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don samuels's avatar

Great article Tom. I'll be reading

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JOHN FINNEGAN's avatar

Great column, Tom. A couple of observations - we have a challenge with a lot of public health issues where the root causes are way upstream, and the policy fixes require long-range planning well beyond biennial arithmetic. Often our policy making is reactive in the short term, and when faced with the need for long-term remediation to avoid a future catastrophe, it's easier to "kick the can down the road." There are few immediate political incentives in addressing possible disasters years off. Think climate change where the science has been warning for decades about accumulating effects. The other thing I've been thinking about is the concept and process of "design thinking" applied to public health challenges and policy tools. It's a framework that has started to take hold in public health but is in its early stages. More thoughts to come! Good start, sir!

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Jeffrey Peterson's avatar

Despite all the long standing evidence you cited smoking was viewed by many as a societal norm, "cool" as reflected in films and entertainment outlets. There were ads featuring doctors- or people playing doctors- touting the benefits of tobacco. Even good science needs, unfortunately, shifts in cultural norms that may take time, as your comments demonstrate. I look forward to more discussions on other topics.

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Keith Dixon's avatar

Welcome to Substack, Tom!! Great piece! The smoking comments got my attention. It made me wonder if smoking was once a “meme” or something in its heyday to imply a rebellious individualism that is distinctly American. Is this American value of rugged individualism - screw the scientific consensus - at the heart of our struggles in public policy? That is: do we refuse to follow science precisely because it relies on consensus? Is there an American Romanticism about the triumphant individual against elite authorities? If you got ‘em, light um. To hell with these pointy-head nerds - like Fauci! Keep it com in’. K

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Tom Horner's avatar

Thanks. It is disturbing that consensus seems to be reason enough for some to oppose good policy. No one is suggesting that science DICTATE policy. But we shouldn't allow bad policies by those who are eager to ignore science because it interferes with their politics.

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