Since a young age, I have been passionate about addressing global issues. Poverty, food insecurity, climate change, healthcare disparities, to name a few. I was unsettled with the idea that people did not have equal access to healthcare, and I felt compelled to act. However, the question was, how? How would I ever make an impact large enough to address these wicked problems?These issues have multiple causes that are interconnected within a larger system, which are daunting to think about. Even the textbook definition of a wicked problem describes it as “a social or cultural problem that is difficult or impossible to solve due to its incomplete or contradictory knowledge, large economic burden, and interconnected nature of these problems with other problems.”
During my Queen Elizabeth Scholarship, I had the opportunity to explore these concepts of systems and complexity. I worked with the Australian Prevention Partnership Centre in Melbourne, Australia. The Prevention Centre approaches issues using a systems approach, evaluating not just programs and policies that affect chronic disease prevention, but also examining how these initiatives coexist and interact within the larger system. Specifically, the project that I worked on, Prevention Tracker, aims to describe, guide, and monitor local prevention systems in order to better understand them and identify areas to intervene to strengthen the system.
This placement taught me about applying systems thinking to chronic disease prevention. We currently live in an obesogenic environment, in which calorie-dense foods are readily available at our finger tips. The food industry is heavily involved with promoting the consumption and increasing the accessibility of unhealthy foods. Physical activity guidelines are difficult to achieve with the sedentary lifestyle that society promotes. The social determinants of health, such as poverty, working conditions, and education, heavily influence the lifestyle choices of an individual. While we can increase the number of programs that tell people to live a healthier lifestyle, we are not addressing the root challenges with the environment that promotes the behaviours in the first place. Working at the Prevention Centre taught me to look beyond the surface and examine how various factors interact to affect change.
Furthermore, I was provided with tools to analyze systemic issues. I learned about causal loop diagrams, which allows us to depict the interconnected factors within a system through a visual map. I learned about organizational network analysis, which can be used to assess the degree to which organizations are connected with and collaborate with one another. I had the opportunity to witness the dynamics of research collaborations with communities as well as various systemic inquiry processes.
I gained perspective on working with communities in addressing these issues. In group model building sessions, we brought together key stakeholders who were involved with community prevention in order to discuss the issues with the current system. Each individual had a different definition of the problem, and bringing diverse people together at the same table to discuss their ideas allowed us to create a shared vision and understand where the differences lay.
Furthermore, I learned that we need to continuously advocate for and ensure that these issues are being addressed. In the previous Australian budget, funding for prevention had been dramatically reduced. While political cycles last several years, the benefits of preventive programs sometimes are not realized until much farther down the road. This makes it difficult to invest in prevention, especially if the public’s attention is focused on curing diseases.
On the other hand, I began to appreciate the fact that these issues are not meant to be solved overnight. I learned patience through understanding that systems take time to change, and I removed the heavy burden from my own shoulders. In my time off, I explored the city of Melbourne. With its artistic laneways filled with street art, buskers at every corner, and green garden spaces, it was hard not to fall in love with this lively place. I met people from all walks of life: a medical student; a street photographer; an entrepreneur; a person who didn’t know what they wanted to do in life, just to name a few. Embedding myself in a new environment played a great role in supporting my personal development and broadening my worldview.
Overall, my experience in Melbourne with the Prevention Centre was incredibly enriching for my personal growth. Systems thinking is something that I will continue to apply in the future. Instead of feeling daunted by complexity, I will approach it with a mind of inquisitiveness, with the insights that I have gained from my placement.
Watch the video from Jean’s QE Scholar Insights webinar here.