COVID‐19: A systems perspective on opportunities for better health outcomes

• Published in: Geographical research 2022-11, Vol.60 (4), p.637-650
• Main Author: Morgan, Michelle J.
• Format: Article
• Language: English
• Subjects: Avoidable; chronic noncommunicable diseases and conditions; COVID-19; Disease control; Disease prevention; Disruption; Economic development; Economic growth; Health disparities; Health status; Jurisdiction; Local government; Noncommunicable diseases; Pandemics; social determinants of health; Social factors; Special | Commentaries on Covid‐19; systems thinking; wellbeing economy
• ISSN: 1745-5863; 1745-5871
• DOI: 10.1111/1745-5871.12561

COVID‐19 has disrupted social and spatial life. In this work, I argue that such disruption provides an opportunity for all tiers of government to reassess collective priorities and reorient societal goals to work towards better health outcomes for all. I offer a systems thinking perspective to show how societal goals such as economic growth are supported by “system rules” created by governments—the same rules largely responsible for prevailing inequities and preventable chronic, noncommunicable diseases and conditions. The work is significant because it shows how the disruption caused by COVID‐19 changed deep system leverage points, highlighting places inside governmental systems susceptible and acceptable to change and revealing how systems can be reoriented. It draws on empirical data from one subnational jurisdiction of Australia. Specifically, in late 2020, 81 Tasmanian local government personnel shared views on diverse governmental changes made in response to the pandemic. Most participants wanted those changes to continue because of their net benefits to health and social, economic, and environmental outcomes more broadly. They expressed overwhelming support for actions to improve the social determinants of health and communicable and noncommunicable disease prevention and management. I conclude that unless such efforts for change continue, poor health outcomes and health inequities are likely to be exacerbated and argue that a shared systems goal to create a wellbeing economy could reorient systems to achieve better health outcomes for all. The aim of this paper is to offer a systems thinking perspective on the significance of the governmental changes that occurred in response to the COVID‐19 pandemic; consider the importance of place in responding to local‐level health needs; and think about how the pandemic offers a rare opportunity for transformational change to build back better. That work is grounded in empirical data from the local government sector in Tasmania, Australia. Unless such efforts for change are taken, poor health outcomes and health inequities are likely to be exacerbated in the longer term.