One of the first key pieces of the project Tackling health inequalities through green/blue infrastructure is to build our theoretical understanding of the complex system underpinning the issues we’re interested in. This approach is increasingly common in public health research, and has been around a for a long while in other disciplines. We’ve been fortunate to have support on this activity from our excellent colleagues Prof Conny Guell and Dr Daniel Mutanda. They have been developing and implementing systems approaches in various projects, and ran an excellent series of webinars in association with the NIHR School for Public Health Research – which you can find on Youtube.

For this project, we set out to build a picture of the system from the ground up, carrying out group model building workshops with project collaborators from various organisations, public partners and academic researchers. Starting with a blank sheet of paper meant that we began without preconceptions of important issues to include, and benefitted from a wide range of perspectives. The first workshop involved discussions around pairs of ‘drivers and consequences’, openly considering anything related to natural environments, health and inequalities. The second workshop involved starting to build these driver-consequence pairs into draft causal loop diagrams (visual representations, with particular attention paid to potential ‘loops’ and other dynamics) using the web tool kumu.

We have been developing the workshop outputs into a full draft system, and starting some basic analysis (e.g. trying to identify key loops). This process has also been informed by other projects, such as work on systems relating nature-based solutions and health led by Dr Miriam Alvarado for REGREEN (see Fig 1).

We’ll soon be sharing the draft causal loop diagram and interpretations with workshop participants, the project steering group and public involvement group to get further feedback. We’ll also be using the existing evidence on nature and health inequalities to bolster our understanding of the system and its components.

Once it’s all done we’ll look forward to sharing more widely. Part of the challenge here is that ‘everything is related to everything else’ – so inevitably this will be only one of many possible views of the system. But it should help us identify where key opportunities are for environmental, planning and related policy and interventions to capitalise on the potential of green/blue infrastructure to tackle health inequalities. It should also help us to explore multiple co-benefits, while also identifying potential for unintended consequences. Watch this space for updates…

In a linked post, project research fellow Mark Ferguson gives a personal reflection on his experience of the process so far.