BACKGROUND: Community groups such as coalitions can create the conditions for whole-of-community change through advocacy, partnerships, pooling resources, and other approaches. Our objective was to describe how coalition committees with deep community expertise perceive the complex systems that influence health trends and report common dynamics across communities. METHODS: Seven coalition committees (n = 97 individuals members) from across the United States (Greenville, SC; East Boston (a neighborhood in Boston), MA; Tucson, AZ; Milwaukee, WI; Worcester, MA; East Aldine (a neighborhood in Houston), TX; and Garfield Park (a neighborhood in Chicago), IL) participated in the Catalyzing Communities Initiative from 2018 to 2023. The Initiative employed Community-based System Dynamics, a participatory systems science modeling approach. Participants created causal loop diagrams (CLDs) of the systems that drive healthy child bodyweights and related health trends in their communities. We conducted a qualitative CLD content analysis and reported code frequency, common dynamics, and alignment with UN's Sustainable Development Goals (SDGs). RESULTS: Nine common dynamics that drive health trends and disparities emerged from the CLDs: (1) intergenerational wealth or poverty; (2) struggling to meet basic needs; (3) time trade-offs; (4) stress, poor mental health, and trauma undermine wellness; (5) supply and demand of healthy foods in communities; (6) perceptions of safety influence health behaviors; (7) community engagement in policy and system change; (8) home food environment and cooking behaviors shape eating behaviors; and (9) norms and expectations related to health. The common dynamics aligned with the following SDGs: 1: No poverty, 2: Zero hunger, 3: Good health and well-being, 4: Quality education, 8: Decent work and economic growth, 10: Reduce inequalities, 11: Sustainable cities and communities, and 16: Peace, justice and strong communities. Finally, participants' involvement in community coalitions reflect SDG 17: Partnerships for the goals. CONCLUSIONS: Social determinants of health were salient to the coalition committees. Common dynamics can be used to build a comprehensive, shared understanding of complex systems that shape health trends and disparities, and facilitate coordinated action to address those systems. Common dynamics encompass many SDGs, reflecting shared experiences of multifaceted barriers to achieving more optimal health and wellbeing outcomes. CLINICAL TRIAL NUMBER: Not applicable.
Calancie et al. (Thu,) studied this question.