprivation and health data Air pollution concentrations highest in most deprived areas where population most susceptible Next highest in least deprived but population less susceptible Air pollution status (PM10) Low Moderate High Least deprived - 1.02 1.06 (0.96 to 1.08) (0.91 to 1.24) All-cause mortality Most deprived 1.56* 1.58* 1.65* Rate ratios show strong associations between all-cause and respiratory mortality and deprivation Air pollution interactions modify associations Targeted intervention that complements universal risk reduction measures can reduce inequalities (1.46 to 1.66) (1.50 to 1.66) (1.50 to 1.80) Least deprived - 1.19* 1.35 Respiratory disease mortality (1.02 to 1.39) (0.86 to 1.95) Most deprived 2.05* 2.21* 2.38* (1.73 to 2.41) (1.92 to 2.53) (1.89 to 2.95) *Statistically significant result; Rate ratio increased as area-level air pollution status worsened
Public health role A key stakeholder in air quality management: - to support others to assess air pollution in the context of public health risks - to support others to mitigate risks - to advise and support planners and regulators - to provide information to the public to reduce risks and drive behaviour change - to manage public health risks associated with acute and chronic incidents - to influence and support action to improve corporate environmental sustainability - to lead evidence-based change through effective advocacy and informed policy development
Drivers for change in Wales Environment Act 1995 (LAQM) ... an integrated policy framework that supports a sustainable approach to tackling linked well-being priorities... Wellbeing of Future Generations (Wales) Act 2015 Environment (Wales) Act 2016 Active Travel (Wales) Act 2013 Climate Change Act 2008 Planning (Wales) Act 2016 Public Health (Wales) Act 2017
