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The Ecological Model: five levels of change

The Ecological Model provides a framework for identifying reasons for public health problems as well as for planning interventions. The basis of the model is the recognition, that public health problems are rarely caused only by wrong individual behaviour but rather by a combination of factors from five different levels:

(1) Intrapersonal factors – individual level: What do individual people know about public health problems? What do they think about proposed solutions? What benefits and problems do they see?

(2) Interpersonal factors – social network level: Who makes family or household decisions? How much money is availably in households and families and how are spending decisions reached?

(3) Institutional factors – organizational level: Who has real influence in the community? Are there organizations that prevent positive changes or that could help bring about those changes? How do the local marketing and distribution systems work?

(4) Community factors – community level: Is there any institutional support for solutions to public health problems? Have public health problems even been identified as problems for the community by the formal and informal leadership? What roles are played by local businesses, schools, clinics, NGOs and other associations?

(5) Policy factors – national level: What influence do national policies (e.g. laws, tariffs, grants, taxes) have on the public health? Which parties and interests are involved in the policy-making process?

The Ecological Model is not just used to identify problems but also to identify key people, groups and resources that can help bring about positive changes.

These lecture notes were taken during 2012 installment of the MOOC “Community Change in Public Health” taught by Prof. Dr. William R. Brieger of the Johns Hopkins Bloomberg School of Public Health at Prof. Brieger blogs under and can be found on twitter as @bbbrieger.
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