Thread by @prof_goldberg

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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https://twitter.com/phil_hutchinson/status/1643096241637564416

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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We need macro-, meso-, and micro- level interventions for stigma and discrimination, all at the same time. They all have strengths and weaknesses. Macro- can be extraordinarily powerful, but have long time horizons and often short and unpredictable policy windows.

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We need to lessen stigma today, not just wait for big social and legal changes at national and global levels.

Micro- is relatively fast and easy to implement, but much less powerful and enduring.

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But what about meso-level interventions? There's very little work on this space; it's where my research teams and I are most active and most interested.

We discuss this some in our @Health_Affairs Policy Brief on structural addiction stigma and law:

healthaffairs.org/content/forefr…

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But we are working on a lot more about this, including some exciting examples of meso-level-driven antistigma work in law and policy unfolding in real time in my home state of Colorado.

#WatchThisSpace

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#PHLaw #PublicHealthLaw #PHLR #PublicHealthLawResearch #LawIsASDoH #LegalEpi #StigmaStudies #StructuralStigma #SocEpi #LegalEpi #PHEthx #PublicHealthEthics #PolicyStudies #PolicyAndAdvocacy #Bioethics #LawAndPolicy

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