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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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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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Read 13 tweets
I am super happy to announce that I have been awarded a US$5000 grant from @StraussLibrary to develop an OER ("Open Educational Resource") Casebook of Public Health Ethics Teaching Cases.

Other than the wonderful CDC Casebook, teaching cases in #PHEthx are scarce.

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I should know, since I have been scraping the Internet for a decade trying to find them. One of the first-day axioms in #PHEthx is that in important ways it is simply different from health care/clinical ethics. Good teaching cases must reflect these differences.

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But some of the early casebooks are frankly dated, and other than the remarkable CDC Casebook ⬇️ there simply are not any good collections of cases really focused on public health ethics & law/policy (let alone open-source ones, either).

ncbi.nlm.nih.gov/books/NBK43577…

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Read 6 tweets
I've found it profitable to trade on a distinction between what I've termed "operational" vs. "structural" #PHLaw #PublicHealthLaw

One task public health lawyers can perform is helping public health officials understand the full scope of their legal authority.

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This task is critically important to functional public health governance, esp. b/c the scope of this authority has changed rather dramatically in the US since the Palpatine began.

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We might term this work "operational public health law," since it is focused on operative provisions of public health law that govern the scope of (at least) state action. It can illuminate what interventions public health officials can "operationalize."

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Read 12 tweets
I've been studying chronic pain for going on 15 years now. I have some thoughts on this, many of which I've articulated elsewhere and for some time now:

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The Quiet Scientific Revolution That May Solve Chronic Pain nytimes.com/2021/11/09/wel…
The headline and the article fundamentally misconstrues the primary causes of the devastating and highly inequitable undertreatment of pain in the US (and globally, but that's another conversation).

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The primary causes for our failures in treating people in pain humanely and effectively are not connected to lack of technical, clinical, or scientific knowledge.

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Read 17 tweets

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