@lucindahiam
2025-26 Harkness Fellow @Brown School of Public Health and Boston College | GP and global public health doctor | Clarendon Scholar @UniofOxford | Commissioner on the @BMJ Future of the NHS | Member @RCGP | Honorary Member @FPH.
Survey flyer asking "have you seen a health policy succeed despite polarization? Take our short survey to help us understand how people move health policies forward in polarized environments". Includes a QR code link to survey (link itself in Prof McKee's post).
Thank you for sharing @martinmckee.bsky.social! Survey flyer below.
🇺🇸 Have you seen a US health policy move forward even when political views were deeply polarized? My colleague @lucindahiam.bsky.social is collecting examples of how people come together to advance health policy in divided environments.
🔗Share examples here: forms.gle/tXR6MGby4fee...
🇺🇸 Have you seen a US health policy move forward even when political views were deeply polarized? We're collecting examples as part of my Harkness Fellowship project on how people come together to advance health policy
in divided environments.
🔗Share examples here: forms.gle/tXR6MGby4fee...
With thanks to my mentors @martinmckee.bsky.social Stefanie Friedhoff and Phil Landrigan; and @craigspencer.bsky.social for conversations around this and feedback on earlier iterations of this piece.
📖 If evidence is to matter, trust has to come first. Showing up, listening, and understanding why people mistrust public health is not endorsement of misinformation, and it may be one of the few ways left to bridge the divide.
🔗 www.bmj.com/content/392/...
📢 The article discusses attempts to rebuild trust through engagement, including initiatives like the @whyshoulditrustyou.bsky.social podcast, which holds conversation across different beliefs without endorsing false claims.
💉 Vaccines save lives, that isn’t in question. But data alone and "trust the science" cannot reach people who do not trust the institutions producing it.
Anti-vaccine views are no longer marginal. They are politically empowered, and public health needs to reckon with that reality.
❓What happens when mistrust of science moves from the fringe to the centre of health policy?
📄 In a new @bmj.com Opinion, I write about the Children’s Health Defense conference in Texas and what it reveals about mistrust, polarisation, and the limits of evidence in public health.
🧵
❗️An important limitation
Because the data do not include time since migration, we cannot say whether these patterns reflect negative acculturation. What we can observe are population-level trends over time and how mortality outcomes for migrants shift year by year relative to the E&W–born.
📌 Why this matters
• Migrants are not a homogeneous population
• Convergence is not necessarily good news when native-born mortality is worsening
• Public health needs to ask which groups are losing protection, and why
Most migrant groups fell into “health advantage, decreasing”: an initial mortality advantage that has eroded over time.
Image showing the 2 x 2 typology of four possible outcomes per country/region of birth when compared with the England & Wales-born population from 2007 to 2021 as listed in the text.
This produces four trajectories:
1️⃣ Health advantage, increasing
2️⃣ Health advantage, decreasing
3️⃣ Health disadvantage, decreasing – initially worse off, but catching up
4️⃣ Health disadvantage, increasing – poor and deteriorating outcomes
A central contribution of the paper is a 2×2 typology that helps make sense of complex trends comparing health advantage vs health disadvantage (relative to England & Wales–born) and whether that is improving vs worsening over the study period.
Using 15 years of national mortality data, we move beyond the idea of a single "healthy migrant effect" and show heterogeneity between migrant groups.
📄 New paper out in Journal of the Royal Society of Medicine with @robaldridge.bsky.social, Rachel Burns, and analysis led by @jonminton.bsky.social
❓How does mortality compare by country/region of birth in England & Wales, 2007–2021?
doi.org/10.1177/0141...
🧵⬇️
“Is anyone here carrying a gun?”
In @bmj.com I reflect on America’s relationship with guns, and why the leading cause of death for ages 1–17 is missing from MAHA’s child health plan. Whose freedom is being protected?
www.bmj.com/content/391/...
Thanks to
@billkole.bsky.social @nelbamg.bsky.social
Amid the US shutdown, my latest @bmj.com column asks why the world’s most expensive health system still fails to deliver fair, universal care.
🔗 www.bmj.com/content/391/...
"The CDC shooting serves as a tragic reminder that political polarisation has become a public health emergency."
@lucindahiam.bsky.social writes the first piece of her year in the US, discussing political polarisation as an overlooked determinant of health
www.bmj.com/content/390/...
🚨 PhD Opportunity
🇬🇧 Are migrants in the UK living longer lives but in worse health?
Work with the brilliant @mjwdemography.bsky.social exploring the immigrant morbidity–mortality paradox
🔗 www.findaphd.com/phds/project...
📅 Deadline: 1 August
@para-mor-ukri.bsky.social
💡 AI has real potential. But without confronting:
🔹 Digital divides
🔹 Systemic bias
🔹 Social determinants of health and impacts of austerity
…it risks entrenching the very inequalities it’s meant to reduce.
@rthonwesstreeting.bsky.social
(5/5)
3️⃣ Tech alone can improve health.
It can’t.
AI-enabled tools that focus on individual behaviour change ignore structural drivers of poor health — like poverty, housing, and food insecurity, and the devastating impacts of austerity.
www.bmj.com/content/385/...
(4/5)
2️⃣ Algorithms are neutral.
They’re not.
AI is only as fair as the data it’s trained on — and systemic bias is baked into much of that data.
Instead of addressing discrimination, AI can reinforce it.
(3/5)
1️⃣ Everyone's online.
They’re not.
1.6 million people in the UK remain offline limiting access to care, digital services, and health tools.
Digital exclusion disproportionately affects many of those already facing the greatest health challenges.
(2/5)
⚖️ Can a digital NHS be equitable?
In our @bmj.com editorial @jessrmorley.bsky.social @eleanorbarry.bsky.social & I argue that while AI in healthcare promises transformation, it rests on three flawed assumptions that risk worsening inequalities 👇
www.bmj.com/content/389/...
(1/5)
The chancellor of the exchequer Rachel Reeves has outlined plans to cut several billion from the UK's welfare budget.
Cuts to disability benefits will worsen health and the economy
www.bmj.com/content/388/...
Led by @gerrymccartney1.bsky.social with @profkatsmith.bsky.social and David Walsh, and contributions from David Taylor-Robinson, @profbambra.bsky.social @dannydorling.bsky.social @benjaminbarr.bsky.social @martinmckee.bsky.social
@thegcph.bsky.social @oxfordgeography.bsky.social
Our @bmj.com editorial ahead of the #SpringStatement
❌ There’s no evidence that cutting social security boosts economic activity—it’s neither "moral" nor effective.
✅ Gains come from investing in health.
💡 Solving the austerity-fuelled health crisis needs political will & strong public services.
BMJ editorial on austerity.
Health is a key driver for economic growth.
It baffles me that the UK government are ignoring the advice of public health experts & going down the track of further austerity.
A @bmj.com editorial by @lucindahiam.bsky.social, @gerrymccartney1.bsky.social & David Walsh.
www.bmj.com/content/388/...
📢 Austerity is a public health emergency
Cuts to welfare & public services have worsened health, driving rising mid-life mortality & health inequalities.
Yet, more cuts are coming.
With @gerrymccartney1.bsky.social & David Walsh in @bmj.com we call for the health community to speak out 1/2