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Introduction. Almost always, those elements can be broken down further into smaller systems. Observing that elements of systems thinking are already common in public health research, the article discusses which of the large body of theories, methods, and tools associated with systems thinking are more useful. Abstract: Improving population health requires understanding and changing societal structures and functions, but countervailing forces sometimes undermine those changes, thus reflecting the adaptive complexity inherent in public health systems. For more introduction, I refer you to Pegasus Communications' What is Systems Thinking. Translating knowledge into policy and practice can improve public health and health systems in the Americas, say Tomás Pantoja and colleagues ### Key messages The evidence informed policy making approach—where policy decisions are informed by the systematic and transparent use of evidence—captured a great deal of international attention at the beginning of the millennium. A little bit about systems thinking, or a definition from my head: Systems thinking requires thinking about elements and their connections through causal pathways. Systems thinking is a process of self-awareness in which the nurse knows boundaries specific to clinical reasoning, personal effort, reliance on authority, and awareness of interdependencies. Public health asks of systems science, as it did of sociology 40 years ago, that it help us unravel the complexity of causal forces in our varied populations, and the ecologically layered community and societal circumstances of public health practice. The purpose of analyzing, and evaluating public health activities, refer to Corso LC and Wiesner PJ. 2000; 6(5): 1-18. Using the Essential Services as a Foundation for Performance Measurement and Assessment of Local Public Health Systems, Journal of Public Health Management and Practice . This is only a very basic introduction to some of the problem solving tools and techniques of Systems Thinking. Improving population health requires understanding and changing societal structures and functions, but countervailing forces sometimes undermine those changes, thus reflecting the adaptive complexity inherent in public health systems. At the same time, the principles of systems thinking make us aware that there are no perfect solutions; the choices we make will have an impact on other parts of the system. Systems Thinking can help us see why measures that may superficially seem likely to worsen the situation may, in fact, be optimal solutions. Systems thinking expands the range of choices available for solving a problem by broadening our thinking and helping us articulate problems in new and different ways. If an outcome depends on many interacting and adaptive parts and actors the outcome cannot be analyzed or predicted with traditional statistical methods. Nurses can use systems thinking to view how caregiving decisions and actions have an overall impact on organizational health outcomes. It is a practice called systems thinking and an education module offered via the AMA Ed Hub™ helps medical students—and residents and practicing physicians who may not have received training during their medical school years—understand the importance of systems thinking in clinical care and learn how to adopt the habits of a systems-thinking health professional who can help improve care. Problems in public health and health policy tend to be complex with many actors, institutions and risk factors involved. This paper explores the question of what systems thinking adds to the field of global health.

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