A brilliant and comprehensive new book has been launched that brings together the best scholars working in the area of systems thinking and complexity and applying it to health.
The book description can be found here along with a link to the abstract for a chapter I co-authored with Andrea Yip looking at the overlap between design thinking and systems science and complexity. This chapter takes a design lens on previous work developing the CoNEKTR model for engagement in complexity and health.
It’s a big book, but well worth a look if you’re wrestling with complexity and systems thinking in health and social innovation.
Complexity, by its very nature, is not a simple concept to communicate, yet it is increasingly becoming one that will define our times and may be the key to ensuring human survival and wellbeing in the years to come. If society is to respond to complex challenges the meaning of complexity needs to be communicated to the world in a manner that is understandable to a wide audience. This is the first in a series of posts that are looking at the concept of complexity and the challenges and opportunities with marketing it to the world.
Across North America this week the temperatures are vastly exceeding normal levels into ranges more akin to places like India or East Africa. The climate is changing and regardless of what the causes are the complexities that this introduces require changes in our thinking and actions or human health and wellbeing will be at risk. To follow Einstein’s famous quote:
“We can’t solve problems by using the same kind of thinking we used when we created them”
Many U.S. States are suffering hurricane-like after-effects from a Derecho that hit last week, knocking out power at a time when temperatures are into the high 90′s and low 100′s. Derechos are rapid moving hot air systems that are difficult to predict and can only be anticipated under certain conditions. The heat wave combined with the lack of air conditioning and supplies left 13 dead, maybe more. The heat wave is continuing and is expected to last throughout the weekend.
But this post is not really about the weather, but the challenges with complexity that it represents and how we need to be better understanding what complexity is and how to work with it if we are to survive and thrive in the years to come.
It’s ironic that this post was delayed by blackout. I live in Toronto, Canada and we have a remarkably stable power supply, yet last night and through this morning I was without power due to suspected overheated circuits attributed to high air conditioning use, shutting down my Internet and everything else with it. In many parts of the world, this kind of blackout is commonplace and a fact of daily living, but not here…yet. This fortuitous bit of timing illustrates the fragility of many of our systems given the reliance on power to fuel much of what we do (e.g., cooking, food storage, Internet, traffic signals, lighting, etc..).
Virtually all of the infrastructure of modern life (here and increasingly globally) is tied to electricity. If you’re interested in imagining what would happen if it all shuts off, I’d highly recommend reading The World Without Us by Alan Weisman. Weisman uses a complexity scientist and futurists’ tool called a thought experiment to craft a book about what New York City would look like if humans suddenly disappeared. The book illustrates how nature might take over, how the underground subways would flood and collapse because of the millions of litres of water needed to be pumped out of it each day, and how certain human-built structures would decay over time (some far faster than we might hope).
Thought experiments take data from things that have happened already, theories, and conjecture and project scenarios into the future based on the amalgam of these. It provides some grounded means of anticipating possible futures to guide present action.
From present delays to future/tense
The Guardian asked a number of scientists working on climate about whether this current spate of extreme weather events is attributable to global warming. The scientists offered a range of answers that (not surprisingly) lacked a definitive statement around cause-and-effect, yet the comments hint at a deep concern. These anomalous conditions are starting to move further towards the end of the normal curve, meaning that they are becoming less statistically plausible to be caused by chance. What this means for the weather, for climate, for our economies is not known; all we have is thought experiments and scenarios. But the future is coming and we may want to be prepared by helping create one we want, not just one we get.
Unfortunately, we cannot wait for the data to confirm that global warming is happening or determine that we are contributing to it and to what degree. This is not just a weather issue; the same situation is playing itself out with issues worldwide ranging from healthcare funding to immigration policies and migration patterns. Interconnected, interdependent and diverse agents and information forms are interacting to create, emergent patterns of activity.
It is for this reason that weather patterns — despite being one of the most monitored and studied phenomenon — can’t be accurately predicted outside of a few hours in advance, if at all. There is too much information coming together between air flows, humidity, land forms, physical structure and human intervention (e.g., airplane contrails) interacting simultaneously in a dynamic manner to create a reliable model of the data. David Orrell’s book Apollo’s Arrow is a terrific read if you want to understand complexity in relation to weather (and more) or see his talk at TEDX on YouTube.
Two’s company, three’s complexity (and other analogies)
The above heading is taken from a title of another book on complexity and tries to simply point to how adding just a little bit of information (another person to a conversation perhaps) can radically alter the experience from being simple or complicated to complex. Just thinking about planning a night out with two people vs. three and you’ll know a little of what this means.
Analogies and metaphors are ways in which complexity scholars commonly seek to convey how the differences in conditions represent varying states of order. Brenda Zimmerman and others write about putting a rocket to the moon as being complicated and raising a child as being complex. One of my favourites is Dave Snowden‘s video on How to Organize a Children’s Party. One of the reasons we resort to analogies is that we need a narrative that fits with their experience. All of us were children and some of us have had them as parents so we can relate to Zimmerman and Snowden’s ideas because we’ve experienced it firsthand.
We haven’t experienced anything like what is anticipated from global warming. In the Americas, parts of Europe and Asia we are enormously fortunate to have entire generations that don’t know what it’s like to be hungry, have no healthcare, be without electricity, or have no access to safe water and proper sanitations. Stories about children’s parties might not bring these scenarios home. It is why Weisman’s book is so clever: it makes a plausible scenario fiction.
Science fact as science fiction
The role of fiction might be the key to opening the marketing vault to complexity. Scott Smith and others have been exploring how the use of science fiction helped pave the way for some of today’s modern technologies and innovations. By weaving together fantasy narratives and imaginations on the future, technologists have managed to re-create these tools for current life. Witness the Tricorder Project that seeks to develop the same multifunction health and information tool used by Dr. McCoy on Star Trek.
We are making headway with complex information as witnessed by the popularity of infographics and data visualizations. But there is much more to be done.
Complex problems require complex solutions. Artists, designers, scientists, marketers, journalists and anyone who can communicate well can play a role. Making complexity something that people not only know about, but want to know about is the task at hand. In doing so, we may find people reaching for and advocating for complex solutions rather than stop-gap, band-aid ones like buying a car with better fuel economy as the main strategy to combat carbon emissions.
It’s been done before. Marshall McLuhan wrote about esoteric, yet remarkably insightful and complex topics and became a household name in part to his appearance in Woody Allen‘s Annie Hall. Our media landscape is far more complex now (no pun intended) to think that a single appearance of any complexity superstar (if one existed) would change public perception of the topic in the same way that McLuhan’s did for his theories on media. Yet, Al Gore’s An Inconvenient Truth might have done more to get people talking about the environment than anything. And while Gore is not known for his witty storytelling, his slide show did a good job.
To begin our journey of marketing complexity we need to come up with our stories so that we can tell ones that are pleasant, rather than the ones that are less so. And if you want one that fits this latter category, I strongly recommend reading Gwynn Dyer’s chilling Climate Wars. Instead, let’s get closer to living what Peter Diamandis and Steven Kotler write about in Abundance.
The future is ours to write.
For more books and resources on complexity, check out the library page on Censemaking.
As we begin to say goodbye to 2011 and hello to the holidays that greet the end of one year and the beginning of a new one, I am writing to wish all my visitors and reader the warmest wishes for health, happiness, creativity, joy and love in these times.
Christmas has been a special time for most of my life. In my family, the creative spirit is expressed most at the holidays with decorations, food, and the giving of gifts and time to each other and themselves. We read, watch movies, sleep, and care for ourselves and each other in ways that sometimes get a little neglected the rest of the year. It’s the kind of spirit that, like many of the holiday songs suggest, really should be with us all year long. It’s also a time of gratitude for the things we have, a time of memoriam for those we lost or neglected, but mostly about the joy of coming together and giving of ourselves.
CENSEMaking has been a wonderful forum for expression, exploration of ideas, and a space to share reflections on what I see as the intersection of systems thinking, design, health and the ways we learn through engaging with it all. Thanks to all who’ve share their thoughts on the posts and added to them. It’s inspiring to consider how powerful the Internet is a force for sharing ideas, learning from each other, and meeting new people and I learned that more than ever this year.
For those of you celebrating Christmas, may it be merry.
For my friends of the Jewish faith, may your Hanukah celebrations continue with joy and light.
For those who are not of any particular faith tradition, may you find much in life to celebrate just because we don’t need a holiday to make our world bright.
In the bigger system of interactions, these small acts of kindness and good intention can make a substantial impact.
Complexity science shows us how small things working in consort can produce large effects.
Design offers us the means to channel these good acts and intentions into something positive.
And the act of creation is a sign of health.
How we make sense of it all is what brings us to life.
The warmest wishes of the season to all of you. — Cameron
The Design4Health conference is on this week bringing together designers from different fields together with health policy, practice and research professionals. While the focus is on the relationship between design and health, it is also inspiring thoughts of how health itself is designed.
This week the first Design4Health conference is being held in Sheffield, UK. The conference attendees includes designers looking at interactions, service, interiors, architecture, fashion, and industrial areas of design. Mixed with is group are physicians, physiotherapists, psychologists sociologists, health promotion practitioners, artists, and policy researchers. This mix represents much of what makes the design and health intersection so exciting, but also the (somewhat) predictable “Tower of Babel” with many disciplines working to be understood by the others.
The language issues have been relatively minor, but on one level the more complicated area of confusion is not where one might guess (the application of design to health issues), but rather the understanding of health itself relative to design.
To illustrate, much has been presented on the way design has re-fashioned devices for those with some form of physical disability. From wheelchair designs that are aesthetically pleasing and light to female portable urinals to address issues of incontinence and the social issues women face trying to relieve themselves in non-toiletted spaces, the products being discussed have shown what some design thinking can do to potentially improve people’s lives. But what if those lives don’t need improvement in the way we think?
Consider the language of health in popular use, which focuses on the ability to control conditions and both be free of physical discomfort and mental stress. These are deficit-oriented models that focus on what must be absent or is undesirable, rather than what a person does with their life and their capabilities to act on their values and interests. What if we viewed health differently?
Further, what happens to design when we focus it’s talents on alleviating pain and discomfort as defined by some standard that is both ideal and unattainable at the expense of promoting personal wellness as defined by the person living their life? What we’ve not talked about is the idea that someone with a substandard medical device might have creative ways to live a life where the sub-standard product becomes nearly invisible. This is not to suggest that we lower the bar, but it does beg the question why we are so focused on ‘problems’ of a particular perceived nature and not opportunities?
We also seem to be poor at reflecting the diversity in the public and their relationship to their bodies, minds and lives that we embrace in our attendance at our conferences. Just as we come from different disciplines, so too do people’s sense of what is a ‘problem’ and what contribution design has to addressing that problem. This is about designing health, not the design for health.
Yesterday I attended the Cure4Kids Global Health Summit at St. Jude Children’s Research Hospital in Memphis, Tennessee. The three day event (continuing for the next two days) aims to bring together researchers, practitioners, and clinicians working on issues of importance to child and youth health — including an emphasis on the role of engaging young people. Of the many presentations and conversations that were had on the first day of the event, the ones that struck me the most were on the potential of games and gaming to engage people and promote literacy.
Games are entered into voluntarily and allow for natural collaboration, creative exploration, and constant, developmental learning.
Developing serious games for health often requires artists, designers, users, engineers, social scientists, educators and health professionals working collaboratively so it provides a natural laboratory for design research and studies on participatory engagement on health issues.
But what excited me the most was seeing how games were being developed through games themselves. Small competitions, limited budgets and compressed timelines along with mentorship produced some amazing results (which will be discussed in a later post).
Watching it all, it opened my eyes to how gaming — the games and the process of creating the game itself – could offer so much to learning about innovation, discovery and collaboration.
Commercial products relying heavily on branding to entice their purchase and use in a crowded marketplace. Is this something that the health sector should consider and, if so, what might it look like?
I’ve just spent a rare free weekend in Chicago walking around, taking in the sights, and doing what a lot of other people do when they travel to another country or city: shop. It is hard to avoid some shopping when down in the Loop on Saturday or Sunday as that is what much of Chicago’s core is made for. The same can be true of most major centers, if you exclude the office buildings that are often semi-vacant on weekends.
A brief tour of many of the shops, from the discounters (Filene’s Basement, TJ Maxx, and Nordstrom Rack) to the mid-range stores (Macy’s) to the higher end department stores (Nordstrom) and the many boutiques, one is easily amazed by the abundance of goods on sale. But what intrigued me as I stood and watched what was around me was that many of the branded goods available at all of these places (including many of the boutiques) were the same. Big names in fashion were at all of them. And the products themselves were virtually indistinguishable from one another except for 1) price and 2) seasonality.
The first is perhaps the most obvious, but as one who is not as attuned to the seasons in fashion beyond the warm-weather/cold weather distinction as many, it the second part that I find most interesting. What makes last year’s $150 pair of Lacoste sunglasses worth $25 this year is nothing other than its seasonality. In other words, they are last year’s model and no longer as coveted.
It struck me that we do this in the health sciences all the time. If your reference list isn’t up to date, people question the sources and the validity of the findings. While probably appropriate for work in basic and clinical sciences, it seems less true for health promotion. It also seems less appropriate for areas where there is great complexity.
Brands also matter with regards to where something is published. A premium is placed on scholarly work that is published in journals with high impact factors over those that are in lesser-known journals. The underlying assumption here is that the more people cite something and the more we believe a source to be high quality the higher the quality the knowledge. The strength of the brand of sources like JAMA, Science, the New England Journal of Medicine and the Lancet exceed the rest of the health field.
While this respect for such “brands” sounds reasonable, there are many problems associated with it. Most notable among these is that they publish a certain type of knowledge in a particular format that adheres to particular models of discovery and rewards particular ways of expressing information. This has advantages, but it also creates path dependencies that shape knowledge itself and restrict the sharing of other forms of knowledge. In doing so, there is some assumption that the “best” knowledge (i.e., that which fits with the brand) looks a certain way and fits a certain way.
An alternative is to create different brands, just as we see in the marketplace for clothing and other retail goods. Apple, once a brand favored by a small, but fervent group of supporters in the early 80′s, is now the world’s most valued brand. It was the small, scruffy underdog and now is the leader. The same might be said for other forms of knowledge. If we were to package health promotion into a form that had the same appeal as other sources, could we create a demand and cache for it in a manner that drew people to it? And would this be a good thing?
I’m not sure. But I do believe it is possible. A colleague of mine once did a study looking at factors that predicted uptake and citation of research knowledge in a particular domain by looking at study qualities across a number of dimensions including design, home institution, discipline and others. After all was considered only one factor predicted uptake: the study used an acronym. Yep, if you branded your study it was more likely to achieve uptake than if you didn’t. To my knowledge this data was never published, presumably because it was so embarrassing to us scientists as it provided evidence that evidence isn’t just what drives our work. Whether it holds over time is worth considering, but it does suggest that brands might matter.
Marketers and companies work hard to distinguish themselves in a crowded marketplace. In a world where there are literally tens of thousands of venues for publishing our findings that are chosen every week, the market is filled. And do we want to rely only on the big brands to fill our knowledge? If so, we run into the same scenario as I did shopping by seeing the same brand everywhere and, because of that, seeing its value discounted because there is so much of it and it expires quickly.
The comparison is not perfect, but neither is it outrageous. Could branding knowledge and knowledge translation be coming to an inbox, book, or library near you?