Building Active Cities: Systems Thinking for Health-ing

Welcome to The Health-ing Podcast, co-hosted by Ushma, founder of Rypple, and Thomas Plochg, director of the Federation for Health in the Netherlands. They address the challenge of staying healthy in a system focused on treating disease rather than prevention, aiming to make "health-ing"—the idea that health must be "earned every day by interacting with your environment"—easy and accessible for everyone. Thomas highlights that "health-ing" is inherently complexity science-based and rooted in ecological thinking. Their guest, Dylan Power, a senior researcher at the Urban Cycling Institute in Amsterdam, brings a global perspective from his work in Ireland, Spain, the US, and the Caribbean. His background includes sport and recreation and a PhD focusing on active travel promotion and systems thinking, emphasizing a practice and policy-oriented approach. Dylan's PhD research in Cork, Ireland, funded by Get Ireland Walking, aimed to create a framework for local governments to engage diverse stakeholders in promoting walking and active travel. He often faced the pragmatic challenge from his supervisors: "So what? What does it mean for the local government?". To bridge the gap between abstract theories and practical application, Dylan leveraged existing reputable frameworks such as the United Nations Sustainable Development Goals (SDGs) and the World Health Organization's Global Action Plan for Physical Activity (GAPA). GAPA, developed with insights from systems and complexity science, helped frame conversations and situate stakeholders' work within a broader system. In Cork, systems mapping based on GAPA revealed that while interventions for "active people" (individual programs) were well-developed, "active systems" and "active environments" (governance, data, policies, infrastructure) were significantly underdeveloped. A key outcome was the establishment of the Get Cork Walking steering committee, a cross-sectoral platform that addressed a critical gap in communication and collaboration. Dylan identifies key barriers to adopting these systemic approaches, including the car-centric nature of many cities and, crucially, the lack of flexibility in people's job descriptions, which often limits cross-disciplinary engagement. Usma shared her own experience of leaving the corporate world due to a misalignment between her values and a healthcare system focused on managing diseases for profit. The discussion also touched on the complex question of "who is the problem owner" in highly interconnected issues like "healthing," which spans mobility, food, healthcare, and environmental quality. Thomas suggests that systems thinking involves "continuously syncing yourself with the changing context" to identify opportunities. Dylan strongly agrees, emphasizing the importance of relying on the expertise of local people and stakeholders to create meaningful impact. He highlights his current project in Bonaire, where an embedded researcher has the flexibility in her job description to build networks and represent the research locally. A significant insight from Bonaire was the need to "de-Dutch the bicycle," recognizing that simply copying Dutch cycling interventions would not work due to different cultural perceptions on the island. Despite favorable conditions, a main barrier in Bonaire appears to be a cultural stigma around cycling and a positive association with cars. Dylan's vision for a city truly embracing "healthing" involves adopting a "health in all policies" philosophy, embedding health considerations across sectors like housing and transport. Such a city would also develop systems and infrastructures that enable continuous cross-sectoral communication and collaboration among various government departments, a process often lacking in many cities today.