wicked problems and health equity - home - public health ......taming wicked problems « attempting...
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Wicked Problems and Health Equity
PHABC 2019Vancouver, November 15, 2020
Val Morrison National Collaborating Centre
for Healthy Public Policy
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The National Collaborating Centres for Public Health
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National Collaborating Centre for Healthy Public Policy (NCCHPP)
Our mandate– Support public health actors in their efforts to promote healthy
public policies
Our areas of expertise– The effects of public policies on health– Generating and using knowledge about policies– Intersectoral actors and mechanisms – Strategies to influence policy making
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Overview
• Defining wicked problems• CAS and wicked problems• Keys to resolving wicked problems• Workshop: Issue and dialogue mapping• Mapping policies|programs to reduce health
inequities
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Wicked problems
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Wicked problems defined1. Wicked problems cannot be defined once and for all.2. They have no precise stopping point when they are
solved.3. There are no ‘right’ or ‘wrong’ solutions, only better or
worse ones.4. Each wicked problem is unique and specific to its context.5. Each attempt to solve a wicked problem is unique and
may affect an infinite set of related problems.6. They are essentially unstable and resistant to policy
solutions insofar as interventions involve multiple stakeholders.
(Rittel & Webber, 1973; Roberts, 2000; Blackman et al., 2006; Conklin, 2006)
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Common attributes
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Wicked problems: a travelling concept
• Social and policy planning• Design (tech)• Management theory• Organisational communication• Complex (adaptive) systems• …
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Typology
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Typology of problems, power and authority (Grint, 2005)
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12(Roberts, 2000)
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Tame Problems
• Tame problems are those where stakeholdersagree on the nature of the problem and on the best way to solve it.
( )© iStockphoto.com/ Eneri LLC
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Complex Problems
• Complex problems are those wherestakeholders agree on the nature of the problem, but not on how to best solve it.
( )© iStockphoto.com/ Dennis Sabo
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Wicked Problems
• With wicked problems, stakeholders agreeneither on the nature of the problem, nor on its solution.
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Taming wicked problems
« attempting to tame a wicked problem, while appealing in the short run, fails in the long run. » (Conklin, 2006, p.22)
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Tackling wicked problems
• If wicked problems are different from tameand complex ones, how do we approachthem?
• The classic Western scientific approach maynot work.
• Wicked problems are compounded by technical and social complexity.
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Traditional /Linear problem solution
(Conklin, 2006 p.9)
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Opportunity-based problem solution
(Conklin, 2006 p.10)
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Strategies for coping with wicked problems
• Authoritative
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Strategies for coping with wicked problems
• Competitive
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Strategies for coping with wicked problems
• Collaborative
( )© iStockphoto.com/ andrey pavlov
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23(Roberts, 2000)
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Resolving wicked problems requires a transdisciplinary approach
• Multidisciplinary – combination of specializations for a particular purpose
• Interdisciplinary – common ground betweentwo specializations possibly developing into a new one (social psychology; biochemistry)
• Transdisciplinary – includes disciplines AND all validated constructions of knowledge and worldviews.
(Brown, V. et al., 2010, p. 4)
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Strategies for coping with wickedproblems
• Key ingredients– Collaboration– Dialogue– Shared Understanding
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Discussion Debate Dialogue
Present ideas Succeed or win Broaden perspectives
Seek answers/solutions Look for weakness Look for shared meaning
Persuade others Stress disagreement Find spaces of agreement
Share information Focus on ‘right’ and ‘wrong’ Bring out ambivalences
Solve our problems Advocate one perspective Invite/allow differences of opinion and expertise
Give answers Search for logic flaws Discover collective meaning
Achieve preset goals Judge other perspectivesas inferior or distorted
Challenge ourpreconceived notions
Listen for disagreement Listen in order to counter Listen in order to understand
Avoid areas of conflict and difference
Focus on conflict and difference as advantage
Articulate areas of conflictand difference
Retain relationships Disregard relationships Build relationships
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(Adapted from Kachwaha, 2002)
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Example of health inequalities
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Issue mapping with SimpleMind
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Conclusion / Summary
• Most public policy problems are wicked in nature.• Wicked problems must be tackled differently than
tame or complex problems.• Focus on collaboration, dialogue and shared
understanding.• Incorporate all related knowledge systems and
worldviews. • « Mapping » issues and dialogues can be useful in
reaching decisions on how to tackle wicked problemswithin complex adaptive systems.
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References• Australian Public Service Commission. (2007). Tackling wicked problems. A public policy perspective. Australia : Commonwealth of
Australia. Consulté en ligne à : http://www.apsc.gov.au/__data/assets/pdf_fil e/0005/6386/wickedproblems.pdf
• Blackman, T., Greene, A., Hunter, D., McKee, L., Elliott, E., Harrington, B., Marks, L. & Williams, G. (2006). Performance assessment and wicked problems: The case of health inequalities. Public Policy and Administration, 21, 66-80.
• Browne, V.A., Harris, J.A. et Russell J.Y. (2010). Tackling wicked problems through the transdisciplinary imagination. London : Earthscan.
• Christensen, K. (2009). Building shared understanding of wicked problems. Rotman Magazine, Winter, 17-20.
• Conklin, J. (2006). Wicked problems and social complexity. Dans Conklin, J. (dir.), Dialogue mapping: building shared understanding of wicked problems. (pp. 1-20). Hoboken, NJ : Wiley.
• Grint, K. (2010). Wicked problems and clumsy solutions: the role of leadership. The new public leadership challenge, 11, 169-186.
• Horn, R. E. et Weber, R. P. (2007). New tools for resolving wicked problems: Mess mapping and resolution mapping processes. MacroVU(r), Inc. and Strategy Kinetics, LLC. Consulté en ligne à : http://www.strategykine tics.com/New_Tools_For_Resolving_Wicked_Problems.pdf
• Kachawa,T. (2002). Exploring the differences between dialogue, discussion, and debate. [Document pdf]. Consulté en ligne à : http://winnebago.uwex.edu/files/2011/08/Dial ogue-Debate-and-Discussion-handout.pdf
• Ney, Steven (2009) Resolving messy policy problems: Handling conflict in environmental, health and ageing policy. London: Earthscan.
• Potvin, L. (2009). L’évaluation, outil de contrôle ou d’innovation ? Présentation réalisée dans le cadre du forum CACIS 2009-L’évaluation des interventions en vue de réduire les inégalités sociales de santé. [Fichier vidéo]. Consulté en ligne le 28 juin 2013 : http://www.cacis.umontreal.ca/video/Louise_ Potvin_ouverture/Louise_Potvin_ouverture.h tml
• Rittel, H. et Webber, M. (1973). Dilemmas in a general theory of planning. Policy Sciences, 4, 155-169.
• Robert, J.S. (2008). Wicked problems in population and public health. POP News, 17. Ottawa : CIHR Institute of Population and Public Health.
• Roberts, N. (2000). Coping with Wicked Problems. Working Paper. Monterey, California : Department of Strategic Management, Naval Postgraduate School. Canadian Institutes of Health Research (2010). A guide to knowledge synthesis. Updated on April 8, 2010. Retrieved from: http://www.cihr-irsc.gc.ca/e/41382.html
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Thank you!
Visit us at www.ncchpp.ca for more resources
Val MorrisonNational Collaborating Centre for Healthy Public Policy
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