Systems science approaches to cardiovascular disease prevention and management in the era of COVID-19: A Humpty-Dumpty dilemma?

Nicolaas P Pronk; Patricia L Mabry; Sam Bond; Ross Arena; Mark A Faghy

doi:10.1016/j.pcad.2022.12.003

Systems science approaches to cardiovascular disease prevention and management in the era of COVID-19: A Humpty-Dumpty dilemma?

Prog Cardiovasc Dis. 2023 Jan-Feb:76:69-75. doi: 10.1016/j.pcad.2022.12.003. Epub 2022 Dec 20.

Authors

Nicolaas P Pronk¹, Patricia L Mabry², Sam Bond³, Ross Arena⁴, Mark A Faghy⁵

Affiliations

¹ HealthPartners Institute, Minneapolis, MN, USA; Department of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA. Electronic address: nico.p.pronk@healthpartners.com.
² HealthPartners Institute, Minneapolis, MN, USA.
³ Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, USA; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA.
⁴ Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, USA.
⁵ Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, USA; Biomedical Research Theme, School of Human Sciences, University of Derby, UK.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic necessitated the implementation and prioritizing of strict public health strategies to mitigate COVID-19 transmission and infection over all else. As we enter a 'recovery' phase in which the impact of the virus recedes (but does not relent), we ask, "How do we develop a game plan that considers prevention over management of public health threats of a more chronic nature, including cardiovascular disease?" We frame this choice point as a "Humpty-Dumpty" moment for public health with enduring and potentially irreversible consequences. Citing clear examples of other public health successes and failures, we outline in detail how sustaining cardiovascular population health under complex post-pandemic conditions will necessitate decision-making to be informed with a systems science approach, in which interventions, goals, outcomes and features of complex systems are carefully aligned.

Keywords: COVID-19; Cardiovascular disease; Complexity; Management; Prevention; Systems science.

Publication types

Review

MeSH terms

COVID-19*
Cardiovascular Diseases* / diagnosis
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / prevention & control
Humans
Public Health