Health disparities along racial and socioeconomic lines are a persistent challenge for policymakers and researchers looking to improve health outcomes. The COVID-19 pandemic has highlighted and at least temporarily exacerbated these patterns: one estimate indicates that despite comprising only 13% of the U.S. population, non-Hispanic Black people accounted for 34% of COVID-related deaths. The causes driving these vastly different outcomes are numerous, often generational in timescale, sometimes inter-related, and geographically dependent, all of which make effective research and policy responses difficult.

A new book from the National Institutes of Health (NIH) seeks to provide policymakers and researchers tools to close the gap with bold, novel approaches. One such approach is a rapidly advancing and interdisciplinary research framework broadly referred to as complex systems science. This framework is uniquely equipped to grapple with the inherent complexity of health disparities and, as our previous work has shown, other policy research areas concerned with progress toward social justice.

The ultimate goal of health disparities research should be to uncover key drivers and craft policies and practices that can effectively and sustainably address them. Until recently, a challenge in reaching this goal has come from reliance on methods focused on isolating and separately quantifying the contribution of individual factors.

The impact of such analyses is limited in two ways. First, the data necessary to convincingly estimate the effects of individual factors is difficult to find or collect (especially in small populations). Second, and more fundamentally, even when efforts to quantify the contribution of individual drivers of health disparities are successful, they are limited in their ability to contribute to meaningful, sustainable solutions because health disparities are caused by multiple, overlapping factors that often operate on large time scales (i.e. across generations) and differ substantially across individuals and settings. Taking a broad perspective that acknowledges and explicitly grapples with this complexity is the best way to effect positive change.

Complex systems science provides a way forward in addressing health disparities research, policy, and practice. Researchers and policymakers can use complex systems approaches to explore interacting mechanisms and answer new kinds of questions concerning why observed levels of health disparities occur, which effect pathways or leverage points might matter most, why past or existing policies and interventions have observed effects in a given context, and how novel proposed policies or interventions might affect different communities (including heterogeneous effects and unintended negative consequences). In short, we can address questions about what works, for whom, and why.

Read the full article about addressing health disparities through complexity by Matt Kasman and Ross A. Hammond at Brookings.