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Wider determinants of health

The wider determinants of health are the everyday conditions that shape our opportunities to live a healthy life. They are sometimes called the building blocks of health because they create the foundations we all rely on to stay well. These building blocks include access to good education and skills, sufficient income and resources, the availability of good work, reliable and sustainable transport, safe and quality housing and our built and natural environment.  

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Why are the building blocks of health important for health, well-being and equity?

These factors matter because they influence our health far more than healthcare alone. When the building blocks are strong, people have better opportunities, reduced stress and more control over their lives resulting in improved physical and mental well-being. When the building blocks are weak—such as poor housing, insecure employment or unsafe streets—they limit opportunities, weaken communities, and pass disadvantage from one generation to the next. Living in poverty indicates a lack of these basic building blocks.

By investing in strong building blocks communities have the conditions to thrive. Healthier communities are more resilient, more productive, and better able to adapt to future challenges such as climate change and demographic change.

Strengthening the building blocks of health contributes to delivering the Well-being of Future Generations (Wales) Act’s seven Well-being Goals and creates a fairer, healthier and more sustainable Wales.

What is Public Health Wales doing to strengthen the building blocks of health?

We work with partners across Wales to improve the conditions that allow people to live healthy, fulfilling lives by:

  • Providing clear, trusted evidence about the conditions that shape health and what works to strengthen the building blocks of health
  • Bringing partners together to share learning and take collective action to improve health and reduce health inequalities
  • Advocating and advising for action by helping decision makers understand the long-term benefits of strengthening the building blocks of health

By working in this way, Public Health Wales helps build healthier environments today while protecting the well-being of future generations.

What action should be taken to strengthen the building blocks of health for a healthier, fairer and more sustainable Wales?  

National level

Key policy actions which can be taken by Welsh Government and other national bodies include:

  • Strengthening housing standards, including improving energy efficiency, reducing damp and cold, and increasing the supply of affordable homes
  • Supporting fair work, including tackling insecure employment, improving wages, and ensuring good working conditions in a growing economy with sufficient opportunities for all
  • Investing in early years, such as quality childcare, parental support, and early education.
  • Improving public transport infrastructure, making services more reliable, accessible and affordable to connect people to jobs, education and services.
  • Embedding health in all policies, using tools such as Health Impact Assessment to ensure national decisions support long‑term well-being.
  • Acting on climate and environmental quality, including clean air, green spaces, and active travel
Regional level

Key actions which can be taken be taken by regional bodies such as Public Services Boards, Local Health Boards, Regional Planning Boards:

  • Aligning regional strategies, such as economic development, transport, and health and well-being plans, so they reinforce healthier living conditions.
  • Investing in skills and employment programmes for local people, especially in communities facing disadvantage.
  • Supporting sustainable transport networks, including integrated bus services, safe cycling and walking routes, and links between towns and rural areas.
  • Coordinating housing, health and social care services to prevent homelessness, support independent living and reduce pressures on health services.
  • Using shared data and evidence to identify communities most in need and target investment accordingly
Local level

Key actions which can be taken be taken by local organisations such as local authorities include:

  • Creating safe, walkable neighbourhoods with good pavements, lighting, parks and play areas.
  • Improving local housing conditions, including tackling mould, cold homes and overcrowding.
  • Supporting local economic development, such as town‑centre regeneration, community hubs and support for local businesses.
  • Strengthening community networks, such as volunteering opportunities, social activities and places where people can connect.
  • Ensuring access to affordable essentials, including transport, food and digital connectivity.
  • Using local planning powers to shape healthier places such as improve access to green spaces or restricting fast food outlets.

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