Evaluating Public Health Efforts to Prevent and Control Chronic Disease: A Systems Modeling Approach

Abstract

The growing burden of chronic disease represents a complex challenge to public health. Innovative approaches, such as system dynamics simulation modeling, can aid public health pro-fessionals in understanding such complex issues and identifying effective solutions. This paper describes a system dynamics model and its application in projecting the impacts of evidence-based interventions on chronic disease for the state of Colorado. The development of the model was guided by data and input from subject matter expertise, peer-reviewed literature, and surveillance data. The model includes 28 intervention levers for chronic disease prevention, screening, and management. Interventions were simulated from 2020 to 2050 to project their impact on ten preventable causes of death. The simulations indicated the 6 most impactful interventions by 2050 to be adult smoking prevention, diabetes prevention, smoking cessation, blood pressure management, adult physical activity promotion, and colorectal cancer screening. Together, these 6 interventions could reduce preventable deaths by 7.1%, or 74% of the 9.6% reduction from all 28 interventions combined. This system dynamics model is a flexible tool that could be adapted or extended to include other popu-lations or preventable chronic diseases. Prioritization and wide-scale implementation of the most impactful interventions could significantly reduce preventable deaths resulting from chronic disease.