Table 1 Comparison between the original definition of Meadows 12 [16] with the translation specific to public health in Public Health 12

1. Transcending Paradigms

The power to transcend paradigms

The ability to continually adapt collective fundamental beliefs leading to widespread change in the way things are, to respond effectively to multiple complex problems.

2. Paradigms

The mind-set out of which the system – its goals, structure, rules, delays, parameters – arises

A population-level shift in fundamental beliefs (e.g. cultural shift) on how to respond effectively to complex problems (a change in the way things are).

3. Goals

The purpose or function of the system

Where a fundamental goal of a system is challenged and changed.

4. Self-organisation

The power to add, change, or evolve system structure

Creating and maintaining infrastructure (e.g. political or governance) for implementing a combination of various level 5-12 actions over time.

5. Rules

Incentives, punishments, constraints

New modified rules such as incentives and accountability mechanisms for change.

6. Information flows

The structure of who does and does not have access to information

Movement of vital information to shift power dynamics that opens the decision-making processes to more (and the right) people.

7. Reinforcing feedback loops

The strength of the gain of driving loops

Initiating a movement toward a target that is self-reinforcing and growing exponentially in the desired direction.

8. Balancing feedback loops

The strengths of the feedbacks relative to the impacts they are trying to correct

Taking action to stabilise a part of the system to achieve a specific intended goal.

9. Delays

The lengths of time relative to the rates of system changes

Strategic planning to align timeframes with available resources, current readiness, and intended outcomes.

10. Stock and flow structures

Physical systems and their nodes of intersection

Building of new physical infrastructure, providing financial infrastructure, and/or improving physical movement through the system.

11. Buffers

The sizes of stabilizing stocks relatives to their flows

To maintain a safety net within our community or system to absorb reasonably foreseeable, but unexpected events without adversely affecting the way things are. This includes supports for individuals and groups built into environments, schools, workplaces.

12. Numbers

Constants and parameters such as subsidies, taxes, standards

To increase or decrease one isolated, existing part of the system.