In this activity, I explore my personal understanding of Health Systems Science (HSS) as a field of study and practice. Through analyzing a case study using both the Social Determinants of Health framework and the Health Equity and Ethical Decision-making framework, I developed a deeper understanding of how HSS connects theory to real-world healthcare challenges.
Health Systems Science is a field that explores the design, function, and impact of health systems, looking at both their strengths and their blind spots. It examines how healthcare is delivered, received, and experienced by different stakeholders, and how various factors—political, social, economic, and environmental—shape these interactions.
HSS is about viewing healthcare not as isolated clinical encounters but as a complex, interconnected web that includes policies, infrastructure, workforce dynamics, information systems, and community contexts. It's a lens through which we can recognize the systemic nature of healthcare challenges and identify leverage points for meaningful change.
Health Systems Science matters because health is not equally accessible to all, and understanding the system is the first step toward making it more just, inclusive, and effective. Through my analysis of the "Intern Dilemma" case study, it became clear that even the most well-intentioned clinical care can fail when it doesn't account for systemic barriers like:
By applying the Social Determinants of Health framework, I was able to identify how these interconnected factors created a situation where the patient's care plan, while medically sound, was practically impossible to implement. The Health Equity and Ethical Decision-making framework further highlighted how healthcare systems often fail to align discharge plans with patients' real-world capabilities.
This matters because without addressing these systemic issues, healthcare interventions will continue to fall short, resulting in poor outcomes, readmissions, and further strain on both patients and the healthcare system.
Studying health systems requires multiple approaches and frameworks. Through this activity, I found that integrating different frameworks provides a more comprehensive understanding than using any single approach:
I noted some limitations in my chosen frameworks. The Social Determinants of Health framework excels at identifying problems but offers less guidance on practical solutions within existing constraints. Similarly, the Ethical Decision-making framework focuses on individual interventions without addressing broader advocacy for systemic change.
To address these limitations, an enhanced approach would integrate systems thinking with a strengths-based perspective that identifies existing assets and resources within communities that could be leveraged for solutions.
This activity has deepened my understanding of Health Systems Science as a field that bridges theory and practice. At its core, HSS is about care—about understanding how we can collectively build systems that truly care for everyone, especially those most vulnerable to systemic barriers.
Moving forward, I see the value in developing a more integrated approach to health systems that combines rigorous analysis with practical implementation strategies. This means not just identifying what's wrong with systems, but also recognizing existing strengths and building upon them to create meaningful change.
In my future work, I will strive to maintain this systems perspective while always keeping the focus on the lived experiences of those the system is meant to serve. Health Systems Science provides the tools to see the bigger picture without losing sight of the individual human stories at the heart of healthcare.
Below is additional documentation that provides evidence of my work on understanding Health Systems Science.