Want to Fix Public Health? Stop Thinking Like a Doctor.

• Extracts

• “medical interventions constitute only 10–20 percent of modifiable factors affecting health”
• “neither doctors’ irrelevant medical knowledge nor relative ignorance of essential fields—labour history, social anthropology, political economy, epidemiology, environmental sciences—is the most troubling aspect of physician control of public health. Rather, it’s the lack of epistemic humility, conferring an inability to recognize the limits and hazards of clinical reasoning, with which medical training often imbues them”
• “the goal of public health is to enable individuals to be free of health limitations that curtail their ability to live as they please. But public health pursues this by very different means. The task is not to help individuals accommodate to oppressive social or labour contexts. It is instead to use the power of government to change conditions that are constraining people’s freedom.”
• “The core tools of public health, then, are not just vaccines or lab tests but also policies pertaining to corporate regulation and consumer safety standards; labour protections; public jobs and housing programs; investments in community health workers, decriminalization, and decarceration; and civil rights lawsuits.”
• “Public health doesn’t meet people where they are at; it enables them to move freely by altering their environment”
• “public health prioritizes protections for those whose freedom is most obstructed by the current state of affairs: those who are immunocompromised, elderly, or incarcerated; migrant agricultural workers; people of colour; and others especially exposed to harm”
• “allowing harm to fall on vulnerable groups will ultimately return as multiplying harm for society”
• “dominance of clinical reasoning that reduces health to individual patients while normalizing their social conditions—what I call “clinicism”—over public health is stronger than ever”