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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This is a fascinating response from Dr. Miller, from whose work I've learned much over the years!

Some thoughts:

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https://twitter.com/hastingscenter/status/1587516082625060864

I agree with Dr. Miller that the utility of ethicists in the #RoomWhereItHappens for public health emergency policy response ought not be assumed. That said, I strongly believe that an appropriately-trained ethicist can be helpful, at least in the following ways:

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I respect Hiroko Tabuchi but once again, we have a NYT story on #COIs btw #academia and industry focused on the wrong points. Far too much time is spent on compliance w/ disclosure requirements, when disclosure FAILS as a remedy for #MotivatedBias.

nytimes.com/2022/10/31/cli…

1/ More discussion is had on the notion that the sponsor has "no influence" on the work of the center at issue when we know beyond a shadow of a doubt that it is the depth of the relationship btw the sponsor and the center that leads to behavior of partiality.

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As anyone who works on #COIs and #MotivatedBias can tell you, this arrangement is ethically unacceptable from an #OccupationalHealth perspective. HCPs paid directly by the league are in NO conceivable sense "independent."

nytimes.com/2022/09/30/spo…

1/ And giving team physicians the "ultimate say" is absolutely the last thing you would do if you truly understood COIs as exposures and #MotivatedBias as a population health harm. It is literally inconceivable that this arrangement continues apace.

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For those following at home, the advice on the Intarwebz explicitly warns against any kind of preheating an empty enameled cast-iron vessel in a cold oven (even if you begin the preheat with the vessel in the oven). To wit:

1/ Note that this warning is not identical to warning against placing a cold empty vessel in a preheated oven. That too is inadvisable but is not the same warning as above.

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bigtimekitchen.com/preheat-enamel…

Look, I just do not understand how to use cloches or bread bakers. I have a nice one which was a gift, but my breads are almost always better when I just bake on a sheet.

I get the idea, I think. When you preheat the vessel and load the dough in

1/ The escaping moisture creates steam (can also be added via various techniques I use). The lid keeps the steam in which helps with a beautiful rise and makes an awesome crust. I get this. But the reality is much more complex for me.

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As someone who knows more than a little about the history of the railway industry and occupational and public health (both US and UK, actually), I'm rendered almost speechless by what is happening with the possible strikes in the U.S.

1/ I firmly believe that it is difficult to understand contemporary problems in public health policy and even health care policy in the US w/o really integrating the histories of the railway industry and railway medicine. The connections are LEGION.

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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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https://twitter.com/alyssaharad/status/1561171132795035648

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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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.

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npr.org/sections/healt… 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.

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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+

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.

1/ 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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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.

1/ 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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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.

1/ 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 +

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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.

1/ 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.

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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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Speaking as someone who studies anxieties about malingering and their connections to health, disability, & social policy, the framing of this NYT article is enormously problematic.

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The Man Who Filed More Than 180 Disability Lawsuits nytimes.com/2021/07/21/mag… The article is well-written, but it leaves out an enormous amount of context. Most importantly, ADA and disability law violations are de rigeur. They are common, frequent, every day occurrences. Ask people w/ mobility impairments how airlines handle their wheelchairs.

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Look, I'm angry, so I am just going to say it:

I really, really wish that non-Jews would immediately cease trying to define Jewish identity on here. It's transgressive and a basic violation of any commitment to antiracist and anti-oppressive praxis.

1/ Jewish identity, like many other social identities, is extraordinarily complex. Jewish people who live it often passionately disagree with each other on identity. If you don't live it, the odds that you're going to get anywhere close to the mark are vanishingly small.

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I would just like to point out that Nate Silver's nonsense today didn't merely insult public health scientists, epidemiologists, and officials.

It also insulted public health ethicists, implying that it takes no special expertise or training to unpack and offer guidance

1/ On the deep and fraught complexities in vaccine allocation and prioritization.

I have noted in @AMJPublicHealth that public health ethics is fundamentally about priority-setting:

ajph.aphapublications.org/doi/abs/10.210…

Some of us have spent years working on exactly these kinds of probs.

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