Simar Bajaj

The sewer knows what you ate! For New York Times, I wrote about the scientists sifting through urine and poop to sequence food DNA, finding traces of chocolate, lettuce, turkey, blueberries, black pepper, and hundreds of other foods — for less than a penny a person. (1/n)

Every week, the New York Times publishes one piece of ideas-driven journalism, explaining a complex problem or illuminating an important way of thinking. Last week, they chose my story on the return of blaming and shaming in public health for the "Ideas" section. For decades, public health has been moving away from stigma — across HIV/AIDS, mental illness, addiction, obesity, and beyond. But health secretary Robert F. Kennedy Jr. has revived a language of personal responsibility, and I wrote about what that reflects and what it costs. What makes stigma so interesting is that it masquerades as accountability while often making care harder to seek and change harder to sustain. But the usual anti-stigma response has its own problems: Too often, it tries to fix stigma by changing hearts and minds one training at a time, rather than changing the structures that give stigma force. Of course, personal responsibility matters. People are agentic. But when it comes to public health, a better message may be “constructive responsibility," acknowledging that individuals have responsibilities but insisting that industries, policies, and environments must also be held accountable. That is what makes Mr. Kennedy’s rhetoric so revealing. He is pointing to something real when he attacks the food industry and other commercial drivers of the chronic disease epidemic. But this critique loses force when he condemns the system and then casts the people shaped by that system as irresponsible. A better public health would meet this tension honestly: not by pretending people have no agency and not by shaming them for failing to overcome rigged conditions — but by changing those conditions so that agency has a fair chance. Full story in the replies