What I had said last night . The Guardian (and I admit I didn’t go look for the trial) said RRR (I can only assume it was RRR as if it were ARR then that would be HUGE) of 30%
A public health approach to public health approaches to
Heard calls for a public health approach to X, y and z
Or someone written something on it??
A quality checklist
🧵
1/
1 Provenance and PH credentials of author. Both in PH and topic concerned
2 Robust epi analysis - outcome, access to interventions to reduce harm, causes, causes of causes. Distribution in population considered
2/
Mar 9 • 40 tweets • 6 min read
Earlier in the week @YHADPH and @YHClimateCom hosted a conference on climate and health
Eventually we will put all the materials here (might take a few days)
This thread is my own take on the take homes
It's long (sorry)
Really challenging material 1/ yhphnetwork.co.uk/links-and-reso…
Five problems
Prob 1 Lifestyle drift is everywhere. Also in this space
Individualisation is the path of least resistance
Challenging the fundamental leverage points oftrn not seen as a legit intervention – the challenge of no real measurable
2/
Dec 15, 2023 • 16 tweets • 3 min read
Testing the effectiveness of different safer gambling messages for sports and race betting: A five-week experiment
An interesting study (the word interesting used advisedly)
Said public health need to do more to prevent illness and is failing to control demand into acute care
Probably true
But....
A thread (nb some may find controversial)
We talked about 25% cuts to budget. This was a genuine surprise.
We talked about c50% cuts to spending power of local government- aka the determinants of health
(and the impact this has probably had on population health, & thus NHS demand)
This was also a surprise
Sep 11, 2023 • 7 tweets • 2 min read
Asked my view on what are my fave papers I have read in last few years
In no order
1 pollution of health discourse & need for effective counter-framing
@spidermaani @maizie333 @petticrewmark @kentbuse
Policy shaped by who prevails in framing problems & solutions
Fags, BP, To a lesser extent cholesterol (see Fig 5)
More marked in male than female
Cations wrt use of GBD
Feb 5, 2023 • 20 tweets • 5 min read
Lots of ppl calling for a statutory levy in gambling reform as the central ask
I am simply not of the belief this will solve any of the fundamental problems
Long thread explaining why
1/
Let me be clear nobody is arguing against some model of sustainable funding.
Many are going for pragmatism and focus on levy as that is what govt may be prepared to go for
In my experience that strongly tends to reinforce existing power and system.
2/
Feb 4, 2023 • 4 tweets • 1 min read
A Public Health approach to gambling harm
Much is written on this
Often mangled and sometimes the language is appropriate with ? malign intent??
Here is best effort of two orgs (soon to be three that have the words Public and Health in their title
1. Absolute independence from industry at all levels 2. Framed not about individual and behavour but product & methods of industry (the former still matters ++) 3. The current system is what is broken & needs shift
Go back to 2005. 2/
Jan 29, 2023 • 23 tweets • 8 min read
Resetting the narrative on the nanny state
A thread
1/1. The academic stuff well summarised in this one
The obvious question is how far upstream you want to go and how you frame “health”.
I am fairly radical here. Others may focus some attention on more “trad” space
A thread
1/1. health ≠ the NHS. Cross govt machine for health. Should health policy BE a DHSC thing or should it be a cabinet office, cross govt thing?
2/
Plenty tell me focus on the small % harmed and don't need to regulate product, industry or shift the system & narrative it plays out in
Ie that regulation is overreach and we should stick to the current model
This is questionable on a number of fronts
1. By the time you realise you are in the 5% it might be too late, lots of harm accumulated already. You dont just arrive there, it is after a long period, often with a catalogue of missed opportunities
May 28, 2022 • 20 tweets • 6 min read
The nature of what we define as “an intervention” in public health
A thread
1/
Went to a great seminar on gambling harm a week or two back. An overview of available evidence of interventions.
2) Health (or lack of it + the gap between haves and haven’t) is fundamental to NHS / social care demand (ie our cost pressures) AND a vibrant productive economy as well as enormous social justice issue
