A systems thinking approach

Systems thinking is defined as a way to make sense of a complex system that gives attention to exploring the interrelated parts, boundaries and perspectives within that system. It is a mental framework that helps us to become better problem solvers. Systems thinkers find ways to shift or recombine the parts in the system that offer an improved outcome.  

Systems thinking and chronic disease prevention

Systems thinking is defined as a way to make sense of a complex system that gives attention to exploring the interrelated parts, boundaries and perspectives within that system. It is a mental framework that helps us to become better problem solvers. Systems thinkers find ways to shift or recombine the parts in the system that offer an improved outcome.

Work in chronic disease prevention, and public health more generally, has targeted individual behaviour, but many factors, including where we work, eat, play and live, and our access to work and education, all affect our health.

It is not enough to simply urge Australians to eat better and exercise more.  We need to look at the wider systems that directly impact on our health or can help or hinder behaviours that cause chronic health problems. We need to look in depth at our communities, our food systems, our environments and workplaces and how each of these interacts to create communities in which healthy behaviours are the easier, more sustainable options.  

Systems thinking helps us to look at these wider systems. Rather than just tackling the tip of the iceberg, a systems thinking approach delves below the surface and identifies the fundamental and interconnecting causes of complex issues such as chronic disease. 

A round table covered in papers at a workshop as participants work together

Why systems thinking?

Systems thinking is useful because it can:

  • Anticipate long-term consequences of well-intentioned solutions
  • Engage with complexity and motivate continuous learning
  • Mobilise stakeholders to see shared interests
  • Identify leverage points for systems change

What is a systems approach?

Systems approaches use specific tools and methods to better understand the system and the complex problems within it. They are particularly useful because they do not require us to know everything about the system before engaging in problem-solving activities.

Systems approaches can help us respond to otherwise unmanageable problems by providing a different perspective (seeing all parts, and their interconnections), as well as the tools and methods that can be used to explore the system, keeping in mind the dynamic nature of the parts and their relationships.

To change health behaviour, we need governments, organisations and individuals to work together to address the problem from many different angles and in dynamic, flexible ways. Applying systems thinking and systems approaches enables us to create environments that support people to avoid chronic disease.

Policymakers and researchers in deep discussion at a workshop

Why use systems thinking in public health?

Policy makers and practitioners working to prevent chronic disease are using system thinking and systems science methods to better understand complex public health problems and inform their decision making about how to intervene. For example, participatory system dynamics modelling uses a range of evidence sources and data to map and model complex problems, engaging academics, policy experts, practitioners and community members in the process. This results in a co-designed decision support tool that can simulate and compare the likely impact of a range of intervention and policy solutions. 

System dynamics modelling and the underlying theories have the advantage of allowing decision makers to experiment with different scenarios and policy options before they are implemented to reduce the risk of negative consequences and unexpected outcomes. 

Models can be used to experiment with different intervention combinations to forecast their impact on alcohol-related emergency department presentations, chronic disease prevalence over time, and cost implications for the health system. 

Systems thinking principles

  • A system is a set of interacting pieces that combine for a common purpose. A system is not only the sum of its parts but the product of their interaction. 
  • Systems thinking is about understanding relationships and their implications so that we can be better problem solvers. 
  • Systems thinking poses two fundamental questions about each interacting part of a complex problem: What does it influence, what influences it? 
  • Systems thinking doesn’t look at problems or solutions in isolation. It looks at inter-linkages and interdependencies. This might mean tackling things in clusters or bundles. 
  • Systems thinking looks for causes and solutions to problems beyond the immediate vicinity of where the problem is experienced. It asks, how does shifting the boundary change the way something is understood. 
  • Systems thinking will also focus on how problems change over time, because that allows better understanding of the dynamics that might explain them. 
  • Systems thinking seeks multiple perspectives of the same thing, because this clues us into dynamics we might not otherwise see, including multiple paths to the same outcome. By ‘dynamics’ we mean processes, procedures, perceptions, practices, policies and incentives that cause increases or decreases in the drivers or reinforcers of change. 
  • Systems thinking seeks to create positive and lasting change. Before we intervene we need to understand why a situation is as it is, and the context in which it occurs, otherwise any change may be temporary, we may make the situation worse, or create new problems. 
  • Using systems thinking to address problems allows us to identify the opportunities and solutions that might otherwise remain invisible or unnoticed. 

Systems approaches in action

Our systems project is identifying and collating key lessons on the use and value of systems thinking, systems practices, and systems science tools in applied prevention research. Using Prevention Centre projects as case studies, this research will illustrate how researchers, policy makers and practitioners can use systems approaches to better work together to bring about change. It will inform policy makers and funders of the key factors that support the use of effective systems approaches, and when, and in what combination, these approaches are appropriate for prevention research. 

Katrina D'onise at a workshop with colleagues

How can I use systems thinking in practice?

In undertaking systems thinking activities, we want to have the capacity to see and sense a system, that is, patterns, structures, relationships, boundaries, feedback loops and unintended consequences of actions. This means regularly reflecting on our assumptions and mental models and exploring unintended consequences of actions and how we listen and learn from other perspectives. These practices will enhance our capacity to see and sense the system when we engage with specific tools such as causal loop diagrams or systems mapping. 

Download a PDF flyer on practices you can use in your every day systems work.

Circular diagram showing the four steps: Define situation, Gain clarity, Find leverage, Act strategically (and repeat).

Systems thinking practices for every day

Challenges can arise when problem-solving approaches that are useful for complicated problems are applied to complex problems. This can often result in quick fixes that fail to recognise and intervene in the root causes of problems. It can also lead to new or worse problems because we have failed to understand the relationships between parts in the system. 

By recognising the complex nature of the problem, and applying systems thinking approaches, investigations can delve below the surface and identify the fundamental and interconnecting causes of the complex issue – such as the patterns of behaviour, the underlying structure and the beliefs of the people and organisations responsible for creating that complex issue. 

Download a PDF  flyer on why complex is not the same as complicated and what this means for how we approach complex problems.

Diane Finegood presenting from a lectern