Ki te toi o te ora: System change to reverse health inequality and environmental degradation

Identifying key levers of change within health and environment policy systems to restore and improve wellbeing.

The need and impact

Social inequality and humanity’s relationship with the Earth have both reached a point of crisis. Compelling and robust evidence accumulates to document these worsening trends globally. Policy and interventions fail consistently, resulting in poor outcomes being reproduced, despite intent and resources aimed at improvement. Blame now points squarely to isolated, siloed and unresponsive approaches, allowing us to identify both scale and complexity as barriers thwarting conventional solutions to these problems.

Guided by the Māori concept of waiora, where health is relational and inextricably linked to environment, we hypothesise that solutions, to be effective in reversing these trends, need to be discern points of commonality and construct pathways to navigate processes associated with complexity.

We develop an evidence-based, ‘whole-system’, waiora-informed representation of health inequality and environmental degradation. The visibility of the system provided through the mapping process, will enable more sophisticated understandings of how to effectively intervene.

Aotearoa New Zealand is committing to reversing trends in the outcomes of social and environmental systems; the current Government introduced a Wellbeing Budget and strengthened the Living Standards Framework, which broadens measurement of the nation’s progress from predominantly GDP, to a broad conceptualisation of well-being, alongside expansive policy development on climate change via the Zero Carbon Act, and freshwater.

The approach

Burgeoning literature argues the need for ‘whole system’ perspectives and responses to population and planetary outcomes, but there is limited application. We will contribute to filling this gap by systematically exploring the ample evidence now available, in order to create a system-wide map of the main drivers, influences, and feedbacks in the reproduction of health inequality and environmental degradation.

The aim is to identify effective levers for systems change in the interrelated complex systems reproducing health inequalities and environmental degradation. We hypothesise that 1) there are systemic barriers, related to scale and complexity, to reversing both health inequality and environmental degradation, and 2) there are commonalities in the influences on these outcomes that require shared approaches to solutions.

We will also evaluate how mātauranga understandings of earth systems and te reo Māori conceptualizations of health and environment contrast, or share parallels, with the so-called ‘Western’ concepts currently guiding policy.

Research aims

  • Developing and deploying a methodology for comprehensive system mapping based on previous work on the characterisation of influences on the causes of obesity, and the mutually reinforcing points within the sustainable development goals.
  • Engaging partners and stakeholders in novel sensemaking processes to assist in selecting and validating the developed mapping nodes and interpretations of interactions across systems.
  • Further validating the map through an international comparison in Vermont, US, featuring similar environment and economic factors with contrasting legal and political frameworks.
  • Undertaking econometric analysis using Stats NZ Integrated Data Infrastructure (IDI) data to confirm case study observations, via relationships in national snapshots, or targeted time-series.
  • Using the latest thinking on achieving transformational systems change to inform our analysis and recommendations.


  • Dr Anna Matheson (Project Co-Lead)
  • Professor Troy Baisden (Project Co-Lead)
  • Dr Daniel Hikuroa
  • Dr Dion O’Neale
  • Professor David Hayman
  • Associate Professor Krushil Watene
  • Dr Lynn Riggs
  • Dr Rachael Ka’ai-Mahuta
  • Justin Connolly