In Health Research Policy and Systems, Nova Fellow Brita Roy and colleagues used group model building (GMB) to develop a systems thinking framework to describe childhood obesity in the Caribbean. GMB facilitators in Puerto Rico, the U.S. Virgin Islands, Barbados, and Trinidad and Tobago convened a group of interdisciplinary stakeholders via virtual meetings in 2021 to articulate a hypothesis of the systems driving childhood obesity. Using causal loop diagrams (CLD), the commonalities and differences between the CLDs were synthesized into a single explanatory CLD across the islands. Nine reinforcing loops address the interconnected roles of schools, policy, commercial determinants, community, and personal experiences of the children in rising childhood obesity rates.
This work determined that the commercial determinants of health are a main driver of childhood obesity in this area. High levels of food importation, especially ultra-processed foods, and external market influences from bigger countries underscore the region’s limited power to regulate multinational commercial actors that contribute to a sustained obesogenic environment.
