Health and Medical News and Resources

General interest items edited by Janice Flahiff

When free speech conflicts with public health objectives: Yale ISP Conference « Wikimedia blog

When free speech conflicts with public health objectives: Yale ISP Conference « Wikimedia blog.

The Public Health and First Amendment Conference took place at Yale University. Harkness Tower photo by Hilary Richardson, licensed under CC-BY-SA-4.0












First Amendment jurisprudence frequently pits societal ideals against free speech. A recent conference at Yale Law Schoolshowed that this is no less the case when commercial free speech protections conflict with public health regulatory objectives.

The conference, Public Health in the Shadow of the First Amendment, was co-sponsored by the Information Society Project, the Yale Global Health Justice Partnership, and the Yale Health Law and Policy Society on October 17 and 18, 2014. The event brought together public health advocates, medical professionals and First Amendment scholars to discuss the implications of recent controversial First Amendment case law. The panels highlighted several areas where courts have protected commercial speech in spite of unpopular consequences for public health policy. Hilary Richardson attended the conference on behalf of the Wikimedia Foundation legal team, given its interest in free speech law.

This conference was especially relevant to Wikipedia’s coverage of medical or health related topics. Since the content for pages on Wikipedia is entirely user-generated by thousands of volunteer editors, critics may argue that imperfection is inherent in the medical content pages. It is up to our community of editors to strike a balance between maximizing the total sum of freely available knowledge and removing information that could be misleading. If you think this sounds like an impossible task, here is some food for thought: in October alone, the New York Times wrote about how Wikipedia became one of the most trusted sources on the Internet for learning about Ebola, and four Wikipedians published a scholarly article on Dengue fever in a peer-reviewed journal based on a collaboratively edited Wikipedia article. In addition to meticulously curating the Ebola page on Wikipedia, Dr. James Heilman startedWikiProject Medicine in order to improve medical and health content on Wikipedia and “benefit the world by giving the general public and health care professionals a text they can all read, appreciate, and respect, free of charge.” Medical schools like UCSF have forged partnerships with WikiProject Medicine so that top medical students can identify gaps in information and update entries using their own knowledge and credible resources.


Professor Post provided insight into how we theorize the First Amendment and why we understand it to protect commercial speech at all. According to Post, the primary distinction between speech that is covered by the First Amendment and speech that is not comes down to our democratic value of self-governance: speech triggers First Amendment coverage when it participates in the formation of public opinion because we want the government to be responsive to public opinion. Generally, this creates a First Amendment right which is speaker-oriented. However, this changed when the Supreme Court invented the commercial speech doctrine. In Virginia Pharmacy,[3] the Court gave two rationales: we need efficient distribution of information in order to have efficient markets, and we protect commercial speech because it distributes information which is necessary for citizens to participate in public opinion formation. Post argued that in this sense, Virginia Pharmacy created a First Amendment right of the receiver to hear information rather than speak it. In the context of commercial speech, the Supreme Court conceives of the public as people capable of processing information. This suggests that it is up to the people to decide what information they need.

Professor Volokh echoed Post and Bambauer in his agreement that First Amendment protections are about protecting a free market, so that it is better for people to have more information when making decisions. Volokh stressed that the logic behind the commercial speech doctrine is that even though we may think that patients and doctors may make bad decisions, it is possible that government regulators might as well: “the First Amendment directs us to be especially skeptical of regulations that seek to keep people in the dark for what the government perceives to be their own good.”

January 26, 2015 Posted by | Health News Items, Public Health | , , , , , , | Leave a comment

The U.S. Health Disadvantage – Part 2: Possible Causes and Solutions

by Kirsten Hartil 

“Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care.”

At least according to Article 25 of The United Nations Universal Declaration of Human Rights, so why does the United States, one of the wealthiest countries in the world, have some of the poorest health outcomes compared to other high income countries?

My previous blog, adapted from the Institute of Medicine (IOM) report U.S. Health in International Perspective: Shorter Lives, Poorer Health, described how the U.S. compares in causes of mortality and years of life lost with other high income and OECD countries. Here, as outlined in the report, I explore some of the social determinants of health that may explain this. Social determinants of health, as opposed to biological determinants (biology and genetics), describe the…

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July 14, 2013 Posted by | Consumer Health, Consumer Safety, Health Statistics, Public Health, statistics | , , , , , , , , , , , , | Leave a comment

The Guide to Community Preventive Services: What Works to Promote Health

The Guide to Community Preventive Services  is a great resource for what methods and interventions work well to improve public health. It is geared towards public health officials, researchers, and policy makers. However, it is also a good aid for anyone looking for the best way(s) to address issues touching family members and friends. The information can be used to promote or advocate for changes in policies and laws at local or national levels. They can be used to positively influence changes for the better in schools, workplaces, public health departments, and more.

A good way to start is through the Topics link at the top of the page. It includes links to issues as asthma, cancer, diabetes, nutrition, obesity, vaccines, and violence. Each topic includes links to more information on the topic and related topics.
Many topics have summaries of recommendations and findings. For example the topic Diabetes includes recommendations for certain disease management programs but insufficient evidence for self management programs in school settings or worksites.

All information on the interventions for a specific topic (as violence, diabetes, alcoholism) is carefully reviewed through a standardized step by step process.  systematic reviews. Each reviews includes summarized results of all related evidence.  These unbiased evidence-based reviews are also called systematic reviews.
[Click here for a good explanation of the systematic review process]

Each topic in this community guide answer questions  such as: c

  • What interventions have and have not worked?
  • In which populations and settings has the intervention worked or not worked?
  • What might the intervention cost? What should I expect for my investment?
  • Does the intervention lead to any other benefits or harms?
  • What interventions need more research before we know if they work or not?

Click on these tabs at the top of the  home page for additional information

April 14, 2012 Posted by | Public Health | , , , , , , , , | Leave a comment

Using public policy as a tool to improve health

Panelists speak at the Joan H. Tisch Forum in Public Health

Georges Benjamin, at left, moderates the Joan H. Tisch Forum in Public Health at Hunter College with Bruce Vladek, Rich Besser and Jim Marks (from left to right). Photo courtesy Philip Kessler Photography



From the 15 December 2011 Public Health Newswire

Our nation is undergoing a significant debate about how best to improve the health of its citizens. Much of that debate has been around insurance coverage and reform. While this is an important debate, much of what influences the degree of healthiness of individuals and communities is outside the traditional health system.

Health is about our housing; where we dump our trash; access to clean, affordable and safe food, water and air; how we build our communities in terms of their ability to support active living and the presence of economic opportunity. These factors are affected by public policy decisions and therefore can be used strategically and on a population basis to improve health.

New York City has used this approach to great effect. They have relied on the findings of community health surveys to determine their health priorities and then developed many of the city’s most significant policy initiatives, including food environment policies such as banning trans fats at restaurants and requiring calorie-count restaurant displays, increasingly aggressive anti-smoking policies, increased bicycle paths, improved access to fresh fruits and vegetables, and a novel registry to track diabetes control.

Read the entire article

December 16, 2011 Posted by | Public Health | | Leave a comment

10 Possible Reasons Public Health Communication Strategies on Behaviour Change May be Failing: An introduction to the 2-6-10 Slot Model.© « drnyashamboti

From the abstract of a Paper to be presented at the International Association of Media and Communication Researchers, Durban, 2012, University of KwaZulu-Natal

By Nyasha Mboti

University of KwaZulu Natal


Every year many millions of dollars are spent on programmes and strategies to motivate ‘at-risk’ populations to ‘change’ their ‘behaviour’. At issue in this paper is the efficacy of such programmes and strategies. The “2-6-10 slot model” is a simple algorithm I have built to explain some of the seemingly obvious failures of Public Health interventions in Africa targeted at so-called ‘Behaviour Change’, specifically in the domain of HIV and AIDS campaigns. The model is draws on unanswered questions about ‘Behaviour Change’ programmes and strategies and is meant to be a critical commentary on the strategic assumptions of such programmes. In building the model, I argue that the notion of ‘Behaviour Change’ is too vague, sometimes to the point of uselessness. As such, the model asks the questions that public health opinion leaders seldom or never ask. The 2-6-10 slot model focuses on the interventions targeted at so-called ‘multi-partnerism’ and the efforts to motivate people to ‘stick to one partner’. It uses ‘slots’ to describe, characterise and reflect on the gaps that conventional Public Health strategies have failed to explain or fill. The model suggests the adoption of more evidence-based modelling of Public Health strategies as opposed to ones that are largely assumption-led. The 2-6-10 slot model is so-called because it comprises of diagrams, or empty slots, that begin at 2 and increase to 6, 10 and so on. The increase in slots represents the increase in failure of a respective public health intervention.

December 12, 2011 Posted by | Psychology, Public Health | , , , , | Leave a comment

Chicago leaders unveil city’s first-ever public health blueprint

From the 16 August 2011 Public Health Newswire blog item by David

While Chicago is known for its deep-dish pizza, sausage and hot dogs, those local delicacies are not likely to be featured on a heart-healthy menu anytime soon. But an ambitious plan unveiled today by city leaders is intended to help transform the health of Chicagoans by addressing everything from the communities in which they live to the food they eat.

Healthy Chicago: A Public Health Agenda for a Healthy City, Healthy Neighborhoods, Healthy People and Healthy Homes identifies 12 priorities for action to improve health such as lowering rates of obesity, teen births and infectious disease and improving the infrastructure of the city’s public health system. For each priority area, the plan presents strategies organized into three sections: policies, including regulatory changes and laws that will be pursued; programs and services to be delivered; and education and public awareness efforts to reinforce these policies and programs….

Read the news article

August 17, 2011 Posted by | Public Health | , | Leave a comment

Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths

Full Text Online Article from the 11 July 2011 issue of Health Affairs – At the Intersection of Health, Healthcare, and Policy

[Abstract]Public health encompasses a broad array of programs designed to prevent the occurrence of disease and injury within communities. But policy makers have little evidence to draw on when determining the value of investments in these program activities, which currently account for less than 5 percent of US health spending. We examine whether changes in spending by local public health agencies over a thirteen-year period contributed to changes in rates of community mortality from preventable causes of death, including infant mortality and deaths due to cardiovascular disease, diabetes, and cancer.

We found that mortality rates fell between 1.1 percent and 6.9 percent for each 10 percent increase in local public health spending. These results suggest that increased public health investments can produce measurable improvements in health, especially in low-resource communities. [Flahiff’s emphasis].However, more money by itself is unlikely to generate significant and sustainable health gains; improvements in public health practices are needed as well.

Click here to read the rest of the article

July 22, 2011 Posted by | Public Health | , , , , , | 1 Comment

Nation’s First Ever National Prevention Strategy.

From the 17 June 2011 Health Literate Chick posting

Yesterday, Surgeon General Regina Benjamin hosted a press conference to announce the nation’s first EVERNational Prevention Strategy.

This is huge Public Health news..HUGE. The Obama administration continues to be an administration that places the focus on public health and disease prevention.

The purpose of the meeting was to talk about how America needs to refocus its perspective to one of building a healthier nation through the prevention of disease and improvement of wellness rather than focussing on disease treatment.

AKA..shifting the focus from medicine to public health.

The plan comes as a result of the Affordable Care Act. Makes sense to me–if you’re going to be the one paying the bill for healthcare wouldn’t you rather just make the nation healthier to start through inexpensive prevention rather than paying for expensive surgeries and medications later?

The plan includes four basic strategies:

  1. Create, sustain, and recognize communities that promote health and wellness through prevention.
  2. Clinical and Community Preventive Services: Ensure that prevention-focused health care and community prevention efforts are available, integrated, and mutually reinforcing.
  3. Empowered People: Support people in making healthy choices
  4. Elimination of Health Disparities: Eliminate disparities, improving the quality of life for all Americans.
Within the above framework of Four (4) strategies are seven (7) priorities which make up the bulk of the report.

• Tobacco Free Living

• Preventing Drug Abuse and Excessive Alcohol Use

• Healthy Eating

• Active Living

• Injury and Violence Free Living

• Reproductive and Sexual Health

• Mental and Emotional Well-Being

June 25, 2011 Posted by | Public Health | , , | Leave a comment


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