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.


npr.org/sections/healt… "This guidance acknowledges that the pandemic is not ov
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.

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

3/ high COVID-19 Community Levels. Public health efforts should
Historical patterns of domination, oppression, and subordination. Even the interventions proposed are virtually all #medicalized w/ zero mention of using legal & policy change to ameliorate impact of #StructuralViolence. It's all up to the least well-off 2 protect themselves.

#MethodologicalIndividualism as a mode for public health action is problematic because it is BOTH generally ineffective AND is more likely to expand existing health inequities. I explain this here:


The fact that the leading public health agency in the US seems to have embraced #MethodologicalIndividualism and #medicalization as preferred approaches is just so upsetting. I've spent years urging resistance to these frameworks!
We have already seen the results of this for marginalized communities and it will continue apace.

#PublicHealthLaw #PublicHealthEthics #PHLaw #PHEthx #PublicHealthPolicy #PolicyStudies #LegalEpi #LawIsASDOH #FundamentalCauseTheory #WholePopulation #SocialEpi #SocEpi


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More from @prof_goldberg

Aug 11
The Kid is a patrilineal Jew (raised Jewish). We've had ++ discussions about how the orthodox rabbinate are not popes, & no one has the authority to exclude zher from Jewish community.

As a Patrilineal Jew, I See Myself in the Golem heyalma.com/as-a-patriline… via @hey_alma
@hey_alma We've discussed our obligations to observe halacha on this and many other issues -- but it is absolute nonsense to me that a person raised Jewish from birth, observing important practices & rituals, being called to Torah for B'nai Mitzvah, is nevertheless deemed to be cosplaying+
@hey_alma Judaism b/c the "wrong" parent is Jewish. Sorry, wrong and transgressive answer. A person who seeks to live a Jewish life and actively engages in Jewish traditions and communities is Jewish. IDGAF what the orthodox rabbinate thinks about this. They are not popes. +
Read 4 tweets
Jul 18
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.

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.

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).


Read 6 tweets
Jul 16
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.

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.

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."

Read 12 tweets
Feb 25
Tomorrow's session in our doctoral seminar on public health ethics centers "Disability, Ethics, & Public Health."

We began this convo in the fall history of public health seminar via extensive discussions on eugenics and basic notions in critical disability studies.

Tomorrow we'll extend our work by attempt to apply working knowledge of #DisabilityJustice and #DisabilityEthics to public health practice and policy. Last week's application exercise of the REAP Framework in evaluating the influence of #StructuralRacism in policy serves +

As a critical bridge to this week's unit, since of course ableism and racism intersect past and present in all sorts of nefarious ways in public health contexts.

(The app exercise involves continuous Medicaid coverage under the current PHE)

Read 4 tweets
Jan 26
I see that we are still slavishly worshipping at the idol of RCTs in epidemiologic science as the evidentiary warrant for public health action. I have written LOTS on the foolishness of this, its disastrous ethical & policy implications, & it's role in #ManufactureOfDoubt.

It's almost as if people have never heard of the #PrecautionaryPrinciple. If we demanded evidence of exposure-harm or intervention-benefit that flowed from RCTs to warrant public health interventions, we would have essentially NO public health action AT ALL.

2/ Even granting the presumption that RCTs are a categorically
More on this, from my 2016 paper on importance of maintaining epistemically reasonable standards for proof of harm (& benefit!) as warrant for public health action:

(The subject of the paper is COIs and lays out my arg for regarding them as ordinary epidemiologic exposures)

3/ robust as we might like. If evidence of the kind envisioned
Read 6 tweets
Nov 11, 2021
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:


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).

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.

Read 17 tweets

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