Case study: EHPs adapt to water scarcity

The Climate Change Risk Assessment for Wales (ASC, 2016) identified a likely increase in extreme weather events that may influence water availability. The risk to water supplies in Wales is increasing – this includes not only the risk of too much water (flooding), but also the risk of water scarcity and drought.

Tomorrow it’s World Environmental Health Day (26 Sept) and this year’s theme is: Environmental Health: Creating resilient communities through disaster risk reduction and climate change mitigation and adaptation. Kristian James, a member of our Climate Change Satellite Panel, shares a really interesting case study with us, outlining how EHPs, working alongside key stakeholders, adapted to periods of water scarcity.

The risk/challenge

During 2018, stakeholders in the health and water sectors in Wales were approached by water users from the public, private, recreational, and agricultural sectors regarding health issues and disruptions related to water scarcity.

At that time arrangements to tackle health and water supply disruption were, fragmented and not universal across and between sectors. Members of the Water Health Partnership for Wales (WHP) subsequently requested a review of how their members responded to the extreme weather of 2018.

The WHP brings together public health professionals including EHPs working in local authority and health sectors, to work on issues related to water and health.

Kristian James, Principal Environmental Public Health Specialist, PHW

A health impact assessment (HIA) was proposed to meet the following objectives:

1. Assess the likeliness of health impacts of drought in Wales
2. Identify any vulnerable populations and those particularly susceptible to the impacts
3. Assess current resilience measures to mitigate drought impacts
4. Assess if more action is needed to reduce health impacts and inequalities of drought
5. Provide recommendations

The solution

What happened?

The health impact assessment (HIA) followed the five-step process within an HIA, starting with screening and scoping. The HIA was undertaken by an EHP working in Public Health Wales as part of their Comprehensive HIA training.

The appraisal of evidence included a literature review on the health impacts of drought, stakeholder knowledge and insights via questionnaires, and a population health profile.

Stakeholder evidence and insights were sought from public health experts from across the UK on the health impacts of water scarcity and drought.

Stakeholders from the water management sector in Wales were interviewed regarding their experiences of the 2018 weather events and the mechanisms in place to mitigate health impacts of water scarcity and drought.

Summary findings were circulated to the WHP and the Wales Government Drought Liaison Water Group.

Learning

Drought is associated with almost entirely negative health impacts. All stakeholders should recognise that the risk of drought is increasing and that negative health impacts are likely among public or private water supply users, as well as agricultural and recreational water users. Negative impacts are possible amongst these broad groups, but there are susceptible sub-populations.

Mains water users (the majority) are the most protected by policy and practice, however, impacts upon other water users need to be acknowledged, including how existing or new policy does or does not serve to protect them.

Stakeholder experience indicates that more action is required to address these negative impacts and inequalities and to avoid unintended impacts

Recommendations

To protect public health, drought and water scarcity requires consideration in line with other extreme weather planning, preparedness, and response – and with a particular focus on the potential health impacts and population groups most vulnerable.

Existing evidence on actions that can help prevent or mitigate many of the identified health impacts should be collated and compiled for a drought context. Good practice and lessons learnt should be shared among stakeholders.

The results/the impact

The HIA provided a starting point for identifying vulnerable groups and taking collaborative action within existing partnership structures to improve resilience.

• Information obtained on vulnerable groups has informed guidance for local authorities to help identify private water supply users who may be vulnerable. This was undertaken in collaboration with the Private Water Supply sub-group of the WHP.
• The Drinking Water Inspectorate (DWI) has also developed its guidance on managing insufficiency of private water supplies.
• Public Health Wales has produced online guidance on coping without a water supply due to loss of supply from a range of weather hazards.

This case study provides an example of how EHPs working in collaboration with other stakeholders, have sought to understand and adapt to emerging hazards, made more likely, by climate change.