When should institutions take sides? | The Healthiest Goldfish

On determining when institutions should formally address contemporary issues.

In recent weeks, there has been much conversation about the role of institutions like universities and corporations in the public debate about issues of consequence. Questions have emerged about when institutions should take a public position on issues, or, indeed, whether they should be taking positions at all. Today’s essay is a synthesis of prior writing I have done on the subject, engaging with the role of institutions in a time of political disruption, global unrest, and social change, towards doing right by our mission in pursuit of health.

As Dean of a school of public health, I come to this from a particular perspective, informed by my work in an academic setting. However, the following thoughts could well apply to any institution as it grapples with how to engage with this moment when much is at stake and the prospects of both speaking out and not speaking out on issues of consequence can feel equally fraught.

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Observing Science: An Introduction | Observing Science

On the workings of science, its limitations, and its promise for a healthier world

Science is our demand that things make sense. We think of science as a modern discipline, systematic and skeptical in its approach and aiming at well-defined results and conceptual clarity. The data that inform science are argued about and interpreted in lecture halls and seminar rooms. Science is written down, following particular approaches, so that it can be replicable.

Much of science is done to prove or disprove ideas and test theories, but its discoveries—observations and evidence—are meant to be useful, although sometimes the uses are far-off. Science has always been a way to know nature, or in the biomedical and population health sciences, our subjects here, the contexts and forces that create the health of humans.

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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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