Dealing with complexity applying group model building to public health and health care

Abstract Public health and health care systems are inherently complex, shaped by dynamic interactions between social, economic, and environmental factors. Traditional linear approaches often fail to capture this complexity, leading to fragmented solutions. Group Model Building (GMB) offers a participatory, systems-thinking approach that engages stakeholders in collaboratively constructing models to understand and address complex health challenges. The national institute for public health and the environment (RIVM) explores the application of GMB in public health and health care, highlighting its ability to foster shared understanding of underlying dynamics, to better understand future challenges and opportunities and to support foresight-informed policy making. By applying GMB a causal loop diagram (CLD) is constructed that reflects the most important variables and their interconnections of public health and health care. It shows that the Netherlands, as most other European countries, are facing a growing mismatch between future health care demands, fuelled by an ageing population with multimorbidity as an main challenge, and the supply of health care, with a n increasing personnel shortage as main challenge. The CLD enables the identification of leverage points for intervention, improving the effectiveness of health policies and programs. Despite its strengths, challenges remain, including resource intensity, stakeholder engagement, and the need for methodological refinement. Future research should focus on optimizing GMB processes, incorporating digital tools, and expanding interdisciplinary collaboration to enhance its impact. As health systems continue to evolve, embracing complexity through participatory modeling will be crucial for developing sustainable, adaptive solutions that address emerging health threats and disparities.