A Systems Thinking Approach for Community Health and Wellbeing

Abstract

Under national or state-based legislation, local governments are commonly required to prepare municipal health and wellbeing plans. Yet, the issues these plans aim to address are often complex, and programmatic planning approaches traditionally used by practitioners struggle to engage with such complexity as they assume these issues can be ‘solved’ in isolation. Systems thinking is increasingly being used as an approach to deal with those struggles more effectively, yet little is known about whether local governments and other stakeholders think systems approaches are feasible and acceptable in practice. This study tested a systems thinking approach to gauge if it could better address complex place-based health and wellbeing issues, such as to reduce noncommunicable diseases. Guided by a systems change framework, the approach comprised a facilitated systemic inquiry and rich picture process involving diverse stakeholders in a remote municipality in the Australian state of Tasmania. Among the participants there was broad support for the systems approach tested and they thought it was effective for increasing systems thinking capacity, collaboratively revealing systemic issues, and identifying opportunities to address those issues. They valued the rich picture because it created shared understandings of local issues. The findings suggest more is needed from macro-level policy to support place-based stakeholders to undertake systems approaches in practice, which could result in more sustainable and effective systems change required to improve health and wellbeing outcomes. The findings have implications for theory, research, and practice across interdisciplinary fields concerned with placed-based systems change, especially in rural and remote municipalities.