Epidemiology – Systems Thinking

  • There is an obesity epidemic in the United States, with increased incidence of Type II diabetes. There is evidence of racial and ethnic disparities in these rates. Use the conceptual model Axis of Nested Hierarchies outlined in Glass et al (2006) as a guide to develop dynamic hypotheses that could explain racial and ethnic disparities in diabetes rates. Address multiple levels in mapping individual, social, and institutional factors. Not all levels need be incorporated, but multiple levels from genomic [underwater] to global [uphill] must be considered. Include facilitators and barriers.
  • Construct a rich picture (eco map) to map issues and concerns among the stakeholders. This should include identifying motivations and perceptions of stakeholders (individuals, health care workers, society, and institutions); identifying formal and informal structures, hierarchies, and networks; process of how things flow; and outcomes including intended and unintended.
  • Construct a causal loop diagram (CLD), using the information from the rich picture and IRD, that demonstrates the dynamic hypothesis or hypotheses. The CLD should contain minimally one balancing or reinforcing loop that may include positive and negative attributes.
  • In conjunction with the CLD, present a paragraph that summarizes the CLD in words
  • Optional: Construct an interrelationship digraph (IRD) that builds on the rich picture in order to explore myriad interactions of the key variables that can have an impact on outcomes (Submit under Optional Assignment in the Assignments section.
  • Notes:
    • Attached is the Axes of Nested Hierarchies. Glass2006.pdf
    • The readings provide information on factors to be considered. The online module and Diez Roux paper provides information on the tools themselves.

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