Community Systems Change

Organizations and communities have been working to reduce social problems affecting health and wellbeing for decades. Unfortunately, most efforts face big challenges and many have failed to achieve their goals. 

Five people working together to put a puzzle together. Why does this happen?

Over the years, communities across the world have realized that social problems like equity in health and wellbeing are far more complex than we used to think (some even refer to them as “wicked” problems!) and require a different problem-solving approach (Meadows, 2008; Stroh, 2015).

What is a Community Systems approach to change?

Transforming a complex problem like population health requires a community systems change approach. This involves understanding and addressing the multiple, interacting barriers or systemic "root causes" getting in the way of shared goals (Foster-Fishman & Watson, 2017). These systemic root causes tend to fall into several categories including (Foster-Fishman et al., 2007):

  • Mindsets, priorities, and goals
  • Policies, rules, and practices
  • Power dynamics and decision-making processes
  • Connections between people and organizations
  • Feedback loops of information to inform action and promote accountability
  • Service components like accessibility, quality, and fit with diverse cultural backgrounds
  • Human, financial, and community resources

A community systems change approach engages diverse perspectives across the community (e.g., residents, service providers, leaders, etc.) in a process to:

  • Understand root causes getting in the way of shared goals
  • Carry out actions to address these root causes.
  • Support effective implementation of change efforts
  • Learn about progress and adapt efforts  

(Foster-Fishman & Watson, 2012)

A community systems approach shifts the focus from solely using programs to address complex problems like health equity to aligning patterns of system behaviors and structures to better support shared goals (Foster-Fishman & Watson, 2012).

Program Focus

System Focus

  • Isolated, uncoordinated efforts
  • Interdependent and interconnected
  • “My Client” mindset
  • “Our Clients” and “Our Partner” mindset
  • Emphasis on addressing immediate needs, not solving entrenched problems
  • Emphasis on solving entrenched problems by targeting root causes
  • Program Improvement and expansion
  • System transformation
  • Isolated learning
  • Shared feedback and learning

(Adapted from Foster-Fishman & Watson, 2018.)

Community Systems Approach Resources

The following are several general resources related to using a community systems approach.

Simple Rules for Systems Change
Describes the six simple rules or habits stakeholders can use to promote systems change within their everyday work.
Source: ABLe Change

See the Tools for Action section for resources on how to carry out a community systems change approach in your region.