The Challenge of Cardiovascular Diseases and Diabetes to Public Health: A Study Based on Qualitative Systemic Approach

Abstract

The most common modeling approaches to understanding incidence, prevalence and control of chronic diseases in populations, such as statistical regression models, are limited when it comes to dealing with the complexity of those problems. Those complex adaptive systems have characteristics such as emerging properties, self-organization and feedbacks, which structure the system stability and resistance to changes. Recently, system science approaches have been proposed to deal with the range, complexity, and multifactor nature of those public health problems. In this paper we applied a multilevel systemic approach to create an integrated, coherent, and increasingly precise conceptual framework, capable of aggregating different partial or specialized studies, based on the challenges of the Longitudinal Study of Adult Health – ELSA-Brasil. The failure to control blood pressure found in several of the study's subjects was discussed, based on the proposed model, analyzing different loops, time lags, and feedback that influence this outcome in a population with high educational level, with reasonably good health services access. We were able to identify the internal circularities and cycles that generate the system’s resistance to change. We believe that this study can contribute to propose some new possibilities of the research agenda and to the discussion of integrated actions in the field of public health.

Aedes ægypti control in urban areas: A systemic approach to a complex dynamic

“…Relationships within and across any of the subsystems and the external environment are the drivers that shape the system. Relationships can be unidirectional or bidirectional influences, in some cases measurable in some unit, more frequently a route for information flow, and not quantifiable in any way [ 20 ]. The internal subsystems are linked through relationships depicted as black arrows.…”

Quantifying a Systems Map: Network Analysis of a Childhood Obesity Causal Loop Diagram

“…Obesity is a prime example [1], along with other population health problems [2]. It has been suggested that any intervention seeking to tackle complexity would be better served if a shared understanding of the complexity was developed to support intervention design, implementation and evaluation [3].…”

Importance of giving health education regarding lifestyle modification and perceived barriers: focus group discussion among community health workers of slum of Kolkata, India

“…Similar results were shown in studies done in healthy individuals also opined that good dietary practices reduce the incidence of NCDs. 9,10 Regarding tobacco quitting, everyone stated that health education through camp, awareness programmes on school, colleges and clubs is the most practical way to approach community. Few other studies had shown that behaviour change communication is the way to break the socio-cultural barriers through locally available clubs and camps.…”