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Lowering Alcohol's Harm

The Connector - Fall 2018 Issue

Lowering Alcohol’s Harm: Modeling the impact of interventions

Kate Garvey Kate Garvey

In Tasmania, as elsewhere, alcohol causes a significant amount of harm, both as a result of single occasion binge drinking or from chronic regular drinking. Acute and long term harms, including unemployment, violence, and chronic illness, can be devastating for individuals and their families and also impose high social costs. In 2017, the Australian Prevention Partnership Center and the Tasmanian Department of Health and Human Services partnered to answer the same challenging question confronting their peers around the world: How do we reduce alcohol related harm in Tasmania with limited resources?

“In the state of Tasmania, the rate of alcohol harms is high compared to national averages on a number of measures and while consumption is decreasing among some groups we are not seeing a comparable drop in harms,” says Kate Garvey, Manager of Partnership Development, DHHS. “We need to try to reduce both the long term and immediate harms caused by consumption of alcohol at above guideline levels but we recognize that many of the levers to control harms are outside our control. We thought, ‘Wouldn’t it be great to have a picture of interventions that are working elsewhere and the ability to test the success of those interventions or combination of interventions in Tasmania?’”

Wouldn’t it be great to have a picture of interventions that are working elsewhere and the ability to test the success of those interventions or combination of interventions in Tasmania?

That picture was developed using a dynamic simulation model built with Stella® from isee systems. “We created the model through a rigorous, participatory process,” says Garvey. “Fifty-six active participants represented state and local government departments, community organizations, academia, and clinicians. Together, they described the problem, surfaced assumptions, and identified sources of data.”

Alcohol consumption data from the Tasmanian Population Health Survey, National Drug Strategy surveys, population and migration data, hospitalizations and Emergency Department presentation data, and police assault data were all used to validate the model from 2011 through to 2016 and enable forecasted outcomes to be simulated until 2052. Where local data was not available, estimates were based on national data sources and research-based treatment effects. “For some novel interventions, estimates were a good place to start and the group had the experience and background to determine what was true for Tasmania,” says Garvey. The smaller group also identified interventions that would or wouldn’t be likely to gain political support and those that seemed ambitious but worth investigation.

“Building and using the model collaboratively was very powerful,” say Garvey. Using the model, the team ran simulations to test the effectiveness of particular interventions or combinations of interventions on both long-term and short-term harms. One of the most powerful insights from the simulation testing was the scale of the impact of some of the novel interventions to modify alcohol availability, such as liquor license density, price, and closing hours of late-night venues versus more well-known counseling and treatment-type interventions.

In other words, reducing access to alcohol is more effective than increasing treatment services. “You can put a lot of money into treatment, but if you never reduce the number of people entering the treatment system, you don’t gain enough traction to lower levels of harm,” says Garvey.

The model pointed to two strategies likely to be the most effective for limiting access to alcohol: equalizing pricing to eliminate deep discounting of alcoholic beverages and reducing liquor license density. “The model showed that when it is less convenient and more expensive to purchase alcohol, alcohol consumption and levels of harm are both reduced.”

Stella makes it easy for everyone to see how the strategies work and where and when they have an impact

Garvey explains that the model and simulations it ran were central to communicating strategies for decreasing alcohol-related levels of harm. “The model is a great presentation tool,” says Garvey. “Stella makes it easy for everyone to see how the strategies work and where and when they have an impact. It’s easy to explain what’s happening and to let people test their own assumptions and propose new scenarios. We bring our particular perspectives and gain shared understanding.”

With such a large group and so many perspectives, the neutrality of the model allowed participants to avoid politically-charged debate. “The model allows someone to say ‘I don’t agree with that strategy for this reason,’ reset the model to fit their assumptions, and then compare results,” says Garvey. “And because the model can show the impact of a strategy over time, it helps to set expectations among stakeholders, which is important. In politics and public policy, everyone expects and wants to see results now.”

The model has delivered evidence to support a new approach to alcohol harm reduction and Garvey sees the opportunity to increase its power by adding a cost-benefit analysis capability.

The Social System Design Lab: Engaging Communities and Building a New Generation of Systems Thinkers

Peter Hovmand Peter Hovmand

The Social System Design Lab at the Brown School at Washington University in St. Louis has been applying system dynamics in community settings for nearly 10 years. In that time, the Lab has engaged a range of organizations in projects that clarify problems and identify opportunities to increase quality and effectiveness of social well-being and health services. At the same time, the Lab is preparing the next generation of problem solvers by involving high school, undergraduate, and graduate students in system dynamics projects.

Most of their work is with foundations, non-profits, and K-12 schools. Peter Hovmand, the founder of the Lab, adds, “We also do research in collaboration with groups which typically involves working with both those who deliver programs and services as well as the intended beneficiaries of those efforts.” Childhood obesity, nutrition, food systems, cancer, and gender-based violence are just a few of the issues the Lab’s client organizations are tackling.

Hovmand founded the Lab in 2009, but was introduced to Systems Thinking in the 1990s while a graduate student at Michigan State University. As is the case with so many system dynamics students from that time, he was intrigued by the work and ideas of Barry Richmond, founder of isee systems. “I had the good fortune to sit next to Barry at a conference luncheon,” says Hovmand. “He keyed me in to the role of language in Systems Thinking.”

Richmond’s decades-old insight on the importance of language to Systems Thinking was central to a recent engagement that offers an example of the Lab’s work. A group of healthcare leaders were trying to improve the quality of care in hospitals. With Professor Camilo Olaya and a technical assistance unit from the Inter-American Development Bank, they were able to introduce the concept of the capability trap and work with leaders to recognize capability traps in their systems. Hovmand explains, “A capability trap is a situation where people get so busy fixing errors and putting out fires that they don’t have time to invest in process improvement. Everyone works harder and harder. People get burned out. They think, ‘Why should I have to work so much harder when the process is obviously broken?’”

Identifying these situations and being able to communicate that to others, especially those outside their organization, can remove some of the barriers to working more effectively together and align their efforts to remove capability traps. “People in healthcare generally want to help and care a lot about their patients. They want to do good work,” says Hovmand. “Over and over, we hear that clinicians want to spend more time with patients to increase the quality of care they deliver. And they’re willing to lend some of the resources they control to get that time.”

Workshop participants took the idea of a capability trap and the language of Systems Thinking back to their hospitals, clinics, and classrooms. Hovmand has heard several examples of how organizations used the capability trap to think about how to investigate and improve their system of care delivery. He has found that Systems Thinking changes the language, removing blocks to collaboration and coordination. This helps “teams work more effectively to achieve lasting impact in their communities.”

There’s a lot to be gained by using Systems Thinking to teach and empower students to develop their skills in Systems Thinking, whether that is to advance their interest in STEM, become the next generation of leaders, or simply find ways to be more resilient

Hovmand plans to apply his twenty years of Systems Thinking experience to leading more projects in community settings. “We want to build capacity and capability in community-based social dynamics,” he says. “Projects often exist in a social network and we can take advantage of that. We’re also interested in learning systems. How do effective organizations look at problems in a way that helps them learn? And there is so much work to do in healthcare, social services, and K-12 education. There’s a lot to be gained by using Systems Thinking to teach and empower students to develop their skills in Systems Thinking, whether that is to advance their interest in STEM, become the next generation of leaders, or simply find ways to be more resilient.”

The importance of engaging students through Systems Thinking is what draws Hovmand to Stella®. He’s found that his high school students are more willing to make and fix mistakes with online software than they are on a whiteboard. They’re more confident about playing with Systems Thinking online and like that their work looks more professional. Once they can use Systems Thinking on their phone, they can move outside the classroom and lab and share their work with friends.

The Lab’s graduate students use Stella for more rigorous System Thinking applications. They draw on generic structures or check the literature for a model that provides a good starting place, then tailor an existing structure to their own research and projects.

Stella creates a balance between model builders and content experts who use models

Lab students often run their own projects and participate in workshops. “Stella creates a balance between model builders and content experts who use models,” says Hovmand. Hovmand has been working with students long enough that some have graduated from high school and begun to use Systems Thinking in their post-secondary lives. Many are pursuing careers in teaching or working for the Lab as staff and helping to lead the design of future K-12 efforts as they share their experience and skills with others around the country.

Ten years ago, when Hovmand’s team first had the idea of investing in K-12, it wasn’t intuitive or obvious to many since they were a small group focused on mostly federally funded research. They believed in making Systems Thinking accessible to all students and the importance of investing in the field’s future capability and diversity. What they couldn't have seen then is how much it has positively shaped them and their practice.

“There’s the saying in Systems Thinking that ‘structure determines behavior,’” Hovmand says, “and so we may sometimes feel overwhelmed by the enormity of the systems and challenges we face and helpless in the moment. While we may have limited immediate influence on outcomes from a system, we can choose how we affiliate ourselves with others, what we share, and how we can be open to learning from others. That does start to change the structure of a system in very real ways. It’s an amazing thing to see and be a part of.”

Read more about the Social System Design Lab.


Be better equipped to succeed with change management through experiential learning. Cohort, a change management business simulation, helps managers and leaders learn the valuable skills needed to manage a prospective change with senior stakeholders.

In Cohort, teams engage with ten senior executives over a nine-month period with the purpose of swaying their support for a major change to the organization. Cohort uses a highly structured approach that blends gamification, informal/social learning, behavioral economics, and business simulation. The central task is to build relationships and have authentic communications about a proposed change with senior members on both a 1:1 basis and in small groups. Each stakeholder has both a public and private profile that gives information on their position in the company, their reputation, and who they network with, aiding participants in deciding how and when to interact with the stakeholders.

Cohort can be tailored to your company, allowing participants to start in the context of their own company and/or the project they are working on. The simulation can be completed in half a day, but additional theory and exercises can be added to extend it to one full day. The book A Systemic Guide to Change Management in Organizational Teams may also be included to support the underlying theory.

isee systems is happy to be partnering with Business Simulations to offer Cohort. For more information, visit here or contact us at to learn how to offer this workshop in your organization.

The Latest and Greatest

Hot off the press!

1.8 was just released. We've added calibration and new enhancements to the interface. Check it out now!

Our software keeps getting better. With the release of Stella Professional in 2015 and Stella Architect in 2016, our new generation of software has allowed us to introduce many new and exciting features. The latest releases do not disappoint.

Here are some highlights:

User-defined macros

You can define macros which act like functions in your equations. These operate similarly to modules.

Causal Loop Diagram Creation

The CLD window offers a simplified toolset for creating causal loop diagrams. Matching the toolset of the Stella Online CLD Editor, the CLD Window makes building CLDs quick and easy.

Picture-in-picture modules

You can quickly see inside a module or a macro on the parent model window.

Auto collapse structure into a module

Select a sector or group of variables and the software will turn it into a module.

Navigation control

Easily add navigation links to your interface as tabs or buttons.

Bubble Charts

Bubble charts allow you to display three different dimensions of an attribute on a single graph. The first two are shown on the X and Y axes and the third is represented by the size of the bubble. Offering a snapshot of the values at a time, these graphs animate during simulation or when dragging the time slider.

Spell check

You can now spell check variable names, documentation, and labels.

To check out the full list of new features in 1.7, 1.7.1, and 1.8, visit our Feature Updates page.

2018 Barry Richmond Scholarship Award

Pooja Prasad accepts Scholarship Award from Karim Chichakly Pooja Prasad accepts the Scholarship Award from Karim Chichakly

The Barry Richmond Scholarship Award was established in 2007 by isee systems to honor and continue the legacy of its founder, Barry Richmond. Barry was devoted to helping others become better “Systems Citizens”. It was his mission to make Systems Thinking and System Dynamics accessible to people in all fields and professions.

The award is presented annually to a deserving Systems Thinking/System Dynamics practitioner whose work demonstrates a desire to expand the field or to apply it to current social issues. Applicants are considered based on quality of work as well as financial need and how well we believe the applicant can further Barry's mission of bringing Systems Thinking to everyone. The recipient receives a $1,000 cash scholarship to help offset the cost of attending the Annual International System Dynamics Conference.

We are pleased to announce that Pooja Prasad is the winner of the 2018 Barry Richmond Scholarship award. Pooja is working to use the power of systems thinking to improve the lives of farmers in India. By taking a broad ranging view and recognizing the interactions of the farmers with the marketplace, government agencies, and environmental factors, Pooja is helping to design reasonable and sustainable policies that will make a difference. Her award-winning paper, Farmponds for Horticulture: Boon or Curse? Analysing Impact on Farm Profitability, Resource Sustainability and Social Welfare, is available here.

On the Road

In August, Co-presidents Karim Chichakly and Bob Eberlein, product support manager Sarah Davie, and lead software developer Billy Schoenberg traveled to Reykjavik, Iceland for the 36th annual International System Dynamics Conference (ISDC). Not only were we able to view glaciers and enjoy the beauty of Iceland, but we also connected with long-time customers and new users alike. It is such a delight to see what our customers are doing with Stella and to hear where we have exceeded expectations and where we need to improve. We look forward to seeing many of our customers at the 37th ISDC in Albuquerque, New Mexico.

In October, Co-president Karim Chichakly once again made the flight south for the 16th Annual Latin American Conference on System Dynamics (CLADS) from October 17-19th at the Tecnologico de Monterrey Campus Puebla in Puebla, Mexico! Karim presented a plenary talk titled “Insights from Systems Dynamics” and gave an introductory workshop. This was isee systems' fifth year in attendance at CLADS and, as always, we were overjoyed to connect with customers and practitioners from warmer climates. If you are a CLADS attendee, be sure to contact us with any questions or to use your discount code!

isee systems in Iceland isee systems in Iceland

Student Packs for University Faculty

If you have not heard, we’ve created a great new option in student licensing! Student packs are like university lab packs. They are owned by the university and include support and maintenance, but student pack licenses are installed directly on a student’s personal computer. Faculty members send us their class lists including students’ names and email addresses, indicating to whom the licenses should be assigned, as well as an expiration date for the software. Once licenses are assigned, the students can install the software on their personal computers. On the expiration date provided by the professor, these licenses will no longer operate, and the license will return to the professor's account for redistribution to a new student.

Support included with these licenses enables the students to download and install the latest versions of the software while they have access to the license. Student pack licenses start at $150 per license for Stella Professional and we offer volume discounts for 20 or more licenses. We can also convert any portion of your existing Lab pack licenses into Student pack licenses for free! Contact us with any questions or to request a quote at or 1-603-448-4990.


As many of you already know, Stella/iThink version 10.1 and its predecessors are no longer compatible with Windows 10 after update 1709 (broadly released January 18, 2018). Microsoft will eventually require you to update your operating system and we do not want you to lose access to your modeling software. We strongly encourage users of version 10.1 and earlier to upgrade to one of our current software products, Stella Professional or Stella Architect. To facilitate a smooth transition, we gave a Stella Professional license to all version 10.1 non-educator, faculty, and lab-pack license holders. You can find it in your isee systems account under “My Products.” We also converted University Lab packs to Stella Professional lab packs. If you are unsure which of our latest software packages (Stella Architect or Stella Professional) would work best for you, please contact us for guidance.


This year, Bob Eberlein, Sarah Davie, Jeremy Wallis, and Hilary Allen participated in the 38th annual Prouty. The Prouty is a large event that benefits the cancer research and patient supportive services at Dartmouth-Hitchcock Norris Cotton Cancer Center. The isee systems team decided to participate in the century bike ride. Training began in the bitter cold of a New Hampshire April, but by July we were all in top form and completed the 100-mile ride in six hours and fifteen minutes! The Prouty is a wonderful event and now that we have a century ride under our belt, our next challenge will be biking to Albuquerque, New Mexico for the 37th International System Dynamics Conference!

The isee team at the Prouty The isee team at the Prouty

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Recent Posts

Fall 2018 Issue

Public health organizations combat alcoholism with Stella, the Social System Design Lab applies system dynamics to community projects, the Cohort simulation helps managers and leaders learn to facilitate change, the 2018 Barry Richmond Scholarship Award winner is announced, new software and licensing features, the 38th annual Prouty, and isee systems heads to Iceland and Mexico…

Fall 2017 Issue

The Ulupono initiative investigates Hawaii food production with systems thinking, African leaders embrace a systems thinking approach to problem solving, a new online training course in creating learning environments, Stella Online has been added to the isee Exchange and exciting updates to Stella Architect...

Fall 2016 Issue

Stella Architect is used to better understand nuclear and other clean energies, high school students learn systems thinking from The Lorax, Systems in Focus looks at waste manangement, Story of the Month: Reissue examines school reform, isee systems heads to Brazil, Stella Architect is released, the company website gets an overdue update...

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