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Policy, Systems, & Environmental Change

Using Policy, Systems, and Environmental Changes to Tackle Public Health Issues

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Terri Saltzman, MPA

Community Wellness Coordinator

Purdue University

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purdue.edu/extension

EA/EO

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PSE…

According to the Plan4Health Organization, “policy, systems and environmental change is a way of modifying the environment to make healthy choices practical and available to all community members. By changing laws and shaping physical landscapes, a big impact can be made with little time and resources. By changing policies, systems and/or environments, communities can help tackle health issues like obesity, diabetes, cancer and other chronic diseases.”

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In essence, studies have shown that encouraging healthy behaviors at the individual level in conjunction with implementing environmental changes creates a far greater positive impact on overall health outcomes.

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EA/EO

Policy change includes policies at the legislative or organizational level. Institutionalizing new rules or procedures as well as passing laws, ordinances, resolutions, mandates, and regulations are all examples of policy change.

purdue.edu/extension

Examples include:

  • No smoking laws.
  • Sidewalk mandates for new construction.
  • USDA ruling to allow online food purchases for SNAP recipients.
  • City ordinances which allow farmers markets on city property.

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Systems change involves change made to the rules within an organization. Often systems change focuses on changing infrastructure within a school, park, worksite, or health setting or instituting processes or procedures at the system level that ensure a healthier workplace.

Examples include:

  • Screening patients for food insecurity challenges and issuing relevant referrals.
  • Installing an on-site gym for employees within an organization and allowing time through the work day to access that gym.
  • Connecting local food producers with area food pantries in order to alleviate food waste and increase food distribution.
  • Ensuring that all food at school parties meet federal nutrition requirements.

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Environmental change is change made to the physical environment. Physical (structural changes or programs), social (a positive change in attitudes or behavior about policies that promote health), and economic factors (financial incentives to encourage a desired behavior) influence people’s practices and behaviors.

Examples include:

  • Community gardens.
  • Walking trails.
  • Bike paths.
  • Vending machines which charge higher prices for the less healthy options.

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EA/EO

purdue.edu/extension

Sector Policy System Environment

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Using PSE…

Make sure that your PSE plan is:

  • Sustainable.
  • At the community level vs. at the individual level.
  • Not a one-time event but on-going.
  • Will produce healthy behavior over time.

Identify Issue

Develop Plan

Implement Initiative

Evaluate Outcomes

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EA/EO

Form A PSE Plan…

purdue.edu/extension

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Identifying an Issue…

Lake County Health Challenges (clickable link)

  • High Adult Obesity Rates
  • High Sexually Transmitted Infection Rates
  • Low Participation in Mammography Screening
  • Large Number of Children in Poverty
  • Low Participation Rates in Flu Vacc.

Resourced from the Robert Wood Johnson Foundation’s County Health Rankings Website

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What is missing?

Evaluation of Initiative…

  • Short-term outcomes (physical space acquired for farmers market)
  • Intermediate outcomes (assessing participation in markets over a time frame)
  • Long-term outcomes (noting adult obesity rates going lower in community)

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More Resources…

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CDC Community Change Tool

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Evaluating Policy, Systems, and Environmental Change Interventions: Lessons Learned From CDC’s Prevention Research Centers

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Robert Wood Johnson Foundation

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Terri Saltzman, MPA

Community Wellness Coordinator

Purdue University

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