264475 Utilizing systems thinking to conceptualize and inform economic evaluation of an assets-based approach to addressing health inequalities: A case study from Scotland

Wednesday, October 31, 2012 : 9:10 AM - 9:30 AM

Mike Harvey, MPH MRes , Department of Health Management and Policy, University of Michigan, Ann Arbor, MI
Damien Williams, BSc(Hons) PhD FRSPH , School of Medicine, University of St Andrews, St Andrews, Scotland
Fergus Neville, BSc(Hons) MRes PhD , School of Medicine, University of St Andrews, St Andrews, Scotland
Prof Peter D. Donnelly, MD MPH FRCP FFPH , Professor of Public Health Medicine, University of St Andrews, St Andrews, Fife, Scotland, United Kingdom
Scotland is often referred to as the “sick man of Europe”, with the poorest members of society disproportionately affected by ill-health. In an attempt to address these health inequalities, the Scottish Government is promoting the assets-based approach (ABA) which aims to empower communities to identify and utilize pre-existing resources (or assets) to develop new community connections and promote health. Unlike the standard, reductionist approach to public health, ABA exhibits the same behavior as a system (i.e. developing interconnections between elements to achieve a common goal) thereby reflecting systems thinking as a dynamic, holistic approach to health promotion.

North-West Kilmarnock, a deprived area in Scotland, is presented as a case study in which systems thinking is applied to ABA to develop a conceptual model of how the approach is implemented, how it functions, and assess its potential effectiveness. Interviews with delivery team members and documentary evidence were utilized in developing an 8-element conceptual model, including: community events, a community garden, volunteer training opportunities.

Moreover, given the Scottish Government's commitment to supporting cost-effective initiatives, a cost-benefit evaluation was undertaken centering on costs associated with the elements of the conceptual model. Due to the dynamic nature of ABA projecting the cost-benefit was necessary, rather than offering a snapshot outcome often associated with reductionist, economic evaluations.

In conclusion, while each implementation of ABA is necessarily context-specific (i.e. based on assets available in a given community) systems thinking is recommended to conceptualize and inform the economic evaluation of this dynamic approach to addressing health inequalities.

Learning Areas:
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe and define the assets-based approach to addressing health inequalities Compare the systems thinking and reductionist approaches to the evaluation of a dynamic Public Health model Discuss the application of systems thinking to the conceptualization and economic evaluation of an assets-based approach Assess the transferability of the assets-based approach to communities outside Scotland

Keywords: System Involvement, Community Assets

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Master of Research student at the University of St Andrews (UK) and I also have a Master of Public Health with emphasis on analysis from the University of Minnesota. I have been the lead author on a health economics studies and have written a thesis on costing and cost-benefit analysis. My research interests are in economic evaluation for public health programs and decision sciences for medical treatments.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5065.0: Systems Thinking