What is Policy, Systems and Environmental Change?

Policy, systems and environmental (PSE) changes are strategic and deliberate ways of addressing public health issues. Traditionally, health education programs focused on individual behavior change, 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 and you simply cannot make healthy decisions if healthy options are not accessible and easily available. By changing laws, rules and environments, PSE strategies ensure healthy choices are practical available and accessible.

This video, produced by our colleagues at the University of Minnesota explains PSE.

Policy Change

  • Policy Change: A formal written statement of position, decision or course of action such as laws, ordinances, resolutions, mandates, guidelines, regulations or rules. Policies are often intended to reach large groups of people and can sometimes have unintended consequences.
  • Examples:
    • A tax on unhealthy food (soda tax)
    • A law allowing residents to plant community gardens on vacant lots
    • The USDA Smart Snacks rule for all foods sold in schools
    • Delaware Public Health Person-in-Charge Food Safety rule
    • School wellness policies
    • Joint-use agreements with school districts to ensure playgrounds are open to the community on weekends and over school breaks
    • Purchasing cooperatives for corner store owners to make healthy foods more profitable

Systems Change

  • Systems Change : An organizational procedure such as a process or method, involving the infrastructure of an organization or community; can involve resource allocation, job duties, etc. Policy changes normally create systems changes
  • Examp les:
    • Healthy cooking training for church kitchen staff (baking versus frying)
    • Teaching locally grown produce procurement to institutional buyers
    • The development and implementation of Hazard Analysis Critical Control Plans (HACCP) or food safety plans
    • The adoption of guidelines for “healthy” meetings by worksites

Environmental Change

  • Environmental Change: Physical, observable changes in the built, economic and/or social
  • Examples:
    • School and community gardens
    • Farmers’ markets (intentionally placed for convenience and access)
    • Municipal planning projects to ensure better pedestrian and bicycle access to main roads and parks
    • The installation of water fountains in a hospital lobby to increase drinking water access for hydration
    • Mobile farmers ‘ markets that accept SNAP benefits to eliminate transportation barriers
    • A family member learned about healthy eating and as a result the family is now eating healthy

To learn how policies, systems and the environment influence one family’s health, please view this video from our friends at the University of Minnesota.