A Systems Thinking Approach to Inform Coherent Policy Action for NCD Prevention Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention"

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.

Understanding obesity‐related behaviors in youth from a systems dynamics perspective: The use of causal loop diagrams

“…Therefore, addressing a part of that chain, such as exclusively focusing on the home setting, is unlikely to effectively tackle unhealthy sleeping behavior in adolescents. There is no silver bullet to address obesity, and multiple actions will likely be needed to effect sustainable changes where it is crucial to move beyond promoting the narrow public health benefits of prevention interventions and show that a more paradigmatic shift would have a multiplicity of sustained benefits across sectors including the economy and environment 15,28 . A key observation reflecting this observation in our study is the central position of screen use in the CLDs.…”

Addressing the commercial determinants of health begins with clearer definition and measurement

“…A practical interdisciplinary CDoH framework can also incorporate new insights from systems science, political economy and political science, creating new bodies of knowledge that can inform public health practice. Systems science can help to create more coherent and grounded understanding of how dynamic systems of power and governance shape the pathways through which CDoH influence health (25). Political economy can help to trace the impact of the rise in neoliberalism on the role of commercial actors while political science can help to identify the social actors who have the power to modify CDoH (26).…”

Developing a Research Agenda for the Analysis of Product Supply: A Response to the Recent Commentaries

“… 9 The situated and integrated approach that Herrick argues for eschews the type of product exceptionalism that has often characterized tobacco control efforts, 19 , 20 and can further expand the scope of pursuit beyond products to consider ecological and human-constructed systems. Milsom et al 21 bring forward a similar point from a different angle, arguing that an analytic gaze focused on policy and institutions as dynamic systems is required to understand both stagnation and change in the realm of policy. This emphasis on systems provides methodological challenges inherent in analyzing a web of factors that cannot necessarily be reduced to simple cause and effect relationships.…”