Discover and read the best of Twitter Threads about #LegalEpi
Most recents (5)
In my work I offer some reasons why we hang on to micro-level interventions even when the evidence is clear that they exert only modest, transient effects.
For one, macro- and meso- level work is challenging and often requires destabilizations of power.
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For one, macro- and meso- level work is challenging and often requires destabilizations of power.
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Yet, as I often argue, for our anti-stigma work we actually DO need micro-level interventions like educations and trainings. They DO have some effects and are easier to implement.
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The only problem is when micro-level interventions come to dominate the entire field of our anti-stigma work, which the evidence suggests happens, especially in public health spaces.
Instead, my teams and I advance a tripartite anti-stigma approach.
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Instead, my teams and I advance a tripartite anti-stigma approach.
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As anyone who works on #COIs and #MotivatedBias can tell you, this arrangement is ethically unacceptable from an #OccupationalHealth perspective. HCPs paid directly by the league are in NO conceivable sense "independent."
nytimes.com/2022/09/30/spo…
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nytimes.com/2022/09/30/spo…
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And giving team physicians the "ultimate say" is absolutely the last thing you would do if you truly understood COIs as exposures and #MotivatedBias as a population health harm. It is literally inconceivable that this arrangement continues apace.
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Remember a week or so back when I talked about the deep connections between the #railroadindustry and contemporary public health policy? This is one of them. The RR industry pioneered the model of having company physicians care for injured workers.
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There's a lot in this thread, but one pt I'd like to extract is connected to something I've been arguing for years and #onhere quite a bit recently:
#MethodologicalIndividualism in public health occurs where we position the individual as the unit of change.
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#MethodologicalIndividualism in public health occurs where we position the individual as the unit of change.
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This is in comparison to structural interventions, which often alter upstream factors and institutions. My favorite example of the latter is laws and policies, but can also include infrastructure and built environmental changes, etc.
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But leading public health officials in the US have completely followed the #MethodologicalIndividualism that has dominated public health policy and priorities for much of the 20th c. until now. See:
pubmed.ncbi.nlm.nih.gov/19965565/
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pubmed.ncbi.nlm.nih.gov/19965565/
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Honestly, the complete takeover of population health policy and approaches by a #medicalized notion of #MethodologicalIndividualism sort of fills me with despair -- not just now, but for the future of public health.
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npr.org/sections/healt…
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npr.org/sections/healt…
Of all the missteps CDC has made, the doubling-down on approaches that position the individual as the unit of change (#MethodologicalIndividualism and b/c of the source) essentially sanctions it as the dominant mode for public health practice is arguably rock bottom.
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It's in the scientific guidance as well. Look at this sentence:
This is of course NOT a Whole Population Approach or even a structural approach to health equity which would require action from those with the power and agency to redress the effects of #StructuralViolence and
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This is of course NOT a Whole Population Approach or even a structural approach to health equity which would require action from those with the power and agency to redress the effects of #StructuralViolence and
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Speaking as someone who studies anxieties about malingering and their connections to health, disability, & social policy, the framing of this NYT article is enormously problematic.
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The Man Who Filed More Than 180 Disability Lawsuits nytimes.com/2021/07/21/mag…
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The Man Who Filed More Than 180 Disability Lawsuits nytimes.com/2021/07/21/mag…
The article is well-written, but it leaves out an enormous amount of context. Most importantly, ADA and disability law violations are de rigeur. They are common, frequent, every day occurrences. Ask people w/ mobility impairments how airlines handle their wheelchairs.
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Ask hearing-impaired or Deaf people about the availability of SL-fluent interpreters in public accommodations. And on and on and on. It's endless.
As w/ most forms of civil rights and antidiscrimination laws in the US, the rules are observed in the breach.
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As w/ most forms of civil rights and antidiscrimination laws in the US, the rules are observed in the breach.
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