Monday, October 18, 2021
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Grave new world of the Welsh

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WE are told that Wales is facing a terrible predicament dubbed the Triple Challenge, outlined in a report published last week.

The title might conjure up images of a rugby trophy, but this is no prize. The Triple Challenge describes the cumulative and individual impact of Brexit, Covid-19 and climate change on health, wellbeing and equity in Wales. Public Health Wales, in its low-profile partnership with the WHO Collaborating Centre has released its word salad of a report (the first in a series) which provides a ‘strategic overview’ of these three ‘seismic’ events, their impact and their interconnectedness. The report presupposes that Brexit could be looked back upon as jointly responsible for all of Wales’s future problems together with the fallout from Covid and the threat of climate change. For example, it implies that new Free Trade Agreements might limit Wales’s ability to tackle climate change and could affect the ‘supply of vaccines’.

Wales’s equivalent to the United Nations Agenda 2030, the Wellbeing of Future Generations Act 2015, referred to in my previous article, provides (according to the new report) an enabling environment for Wales to ‘utilise the application of a Triple Challenge lens to policies and strategies’.



The report is aimed at public bodies responsible for formulating such policies and strategies. Indeed, the United Nations Sustainable Development Goals are mentioned in the section on international policy context.

It summarises potential actions in response to the three ‘enormous’ events such as Health Impact Assessments and health promotion:
‘Brexit, Covid-19 and climate change can have direct and indirect impacts on health behaviours for example, diet, nutrition, active travel and alcohol. Health promotion messages should highlight the co-benefits of behaviour change to target audiences for example, adopting a planetary friendly diet.’

Alternative scenarios are covered for a range of issues including supply chains and employment. My previous piece mentioned the alternative scenario which has been suggested regarding schooling, which is that schools could disappear altogether due to rapid advancements in artificial intelligence.

Wales was the first UK nation to introduce a Public Health Act in 2017.
Part of this Act places a duty on Welsh ministers to make regulations which require public bodies to carry out Health Impact Assessments (HIAs) in specified circumstances. This includes public bodies having to undertake HIAs prior to commencing new programmes in order to assess short, medium and long-term implications of both physical and mental health. One such HIA is currently being finalised – coincidentally by one of the authors of the report – to assess the health and wellbeing impacts of climate change in Wales.

The Welsh Programme for Government has a strong focus on climate change and the environment. It is committed to embedding response to the ‘climate and nature emergency’ in everything it does and has created a ‘Super Ministry’ to help achieve its legally binding target of net zero by 2050. 

The ‘containment policies’ (lockdowns) referred to in the Triple Challenge report were probably more effective in achieving a dry run for Welsh Government’s future aims than they were at containing the virus: ‘The radical implementation of the lockdown measures across the world demonstrated that decarbonisation could be applied extremely quickly and thus result in improved air quality, reduced levels of vehicle traffic and air travel, reduced noise and pollution levels, which all contribute to climate and planetary health renewal.’

On the subject of air quality, a White Paper on a Clean Air (Wales) Bill was issued in January

Wales also had an Active Travel Act passed in 2013. Active travel is mentioned in this recent report together with the fact that Wales has this year announced a £38million pledge to promote cycling, scooting and walking.


The new report also suggests that as a result of the Triple Challenge 20-minute neighbourhoods could be enabled. These are places in which most of people’s daily needs can be met within a short walk or cycle. 

Climate change appears in this publication to be marginally more of a threat than the other two challenges. It is the only challenge of the three which is linked with suicide and PTSD and can apparently lead to higher alcohol consumption. We are informed that a 2018 Swedish paper noted that increased alcohol intake will lead to an increase in alcohol-related greenhouse gas emissions. Curiously, men were found responsible for 90 per cent higher GHG emissions due to their mainly wine and strong beer consumption. Could this be a hint that unfettered access to alcohol might be restricted in future? Or maybe it will justify further raises in the Minimum Unit Price for alcohol.

The publication frequently mentions ‘windows of opportunity’ for policy change with its conclusion containing the term ‘rapid, effective and lasting change’. One such change hinted at is that as the economic situation evolves, there will be opportunity to move away from measuring progress of a nation state by GDP. Wales, along with Scotland, Finland, Iceland and New Zealand, is a member of the Well-being Economy Governments partnership. This global collaboration adopts a ‘shared ambition of building well-being and economies in which policy is framed in terms of human and ecological well-being, not simply economic growth’. It is part of the Wellbeing Economy Alliance which aims to deliver ‘social justice on a healthy planet’.

It would appear that Wales is deeply entrenched in global geopolitical trends, with the majority of its citizens being blissfully unaware. Health is being redefined within multiple contexts – human, planetary and economic to name just three. We learn from the Triple Challenge publication that in his report of 2021 the Welsh Chief Medical Officer Dr Frank Atherton promotes a ‘one health’ approach. This views the health and wellbeing of the population, animals and ecosystems as being linked; an ‘animal-human-ecosystems interface’.


The Public Health Wales report’s summary of findings includes the following bullet point:

‘The Triple Challenge will have a wide range of compounding impacts across multiple determinants of health. These will need to be viewed in synergy, cumulatively and not through a singular lens.’

Perhaps a kaleidoscope might be an appropriate lens through which to view these impacts, in order to confuse the populace even further? Although perhaps only a kaleidoscope restricted to multiple shades of green would suffice.

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Nicola Lund
Nicola is a former teacher, and now a part time retail worker and carer. Her Twitter handle is @MrsLund1.

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