Some thoughts on free speech | The Healthiest Goldfish

On balancing a commitment to free expression with the values of civility, inclusivity, and respect for all.

Few subjects are as fundamental to our society as our engagement with speech. It concerns nothing less than the expression of the ideas that are at the heart of all we do. In recent weeks, there has been much conversation about, well, conversation—about the exchange of ideas in the public debate. Emotionally charged subjects like the Israel-Hamas war and the daily drama of politics in the US and globally have raised perennial questions about how we should conduct ourselves in the central debates of the moment. We are in a time when we continually face questions like: how can we have conversations that are inclusive and respectful, while honoring our commitment to free speech? What limits, if any, should we place on expression? How can we speak in ways that are true to all our values, not just some?

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Towards a new radicalism | The Healthiest Goldfish

On striking a balance between engaging with upstream and downstream forces, to create a fundamentally healthier world.

The Oxford English Dictionary defines “radical” as

“of change or action: going to the root or origin; touching upon or affecting what is essential and fundamental; thorough, far-reaching.”

This definition aligns well with the work of public health. We are centrally concerned with “going to the root or origin”,  with “what is essential and fundamental.” We pursue our work with the understanding that the creation of a healthier world is, by definition, engagement with the foundational drivers of health. This is reflected in a metaphor I have long used to explain the work of public health. It is that of standing on the bank of a river, seeing people falling in and pulling them out one by one before realizing that the more fruitful action is to address what is throwing them in the river in the first place. This metaphor serves well for explaining what we do to those who are new to public health and has an important place in illustrating the philosophical underpinnings of our work. It reflects the necessity of dealing with the root causes of poor health, the structural forces that decide whether we are healthy throughout our lives.

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Balancing our moral and empiric imperatives | The Healthiest Goldfish

Revisiting the importance of drawing a line between our values and our data.

Happy new year everyone. I am starting the year leaning into hope, even as challenges globally and domestically swirl. We shall reflect on those during the year I am sure.

Meanwhile, I wanted to start the year with a reflection on values, and how those who think about health can balance moral and empiric inputs. This seems particularly germane given some of the recent swirl in the public conversation that has been pushing the idea that somehow academic work should exist in a moral vacuum, and that values do not, or should not inform the work of idea generation. 

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Looking back at 2023 through the lens of The Healthiest Goldfish

Reflecting on the thoughts that emerged over the past year.

This is the last Healthiest Goldfish essay of the calendar year 2023. As I was considering topics for this piece, I thought that, rather than introduce a new subject, I would look back a bit on all I wrote over the past year and on the conversations these reflections helped inform. The Healthiest Goldfish has, from the start, been organized around key themes and a certain spirit of inquiry. These themes include looking back on the COVID moment, to understand what we did right and what we did wrong, trying to better balance our values and data in pursuit of our mission, avoiding the pitfalls of communication in an age of social media and the attendant moral grandstanding that can undermine the humility and genuine moral courage that are central to scientific work, engaging thoughtfully with the foundational drivers of health, and shaping a philosophy that can support an effective, pragmatic public health mission to generate transformative change in this post-war moment. I have tried to engage with these topics in a spirit of self-critical reflection. Such reflection can be difficult, uncomfortable. But I do so out of a belief that it is necessary to become better in our pursuit of health.

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Passion play | The Healthiest Goldfish

How a passionate few capture conversations, with implications for how we do what we do.

During the recent Thanksgiving season, my historical reflections drifted towards a consideration of the French Revolution. This drift was inspired, perhaps, by the recent cinematic treatment of the life of Napoleon, whose career in many ways marked the apex and the end of that revolutionary era. In studying the French Revolution, one is struck by how many currents of thought were swirling around France in that period. The constant political swings—from radical to reactionary, from reformist to an embrace of violence and terror—reflect an era when anything seemed possible for society. In this sense, the period is representative of a characteristic common to many politically unsettled times, the present moment included. That characteristic is the presence of many voices speaking for movements and speaking within movements, all with the potential—with each sudden shift of circumstance—to become the guiding philosophy of masses of people or even of governments, with results both good and bad.  

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Why I wrote Within Reason | The Healthiest Goldfish

Holding a mirror to ourselves, to the end of being better at what we do.

This week saw the release of my book, Within Reason: A liberal public health for an illiberal time. For the past few weeks, we have been running brief readings from the book together with The Healthiest Goldfish, so readers of these essays will, by now, have an idea of what the book is about. As the book is released, I thought I would summarize here the core argument of Within Reason, the motivation behind it, and the ideas that I hope the book will encourage discussion about, even if I realize that some (many?) may not agree with these ideas.

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The integrity of the mission to promote health

On being clear on values that guide both thought and action

In “Letter from Birmingham Jail,” Martin Luther King Jr. wrote “In any nonviolent campaign there are four basic steps: collection of the facts to determine whether injustices exist; negotiation; self purification; and direct action.” This is an interesting statement for several reasons, each deserving of its own essay. But what has long struck me most about it is its call for anyone looking to create a better world to first engage in “self purification.” I take this to indicate the importance of carefully examining our values and motivations, to ensure that they support actions that can build a better world. Such work is difficult, and it is on us to make sure that before we do anything we think deeply about the first principles of our work—the values that underlie all we do. Are we truly acting on behalf of better health for all, or are we looking to posture and grandstand?  If we find ourselves alone in taking a position, have we thought deeply enough about what we believe to be able to hold to our convictions when the winds of controversy blow? Such examination is a central goal of these essays. Values help guide our efforts, providing a lens through which to view the world, helping us determine the best application of our scientific data, towards shaping approaches that create better health for all. This is particularly true in this post-war, post-COVID moment.

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An imperfect health | The Healthiest Goldfish

On creating a world that allows all of us to live healthy lives, no matter how we may define doing so.

In writing these essays, and in much of my past writing, I often invoke health. In addition to essays and articles, I have written several books, all of which are centrally concerned with creating a healthier world. Two of my more recent books, Healthier: Fifty Thoughts on the Foundations of Population Health and Well: What We Need to Talk About When We Talk About Health, are efforts to help shape a vision of health that can get us closer to a radically healthier world. The pursuit of such a vision is informed by the assumption that we have, collectively, a shared understanding of what health is: I know what it is to be healthy and so do you. Our goal is to help each other get there by creating a world that is better, healthier.

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