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Using systems science to understand the determinants of inequities in healthy eating

Author

Listed:
  • Sharon Friel
  • Melanie Pescud
  • Eleanor Malbon
  • Amanda Lee
  • Robert Carter
  • Joanne Greenfield
  • Megan Cobcroft
  • Jane Potter
  • Lucie Rychetnik
  • Beth Meertens

Abstract

Introduction: Systems thinking has emerged in recent years as a promising approach to understanding and acting on the prevention and amelioration of non-communicable disease. However, the evidence on inequities in non-communicable diseases and their risks factors, particularly diet, has not been examined from a systems perspective. We report on an approach to developing a system oriented policy actor perspective on the multiple causes of inequities in healthy eating. Methods: Collaborative conceptual modelling workshops were held in 2015 with an expert group of representatives from government, non-government health organisations and academia in Australia. The expert group built a systems model using a system dynamics theoretical perspective. The model developed from individual mind maps to pair blended maps, before being finalised as a causal loop diagram. Results: The work of the expert stakeholders generated a comprehensive causal loop diagram of the determinants of inequity in healthy eating (the HE2 Diagram). This complex dynamic system has seven sub-systems: (1) food supply and environment; (2) transport; (3) housing and the built environment; (4) employment; (5) social protection; (6) health literacy; and (7) food preferences. Discussion: The HE2 causal loop diagram illustrates the complexity of determinants of inequities in healthy eating. This approach, both the process of construction and the final visualisation, can provide the basis for planning the prevention and amelioration of inequities in healthy eating that engages with multiple levels of causes and existing policies and programs.

Suggested Citation

  • Sharon Friel & Melanie Pescud & Eleanor Malbon & Amanda Lee & Robert Carter & Joanne Greenfield & Megan Cobcroft & Jane Potter & Lucie Rychetnik & Beth Meertens, 2017. "Using systems science to understand the determinants of inequities in healthy eating," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-18, November.
    • Handle: RePEc:plo:pone00:0188872
    DOI: 10.1371/journal.pone.0188872
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    Cited by:

    1. Joreintje D. Mackenbach & Marielle A. Beenackers & J. Mark Noordzij & Joost Oude Groeniger & Jeroen Lakerveld & Frank J. van Lenthe, 2019. "The Moderating Role of Self-Control and Financial Strain in the Relation between Exposure to the Food Environment and Obesity: The GLOBE Study," IJERPH, MDPI, vol. 16(4), pages 1-12, February.
    2. Sarah Gerritsen & Sophia Harré & Boyd Swinburn & David Rees & Ana Renker-Darby & Ann E. Bartos & Wilma E. Waterlander, 2019. "Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors," IJERPH, MDPI, vol. 16(8), pages 1-19, April.
    3. Moira Zellner & Dean Massey & Anton Rozhkov & John T. Murphy, 2023. "Exploring the Barriers to and Potential for Sustainable Transitions in Urban–Rural Systems through Participatory Causal Loop Diagramming of the Food–Energy–Water Nexus," Land, MDPI, vol. 12(3), pages 1-27, February.
    4. Helen Brown & Katrina Proust & Barry Newell & Jeffery Spickett & Tony Capon & Lisa Bartholomew, 2018. "Cool Communities—Urban Density, Trees, and Health," IJERPH, MDPI, vol. 15(7), pages 1-16, July.
    5. Pippa McKelvie-Sebileau & David Rees & David Tipene-Leach & Erica D’Souza & Boyd Swinburn & Sarah Gerritsen, 2022. "Community Co-Design of Regional Actions for Children’s Nutritional Health Combining Indigenous Knowledge and Systems Thinking," IJERPH, MDPI, vol. 19(9), pages 1-14, April.
    6. Robert J. Noonan, 2018. "Poverty, Weight Status, and Dietary Intake among UK Adolescents," IJERPH, MDPI, vol. 15(6), pages 1-8, June.
    7. Patricia E Jessiman & Katie Powell & Philippa Williams & Hannah Fairbrother & Mary Crowder & Joanna G Williams & Ruth Kipping, 2021. "A systems map of the determinants of child health inequalities in England at the local level," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-25, February.
    8. Meron Lewis & Sarah A. McNaughton & Lucie Rychetnik & Mark D. Chatfield & Amanda J. Lee, 2021. "Dietary Intake, Cost, and Affordability by Socioeconomic Group in Australia," IJERPH, MDPI, vol. 18(24), pages 1-14, December.
    9. Nisbett, Nicholas, 2019. "Understanding the nourishment of bodies at the centre of food and health systems – systemic, bodily and new materialist perspectives on nutritional inequity," Social Science & Medicine, Elsevier, vol. 228(C), pages 9-16.
    10. Mohammad Reza Davahli & Waldemar Karwowski & Redha Taiar, 2020. "A System Dynamics Simulation Applied to Healthcare: A Systematic Review," IJERPH, MDPI, vol. 17(16), pages 1-27, August.

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