How To Think About Systems Change

Adapted from NLC’s Citiespeak Blog

While it’s easy to understand how someone’s personal decisions or behaviors can impact their health, it’s often harder to visualize how systems can influence individual and community health outcomes. As a result, conveying the need for “systems change” can be challenging.

Even when people do understand the impact of systems on individuals, they can find the problem overwhelming, even insurmountable.

“Americans see systems as opaque, intransigent, unwieldy … For many, it’s how they see systemic racism—we can see it, we can know it’s wrong, but we feel deep angst because we believe it’s too big for us to solve.

Still, city leaders know that helping constituents and partners understand the impact of systemic influences is essential to making progress toward addressing root causes and advancing health equity. As Ali Abazeed, Inaugural Director of the Dearborn Public Health Department and participant in NLC’s Cities of Opportunity Action Cohort, recently observed: “Health communications is an intervention in and of itself. We have to do a better job communicating what we do.”

To support city leaders in this goal, we are debuting a series of communication tools at this year’s Cities of Opportunity Solutions Forum. The Plain Talk tools take concepts and terms essential to the work of health equity and offer tips on how to communicate them simply and effectively. The tips are based on current communication research and best practices.

For example, here are three Plain Talk suggestions for introducing the concept of “systems change:”

1. Start small. If you start by talking about big systems that are related to how a city functions—like the economic system or infrastructure system—it can overwhelm people. Instead, identify a smaller system that people can easily understand. The metaphor of a school is helpful.

a. “A system is basically a group of parts that are connected for a bigger purpose, like a school, where the purpose is learning.”

2. Then focus on the role of people—both as creators of the system and as being impacted by the system.

a. “People— parents, teachers, principals, school boards, students—create and influence the school system. They’re also influenced by it. Since it’s all connected, we have to consider whether it’s working for everyone. If it’s not, we need to figure out why. And any change we make to this system can impact people— and in different ways.

3. Admit that system change tackles complex problems! Again, people can get overwhelmed by the idea of “transforming the system.” Stress the need for time, patience, collaboration, open communication, research, and planning. Use “yes, and…” language instead of “Yes, but…:”

a. “Yes, it’s going to take time, and we’ve already made a smart change that’s going to directly impact people.”