Tag: Personal Responsibility

FLINT, MICHIGAN January 23, 2016: City Of Flint Water Plant Sign In Flint, January 23, 2016, Flint, Michigan.

Digging Deep to Find Community-Based Health Justice

The Petrie-Flom Center Staff Leave a comment

By Melissa S. Creary

Public health interventions aimed at Black and Brown communities frequently fail to recognize that these communities have, over and over, been made sick by the systems that shape their lives.

When we fail to recognize that these problems are happening repeatedly, we are likely to address the most recent and egregious error, ignoring the systemic patterns that preceded it. Public health and technological policy responses that do not address these underlying structural and historical conditions are a form of bounded justice, i.e., a limited response sufficient to quiet critics, but inadequate to reckon with historically entrenched realities.

By only responding to the acute crisis at hand, it is impossible to attend to fairness, entitlement, and equality — the basic social and physical infrastructures underlying them have been eroded by racism.

To achieve health justice, we must move beyond bounded justice. Rather than simply recognizing the existence of underlying social determinants of health, we must do the hard work to create and re-create systems, interventions, policies, and technologies that account for that erosion and offer high-grade reinforcements.

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U.S. Supreme Court

There’s No Justice Without Health Justice

The Petrie-Flom Center Staff Leave a comment

By Yolonda Wilson

Last month the U.S. Supreme Court struck down the eviction moratorium issued by the Centers for Disease Control (CDC). The Court reasoned that, among other things, the eviction moratorium was an overreach by the CDC. That is, even in light of a global pandemic where being unhoused increases one’s risk of acute COVID-19 infection and subsequent serious illness, the Court rejected the CDC’s argument for the connection between housing justice and health justice. The Court raised several telling rhetorical questions in their decision that were intended to show the potentially troubling slippery slope that would commence if the moratorium were allowed to stand:

Could the CDC, for example, mandate free grocery delivery to the homes of the sick or vulnerable? Require manufacturers to provide free computers to enable people to work from home? Order telecommunications companies to provide free high-speed Internet service to facilitate remote work?

Whereas the Court viewed the eviction moratorium as an overreach that would lead to unthinkably absurd consequences for other sectors of social and economic life, a Black feminist conception of justice, as expressed, for example, in the historic statement of the Combahee River Collective, is necessarily grounded in a sense of the importance of community, rather than as a mere collection of individuals who may have little to no connection with or obligations to one another. Though the Court prioritized the interests of landlords and real estate agents, a Black feminist conception of justice foregrounds the needs of the overall community, such that if the well-being of the community depended on free grocery delivery to the sick and vulnerable, then so be it. The community rises and falls together, and so justice must account for the whole, not merely the well-heeled. Implicit in this conception of justice is an understanding that the community can only thrive, can only aspire to a Black feminist conception of justice, to the degree that the community is well or ill.

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Happy Public Health Week: “We’re Good Enough, We’re Smart Enough, and Doggone It, People Like Us”

Temple University Center for Public Health Law Research Leave a comment

By Scott Burris

We may be living in a golden age of group-think. A weekly reminder is poor Paul Krugman railing against the apparently universal belief in America and Europe that we’ve got to cut budgets right now or disaster will strike. He calls this a Zombie idea, a false claim that has been falsified with plenty of stakes in the heart, silver bullets and blows to the head, but will not stay in the grave.

Closer to home for us in public health is the claim that Americans don’t like government rules regulating their behavior and meddling with their preferences.  Cass Sunstein and Richard Thaler have delivered some solid blows to the idea that paternalism typically messes with solid preferences. As we celebrate Public Health Week, I want to highlight two recent papers that show that Americans, like the children in Mary Poppins, actually like their nannies, who do some pretty great things.

Public Health Law Research has recently posted the manuscript of a paper that Evan Anderson and I have prepared for the Annual Review of Law and Social Science. The paper describes the dramatic rise of law as a tool of public health since the 1960s in five major domains: traffic safety, gun violence, tobacco use, reproductive health and obesity.  These topical stories illustrate both law’s effectiveness and limitations as a public health tool. They also establish its popularity by the most apt of metrics – the willingness of legislators to enact it. The one picture worth a thousand words, below, depicts the rapid adoption of a variety of interventions by state legislatures. (By the way, the five examples also show that public health law research can and does influence the development and refinement of legal interventions over time.)

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Professional Athletes and Personal Responsibility for Health

jschenker 3 Comments

[Disclaimer: I am not involved in this, and the views expressed here are entirely my own.]

Concussions and Performance Enhancing Drugs (PEDs) have been the dominant subject of concern in the sports world recently, and for good reason, but I would like to highlight an often overlooked and more general problem.  Our athletes are rewarded for pushing their bodies to the brink to accomplish majestic feats, requiring physical perfection.  We laud playing through injuries to succeed at the pinnacle of sport, or recovering from injuries at super human speeds, only to return those bodies to the brutal punishment of competition.[1]  With these pressures, Concussions and PEDs can be viewed as mere symptoms of a culture that runs from the fans to the teams to the players themselves, asking them to sacrifice their bodies, sometimes, to the detriment of their long-term health.  In this new age of awareness about player health, we should be asking: Are athletes making properly informed rational choices about their health?  Or are there situations where neither the players nor their teams are properly incentivized to protect long-term player health due to the culture described above?

Some recent stories have exemplified the culture:

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No Doctor for the Obese?

Nir Eyal Leave a comment

by Nir Eyal

Yesterday, Boston public radio station WBUR interviewed a Massachusetts primary care physician who refuses to admit new obese patients. She claims that it’s because she lacks proper equipment, but she seems to have mixed motives. Earlier she had admitted that it’s rather because she feels that if they don’t lose the weight, “I’m paying the cost of other people’s choices.” I bet if she lacked the equipment for wheelchair-bound patients, she would go buy it.

In an upcoming post (09/07: update here), Holly Fernandez Lynch, who, along with Glenn Cohen, gets kudus for kicking off this blog, will explain whether it’s legal for doctors to reject obese patients. But before rejecting them becomes the next trend, is it right?

A whopping 35.7% of Americans are obese, and the trend continues upwards. Obesity increases risk for heart disease, stroke, type II diabetes, and various cancers. It costs the system a fortune. We must tackle this problem head on. But conditioning physician access on weight loss is not the way. Read More