I recently returned from Scotland where I was guest lecturing at the University of St Andrews School of Medicine. This is the second year I’ve been asked by my good friend, Dr. Damien Williams, to deliver a lecture as part of their MSc in Global Health Implementation programme. The topic of the lecture was ‘Addressing health inequities: Dynamic systems approach for global health implementation.’ Tackling complex problems in public health is an important topic; I want to give a brief overview of using a systems approach to complex problems in public health.
Complex problems in public health
Global and public health present many complex problems such as obesity, mental health, drug and alcohol abuse, and violence. These complex problems are difficult to solve for many reasons. Complex problems may have multiple causes making the problem difficult to define. Each problem is unique, even if common themes are shared across other problems. Approaches to one problem may not always be effective for other similar problems. Furthermore, complex problems do not have solutions – only improvements.
Many public health programmes have tried to tackle complex problems using a reductionist approach, with limited success. A reductionist approach breaks down a problem into small pieces and attempts to fix one piece with little regard for other parts of the problem. Taking this view, each piece is something that is ‘broken’ and therefore can be ‘fixed’.
Understanding the systems approach to complex problems
The systems approach, or systems thinking, is a different way of understanding and conceptualising complex problems. The systems approach examines how pieces interact and connect with other pieces to understand the overall behaviour that is produced within that system. Using the systems approach gives us the ability to find leverage points within that system. Public health programmes can be designed to use these leverage points to push or pull a system in a different direction with the intent to change the behaviour of that system and improve health outcomes.
Using a systems approach is a growing field for public health research, and there are countless opportunities for further investigation. Methods like Soft Systems Methodology provide a good starting place for anyone interested in applying a systems approach to their complex problem. I have compiled some resources on problems, systems thinking, and soft systems methodology below. Contact us to find out how a systems approach can help solve your problems.
Dr Michael Harvey