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Appears in Collections:Management, Work and Organisation Journal Articles
Peer Review Status: Refereed
Title: Building a Systems Map: Applying Systems Thinking to Unhealthy Commodity Industry Influence on Public Health Policy
Author(s): Bertscher, Adam
Nobles, James
Gilmore, Anna
Bondy, Krista
Van Den Akker, Amber
Dance, Sarah
Bloomfield, Michael J
Zatonski, Mateusz
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Keywords: Systems Mapping
Complex Adaptive Systems
Participatory Research
Unhealthy Commodities
Commercial Determinants of Health
Noncommunicable Diseases
Issue Date: 13-Mar-2024
Date Deposited: 19-Mar-2024
Citation: Bertscher A, Nobles J, Gilmore A, Bondy K, Van Den Akker A, Dance S, Bloomfield MJ & Zatonski M (2024) Building a Systems Map: Applying Systems Thinking to Unhealthy Commodity Industry Influence on Public Health Policy. <i>International Journal of Health Policy and Management</i>.
Abstract: Background Unhealthy commodity industries (UCIs) engage in political practices to influence public health policy, which poses barriers to protecting and promoting public health. Such influence exhibits characteristics of a complex system. Systems thinking would therefore appear to be a useful lens through which to study this phenomenon, potentially deepening our understanding of how UCI influence are interconnected with one another through their underlying political, economic and social structures. As such this study developed a qualitative systems map to depict the complex pathways through which UCIs influence public health policy and how they are interconnected with underlying structures. Methods Online participatory systems mapping workshops were conducted between November 2021 and February 2022. As a starting point for the workshops, a preliminary systems map was developed based on recent research. Twenty-three online workshops were conducted with 52 geographically diverse stakeholders representing academia, civil society, public office and global governance organisations. Analysis of workshop data in NVivo and feedback from participants resulted in a final systems map. Results The preliminary systems map consisted of 40 elements across six interdependent themes. The final systems map consisted of 64 elements across five interdependent themes, representing key pathways through which UCIs impact health policymaking: 1) direct access to public sector decision-makers; 2) creation of confusion and doubt about policy decisions; 3) corporate prioritisation of commercial profits and growth; 4) industry leveraging the legal and dispute settlement processes; and 5) industry leveraging policymaking, norms, rules, and processes. Conclusion UCI influence on public health policy is highly complex, involves interlinked practices, and is not reducible to a single point within the system. Instead, pathways to UCI influence emerge from the complex interactions between disparate national and global political, economic and social structures. These pathways provide numerous avenues for UCIs to influence public health policy, which poses challenges to formulating a singular intervention or limited set of interventions capable of effectively countering such influence. Using participatory methods, we made transparent the interconnections that could help identify interventions future work.
Rights: Copyright: © 2024 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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