Mind the Gap: Tackling Health Inequalities in Wales

Published on: July 19th 2022

Poverty causes ill-health and illness, which is why 50 organisations across health, housing, and social care, including Community Leisure UK, royal colleges and patient advocacy groups have come together to launch Mind the gap: What’s stopping change? – The cost-of-living  crisis and the rise in inequalities in Wales

The new paper, published on Friday 15 July, from the Welsh NHS Confederation Health and Wellbeing Alliance, in partnership with the Royal College of Physicians (RCP), is calling on the Welsh Government  to produce a cross-government plan to reduce poverty and tackle inequalities.  

Over the coming months, as the everyday cost-of-living continues to rise, an increase in poverty and inequality will lead to greater strain on people’s health and the NHS. We urgently need coordinated cross-government action to improve people’s lives and protect health and care services.  

The Alliance is also calling on Welsh Government to make a real difference to local communities by providing more hands-on support and detailed guidance for smaller  organisations on how to tackle inequalities as well as simplifying a complex and ever changing landscape with hundreds of targets and performance measures. 

This report comes as research finds that 60 per cent of people in Wales feel their health has been negatively affected by the rising cost of living, according to a YouGov poll commissioned by the RCP.

  • 90 per cent said it was due to increased heating costs,
  • More than three quarters (76 per cent) said it was a result of the rising cost of food,
  • Almost half (45  per cent) said it was down to increased transport costs.
  • 72 per cent said that other fixed bills (council tax, water etc) were also having a negative impact on their mental or physical health. 

Health inequalities – unfair and avoidable differences in health and access to healthcare across the population, and between different groups within society – have long been an issue, but the COVID-19 pandemic and the rising cost of living has exacerbated them.  

Respiratory conditions such as asthma and COPD are often made worse by air pollution or exposure to mould in poor quality housing. Recently, a debt counselling charity warned that  the proportion of people in arrears with their energy bills in Wales is worse than any other  part of the UK, which is pushing people into mental health crisis.  

That is why the Welsh NHS Confederation Health and Wellbeing Alliance is calling for cross government action to reduce inequalities and tackle poor housing, food quality, community  safety, low incomes, fuel poverty, racism and discrimination, poor transport links and air  pollution, many of which are outside the remit of health and social care services. 

Inequalities at a glance 
• Health inequalities cost the Welsh NHS £322 million every year (Public Health Wales).
• Wales now has the worst child poverty rate of all the UK nations at 31% (End Child  Poverty). 
• One in ten Welsh households live in insecure housing (Bevan Foundation).
• People in Wales face a higher risk of dying in poverty than any other UK nation (Marie  Curie) 
• Almost 60% of adults in Wales are living with overweight or obesity (Public Health  Wales). 
• The full social cost of obesity to Wales is around £3 billion a year (Frontier Economics).
• 12% of Welsh households are at least one month behind on a bill (Bevan Foundation).
• Child poverty has increased in 20 of 22 local authorities over the past 5 years (End Child  Poverty). 
• Half of all children in lone-parent families in the UK are now living in relative poverty  (IFS). 

Nesta Lloyd-Jones, assistant director of the Welsh NHS Confederation and chair of the Health and Wellbeing Alliance, said: 

“The COVID-19 pandemic has exposed the extent of the country’s inequalities – we know those living in more deprived areas have been disproportionately affected by the impacts of the pandemic. Data shows the stark difference in life expectancy between different parts of Wales and health leaders are deeply worried about the impact the rising cost of living is  having, and will continue to have, on patients in their local communities. 

“Tackling inequalities needs concerted and holistic action across Welsh Government  departments and all sectors. There is clear evidence of the impact that poor quality housing,  air pollution, food poverty and access to transport, sport and the arts has on people’s health.  It is now vital that the government details how it will address the health divide and tackle the  issue head on.” 

Dr Olwen Williams, vice president for Wales, Royal College of Physicians said:  

“We know that poverty causes illness and poor health. In fact, everything affects health. The  cost of living crisis is likely to have a significant impact on the NHS and social care in the  coming months as more people become ill and join growing waiting lists for healthcare.  

“People in poverty die younger. Inequalities in life expectancy in Wales are getting wider,  partly due to the pandemic, which has highlighted how economic conditions can cut lives  short. People should be able to afford healthy food and warm homes without worrying so  much that it negatively impacts their mental and physical health. 

“Concerted cross-government action to reduce health inequalities would help keep people  contributing to the economy, their local communities, and wider society and reduce avoidable  illness, and in the long-run, avoidable pressure on the NHS.” 

Clarissa Corbisiero, deputy chief executive, Community Housing Cymru said:  

“Society’s responsibility for health and wellbeing goes beyond simply healthcare. All public  services have a part to play – not just the NHS. This report reinforces the fact that not  everyone in Wales has access to the things they need to stay healthy and well – such as  adequate housing, fair employment, quality food, access to green space and more. 

“Housing associations in Wales are supporting the shift to prevention across the multiple  issues and areas affecting these inequalities, including poverty, homelessness and social  care. By working together, and with a cohesive plan, we can close the health inequality gap  for good.” 

Rhys Jones, Chair of the Health Special Interest Group of Community Leisure UK (Wales) and Head of Service for GLL in Cardiff. Community Leisure UK (Wales) is a member association whose members in Wales are all charities and social enterprises managing 115 community-centred facilities, including leisure centres, pools and theatres.

He said: “Our members in Wales provide many programmes that help reduce health inequalities by providing access to tailored and supervised physical and cultural activity that improve people’s physical and mental health.

With pressures on the health and care system exacerbated by the Covid-19 pandemic, now is the time to work with a range of partners to support the population’s health and wellbeing. It is imperative that we collaborate to keep public leisure and culture accessible and inclusive for those who need it the most.”



Notes to editors: The Welsh NHS Confederation Health and Wellbeing Alliance consists of over 70 health and  care organisations from Royal Colleges, third sector organisations and social care organisations, and was established in 2015 to discuss key priorities and policy areas. The sub-group on health inequalities is chaired by the Royal College of Physicians and  Community Housing Cymru.