The Public Health Implications of Brexit in Wales: A Health Impact Assessment (HIA) approach

Abstract

On March 29th 2019, the United Kingdom was due to exit the European Union (EU) in a process known informally as ‘Brexit’. The 2 years before this time (and ongoing) experienced a period of unprecedented political and social upheaval with many unknowns and much uncertainty attached to the outcomes and future impact of withdrawal and transitionary period. Public Health Wales commissioned the Wales Health Impact Assessment (HIA) Support Unit to carry out a HIA of Brexit in Wales to assess the potential impact, extent and nature of ‘Brexit’ on health and wellbeing in Wales which would to inform its planning, future work and support other bodies decision-making, planning and policymaking. A comprehensive HIA was conducted over a 6 month period in 2018/19, steered by a Strategic Advisory Group. Methods included; a literature review; stakeholder workshop; interviews with policy leads, a community health profile, and report with evidence synthesis. Trade agreements, economic impacts, changing relationships with EU agencies, uncertainty and loss of regulatory alignment were key pathways for health impacts to occur. Potential impacts included; food standards/safety; environmental regulations; working conditions; and health and social care. Many impacts will affect the whole population. Vulnerable populations included; children/young people; those at risk of unemployment;Welsh areas receiving significant EU funding. Potential indirect impacts were identified on mental well-being. Brexit has the potential to impact significantly on the determinants of health.The HIA has informed and influenced cross-sector planning and policy in response to the short/long-term implications of Brexit to ensure that health and inequalities are considered at every juncture.This unique work demonstrates continued leadership by Wales in the field of impact assessment and ‘health in policies’ and has been positively received. It has transferable learnings for many nation states and health policy leads. Key messages Brexit is a major policy change with major health impacts. HIA is an informative and influencing process to support planning and future policy making.