Category Archives: Systems Design

Viewing Health as a System

Charlie Homer
Charlie Homer




What Is the System that Produces Health?






Envisioning a More Complete Model




Seeking a Systems Model








Far From Gold Medal Performance

JS Profile
Jonathan Small

The Olympics were a source of great pride and entertainment for millions of people around the world. I was personally glued to the TV for two weeks and was filled with admiration and respect for these impressive athletes. I frequently found myself thinking about all the hard work and sacrifices needed for them to reach the pinnacle of their sport. I was inspired.

And then the director cut to commercial and I had the displeasure of seeing this ad from Cadillac. In it, actor Neal McDonough glorifies the value of hard work while berating the more leisurely lifestyle of other countries:

Other countries, they work. They stroll home. They stop by the café. They take August off. Off. Why aren’t you like that? Why aren’t we like that? Because we’re crazy-driven, hard-working believers, that’s why.

Then as he revs up his spanking new electric Caddy in the driveway of his ultra luxury home, he ponders the acquisition of material goods and posits they are “the upside of only taking two weeks off in August, n’est-ce pas?”

OK, fine. But what’s the downside? What price does our society pay for discouraging leisure time and mental health days? How much social capital do we lose when we don’t stop by the café?  How many families have dissolved under the pressure of our cultural norms? How many children lack the support systems necessary to achieve their optimal health? And don’t even get me started about maternity leave and childcare benefits.

The US has higher rates of infant mortality and childhood obesity than most other industrialized nations and lags behind in breastfeeding rates as well. These statistics are nothing to brag about. When viewed through a disparities lens, they are even more troubling. For example, the risk of infant death for babies born to non-Hispanic black women is more than two times greater than the risk of infant death for non-Hispanic white women. That’s horrific and embarrassing.

Maybe these “other countries” have something figured out about life balance, n’est-ce pas?

Certainly there is reason for optimism. Recent reports show obesity rates coming down and breastfeeding rates on the rise.  Infant mortality rates are also moving in the right direction and we are confident national initiatives will continue to drive them down.

But we have a long way to go before we get a gold medal in child health outcomes. I suggest we begin in a humble place – with the recognition that, while we may have much to teach other countries, we also have a lot to learn. Of course, this approach would not be very effective for selling cars.