These are some of the areas I need to expand with the essay: With respect to the

These are some of the areas I need to expand with the essay: With respect to the indispensable role of science in public health, you make the right point, however, I think it would be stronger if you support it with examples and more discussion.  What is good data?  Have there been any instances where bad data has been troublesome in the public health and policy arena?  You mention WHO statistics on Covid deaths.  Is this good data?  Was it collected in a scientific manner?  Do all countries count deaths from Covid the same way?  Are there any motivations for countries to under count or over count cases?  Who did the counting?  Who checked the math?  How are co-morbidities taken into account?  Are there any contrary views?  Would it effect our public policy goals if this data understated deaths by 10%?  What if there were actually 50% more deaths than WHO statistics report?  What if there were actually 50% fewer deaths?  Let’s assume WHO has the data exactly right, and the count of deaths is spot-on.  Can you prove this is the case?  I don’t actually expect you to cover all these questions in a short memo, however, when you use the data and there are a lot of easy questions that arise about the quality of data, does it help or hurt your main thesis about social determinants of health?  How do you get the reader who is either without information/opinion or inclined to disagree with you to think about your point of view?  Readers who already agree with you will always stick with you, but that doesn’t really accomplish the goal of writing a memo like this.
Your memo makes critical points about the possibility that prioritizing individual freedoms may obstruct the pursuit of collective public health goals.  You should discuss this in much greater detail.  Why is this the case?  Is it wrong to prioritize individual freedoms?  If we should prioritize public health goals above individual liberties, why?  Can a public health agency report a problem, offer ideas for solutions, and encourage better public decision making, but stop short of conflict over liberties?  This is essentially what we do with obesity, tobacco use, recreational drug use, alcohol, seatbelts (in NH), high-cholesterol, fitness, heart disease, flu-shots, and literally an endless list of other public health concerns.  Why do we allow motorcycles to exist when the driver will experience infinitely worse injuries in an accident compared to a passenger car?  Even with respect to social determinants of health, we don’t generally use mandates or tools that conflict with individual liberties.  In fact, informed consent is usually the highest controlling principle in our health care system.  We don’t round up homeless people and herd them into a shelter, even though we know with 100% certainty it is healthier for the homeless person to be out of the elements.  So, where are the boundaries the separate obesity or homelessness, or mental health where we never, ever intrude on liberty from a Covid policy where we may decide we should or must intrude on liberties.  The answer is not that Covid is dangerous or contagious.  These other health conditions kill at a far greater number and spread through society at least as effectively as an infectious disease.
I think social determinants of health are intended to be a prominent part of your thesis, however, the discussion is too brief.  What do you mean by social determinants of health?  What are these things that tend to expose an individual to a higher risk lifestyle, and restrain an individual’s access to care or healthy options?  What does the discussion about social determinants of health have to do with data quality?  Is there truly reliable data on social determinants of health?  How do we do a double-blind study on social determinants of health?  If language, culture, geography, transportation, diet, education, profession, and the like are both social determinants of health, and part of my identity, why is it a public policy goal to change those things?  In other words, if I am a French-speaking farmer living in a remote farming town and I hunt ducks, deer, I ride motorcycles in the woods all weekend, I never access the internet, cannot read, drink lots of wine, and eat 5 eggs for breakfast,  I will be unhealthy and have poor access to care.  Have I done anything that should be a proper target of public health policy to change?  Maybe learning to read is a goal.  But not a mandate.  I don’t mean to say that housing support or avoiding poverty, access to education and the internet are not the right goals.  However, social determinants of health are also tied to race, ethnicity, culture, music, recreation, national origin, religion, and a host of things we prize.  When is a social determinant of health something to be fixed, and when should it be left alone?  Why?  Who gets to decide?
Lastly, your memo raises a couple of important concepts, but does not include support with data.  Do we have a proclivity to react only in a crisis?  We did react to Covid in a crisis mode.  We haven’t reacted to opioids in crisis mode, yet.  Same for homelessness, drug use, obesity, cancer, diabetes, and the like.  We have lots of public health initiatives with respect to homelessness, mental health, education, disability, health screening, internet access, and the like.  Sometimes there have been crisis in these areas, but our reaction or action doesn’t particularly track with a crisis.  If we only act in a crisis, why did we adopt the Medicaid program, Medicare, the Affordable Care Act, public housing, public education, public funding for college, public transportation, WHO, the Centers for Disease control, the FDA, clean water act, public sanitation, public health departments, and on and on.  Sometimes there was an immediate circumstance that precipitated these things, but more often than not, these are slow progressions in public health without an immediate crisis.  By the same token , support the statement that we act for the benefit of persons with economic power.  Provide examples.  Discuss how we came to have the various initiatives I list here, and how those relate to persons with economic power.