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DPH @Sheffcouncil.  President @ADPHUK. co investigator @sipherc. member UKNSC. Tweets = my view. RTs= someone else's view. Death metal enthusiast.
Apr 10 7 tweets 1 min read
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)

A threadsciencedirect.com/science/articl… It is always good to see experimental data
(you know there is a but coming)
Sep 30, 2023 19 tweets 6 min read
Talking to senior NHS hospital leader recently 

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

3 suggestions on actionsbmj.com/content/377/bm…
Apr 14, 2023 15 tweets 6 min read
Premier League / gambling advertising

a thread

Many are welcoming (with varying degrees of caution)

I'm somewhat more cautious than the most cautious of cautious. Here is why
1/ See @Doc_Samantha tweet

What she said 2/
Apr 13, 2023 12 tweets 4 min read
"Prevention doesnt work" so says lots of people

asked a few days ago if any examples of evidence of national strategies

a short thread 1. Evaluation of the national health inequalities strategy (1997 - 2010)
sciencedirect.com/science/articl…

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

adph.org.uk/2022/06/protec…

1/
Let me try to boil it down to 3 fundamentals

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 

Perspectives on Paternalism and Public Health   fph.org.uk/media/3662/fin…
HT @FPH

 a reading list from me:
some (academic) rebuttal arguments to the nanny state line   gregfellpublichealth.wordpress.com/2016/12/04/som…

2/
Jan 29, 2023 19 tweets 6 min read
Six broad thoughts on where I think I would be on health select committee call: committees.parliament.uk/committee/81/h…

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/
Dec 13, 2022 11 tweets 2 min read
Public health, population health
Some terms

A thread

1. Public health  - usual benchmark application here fph.org.uk/media/2582/fph…

NB the bits on science AND art, and the bits on organised efforts of society

Good overview of system here via

fph.org.uk/media/3031/fph… Often framed in the context of “helping individuals”. Not wrong, but wrongly framed and not sufficient healthcareers.nhs.uk/working-health…

Often confused with......
Dec 11, 2022 9 tweets 2 min read
Gambling harm

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.

Summary of this work from a few years ago
fundingawards.nihr.ac.uk/award/NIHR1297…
sciencedirect.com/science/articl…

the research is good. Thorough and comprehensive

2/
May 3, 2022 7 tweets 5 min read
so I got asked this afternoon.... why the fuss about commercial determinants of disease (or health .... interesting linguistic point in itself)

a short thread

1) see the embedded tweet and thread for full set of thoughts. Written for the jobbing service PH professional 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