About Complex Systems Thinking
What's the difference between complex systems thinking and public health?
Unlike public health, complex systems thinking is not a profession—it's a paradigm. It's a perspective that views problems from an unfamiliar angle. To some extent, public health professionals still focus on isolated programs to tackle individual diseases. That approach worked very well for diseases like smallpox and polio, but is inadequate for today's challenges. A complex systems thinking approach to public health would focus instead on mobilizing communities around a shared vision, interventions at leverage points, and fostering an environment of self-organization and emergence (not familiar with these terms?). This approach is much better suited for complex challenges like poverty, diabetes, and cancer. So public health practitioners should use complex systems thinking, but most do not.
In some ways, public health is already on the leading front of a health revolution. The socioecological model, which is broadly understood and applied in public health, is a step toward complex systems thinking, but it doesn't go far enough. Complex systems thinking exceeds the socioecological model in at least four ways:
1) A consideration of dynamic interactions over time.
2) Providing a transformational paradigm shift.
3) An emphasis on trans-disciplinary collaboration and crossing sectors, using approaches like collective impact.
4) A vision for the fundamental public health ideals, like prevention, to infiltrate all sectors (policy, clinical medicine, etc).
(Livingood, William C., et al. "Applied social and behavioral science to address complex health problems." American journal of preventive medicine41.5 (2011): 525-531.)
Is complex systems thinking aligned more with one political party or ideology?
No. We think the concepts could be applied equally by socialists and libertarians.
What style of systems theory are you talking about? Aren't there several different disciplines, like systems dynamics, complexity theory, systems analysis, chaos theory, and cybernetics?
Purists may be disappointed, but we apply those concepts and theories (and combinations) that seem to have practical application. Mostly complex adaptive systems, and systems thinking.
Dr. Swanson has been influenced by the following books (all worth glancing over): Peter Senge’s the Fifth Discipline; Donella Meadows’ Systems Thinking: A Primer; Bob Williams’ and Richard Hummelbrunner‘s Systems Concepts in Action; and Scott Page’s Great Course on Complexity.
Mostly, we hope to contribute to institutional changes where experts and practitioners are supported and incentivized to apply any and all of the complexity and systems methods, tools, concepts, approaches, and theories as needed to optimize how we as a society approach health improvement.
About Revolutionize Health
Do you want to replace biomedical reductionism with complex systems thinking in health?
No. We recognize and appreciate the phenomenal successes of reductionism. We want an optimal balance between reductionism, and using that knowledge in a way that better achieves what we as a society want.
I understand that the group wants to use CST to change how healthcare works, but I am still unsure of what you are trying to accomplish.
To be clear, we aren't just talking about healthcare reform. We're talking about a wide-spread societal movement to change everything from the way we commute to work to what we eat. It seems radical, and it is somewhat, but the theory is solid. Scientific medicine was radical in its day!
We want to do something similar to what Flexner did to medical education in 1910. Our goal is to incorporate CST into professional health education (doctors, public health professionals, nurses, administrators, etc). The idea is that education trains us how to think, and in order to make much needed progress, we need to think about health challenges differently than we do now (from a reductionist to a CST paradigm).
What is the problem with the way we do things now?
The problem is the way we approach health challenges. Right now we apply a reductionist approach which creates systems that produce unnecessary waste, redundancy, and leave massive gaps in equity. Because it is so common, we often don't recognize that we use a reductionist mindset, or that there could be better ways to approach health. Most of our global efforts at improving health come from within a traditional mindset— only focusing on one problem at a time— and will continue to fall short of what we really want.
I don't understand how your solution would make things better. Can you elaborate?
Our solution is less of a solution and more of a better way forward. Rather than attempting to plan detailed, discrete interventions to tackle individual diseases (see this website for a very common example of the way we currently operate), we would focus on mobilizing entire communities around a shared vision of a healthy future, establishing ground rules, and allowing stakeholders to self-organize toward that future. That's an overly simplistic description of CST, but it's a good start.
Flexner didn't know exactly how science would make medicine better, but he understood that traditional medicine didn't work and that science could improve the efficacy of medical practice. Likewise, we don't know exactly how CST would improve our health, but we know that people suffer and die needlessly because systems are broken. Better thinking creates better systems, which will produce better health for everyone.