Belfast Healthy Cities is a member of the WHO European Healthy Cities Network and is currently delivering programmes under Phase VII (2019–2025). This phase is guided by six core themes known as the 6Ps: Peace, People, Place, Planet, Prosperity, and Participation. These themes represent the Sustainable Development Goals translated for cities, helping to enable their implementation at the local level.

The ‘People’ theme focuses on a human-centred approach to development, prioritising equitable access to shared resources and services. It emphasises the importance of building trust and strengthening relationships through investment in people and communities.

Defining a Wellbeing Economy

The Wellbeing Economy is an approach being adopted by many countries and Belfast Healthy Cities is working with the World Health Organization within this area. A Wellbeing Economy prioritises people over profit in terms of measuring economic growth and improvements in society. This is accomplished by placing planetary and human health and wellbeing at the centre of all legislation and policy. As a result, economic growth is seen as a way to achieve wellbeing. Economic growth is based on a diverse set of indicators focused on positive increases in areas that matter to people such as meeting their basic needs in safety, nutrition, freedom, housing, mental health, physical health, and regenerative nature (the capacity of living systems, like ecosystems and organisms, to renew, recover, and restore themselves).1 This is in contrast to current economic measurements of wealth, such as a countries GDP. Wellbeing Economies assist with addressing health, climate, economic and social crises by improving environmental sustainability, social equity and inclusion, global collaboration and cooperation and building resilient communities.1

The World Health Organization’s economic indicators of a Wellbeing Economy include planetary well-being, human well-being, economic well- being and social well-being. Planetary well-being includes areas such as good air and water quality, sustainable and active travel, circular economies and healthy sustainable living environments. Human well-being refers to early childhood development, mental health, well-being, life expectancy, and universal polices for housing food and fuel security. Economic well-being looks beyond normal costs and GDP and involves a living wage, reducing gender inequalities in the workforce, universal social protection throughout life and a mental health promoting work environment. Finally, social wellbeing involves living in a safe and free-from-violence environment, social support and protection, sense of belonging, building trust and social cohesion which embraces diversity.2 The growth of an economy and positive economic indicators are measured based on positive achievements within these areas of well-being. As such, a wellbeing economy sets the stage for progress to be made in many areas that benefit people and the planet, as well as assisting countries with reaching many policy targets and improving the lives of its citizens in a wide variety of areas.

Also, a Health in All Policies (HiAP) model can help guide and transition governments into a Wellbeing Economy. An HiAP model looks at how all polices including those in relation to transportation, housing, education and economics, impacts health and influences health equity. According to the World Health Organization, a Health in All Policy model is “an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity.” 3 An HiAP model approach must recognise and address that human health is influenced by many factors within the broader social determinants of health. This includes the circumstances people are born into, grow, live, work, and age as well as additional outside factors such as economic and development polices, political systems, social norms and social policies.3 An HiAP model approach supports a Wellbeing Economy by ensuring policies promote healthy communities, address the social determinates of health and health equity, by applying a health focus to all policies and programmes. Prioritising health will assist wellbeing economies with reaching indicators related to health and wellbeing but will also assist with reaching other indicators in relation to planetary and social wellbeing, such as those outlined in existing environmental, and community polices.

Putting Policy into Practice

“The Welsh approach shows that shifting to a well-being economy requires placing people at the heart of a decision-making process and well-being at the centre of policy decision-making.”

The Welsh government serves as a key example of how a government can move toward a wellbeing economy and work to prioritise health. For example, the Welsh government established the Well-Being of Future Generations Act in 2015, which encourages policy and decision makers to think more holistically, use collaborative decision-making processes and highlights that they are required to address four dimensions of wellbeing including, social, environmental, economic and cultural. All public bodies and decision makers are legally committed to considering the impact public investment or spending and national legislation will have on intergenerational well-being. The seven wellbeing goals of this act included: A prosperous Wales, A Resilient Wales, A Healthier Wales, A more Equal Wales, A Wales of Cohesive Communities, A Wales of Vibrant Culture and Thriving Welsh language and a Globally Responsible Wales. This involves creating an innovate, productive, low carbon global society, as well as safe communities, healthier citizens, protected natural environments and promotes and encourages participation in arts, sport and recreation.4

Furthermore, the Welsh Programme for Government sets wellbeing objectives to aid with reaching these seven well-being goals. The target areas for these objectives are, social services, health, education, the environment and local government. Also, the Welsh wellbeing economy requires measured milestones beyond GDP metrics and the Welsh ministers are required to set wellbeing indicators with future milestones.4 These 50 national well-being indicators can be used by other governments to steer policy toward wellbeing and measure success and satisfaction within a well-being economy context. For example, one relevant indicator is “Percentage of adults with 2 or more healthy lifestyle behaviours” with an accompanying national milestone “to increase the percentage of adults with two or more healthy lifestyles behaviours to more than 97% by 2025”.4 These indicators would allow governments to prioritise health promoting laws, policies and practices.

In Northern Ireland, the priority areas outlined in the recent Programme for Government align with the Well-being economy. And the corresponding Missions of People, Planet, Prosperity and Peace all acknowledge that wellbeing is influenced by economic, social and environmental factors. The Wellbeing Dashboard which is set forth by the Programme for Government, to assist the government with monitoring progress, address gaps and replace measurements, mirrors the indicators and measurements being used in Wales to implement a Wellbeing Economy Framework. For example, the Northern Ireland Wellbeing Dashboard examines community safety and perceived safety by measuring the “percentage of people feeling very unsafe walking alone in their area after dark” – similarly, the Welsh well-being indicators include “Percentage of people feeling safe at home, walking in the local area and when travelling.” Also, one of the Welsh indicators to address both environmental and health dimensions of well-being is “levels of nitrogen dioxide pollution in the air” a similar indicator “annual mean roadside levels of nitrogen dioxide as measured by micrograms per cubic meter (ug/m3)” is used to monitor cleaner environment in Northern Ireland and ties back to both the People and Planet Missions of the Northern Ireland Programme for Government. There are clear crossovers between the Northern Ireland Wellbeing Dashboard and the Welsh Wellbeing Indicators.

Arguably, Northern Ireland is beginning to implement this Welsh framework and work toward making Northern Ireland a Well-being Economy. At Belfast Healthy Cities, we look forward to seeing how the Governments Wellbeing Dashboard progresses and hope to see new policies and programmes throughout Northern Ireland use the indictors establish in the Dashboard and the Dashboard begin to include additional indicators from other policies. We believe this Dashboard, in partnership with a Health In All Policy approach could serve as a great step toward bringing Northern Ireland closer to becoming a Well-being Economy. We welcome a people centred approach taken in government policy, and investment into people and their wellbeing as a main priority for Northern Ireland.

References

1. Institute of Public Health. (June 2024). Creating an impactful and sustainable Wellbeing Economy for better public health. https://www.publichealth.ie/sites/default/files/resources/Sustainable%20Wellbeing%20Economy%20report%20final.pdf

2. World Health Organization. (2024). Political statement of WHO European Healthy Cities Network Towards thriving societies: advancing health in the well-being economy. https://iris.who.int/bitstream/handle/10665/376153/WHO-european-healthy-cities-network-Utrecht-statm-2023-eng.pdf?sequence=

3. World Health Organization. (n.d). What you need to know about Healthy in All Policies. https://cdn.who.int/media/docs/default-source/mca-documents/rmncah/health-in-all-policies-key-messages-en.pdf?sfvrsn=a4982d1_1

4. WHO European Region. (2024) Country deep dive on the well-being economy Wales. https://iris.who.int/bitstream/handle/10665/378205/WHO-EURO-2024-10150-49922-75119-eng.pdf?sequence=1