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Daniel S. Goldberg

Hi Bill,

I'm traveling this weekend, so I can't write as much as I normally would right now, but I'll just say that when I say "macrosocial intervention" I mean something very, very different from banning sugary drinks. If one examines the literature on agentic interventions (I like Capewell & Graham 2010 as a particularly nice discussion), it is plain that even interventions applied to everyone are agentic if the unit of change is the individual.

Thus banning sugary drinks target behaviorial changes on the individual level. This is agentic. In contrast, e.g., sanitation does not target individual behavior. The unit of intervention is collective, not individual, although of course collective interventions may have significant individual benefits.

Thus, when I say "macrosocial interventions," I don't mean individual behaviorial changes mandated for all. I mean nothing less than radical social and economic reform, with the emphasis on "radical."

Thanks for the great discussion. More anon!

Richard A.

Maybe parents should ban sugar-sweetened beverages at home.

Bill Gardner

Daniel, thanks again. I am learning a lot here. In case it isn't obvious, I am not an SDOH person. I am a health services researcher -- maybe 'clinical process engineer' would be a better term. So you will not go wrong if you assume that I need terms explained for me.

I like your distinction, and I like mine too. Will think about the resulting typology...

Bill Gardner

Richard A: My kids have now left the nest, but I wish we had done more to reduce the sugar in our home.

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