Why are some in pub health against paid shutdowns, or for rushing to reopen schools? Why are their imaginations limited to PPE? How does the language of equity end up weaponized? A on analogies from research about the psychology of risk & climate change #epitwitter #medtwitter

2/ The punchline: People struggle to think through problems that require solutions outside their comfort zone. Paradoxically, increased scientific knowledge can actually decrease understanding of climate risk, for example. How come?

3/ Dan Kahan writes that people form conceptions of risk that reinforce particular world views, which essentially map onto this grid. People gravitate toward perceptions of risk that advance the way of life to which they are committed.

4/ Analogously, some pub health academics with individualist or hierarchical cultural risk frames might be dismissive of pandemic policies that lead to restrictions on forms of behavior they are accustomed to, or which threaten their perceived authority as scientific elites.

5/ In climate risk science, this is borne out empirically. “Members of the public with the highest degrees of science literacy & technical reasoning capacity were not the most concerned about climate change...they were the ones among whom cultural polarization was greatest.” Why?

6/ Most likely because well-educated hierarchical individualists have superior intellectual resources for justifying their priors—their commitments to a particular cultural way of life.

7/ Another key insight is the concept of “solution aversion.” Essentially, people reverse engineer their understanding of a problem based on their willingness to cope with the solution.. https://pubmed.ncbi.nlm.nih.gov/25347128/ 

8/ But why would public health “fear the solution more than the problem”? For much biomedicine & public health, “social determinants” just “happen” to individuals. The structures that produce them are not eligible for social action, only their downstream mediators.

9/ This is of course related to the “way of life” commitments (or dare I say, class position) of academic elites. It also starts to explain the liberal perversion of equity discourse that @KeeangaYamahtta, has described with such brutal clarity: https://twitter.com/KeeangaYamahtta/status/1355315787112837128?s=20

10/ In public health, some MDs and epidemiologists use “equity” to mean “equally bad.” To avoid actually listening to what Black parents are worried about or taking restaurant workers and teachers unions seriously.

11/ And their solution aversion is their inability to see $trillions in direct payments to workers and businesses as a viable public health solution: all they can imagine is masks, abstract/vague “workplace protections,” social distancing, and waiting for vaccines.

12/ I don’t have answers aside from better political education and organizing in our field. But understanding these dynamics and their analogies with climate change can help, especially since this pandemic response is a prelude to state responses to climate catastrophe.

13/13 h/t @aldatweets for pointing me in the direction of this research and helping me frame it, and @abbycscience, @jfeldman_epi, and @Arrianna_Planey for helping me think it through!