AJPH First Look, published online ahead of print Jan 31, 2006
March 2006, Vol 96, No. 3 | American Journal of Public Health 402
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.084459
Thinking of Systems
Kenneth McLeroy, PhD, Editor
Public Health Matters, School of Rural Public Health, Texas A&M System Health Science Center, College Station, Tex
I feel extremely fortunate to have worked on this issue with Scott J. Leischow and Bobby Milstein, who have been indefatigable in their efforts to conceptualize the theme, recruit authors, and represent the importance of systems thinking and its potential applications in public health. This issue represents one of the goals of the Journal department Public Health Matters: to provide new and critical ways of framing public health and public health concerns, with particular emphasis on the social and behavioral sciences. New ways of framing public health may increase our understanding, expand our options for interventions, and increase our effectiveness. I will be writing more about the reenvisioned goals of Public Health Matters in a future issue.
Another goal of this issue is to stimulate interest within the public health community in systems approaches and models. This issue is being published at the same time that the Systems Thinking Workgroup of the Association of Schools of Public Health is identifying and developing systems competencies for public health training programs. Of particular interest is the group’s discussion of critical themes to be included in the systems competencies, including interconnectedness (a relational perspective); a nonreductionist approach; integrating systems thinking into practice, including comparing and contrasting various systems models; a focus on context, particularly the idea of embedded systems; the nature of causality, particularly nonlinear relationships and the importance of feedback loops, stocks, and flows; the importance of progressive approximation for testing of models; the dynamic nature of systems across time; the importance of boundaries, including the subjective nature of the relationships between the observer and the observed; the importance of a multidisciplinary approach in systems thinking; emergent properties, including the concepts of chaos and complexity; and autopoesis, or the self-organizing nature of some systems. While these critical themes are at an initial review stage, they are all represented in the contents of this issue.
My interest in systems thinking goes back a number of years to my doctoral studies at the University of North Carolina, Chapel Hill. I was fortunate to participate in a doctoral seminar (organized by Carol Runyan and Lou Margolis and directed by Bert Kaplan) in which we applied Bronfenbrenner’s model of social ecology to a problem of interest at that time: type A behavior (Margolis LH, McLeroy KR, Runyan CW, Kaplan BH. Type A behavior: an ecological approach. J Behav Med. 1983;6:245–258[CrossRef][ISI][Medline]). I have subsequently used what I learned in that seminar to apply social ecology as a conceptual framework for thinking about how we change social systems to accomplish the goals of health promotion (McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective for health promotion programs. Health Educ Q. 1988;15: 351–378[ISI][Medline]). For several years I participated in the Public Health Education Leadership Institute funded by the Centers for Disease Control and Prevention, in which I was exposed, through the efforts of a great teacher, Sherry Immediato, to other ways in which systems thinking may be used to understand organizational dynamics.
Contributing to this issue has substantially expanded my understanding and appreciation of the wide array of systems approaches that are used, the tools that are available, and the various stages through which systems models have progressed in the last 50 years. This issue illustrates the promise of systems thinking and the importance of using the plural: systems models and systems thinking.
Copyright © 2006 by the American Public Health Association
