Policy, Systems, & Environmental Change

Policy, systems, and environmental (PSE) change aims to alter the environment to ensure equitable, accessible, and relevant wellness for all community members. These changes affect laws, shape physical landscapes, and enhance institutions, making healthy living more accessible and addressing the root causes of health inequities.

About Policy Change

• Policy change includes policies at the legislative or organizational level.
• Policy change includes institutionalizing new rules or procedures as well as passing laws, ordinances, resolutions, mandates, and regulations.
• Government bodies (federal, state, local level), school districts and schools, park districts, healthcare organizations (hospitals, health systems), work sites, and other community institutions (jails, daycare centers, senior living centers, faith institutions) all make policy changes.
• Policies greatly influence the choices we make in our lives. Laws that are passed (like workplace policies, and school policies) greatly influence the daily decisions we make about our health.

About Systems Change

• System change involves changes made to the rules within an organization.
• Systems change and policy change often work hand-in-hand.
• Systems change impacts all elements of an organization. Often systems change focuses on changing infrastructure within a school, park, work site, or health setting.

About Environmental Change

Environmental change is a change made to the physical environment.

Physical (structural changes or programs or services), social (a positive change in attitudes or behavior about policies that promote health or an increase in supportive attitudes regarding a health practice), and economic factors (presence of financial disincentives or incentives to encourage a desired behavior) influence people's practices and behaviors.

While related to the environment, such changes are not isolated to a few households or individuals but instead reflect a population-focused effort.

Environmental change can be as simple as installing bike signage on already established bike routes or as complex as sidewalk installation and pedestrian-friendly intersections to promote walking and biking among its citizens.

Event/Program versus PSE Change

Characteristics of the event or program:

• One time
• Addictive: often time results in only short-term behavior change
• Individual level
• Not part of an ongoing plan
• Short-term
• Non-sustaining

Characteristics of PSE change:

• Ongoing
• Foundational: often produces behavior change over time
• Community/Population level
• Part of an ongoing plan
• Long-term
• Sustaining