Article Text

Systems science and systems thinking for public health: a systematic review of the field
  1. Gemma Carey1,
  2. Eleanor Malbon2,
  3. Nicole Carey3,
  4. Andrew Joyce4,
  5. Brad Crammond5,
  6. Alan Carey6
  1. 1Regulatory Institutions Network Australian National University, Canberra, Australia
  2. 2The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia
  3. 3Self-organizing Systems Research Group School of engineering and applied sciences Harvard University
  4. 4Centre for Social Impact, Swinburne University, Melbourne, Victoria, Australia
  5. 5Centre for Epidemiology and Preventive Health. Monash University, Melbourne, Australia
  6. 6Maths Science Institute Australian National University
  1. Correspondence to Dr Gemma Carey; Gemma.carey{at}


Objectives This paper reports on findings from a systematic review designed to investigate the state of systems science research in public health. The objectives were to: (1) explore how systems methodologies are being applied within public health and (2) identify fruitful areas of activity.

Design A systematic review was conducted from existing literature that draws on or uses systems science (in its various forms) and relates to key public health areas of action and concern, including tobacco, alcohol, obesity and the social determinants of health.

Data analysis 117 articles were included in the review. An inductive qualitative content analysis was used for data extraction. The following were systematically extracted from the articles: approach, methodology, transparency, strengths and weaknesses. These were then organised according to theme (ie, commonalities between studies within each category), in order to provide an overview of the state of the field as a whole. The assessment of data quality was intrinsic to the goals of the review itself, and therefore, was carried out as part of the analysis.

Results 4 categories of research were identified from the review, ranging from editorial and commentary pieces to complex system dynamic modelling. Our analysis of each of these categories of research highlighted areas of potential for systems science to strengthen public health efforts, while also revealing a number of limitations in the dynamic systems modelling being carried out in public health.

Conclusions There is a great deal of interest in how the application of systems concepts and approach might aid public health. Our analysis suggests that soft systems modelling techniques are likely to be the most useful addition to public health, and align well with current debate around knowledge transfer and policy. However, the full range of systems methodologies is yet to be engaged with by public health researchers.

  • systems thinking
  • complexity
  • systems science

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