A pragmatic public health-driven approach to enhance local air quality management risk assessment in Wales, UK

Abstract

Abstract Air pollution, poor health and deprivation are inextricably linked. These stressors can combine to create a triple jeopardy effect where more deprived individuals and communities can be disproportionately affected by exposure to air pollution. Despite acknowledgement of this, however, the current statutory Local Air Quality Management regime prescribes that air pollution risks are considered in isolation. This project aimed to develop and test application of a practical method for carrying out air pollution risk assessment in the context of wider health determinants. A number of data components describing health, air pollution and deprivation at small area level were identified for one health board area (comprising two local authority areas) in Wales for 2011-15. These data were then combined within each of the triple jeopardy domains and then overall to assign each small area a prioritisation score to inform air quality management action. Areas were then ranked in order with a view to identifying priority areas (and clusters) for integrated air quality management and public health intervention. Local environmental and public health stakeholders were involved throughout the process and asked to provide feedback on the approach, particularly in relation to applying it in practice and evaluating its merit in terms of helping achieve local and national wellbeing policy goals. The piloted tool - called Health and Air Pollution Risk Assessment/Area Prioritisation (HAP-RAP) - offered a contemporary public health-driven approach to risk assessment intended to complement existing [narrow focus] prescribed air quality management approaches. It highlighted areas for action that were different in location, scale and size from local air quality management areas declared through existing processes. Further, stakeholder comments suggested the approach can help support more collaborative, effective and efficient ways of working, facilitate stronger policy and practice integration and achieve greater population health impact.