Public Health Concepts Research Articles

Infographic as a form of communication in public health

Abstract Background Infographics are a communication tool used in the digital environment that can present information, data or knowledge in an easy and understandable way to a wider audience. The aim of this study was to analyze if, and in which areas of public health, infographics are used as a form of communication in Croatia in relation to the world. Methods The research analyses available infographics of leading institutions in public health in relation to Croatia and the world. Results Visualization of key information is an accustomed concept in public health with infographics being a recognizable form of communication and an important part of digital health. However, only a small number of infographics in public health in Croatia are used. Infographics published in Croatia were mainly about exercise, cancer, ageing and stress. In the European Union, the topics found were aging, risk assessment, harassment/violence in the workplace and work-related stress. Infographics from the world addressed child labour, youth employment, gender equality, better work, dialogue promotion, migrant workforce, migration, domestic workers and safety at work. Moreover, International Labour Organisation made interactive media containing infographics - infostories - with topics: young workers, gender gap, migrants, non-standard employment, disability inclusion, forced labour and collective bargaining. Conclusions We suggest to include more public health topics and to raise awareness among Croatian public health experts on the importance of infographics as a form of communication. Key messages Visualization of key statistical data in the style of infographics enables public health professionals to educate their employees and the public. Infographics are excellent tools for communicating important topics and are more likely to drive action and change behavior.

THE OTTOMANS DURING THE GLOBAL CRISES OF CHOLERA AND PLAGUE: THE VIEW FROM IRAQ AND THE GULF

AbstractThe cholera and plague pandemics of the 19th and early 20h centuries shaped Ottoman state-building and expansionist efforts in Iraq and the Gulf in significant ways. For Ottoman officials, these pandemics brought attention to the possible role of Qajar and British subjects in spreading cholera and plague, as well as the relationship between Iraq's ecology and recurring outbreaks. These developments paved the way for the expansion of Ottoman health institutions, such as quarantines, and the emergence of new conceptions of public health in the region. Specifically, quarantines proved instrumental not only to the delineation of the Ottoman–Qajar border, but also to defining an emerging Ottoman role in shaping Gulf affairs. Moreover, the Ottomans’ use of quarantines and simultaneous efforts to develop sanitary policies informed by local ecological realities signal a localized and ad hoc approach to disease prevention that has been overlooked. Ultimately, this study demonstrates that environmental factors operating on global and regional scales were just as important as geopolitical factors in shaping Ottoman rule in Iraq and the Gulf during the late Ottoman period.

Engaging a wider public health workforce: bringing public health into architecture education

Abstract Background Current public health challenges necessitate the closer working of public health with built environment professionals. Despite growing evidence of benefits, there remains little progress in practice. Architects can play a key role in ensuring urban and building design is health promoting, however there is no requirement to teach health by architectural accreditation bodies across Europe. Objectives In the United Kingdom in 2010, the Public Health Practitioner in Residence programme (PHPiR) was established to address this situation. Public health professionals are embedded within the Faculty of Environment and Technology at the University of the West of England, and contribute to research, pedagogic programme development, teaching and mentoring. The aim was to embed public health concepts and issues into architecture training, to empower the profession as part of the wider workforce, to improve health and wellbeing when designing buildings and places. The PHPiR was evaluated using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Data was collected (questionnaires, focus group, semi-structured interviews, programme documentation) on a Masters of Architecture cohort (N = 34) at intervals from 2011-2019 to see if the PHPiR has long lasting effects as students enter practice. Results Public health concepts including; inequalities, life course approach, and social capital, became embedded into the architecture curriculum. Projects produced had increased reference to wider health promoting issues and participants thinking shifted from the building itself to who would use the building, suggesting the intervention achieved its aims. Conclusions The PHPiR offers a novel approach for built environment professions to better understand public health issues and the relevance to their chosen fields. This model could be applied to other courses and replicated in educational institutions and public health training programmes across Europe. Key messages The PHPiR influenced the architecture curriculum, improved architects understanding and public health issues and concepts, and empowered them to create more health promoting environments. Embedding public health professionals into training for other disciplines may be an effective, sustainable method for increasing the wider public health workforce.

Round table: Measuring values: enhancing how WHO monitors and reports on health and well-being

Abstract Many concepts that are key to public health policy-making are conceptual and often values-based. How such concepts can be implemented by Member States, and how the effectiveness of this implementation can be measured and reported, remains an critical challenge that all major monitoring frameworks are faced with, from Health 2020 (WHO’s European policy framework for health and well-being), to the Sustainable Development Goals for Agenda 2030. In 2016, WHO established a project to interrogate how four key values-based public health concepts can be better measured and reported on, to increase the accountability of Member States towards these concepts. Based on the priority areas of Health 2020, the concepts which were chosen are: resilience;empowerment;life-course approach; andwhole of society approach. Four Health Evidence Network (HEN) synthesis reports were commissioned from leading experts and have now been published, synthesizing the best available evidence and grey literature on these concepts, and proposing a variety of quantitative and qualitative approaches to measuring them. The workshop will be organized as round table workshop. It will bring together the authors of all four reports to provide an overarching thematic discussion on how to enhance the monitoring and reporting of values-based public health concepts. In addition, it will also present an opportunity to discuss the findings of the reports, in particular how qualitative evidence can be deployed to make up for the shortcomings of quantitative indicators. The role of culture in informing these values-based concepts will also be discussed. The session will be chaired by Nick Fahy, who will set the scene and provide some background to the WHO Europe project on enhancing monitoring and reporting. Jane South will then give overview of the HEN synthesis report on measuring resilience, followed Glenn Laverack, who will talk about the HEN report on measuring empowerment. Mark Hanson and Scott Greer will review their respective HEN reports on measuring the life-course approach and whole-of-society approach implementation. Each speaker will be asked to illustrate their presentation with a case study which demonstrates how qualitative evidence can enhance the monitoring and/or reporting of the various concepts. During the discussion, a number of key questions will be discussed by the panel with input from the audience. How can actionable measurement strategies be derived from existing research regarding values based concepts?How can meaningful, country-level reporting mechanisms be expanded to include quantitative and qualitative health information and indicators?What is the role of cultural contexts in mediating these (and other) values-based concepts? Key messages Many key public health concepts are inherently values-based. However, this is often not acknowledged, making it challenging to monitor and report on them. Qualitative evidence can be key to designing more effective ways to measure the implementation of values-based public health concepts. Jane South Contact: J.South@leedsbeckett.ac.uk Glenn Laverack Contact: grlavera@hotmail.com Mark Hanson Contact: M.Hanson@soton.ac.uk Scott Greer Contact: slgreer@umich.edu

Interprofessional Education Collaborative Competencies and the Public Health Professional

Interprofessional education involves programs that foster the partnerships of two or more individuals studying different health professions, thus allowing students to learn with and about the other professions. The Interprofessional Education Collaborative Competencies were updated in 2016 with a threefold purpose that included a greater emphasis on population health, thereby encouraging the health professions who typically work on an individual level to broaden their understanding of the field of public health. In the professional preparation of public health professionals and health education specialists, both foundational competencies and areas of responsibility imply and/or explicitly state that public health professionals and health education specialists must be able to work with interprofessional teams. Interprofessional collaborative learning activities have been recommended to be offered early and often during health professions training. Not only do public health and health education students benefit from inclusion in these interprofessional education activities but other health professions students also benefit from exposure to public health students and population health concepts. Public health and health education have contributed to leadership in interprofessional education initiatives and are well-situated to lend population health expertise to improve health care delivery as well as population and patient health outcomes.

Development of an online public health curriculum for medical students: the public health commute

BackgroundAs public health becomes increasingly central to the practice of medicine, educational efforts are necessary to prepare medical students to apply public health concepts in their care of patients. There are few accessible and informative tools to prepare students to engage with population health challenges.MethodsWe distributed an online questionnaire to clinical students, querying gaps in their education on public health topics. Based upon the responses, we developed a web-based curriculum for medical students rotating at a public safety-net hospital on pediatrics, medicine, primary care, psychiatry, and surgery services from April–December 2017 (available at www.publichealthcommute.com). Students received guiding questions and media-based resources (e.g. podcasts, TedTalks, YouTube videos) in weekly modules addressing topics in public health. Each module incorporated 30 min of mobile-optimized content, including specific data relating the topic to the Central Harlem community. Familiarity with public health was assessed with pre- and post-program quizzes, including 10 multiple-choice and 2 open-ended questions.ResultsAmong the 70 participating students, 59 (84%) completed both the pre- and post-assessments. The five-week curriculum covered health systems, social determinants, race, substance use, violence, and alternative care models. After completing the five-week curriculum, the mean correct score on a multiple-choice quiz rose from 57 to 66% (p = 0.001). In the qualitative section of the test, students were asked what public health topics should be taught in medical school. Frequently suggested topics included social determinants of health (25%), epidemiology (25%), health systems (25%), insurance (21%), policy (17%), economics (17%), racism (15%), and health disparities (8%). When asked how public health will impact their medical career, students frequently responded that it would greatly impact their clinical practice (49%), choice of residency program (17%), and decision to pursue advocacy or additional degrees (15%).ConclusionsLearners participating in this five-week online public health curriculum demonstrated a significant increase in public health knowledge. The online format allowed for high participation across five different specialty rotations, and community-specific data allowed students to recognize the importance of public health in medical practice.

Terapia Ocupacional en Costa Rica: historia, evolución y retos futuros en la formación profesional

La Terapia Ocupacional (TO) como carrera socio sanitaria, centrada en el ser humano, se ocupa de promover la salud y el bienestar a través de la ocupación, cuyo objetivo principal es permitir que las personas participen en las actividades de la vida cotidiana (ocupaciones) a lo largo del ciclo de vida. La TO ha adquirido a través del tiempo un rol preponderante en el concepto de promoción, prevención, rehabilitación, inclusión y salud pública en general. Esta disciplina se ha expandido a diversas áreas de la atención a las personas y ha demostrado un impacto positivo en los sistemas de salud de diversas naciones. Este artículo tiene como objetivo describir la historia y evolución de la TO en Costa Rica, su impacto en la salud pública, así como los principales retos para la formación profesional que respondan a las necesidades sociales y sanitarias actuales, así como las emergentes de la población del país.

Neither boat nor barbeque: in search of new language to unleash the transformative possibility of restorative justice

ABSTRACTRestorative justice (RJ) has emerged as a justice approach designed to address some of the perceived inequity and marginalization engendered by traditional retributive justice systems. However, grounding restorative justice philosophy and practice in linguistic and discursive formulations of ‘justice’ cannot be disentangled from historical actions, systems, and narratives that use such language to simultaneously produce and exacerbate marginalization, oppression, and exclusion. Drawing on J.L. Austin’s classic theory of language and Ferdinand de Saussure’s concept of semiotics, this article argues that the current linguistic environment of RJ may prevent it from accomplishing true societal transformation as a social movement. Using the linguistic examples of ‘boat’ and ‘barbeque’ to help elucidate the limiting aspects of restorative justice language, we then introduce the concepts of linguistic abstractions and conversational domains as pathways to liberate restorative justice from the limiting constraints of its languaging. By introducing three central questions, we provide an inquiry framework that offers related concepts of public health, permaculture, racecraft, and satyagraha to demonstrate how alternative languaging may be needed to fully achieve the aspirational possibilities of ‘restorative justice.’

The Importance of Public Health Policies in the Social - Economic Development of Romania

For each individual, as well as for the entire community, health is one of the most important factors that ensure life and activity. Health care is not only a problem of healthcare but also a problem of a profound social nature, making it an integral part of all the social and economic development conditions. The right to health is conditioned by the health system and the socio-economic factors, which are reflected in the health of the population. The way in which this system is organized is a determinant of the individual's and community's health, putting their mark on the whole of their lives. Human health seen in the concept of public health is based on the individual's health as a component of the health of the population. Areas of approaches are diverse and start from existing health problems such as the state of the environment, socio-economic development or political governance. To ensure health protection, the governments of the world tend to include health in development programs through public policy. This article aims to bring to the attention of readers the importance of social and economic development and the importance of public health policies in this respect. Also, the inequalities existing in Romania regarding access to health services are an area of general interest, as it affects society as a whole.

Changes in the State Governmental Public Health Workforce: Demographics and Perceptions, 2014-2017

Context:Workforce is a critical cog in the governmental public health enterprise in the United States. Until 2014, workforce research was largely conducted at the organizational level. However, the fieldings of the Public Health Workforce Interests and Needs Survey allow for nationally representative comparisons with individual respondents.Objective:Using data from agencies that participated in 2014 and 2017, we conducted multi–cross-sectional comparisons of the Public Health Workforce Interests and Needs Survey data.Design:The Public Health Workforce Interests and Needs Survey participants at the State Health Agency Central Offices were surveyed using a Web-based platform. Balanced repeated replication weights were used to account for differential designs between 2014 and 2017.Setting:Thirty-three state health agency central offices that participated in both 2014 and 2017.Participants:Permanently employed governmental public health staff.Main Outcome Measures:We examined changes in perceptions of the workplace environment, job and pay satisfaction, intent to leave, awareness of emerging concepts in public health, and demographic/worker characteristics. Pearson and Rao-Scott–adjusted χ2 analyses were used to compare changes between 2014 and 2017.Results:The percentage of staff who are people of color increased from 29% (95% confidence interval, 28%-30%) to 37% (95% confidence interval, 36%-38%) from 2014 to 2017 across 33 states. Approximately 26% of staff were younger than 40 years in 2014 compared with 29% in 2017 (P < .001). Job satisfaction increased in 17 states overall (P < .05, n = 5) and decreased in 16 states (P < .05, n = 5) but did not change in aggregate. Overall, the percentage of staff considering leaving the organization in the next year or retiring within 5 years is up from 44% to 48% (P < .001).Conclusions:Global measures of satisfaction are relatively high and consistent between 2014 and 2017. Demographics are shifting toward a marginally younger workforce as many retire, and a significant portion of staff indicates that they are considering leaving their organization or planning to retire.

The Methods of PH WINS 2017: Approaches to Refreshing Nationally Representative State-Level Estimates and Creating Nationally Representative Local-Level Estimates of Public Health Workforce Interests and Needs.

The Public Health Workforce Interests and Needs Survey (PH WINS) was first fielded in 2014 and is the largest public health workforce survey in the nation. This article elucidates the methods used for the 2017 PH WINS fielding. PH WINS was fielded to a nationally representative sample of State Health Agency Central Office (SHA-CO) staff, as well as local health department (LHD) staff. The instrument largely mirrored 2014, though the training needs section was revised, and a validated item measuring burnout in staff was added. Staff lists were collected directly from all participating state and local agencies. Forty-seven state health agencies (SHAs), 26 large LHDs, and 71 midsize LHDs participated. All SHAs were surveyed using a census approach. The nationally representative SHA-CO frame is representative of all central office staff members. The nationally representative local frame was a complex survey design, wherein staff from LHDs were randomly sampled across 20 strata, based on agency size and geographic region. Staff were also contributed with certainty from large LHDs in nondecentralized states. The frame is representative of staff at LHDs serving more than 25 000 people and with 25 or more staff members. Other LHDs are excluded, and so PH WINS is not representative of smaller LHDs. Balanced repeated replication weights were used to adjust variance estimates for the complex design. Overall, 47 604 people responded to PH WINS in 2017 across all frames. PH WINS 2017 achieved a response rate of 48%. The design effect for the SHA-CO frame was 1.46 and was 16.42 for the local frame. PH WINS now offers a nationally representative sample of both SHA-CO and LHD staff across 4 major domains: workplace environment, training needs, emerging concepts in public health, and demographics. Both practice and academia can use PH WINS to better understand the perceptions and needs of staff, address training gaps, and work to recruit and retain quality staff.

The Relationship Between Health Department Accreditation and Workforce Satisfaction, Retention, and Training Needs.

To improve quality and consistency of health departments, a voluntary accreditation process was developed by the Public Health Accreditation Board. Understanding accreditation's role as a mediator in workforce training needs, satisfaction, and awareness is important for continued improvement for governmental public health. To compare differences in training needs, satisfaction/intent to leave, and awareness of public health concepts for state and local health department staff with regard to their agency's accreditation status. This cross-sectional study considered the association between agency accreditation status and individual perceptions of training needs, satisfaction, intent to leave, and awareness of public health concepts, using 2017 Public Health Workforce Interests and Needs Survey (PH WINS) data. Respondents were categorized on the basis of whether their agencies (at the time of survey) were (1) uninvolved in accreditation, (2) formally involved in accreditation, or (3) accredited. Multivariate logistic regression models found several significant differences, including the following: individuals from involved state agencies were less likely to report having had their training needs assessed; staff from accredited and involved agencies identified more gaps in selected skills; and employees of accredited agencies were more aware of quality improvement. While state employees in accredited and formally involved agencies reported less job satisfaction, there were no significant differences in intent to leave or burnout. Differences were identified concerning awareness of various public health concepts, especially among respondents in state agencies. While some findings were consistent with past research (eg, link between accreditation and quality improvement), others were not (eg, job satisfaction). Several self-reported skill gaps were unanticipated, given accreditation's emphasis on training. Potentially, as staff are exposed to accreditation topics, they gain more appreciation of skills development needs. Findings suggest opportunities to strengthen workforce development components when revising accreditation measures.

Les psychologues dans le champ de la santé mentale : les perspectives en promotion de la santé mentale positive

Literature findingsMental health promotion is still insufficiently known by psychologists and few of them work in this field, in part because it is based on public health concepts and data. Furthermore, its approach is focused on positive health – as opposed to deficit models – which proposes interventions consisting in developing human competencies and strengths as a means of preventing potential future mental illnesses. DiscussionThe present stake, in the field of mental health, thus requires a paradigmatic change in psychologists which would enable to move from mainly curative interventions to actions oriented towards individual and collectives’ potentialities. This article presents a synthesis of mental health determinants as well as national and international public policies aiming at developing health promotion. ConclusionIt concludes on how psychologist could become major actors in this field.

Bridging the Housing and Health Policy Divide: Lessons in Community Development From Memphis and Baltimore

ABSTRACTGovernments and nonprofits routinely partner to launch place-based initiatives in distressed neighborhoods with the goal of stabilizing real estate markets, reclaiming vacant properties, abating public nuisances, and reducing crime. Public health impacts and outcomes are rarely the major policy drivers in the design and implementation of these neighborhood-scale initiatives. In this article, we examine recent health impact assessments in Baltimore, Maryland, and Memphis, Tennessee, to show how public health concepts, principles, and practices can be infused into existing and new programs and policies, and how public health programs can help to improve population health by addressing the upstream social determinants of health. We provide a portfolio of ideas and practices to bridge this classic divide of housing and health policy.

Cosmetovigilance: A review of the current literature.

The term “pharmacovigilance” defines the activities related to the collection, detection, assessment, monitoring, and prevention of adverse reactions occurring with medications. Recently, the spectrum of “-vigilance” has broadened to include safety of herbal products and cosmetic products as well. “Cosmetovigilance” was introduced as a new term used for defining surveillance carried out by industry to address the safety of cosmetic products. It was first used in literature by Vigan (1997) to refer to the monitoring of cosmetic product safety. Today, it is recognized globally as a concept of public health. For this systematic review, a PubMed search was conducted in July 2018 for the term “cosmetovigilance.”

NATURAL ENVIRONMENT AS COMPONENT OF PUBLIC HEALTH: SOME ASPECTS OF ITS LEGAL REGULATION

Introduction: Human health depends on various factors that have a different physical origin, degree of influence on the human body, methods of manifestation and other characteristics. Within public health, their research is carried out implementing an integrated approach and understanding the causation of the factors that influence each other as well as their effects on the human body. The natural environment, namely its state in general and individual natural objects, in particular, is one of the elements having both direct and indirect effects on human health. The aim: To analyze the legal basis for the regulation of the impact of the natural environment as a component of public health. Materials and methods: The study examines provisions of international documents and scientists' attitudes. The article analyzes generalized information from scientific journals by means of scientific methods from a medical and legal point of view. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. Within the framework of the system approach, as well as analysis and synthesis, the concepts of public health, health and influence of the natural environment on them are researched. Review: As a result of the study of a particular range of problems, it may be noted that human health depends on a number of factors that allow it to be adequately addressed. The environmental component, namely, the state of the natural environment affecting the human body both directly and indirectly, is not the least of them. Proper legal settlement of the above-mentioned range of problems will allow a comprehensive approach to understanding the causation of human health and the natural environment. Conclusions: when researching the impact of the natural environment within public health, it can be noted that the legal basis for the multidimensional regulation of the notion of health in general, as well as its individual components, in particular, has been formed and reflected in a number of regulatory legal acts. In turn, inadequate implementation of the systematic approach with an in-depth understanding of the real and potential factors that affect human condition in one way or another does not allow the fullest possible determination of their causation both on the positive and negative sides.

Patents and public health

Tensions are now known between the interests of holders of patent rights over medicines and those of other groups, especially in developing countries. This work tries to deepen these interests from a point of view, mainly legal, which is accompanied by comments of an economic nature, while identifying possible legal and institutional ways to alleviate the negative social consequences of the current system. To this end, the conflicts generated by patents in the context of public health and, specifically, in relation to access to medicines, will be described, to then address the role of intellectual property systems and the concept and scope of public health. Finally, various legal channels will be presented to reconcile the affected interests and possible programmatic and institutional measures.

МОДЕЛІ СОЦІАЛЬНОГО ВІДНОВЛЕННЯ В КОНТЕКСТІ ОСОБИСТІСНО-ОРІЄНТОВАНОЇ ПАРАДИГМИ

This paper analyzes main features of social recovery models, developed within the frameworks of Person-centered paradigm. Person- centeredness is an increasingly common public health and social care concept, that is used to describe a standard of care that ensures that the patient / client is at the center of care delivery. There is no single definition of person-centered care, rather we can find such terms as patient- centered, family-centered, user-centered, individualized. But irrespective of the terms used, a lot of research has looked at what matters to patients and how to provide personalized care to ensure that people have a good experience. Person-centered recovery depends on a number of aspects, in particular: the values of people and placing people at the center of care, taking into account the desires of people and the needs they have chosen, ensuring that people are emotionally comfortable and secure with family and friends, ensuring that people have access to the appropriate care they need, when and where they need to ensure that people receive all the care they need. Main principles of person-centered approach are: recognizing dignity, giving respect and compassion to service users and providers; collaboration with the individual, their family and staff in care planning and assessment; enabling systems and services to help people recognize and build on their own strengths, preferences and objectives in order to realize their full potential. One of the strongest and most methodologically grounded models built in the person-oriented framework is the Comprehensive Rehabilitation Approach (CARe), developed by Dirk den Hollander and Jean Pierre Wilken. The model is based on psychological rehabilitation, recovery and empowerment principles, and is intended to support individuals in their personal development. CARe works with the client in three domains: meeting quality of life wishes and objectives; overcoming insecurity and increasing strength; gaining access to ideal environments and optimizing the quality of life of living environments and social networks.

HYGIENIC PERIODICALS AND THE SHAPING OF DISCOURSE OF PUBLIC HEALTH IN LVIV AT THE BEGINNING OF THE TWENTIETH CENTURY

During the nineteenth century socio-political and economic transformations, as well as scientific discoveries, changed views on health and its value. Also,the concept of public health, which was no longer concentrated on the individual but on a group of people, was included in the sphere of interest of thebroader strata of society in the Central and Eastern Europe. The hygienic movement occupied an important modernizing segment in a wide range ofsocial movement and had an influence on changes in urban space during the nineteenth and the twentieth centuries. Cleanliness and health became signsof modern city and civilization.More noticeable public interest to hygienic ideas in Lviv emerged in the late nineteenth-early twentieth century. One of the manifestations of this was the emergence of hygienic periodicals that focused on issues of public health issues, and especially hygiene, covered almost all areas of everyday life – hygieneof clothing, nutrition, school an urban hygiene etc. At the first time, such journal was published in Lviv during 1872. Four periodicals dedicated to hygiene were published in the city in the period between 1902 and 1914. The publishing of all these periodicals was a non-profit enterprise, and editors were constantly looking for financial resources to ensure their existence.In the first place, the initiative of publishing belonged to Ukrainian and Polish doctors. Lviv hygienic periodicals were published in Polish and Ukrainian and were addressed to the respective national communities. They discussed the same issues, spread the same ideas, but focused mostly on Polish or Ukrainian readers, reflected the socio-political ideas of that time and integrated the concept of health into the competitive ideas of national development.

Is gambling an emerging public health issue in Wales, UK? An assimilation of literature and data

BackgroundHarm from gambling is found at individual, social, and community levels, and includes financial hardship, psychological distress, and interpersonal conflict or relationship breakdown. The harm from gambling to wider society includes fraud, theft, loss of productivity, and the cost of treatment. We aimed to assess whether gambling is an emerging public health problem in Wales. MethodsWe reviewed existing data sources (such as surveys and tax receipts for the past 10 years) and literature (for 2014–17, using a search conducted on “problem gambling” by the Welsh Government Library Service) to ascertain the impact of gambling in Wales with respect to four key public health concepts: cost to society, preventability, inequalities in society, and need for population level interventions. Multiple academics, third sector organisations, and statutory bodies were engaged in informing this study. FindingsIn Wales, 61% of adults had gambled in 2016 (1·5 million people) and 1·1% of the population (30 000 people) self-reported as having a problem with gambling. The annual estimated excess cost of gambling for Wales was between £40 million and £70 million, which is a substantial cost to society. People categorised as most deprived were more likely than those in the least deprived category to bet more than they can afford, to have experienced financial problems caused by gambling, and to classify themselves as problem gamblers. We found that gambling harm can be limited by use of evidence-based interventions from international best practice; the characteristics that they must combine are multiple, coordinated population-level interventions implemented over a sustained period of time. InterpretationOur study provides a picture of the rapidly evolving developments and infrastructure that make gambling an emerging public health issue in Wales. The public health approach aims to improve quality of life and to achieve health equity. This focus on equity is necessary since people living in areas of deprivation are more likely to experience gambling-related harm. Public health action to reduce harm from gambling should include numerous population-based measures. FundingNone.