The widening of the inequality gap across health in Wales is putting future generations at risk

The Future Generations Commissioner for Wales is challenging Welsh Government and NHS Executive to significantly reduce preventative illness and in turn the health inequalities faced by people living in areas of deprivation.

Derek Walker says a truly collaborative and preventative approach in health would significantly reduce the growing burden of chronic diseases, develop healthier communities, and create a more sustainable healthcare system for all.

Wales is the only country in the world with a Well-being of Future Generations Act, which requires public bodies to work together to improve life for now and for people not yet born.

The gap in healthy life expectancy between the most and least deprived areas of Wales is around 13 years for males and 17 years for females* – meaning people in the poorest communities become ill or disabled far earlier in life than those in more affluent areas.

In 2023, the Chief Medical Officer (CMO) for Wales reported that nearly one in three children in Wales are overweight or obese by the time they start primary school.

This year, Nesta found that a third of Welsh adults are obese, which may make Wales the most obese nation within the UK.

Public Health Wales estimates that the cost of obesity to the NHS in Wales could reach £465 million a year by 2050, with the wider costs to the Welsh economy rising to £2.4 billion.

Nearly one in three school-aged children, and 62% of adults are currently overweight or obese. * Risk factors associated with obesity include type 2 diabetes, hypertension, cardiovascular disease, and some cancers, and it also impacts people’s wellbeing, ability to work, and quality of life.

Mr Walker is calling for better prevention at the outset of all clinical pathways, eg before diagnosis of a serious health problem.

He said: “We can’t accept that Wales some of the highest rates of preventable ill-health in the UK and that worsening lives are inevitable for our most vulnerable people and their children, with those in poorer communities expecting to live shorter lives as a result. We need drastic action, including a serious switch to preventative health, using all of our public services so we don’t pass on poor outcomes to future generations.

“If we fail to address these preventable conditions across Wales, then our waiting lists will continue to rise, treatment times will increase, and we will be reducing the quality of lives for our children and grandchildren. Not taking a preventative approach to health causes preventable suffering, and we shouldn’t tolerate this any longer. It exacerbates inequalities too.”

The commissioner will be making his recommendations to Welsh Government and other public bodies on April 29, within his Future Generations 2025 Report.

Within it, he is calling on Welsh Government to develop a plan to halt the rise in obesity within five years, reverse it within 10, and create a Wales that supports healthy weight by default by 2035. The development of a national food resilience plan is also recommended to ensure equal access to all for local, affordable, healthy, and sustainable diets.

Public Bodies are being called upon to work together more, along with the private and voluntary sectors, to identify the most significant areas of inequality within their local areas, and develop targeted plans to close the equity gap in health outcomes.

One project in Flintshire is seeking to bridge the gap between health professionals and support services. By viewing healthcare from a preventative angle, 2025 Movement has reshaped its policies to create a more resilient, sustainable, and equitable society in north Wales.

Joanna Seymour, Project Manager, 2025 Movement said: “We’re working with GPs and pharmacies to identify people whose living conditions might be affecting their health. Healthcare providers know the links between cold, damp homes and health, but previously there’s been no clear path for referrals; we’re creating that service so health professionals can connect people directly to support.”

The Future Generations Commissioner is hosting the Future Generations Action Summit in April, to encourage further positive change in Wales using the Well-being of Future Generations Act, which has already led to progressive school curriculum now with qualifications to teach people to be planet stewards; greener, healthier transport focus, a new way to define prosperity that focuses on people and planet and a plan for an anti-racist Wales.

Last week, the Bevan Commission hosted the Sir Mansel Aylward Spring Summit, to galvanise collective action towards a more unified, sustainable, and equitable approach. The Turning Point: Uniting for the Future of Health and Care in Wales, took place in Cardiff.