Living sustainably begins with increasing our awareness about our environments. As we seek to reduce waste and reduce harm to our external environment, we will similarly improve our internal environments, our health. The rising prevalence of chronic disease world-wide is another costly symptom of the need to shift our thinking and behavior. Sustainable shifts to use our own locomotion and to eat unprocessed, locally-grown food help not only to repair our bodies, but our world.
Since 2006, Sustainability Institute has been working with the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention (CDC) to use system thinking and system dynamics to better understand the leverage points for decreasing cardiovascular events and chronic disease costs. Building on the SI Diabetes project led by Drew Jones and Jack Homer, the team has developed a simulation model focusing on risk factors for first-time cardiovascular disease events. These risk factors include local contextual factors such as characteristics of the built environment and environmental policies.
The simulation model is being used in action labs to enable groups of stakeholders to interactively explore policy options to decide what to implement. It is being applied at the national level, as well as with several local communities to increase alignment among stakeholders, and to ensure programs are implemented for interventions having the highest impact on disease and costs. Team partners in Austin, TX at the Travis County Health Department were involved in the development of the local context portion of the model. A community chronic disease coalition was organized out of the learning labs there, to continue to coordinate the implementation work. The model is also being used in the Mississippi Delta Region to provide a vehicle for systemic understanding and aligned strategic action among a diverse set of stakeholders.
In 2008, the CDC System Dynamics team, including five members of the diabetes and cardiovascular teams, accepted the inaugural "ASysT Prize" from the Applied Systems Thinking Institute for a suite of projects on systems thinking in health issues, including the diabetes and cardiovascular work. The ASysT Prize is an annual award for a significant accomplishment achieved through the application of systems thinking to a problem of US national significance in the area of national security, homeland security, energy, environment, health care or education. $20k went to the CDC Foundation to do more in this area.
Future plans for the simulation model include expansion to capture other key drivers of disease and cost, especially post-cardiovascular populations. The expanded model will be used for detailed policy testing at the national level, as well as continued use in local communities to focus galvanize action.
The CVD System Dynamics Team
- Kristina Wile, Systems Thinking Collaborative
- Jack Homer, Homer Consulting
- Andrew (Drew) Jones, Sustainability Institute
Resources
- View the CVD Risk Factors Causal Map.
- "Where is the Leverage?" Excerpts from an interactive tool to explore scenarios from the model.
- The first paper on the modeling project has been published in Preventing Chronic Disease. Reference:
Homer J, Milstein B, Wile K, Pratibhu P, Farris R, Orenstein D. Modeling the local dynamics of cardiovascular health: risk factors, context, and capacity. Preventing Chronic Disease 2008; 5(2). http://www.cdc.gov/pcd/issues/2008/apr/07_0230.htm
For a copy of the paper, follow the link above. - CVD System Model Reference Guide, Jack Homer (2008) (263KB pdf). Overview of model structure and assumptions.
- Simulating and evaluating local interventions to improve cardiovascular health, Jack Homer, Bobby Milstein, Kristina Wile, Justin Trogdon, Philip Huang, Darwin Labarthe, Diane Orenstein (2009). Submitted to Preventing Chronic Disease. For a copy of the working paper, email Kris Wile.
Supplemental materials for this paper.- Additional references (18KB pdf).
- Appendix 1 - Cardiovascular Risk Calculation (24KB pdf).
- Appendix 2 - Cost Calculation (36KB pdf).
- Appendix 3 - High and Borderline Risk Analysis (18KB pdf).
Contact
- Kris Wile (model and project direction)