For many years, health programs have focused on individual behavior, assuming that if you teach people what will make them healthy, they will find a way to do it. Unfortunately, being healthy is not just about individual choices. Where you live affects how you live - you simply can’t make healthy decisions if healthy options aren’t available to you. Policy, systems and environmental change makes healthier choices a real, feasible option for every community member by looking at the laws, rules and environments that impact our behavior.
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 (PSE Change), communities can help tackle health issues like obesity, diabetes, cancer and other chronic diseases. Changes do not have to be at the governmental level, though, to have an impact. You can help make changes to improve health in community organizations, worksites, and other local settings.
| Differences Between Programs and PSE Change | ||
|---|---|---|
| Setting | Programs/Events | Policy, Systems and Environmental Change |
| School | Celebrate national nutrition month |
Add fruits and vegetables to the a la carte options in schools Develop nutrition guidelines for PTA events and bake sales |
| Community | Host a community bike ride and parade |
Implement a Complete Streets policy to ensure community roads are constructed for safe biking, walking and driving Install bike racks at a community center |
| Worksite | Hold health screenings for staff |
Implement a healthy vending machine policy that offers healthy snacks at an affordable price Implement “walking meetings” |
- Policy change includes the passing of laws, ordinances, resolutions, mandates, regulations, or rules.
- Government bodies (federal, state, local level), school districts and schools, park districts, healthcare organizations (hospitals, health systems), worksites and other community institutions (jails, daycare centers, senior living centers, faith institutions) all make policy change.
- Policies (like workplace policies, community based organization policies) greatly influence the daily decisions we make about our health.
- Examples: Amending homeowners association rules to allow residents to plant community gardens in open spaces; Establishing a church policy limiting the amount of junk food and sweets that can be sold at fundraisers.
- System change involves change made to the rules within an organization. Systems change and policy change often work hand-in-hand.
- Systems change impacts all elements of an organization. Often systems change focuses on changing infrastructure within a school, park, worksite or health setting.
- Examples: Encouraging employee physical activity through walking meetings and incentives (such as flex time) for engaging in physical activity; Creating a process to evaluate the safety and accessibility of playgrounds built and maintained by a homeowners association.
- Environmental change is a change made to the physical environment.
- Environmental change can be as simple as installing bike signage on already established bike routes or as complex as sidewalk installation and pedestrian friendly intersections to promote walking and biking among its citizens.
- Examples: Beautifying workplace stairwells (by adding pictures, etc.) to encourage people to take the stairs; Repairing damaged sidewalks; Adding a basketball court to the community or the churchyard.
Excerpted from “ What is Policy, Systems, and Environmental Change?,” published by the Public Health Institute of Metropolitan Chicago and the Cook County Department of Public Health.