Agent-Based Modelling of Health Inequalities following the Complexity Turn in Public Health: A Systematic Review

Abstract

There is an increasing focus on the role of complexity in public health and public policy fields which has brought about a methodological shift towards computational approaches. This includes agent-based modelling (ABM), a method used to simulate individuals, their behaviour and interactions with each other, and their social and physical environment. This paper aims to systematically review the use of ABM to simulate the generation or persistence of health inequalities. PubMed, Scopus, and Web of Science (1 January 2013–15 November 2022) were searched, supplemented with manual reference list searching. Twenty studies were included; fourteen of them described models of health behaviours, most commonly relating to diet (n = 7). Six models explored health outcomes, e.g., morbidity, mortality, and depression. All of the included models involved heterogeneous agents and were dynamic, with agents making decisions, growing older, and/or becoming exposed to different health risks. Eighteen models represented physical space and in eleven models, agents interacted with other agents through social networks. ABM is increasingly contributing to our understanding of the socioeconomic inequalities in health. However, to date, the majority of these models focus on the differences in health behaviours. Future research should attempt to investigate the social and economic drivers of health inequalities using ABM.

Action against inequalities: a synthesis of social justice & equity, diversity, inclusion frameworks

“…The constructs above may be assessed from the perspectives of multiple marginalized groups. The diversity and inclusion of specific groups in a social justice framework was conceptualized in this synthesis as follows: drawing upon Young, Freire, and Snell-Rood et al's shared construct, EDI emerges as too complex [112][113][114] to be confined to a singular construct. Instead, each of the sixteen constructs has capacity to present differing -or, inequitable -levels of benefits and risks depending on the sub-group of focus.…”

The current state of complex systems research on socioeconomic inequalities in health and health behavior—a systematic scoping review

“…Interest in applying a complex systems approach to socioeconomic inequalities in health is growing. Some existing reviews have described the application of systems thinking in public health [ 11 ], of simulation models in public health [ 12 ], or of simulation models to socioeconomic inequalities in health [ 13 , 14 ]. Others have summarized complex systems approaches for specific outcomes, like diet [ 15 ], obesity [ 16 , 17 ], and food environments [ 18 ].…”