RCN Congress: The Systems Table and the Missing Cog
Across two maillists: SDOH Social Determinants of Health and POHG Politics of Health Group a discussion and debate regards public health, longevity and policy, was provoked by a study:
https://www.theguardian.com/society/2026/may/20/responsibility-ill-health-old-age-oxford-longevity-project-study
'... Individuals bear at least 80% of the responsibility for their ill health in old age, according to a report aimed at challenging the belief that physical decline is either inevitable or primarily the responsibility of the state.
The report, launched at the Smart Ageing Summit in Oxford last week, argues that individuals have far greater control over their longevity than is commonly understood. The authors call on the government to take legislative action on alcohol comparable to restrictions on smoking.
Living Longer, Better – the Oxford Longevity Project’s first Age-less report – was co-authored by an interdisciplinary panel of UK-based experts in medicine, physiology, ageing and education policy. It was sponsored by Oxford Healthspan.
The report’s authors, Sir Christopher Ball, Sir Muir Gray, Dr Paul Ch’en, Leslie Kenny and Prof Denis Noble, present the figure of 80% as a conservative estimate.
Ball, a 91-year-old former Parachute regiment officer who intends to reach 100, said: “Some have gone higher and said it’s approaching 90%. But I think 80% seems about fair.”The claim, however, has been described as simplistic and said to neglect wider arguments about whether people are genuinely in control of individual choices when it comes to issues including poverty, pollution and healthcare access.
Nancy Krieger, professor of social epidemiology at Harvard TH Chan school of public health, said: “The report is to be commended for rejecting genetic determinism but it problematically avoids engaging with the societal determination of health and health inequities; the role of work, economic deprivation and government policies that give corporations free rein to sell unhealthy products.”
Steven Woolf, professor of family medicine and population health and director of the Virginia Commonwealth University Center on Society and Health, agreed, saying the paper “ignores and oversimplifies the actual, multilayered root causes of the conditions that foster poor health in a population”.
Woolf added: “There are factors affecting health that are beyond personal choice. So while it’s good to give people clear guidance on how their choices affect their health, it’s taking policymakers and others off the hook.” ...'
This provides me with evidence (well it would - wouldn't it^) on the need for, the purposes, and applications of Hodges' model.
More philosophically (perhaps), I'm reminded of the work of several academics - thinkers, Michel Serres stands out for me. Serres felt that positional adverbs were important, e.g. between, above, and under.
He also wrote of life (as per many philosophers), and the universe e.g. his writings on Physics and Lucretius - as flow - a river.
For new life, the options are seemingly infinite, far, far upstream: at source - not recognisable even as a trickle... but soon a rivulet, a stream, a river of so many tributaries.
As we grow older we get closer to the sea (of the 'eternal'), the options open to us shrink gradually, but ultimately radically - inevitably.
But looking back the turbulence, uncertainty, unpredictability (trauma and joy), all contribute, not just to where we end (up) but how this came about.
Life's signature at death.
In "Hodges' Health Career Model" 'health career' refers specifically to the idea of life chances (of course) and how other careers, education, work, retirement, caring (self - others - planet) .. are impacted through life and death's course.
So often 'Nursing' is absent from the POLITICAL / POLICY table:
- Workforce planning
- Safety
- Higher Education?
- Research funding?
- Information / Health infomatics policy?
Speaking for myself, nursing is not interested in the four-course meal, but being involved and engaged in the after dinner discourse can be critical.
Politicians, policy makers, business, management consultants and lobbyists are so quick to point to and extol the 'SYSTEMS' perspective, and the need for 'systems thinking'.
Guilty of systemic neglect, they clearly have no idea of what a system is, an inability to appreciate and apprehend scope, scale and the 'whole'.
In mitigation (or not), for all groups: voice matters. Especially the voices of foresight, balance, advocacy, Their ability to ascend always proves an issue.
Related papers listed in the sidebar:
Jones, P. (2008) Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons, IN Kidd, T., Chen, I. (Eds.) Social Information Technology Connecting Society and Cultural Issues, Idea Group Publishing, Inc. Chap. 7, pp. 96-109.
Jones, P. (2009) Socio-Technical Structures, the Scope of Informatics and Hodges’ model, IN, Staudinger, R., Ostermann, H., Bettina Staudinger, B. (Eds.), Handbook of Research in Nursing Informatics and Socio-Technical Structures, Idea Group Publishing, Inc. Chap. 11, pp. 160-174.
Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from https://www.academia.edu/3794699/Reflecting_on_the_glocal_through_the_conceptual_framework_of_Hodges_s_model
^Because these days you need to make every kernel - found or created on the continuum of evidence - count.
Previously: 'life chances' : 'health career' : 'Serres' : 'APPGs'
Liverpool, UK. RCN Congress 2026 -
n.b. See you in Liverpool 2027?
orcid.org/0000-0002-0192-8965
