Appraising cascading systemic risks, ‘watchpoints’, and interventions –methodological reflections

Non-technical summary Continued global environmental degradation generates risks to human health, for example, through air pollution, disease, and food insecurity. This study focuses on these three types of health impact and explores what drives these risks. The risks can arise from diverse causes including political, economic, social, technological, legal/regulatory, and environmental factors. We assembled diverse experts to work together to produce ‘system maps’ for how risks arise, identifying monitoring ‘watchpoints’ to help track risks and interventions that can help prevent them materialising. We critically appraise this pilot methodology, in order to improve our capacity to understand and act to protect human health. Technical summary Systemic risks arise through a process of contagion across political, economic, social, technological, legal/regulatory, and environmental systems. The highly complex nature of these risks prevents probabilistic assessment as is carried out for more conventional risks. This study critically explores a new approach based on participatory systems mapping with experts from diverse backgrounds helping to appraise these risks and identify data and monitoring ‘watchpoints’ to track their progress. We focus on three case studies: air quality, biosecurity, and food security. We assembled 36 experts selected in a stratified way to maximise cognitive diversity, plus 14 members of the interdisciplinary project team. Across 7 workshops, we identified 39 ‘risk cascades’, defined as pathways by which systemic risk can have negative impacts on human health, and we identified 681 watchpoints and interventions. We identify a broad range of interventions to reduce risk, exploring systems approaches to help prioritise these interventions; for example, understanding co-benefits in terms of reducing multiple different types of risk, as well as trade-offs. In this paper, we take a reflective approach, critically discussing constraints and refinements to our pilot methodology, in order to enhance capacity to appraise and act on systemic risks. Social media summary How can we act on the risks from air pollution, disease, and food insecurity? Insights from a new systemic risk assessment methodology.