Systems Thinking in Public Health; Comment on "Using System Dynamics to Understand Transnational Corporate Power in Diet-Related Non-Communicable Disease Prevention Policy-Making: A Case Study of South Africa"

Milson and colleagues illustrate the value of a systems approach to nutrition policy in South Africa. We respond to their call to use systems approaches, and especially, causal loop diagrams, more widely in public health. We begin with examples of how systems approaches have provided valuable perspectives on health-related problems and continue with an example of where this approach could have been used but was not, England’s response to the COVID-19 pandemic. We show how an effective response would have required integrated health, economic, and social policies, yet the British government adopted a siloed approach. We conclude by noting that examples of how systems thinking, and specifically causal loop diagrams, have been used to support pandemic responses. We conclude by emphasising the need to embed systems thinking in public health policy-making to enhance resilience and preparedness for future crises.