Safe communities and individuals (see our ‘cohesive communities’ well-being goal summary for further information).

Compared to other parts of the UK, both local authority areas have low rates of crime and anti-social behaviour, although in the case of Denbighshire there are pockets with higher rates within parts of Rhyl. For both local authority areas domestic violence remains a key challenge in relation to personal safety. Exploitation of individuals and groups, especially those that have experience adverse childhood experiences), is a common feature across the counties (priorities for policing include organised drug supply, child sexual abuse, modern slavery, domestic abuse, hate crime, missing persons, fraud (including cyber-crime), driving under the influence, and rape and serious sexual offences).

Building on work at the national level our assessment recognises that giving children the best start in life, protecting them and preventing Adverse Childhood Experiences (ACE) as much as possible is a key to well-being.  Adverse Childhood Experiences in particular can damage a child’s chances for living a good life. A tough start can affect physical and mental health, resilience and well-being. This in turn affects educational achievement, employability, risks of getting into the criminal justice system, use of health and social care services and risk of early parenthood and continuing the intergenerational cycle of disadvantage.

Online safety and misinformation

As well as the social and economic opportunities offered by digital technologies, there are some negative aspects around online safety which are increasingly causing concern, and which public authorities, providers of technology and society as a whole are still developing means of dealing with. These include controlling access to inappropriate content for children and young people, on-line grooming (including radicalisation), cyber-bullying, trolling and online fraud/identity theft.

Online fraud and identity theft are also particular areas of concern. Though these are new twists on longstanding criminal activity, as with cyberbullying the growth on new technology means that these forms of abuse are now potentially everywhere, all the time.

In recent times, misinformation, or ‘fake news’, and social media have presented serious challenges to governments, businesses and people themselves. Examples include anti-vax campaigns, electoral tampering, ‘Covid is a hoax’ campaigns. Fake news is designed to undermine trust and confidence in democracy and public institutions. The World Health Organisation has started to refer to this as an ‘infodemic’, where there is “too much information including false or misleading information in digital and physical environments during a disease outbreak.” In relation to the Covid-19 pandemic, the WHO has developed guidelines to ensure successful ‘infodemic management’, which involves ensuring consistent and factual information is disseminated appropriately.^[1] We do not currently have evidence to fully understand to what extent misinformation is causing people anxiety, or affecting Covid-19 vaccine uptake for example.

Resilient communities

Ensuring communities are resilient in the face of extreme weather events, notably flooding and extreme heat, is a major challenge. As well as efforts to prevent and reduce environmental damage, adaptation to climate change is already a pressing issue. There is still more to do to make sure that there are healthy places for people, protected from environmental risk across the areas (see our ‘resilient’ well-being goal summary for further information). People living in those areas described as experiencing concentrated deprivation are also communities at risk of flooding, they may also be more likely to experience food poverty, and are less likely to benefit from energy improvements. In short, they will be more likely to be affected by climate change than more affluent groups and communities, who tend to rely less on public services that could also be disrupted due to climate change.

Housing

While cohesive communities are based around people, attitudes and opportunities to access quality accommodation is a necessary pre-requisite and a key factor in community and individual well-being. Good quality, affordable housing can directly improve people’s well-being. Delivering affordable and high-quality new housing in the right locations, density and design creates opportunities for growing food, for outdoor play and learning, integration with existing services and infrastructure, proximity to public transport, green active travel routes, and access to biodiverse, high quality green and blue space and nature. Existing housing stock can be retrofitted to improve energy efficiency and reduce fuel poverty as well as being adaptable to meet changing needs of the household. Investing in energy efficient homes lowers energy use, reduces overall energy demand in the economy and makes individual households, and Wales, more resilient to fuel price fluctuations.

While the expansion in the house building programme has been meeting need local housing needs, there is a risk that continued growth could undermine environmental resilience and a sense of ‘place’ with a local identity.

Infrastructure

A person’s physical environment, including access to green space, plays a key role in personal well-being. Human health depends on ecosystem services that include food and fresh water; regulation of climate, floods and disease; opportunities for physical activity; for living, learning, working and playing and for aesthetic and cultural enrichment. Living or working in a poor local environment is not just unsightly (for example due to litter, dog fouling, fly-tipping, graffiti and even poor air quality), it can have an impact on physical and mental health. It may also impact how much investment an area attracts, levels of antisocial behaviour and can even impact on local democracy.

Transport and digital connectivity are set to continue as barriers for some people for the long term. Over the next five to 10 years, those with fewer than 100 mbps could be considered ‘left behind’. Online safety and misinformation will be a concern for communities and services alike.

It is also important to note the potential impact of growing tourism on infrastructure, including housing, and tourism should be sustainable and not impact negatively on our communities and our natural resources.

Poverty and inequality

There are a range of factors (or drivers) that result in poor well-being, and well-being inequality, i.e. inequality that differs between groups or across areas. Using national well-being data, we can see that currently, all local authority areas in Wales have well-being inequality. Incomes, rurality, engagement in culture and heritage, access to green space, life expectancy, long-term illness or disability, housing, education and so on, all impact upon a person’s well-being. What is more, people may often possess overlapping identities or multiple protected characteristics, for example disabled, LGBTQ+ older people or socio-economically disadvantaged and Gypsy, Roma and Traveller groups. This is often described as ‘intersectionality’. Data is not available nationally nor locally to assess how intersectionality impacts well-being.

Welsh Government research^[2] indicates that certain groups are more likely to experience poverty.^[3]

“…socio-economic deprivation is highly intersectional. Deprivation interacts with protected characteristics, and certain communities of interest and communities of place may also experience worse outcomes in many areas. This intersectionality between deprivation and other characteristics can be thought of as a web, where different areas connect, compounding and exacerbating each other. This makes it no surprise that poverty can quickly become cyclical, or thought of as a trap that is difficult to escape. Unfortunately, disentangling this web is a complex, multifaceted issue that demands work from a wide range of stakeholders.“^[4]

Conwy and Denbighshire have areas with high levels of multiple deprivation. People living within these areas have poorer outcomes than other groups in employment, income, health, housing, community safety, access and the environment. Poverty, and particular income poverty are not confined to these areas and incidence of household income poverty and child poverty exist scattered throughout the area.  Health inequalities, associated with poverty and deprivation have been clearly demonstrated in further public health research.

Overall, the root cause of well-being inequality appears to be poverty. Specifically, its associated relationship with factors such as very poor health, being disabled, workless, having no or only a basic education, being single, separated, widowed or divorced, renting or being middle aged. People living in the most deprived areas not only have a shorter lifespan, but also spend less of it in good health. Despite overall increases in life expectancy, the gap between the proportion of life expected to be spent in good health in the most and least deprive areas has shown no clear sign of reducing in the last 10 years.

People in persistent poverty are at particular risk of having poor physical and mental health; and children, especially, are at an increased risk of mental health problems, obesity and long standing illness. The poor diet of people in poverty is largely the result of socio-economic disadvantage, not poor choices.  Poverty is one factor that can lead to the poor health and unhealthy choices of those living in the most deprived areas as they have a limited range of options available to them due to low incomes and the stress associated with poor conditions.

There are significant health inequalities affecting the lives of people living in Conwy County Borough and Denbighshire. The wider determinants of health such as housing (in terms of quality and supply), education, employment and environment may contribute to less healthy lives.^[5] Health impacting behaviours such as smoking, drinking/substance misuse, poor diet, and a lack of physical activity are also influenced by mental well-being, which can be low if these determinants are poor.

Whilst the long term resilience of groups with poorer personal well-being and less favourable outcomes is currently unclear, without intervention, some small communities are likely to continue living with factors associated with deep rooted deprivation.

The effects of the Covid-19 pandemic have not affected everyone equally, and have, in particular, resulted in significant impacts for people’s physical and mental health, and well-being more generally. Those over 65 years old have been particularly affected, as have males, people from ethnic minorities and those from deprived backgrounds.^[6] Worsening mental health is more likely to be seen in those most affected by the virus. This is a particular concern for certain groups, including young people, people from low-income urban households and Black, Asian and minority ethnic groups, who may be more likely to live in overcrowded homes and poor quality-environments, and to lack access to green spaces.

This is discussed in more detail in our ‘A more Equal Wales’ summary.

Health

A person’s physical environment, including access to green space, plays a key role; with poor health associated with homelessness, poor quality accommodation and fuel poverty. By the same token poverty, unemployment and personal safety, all affect a person’s physical and mental health.

We see high levels obesity, alcohol consumption and smoking that are common throughout the Western World. There is some evidence of concentrations of particular poor lifestyle choices among certain geographical communities and among people from particular backgrounds or with particular characteristics although further work is required to develop a firmer understanding.  The key assets for tackling these issues are those facilities and outdoor activities that promote active lifestyles and the public health interventions and services focused on smoking cessation, drugs and alcohol.

Good health is critical to overall personal well-being and can have a direct impact on the wide well-being of individuals and communities. Unfortunately, health and well-being in North Wales are not showing a wholly positive trajectory. The main factors that contribute to poor health and wellbeing are deteriorating rather than improving and social and health care use is increasing not decreasing.^[7]

The demographic evidence we have gathered highlights some key considerations. Assuming the intention of sustaining balanced communities that meet the needs of all ages and promote good intergenerational relations; we need to consider the differing needs at different life stages.

The aging population, which is testament to people living longer – a positive trend – is expected to need support to retain their independence and allow access to services and prevent social isolation. Certain areas in both counties tend to have a higher proportion of older people, such as the “East” and “North” sub-areas of Conwy County Borough and Prestatyn in Denbighshire.

Outmigration of local young people is set to be a continuing trend. Economic and educational opportunities, along with affordable accommodation have been identified as key factors in retaining and attracting young people to the area.

Both Conwy and Denbighshire have large populations over the age of 65 and therefore already experience the challenges of supporting people with age related problems such as, chronic physical and sensory diseases, dementia and falls.  We have also highlighted the issue of social isolation which can be particularly damaging for older people.  Our evidence also highlights the comparatively small numbers of young people residing in the two local authority areas with out-migration of local young people exacerbating this issue.

Mirroring the relatively large proportion of the population with support needs is the large proportion of the population who care for others.  Unpaid carers made up 11.8% of the population in Conwy and 12.4% of the population in Denbighshire at the time of the last census.

Social isolation and loneliness

Social isolation can reduce independence and damage mental health in particular, but can also lead to problems with physical health if services such as GPs, dentists and active leisure and social opportunities are inaccessible. There are particular concerns about social isolation of young and older people throughout the two counties.^[8]  The rural nature of both local authority areas means that both have areas with poor access to services from a travel and transport perspective.

[1] https://www.who.int/health-topics/infodemic#tab=tab_1. Accessed 26 July 2020

[1] These were identified as:

1. Lone parents had the highest rate of transient poverty and persistent poverty
2. Single pensioners also had high levels of persistent poverty
3. Families with two adults were less likely to experience poverty than their single-adult equivalents.
4. Families with children were more likely to have experienced poverty than the equivalent family type (single or couple) without children.
5. Disabled people are more likely than non-disabled people to be workless and therefore more likely to experience poverty.
6. Women are more likely than men to live in single-parent households, to have low incomes, and to have only part-time work and are therefore more likely to experience poverty.
7. Pakistani and Bangladeshi women are also more likely, than other women, to be workless and therefore more likely to experience poverty.

Welsh Government, 2014 https://gov.wales/sites/default/files/statistics-and-research/2019-07/140409-dynamics-low-income-en.pdf

[2] Government Social Research (2021). Implementing the Socio-economic Duty: A review of evidence on socio-economic disadvantage and inequalities of outcome

[3] Government Social Research (2021). Implementing the Socio-economic Duty: A review of evidence on socio-economic disadvantage and inequalities of outcome

[2] The wider determinants of health is one of Public Health Wales’s strategic priorities. Here’s their long-term plan and a range of publications can be accessed here.

[4] North Wales Social Care and Well-being Services Improvement Collaborative (2021), Locality Health and Social Care Needs Assessment North Wales.

[5] The data shows that twice as many younger adults say they’re lonely more than older people. Percentage of people who are lonely by age and gender (gov.wales)