Abstract
Lencucha and Thow tackle the enormous public health challenge of developing non-communicable disease (NCD) policy coherence within a world structured and ruled by neoliberalism. Their work compliments scholarship on other causal mechanisms, including the commercial determinants of health, that have contributed to creating the risk commodity environment and barriers to NCD prevention policy coherence. However, there remain significant gaps in the understanding of how these causal mechanisms interact within a whole system. As such, public health researchers’ suggestions for how to effectively prevent NCDs through addressing the risk commodity environment tend to remain fragmented, incomplete and piecemeal. We suggest this is, in part, because conventional policy analysis methods tend to be reductionist, considering causal mechanisms in relative isolation and conceptualizing them as linear chains of cause and effect. This commentary discusses how a systems thinking approach offers methods that could help with better understanding the risk commodity environment problem, identifying a more comprehensive set of effective solutions across sectors and its utility more broadly for gaining insight into how to ensure recommended solutions are translated into policy, including though transformation at the paradigmatic level.
Highlights
Lencucha and Thow’s1 analysis begins to reveal the risk commodity environment as a complex systems problem, in which interactions between multiple elements and agents across political, economic and social domains mean that decisions taken at one level can have multiple, often delayed and distant, effects elsewhere.[2]
They do not progress this formulation, critically the role of dynamic complexity – the often unintuitive behaviour of a complex system that arises from interaction of elements and agents over time – that we suggest underlies the political challenge of achieving greater policy coherence for non-communicable disease (NCD) prevention.[2]
This suggests that addressing NCD policy coherence challenges that have emerged from compliance with neoliberal norms, such as international investment policy promoting transnational risk commodity corporations (TRCCs) entry into a country, entering into a new trade deal, or the involvement of commercial actors in policy-making may be complex system problems, but how can a systems approach be operationalized? System dynamics and soft system methodologies (SSM) offer two of the most sophisticated perspectives and methodological approaches
Summary
Lencucha and Thow’s1 analysis begins to reveal the risk commodity environment as a complex systems problem, in which interactions between multiple elements and agents across political, economic and social domains mean that decisions taken at one level can have multiple, often delayed and distant, effects elsewhere.[2].
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