Wicked problems and health promotion: reflections on learning.

83 What do complex issues such as inequity, climate disruption, food insecurity and obesity challenge us to learn? These are wicked problems that require action at every scale. 1, 2 With multiple, interacting causes, solutions lie well beyond the traditional domain of any one jurisdiction or organisational entity, and beyond business-as-usual. 2-5 A discourse is emerging in health promotion literature on relevant new perspectives and practitioners now appear to be poised at a significant learning threshold. 6, 7 We are practitioners in a team of health promoters who are encouraged to innovate. Addressing health inequity and climate change in North Coast New South Wales, we launched an Action Learning process to understand how Complex Adaptive Systems theory could help address wicked problems. 8 We discussed articles, podcasts and videos, helping each other understand new concepts such as self-organisation, emergence, networks, and key concepts of resilience theory. 9-11 We came to realise that human communities are not well served by the dominant, mechanistic framework that assumes clockwork predictability. 3 We learnt that communities are webs of cause/effect characterised by non-linear feedback loops, tipping points, and unpredictability; that trying to reduce them to treatable components ignores the dynamic interconnectedness of the whole and dismisses the power of networked communities to address problems in unexpected ways. 3, 5, 12 We now see ourselves as active members of these networks and our actions as events within the developmental history of the community. 6 We started embedding these learnings into our practice. Sensitised to the surprising outcomes from community development, we now understand that reductionist bio-medical approaches are not helpful in planning, evaluating and managing projects that address complex problems. 13 They cannot help us understand creative, emergent action in communities. On reflection, our learning journey followed a well worn path. At first we were unaware of what we needed to know. Then came disorientation as we sensed the rich potential of concepts we did not yet fully understand. Our collective process finally helped us understand the complexity framework and then apply it to planning, design, evaluation, collaborative engagement, governance and organisational change. Optimism grew with application. We know there is more to learn before fluency, but this gap gives hope of future effectiveness in addressing the complex, urgent issues that demand our attention. The method was informed by complexity theory to maximise collective problem-solving. 14 We asked delegates to engage with the following scenario: …