Mobile health applications that promise the user to help her with some aspect of her health are very popular: for-profit apps such as MyFitnessPal, Fitbit, or Headspace have tens of millions of users each. For-profit health apps are designed and run as optimization systems. One would expect that these health apps aim to optimize the health of the user, but in reality they aim to optimize user engagement and, in effect, conversion. This is problematic, I argue, because digital health environments (...) that aim to optimize user engagement risk being manipulative. To develop this argument, I first provide a brief analysis of the underlying business models and the resulting designs of the digital environments provided by popular for-profit health apps. In a second step, I present a concept of manipulation that can help analyze digital environments such as health apps. In the last part of the article, I use my concept of manipulation to analyze the manipulative potential of for-profit health apps. Although for-profit health can certainly empower their users, the conditions for empowerment also largely overlap with the conditions for manipulation. As a result, we should be cautious when embracing the empowerment discourse surrounding health apps. An additional aim of this article is to contribute to the rapidly growing literature on digital choice architectures and the ethics of influencing behavior through such choice architectures. I take health apps to be a paradigmatic example of digital choice architectures that give rise to ethical questions, so my analysis of the manipulative potential of health apps can also inform the larger literature on digital choice architectures. (shrink)

Classical particles of the same kind are distinguishable: they can be labeled by their positions and follow different trajectories. This distinguishability affects the number of ways W a macrostate can be realized on the micro-level, and via S=k ln W this leads to a non-extensive expression for the entropy. This result is generally considered wrong because of its inconsistency with thermodynamics. It is sometimes concluded from this inconsistency, notoriously illustrated by the Gibbs paradox, that identical particles must be treated as (...) indistinguishable after all; and even that quantum mechanics is indispensable for making sense of this. In this article we argue, by contrast, that the classical statistics of distinguishable particles and the resulting non-extensive entropy function are perfectly all-right both from a theoretical and an experimental perspective. We remove the inconsistency with thermodynamics by pointing out that the entropy concept in statistical mechanics is not completely identical to the thermodynamical one. Finally, we observe that even identical quantum particles are in some cases distinguishable; and conclude that quantum mechanics is irrelevant to the Gibbs paradox. (shrink)

Online social networks play an increasingly important role in communication between friends, colleagues, business partners, and family members. This development sparked public and scholarly debate about how these new platforms affect dynamics of cultural diversity. Formal models of cultural dissemination are powerful tools to study dynamics of cultural diversity but they are based on assumptions that represent traditional dyadic, face-to-face communication, rather than communication in online social networks. Unlike in models of face-to-face communication, where actors update their cultural traits after (...) being influenced by one of their network contacts, communication in online social networks is often characterized by a one-to-many structure, in that users emit messages directly to a large number of network contacts. Using analytical tools and agent-based simulation, we show that this seemingly subtle difference can have profound implications for emergent dynamics of cultural dissemination. In particular, we show that within the framework of our model online communication fosters cultural diversity to a larger degree than offline communication and it increases chances that individuals and subgroups become culturally isolated from their network contacts. (shrink)

We present an analysis of the Frauchiger–Renner Gedankenexperiment from the point of view of the relational interpretation of quantum mechanics. Our analysis shows that the paradox obtained by Frauchiger and Renner disappears if one rejects promoting one agent’s certainty to another agent’s certainty when it cannot be validated by records from the past. A by-product of our analysis is an interaction-free detection scheme for the existence of such records.

The concept of recognition has been pivotal in critical theory in recent years. This paper discusses how two goals of a critical theory of recognition – to explain and to morally evaluate social change – are interrelated. In doing so, this paper draws the limits of the concept of struggles for recognition. It is argued that if a social movement can be deemed illegitimate, this movement can no longer be understood as struggling for recognition. This implies that the two goals (...) of a critical theory of recognition cannot be fulfilled simultaneously: a moral standard that distinguishes between legitimate and illegitimate social struggles cannot distinguish between different types of struggles for recognition, but only between struggles for recognition and other types of social struggles. Drawing the limits of the concept of struggles for recognition in this way helps to better distinguish between different types of social struggle and contributes to a more precise understanding of what struggles for recognition entail. (shrink)

This edited collection offers a much-needed interdisciplinary exploration of the longevity and impact of the spatial turn across disciplines. It is aimed at advanced undergraduates, postgraduates and scholars interested in space and place in the humanities and social sciences.

Social media (SM) influence young adults’ communication practices. Artificial Intelligence (AI) is increasingly used for making recommendations on SM. Yet, its effects on different generations of SM users are unknown. SM can use AI recommendations to sort texts and prioritize them, shaping users’ online and offline experiences. Current literature primarily addresses technological or human-user perspectives, overlooking cognitive perspectives. This research aims to propose methods for mapping users’ interactions with AI recommendations (AiRS) and analyzes how embodied interactions mediated by a digital (...) agent can lead to changes in social and cultural practices. For this, this work proposes a comparative analysis of central practices evoked by AI recommendations-mediated communication on SM among users in Italy, Estonia, and the Netherlands in the age category 18–26 years old. The data used in the comparative analysis was collected via semi-structured interviews and elaborated based on cognitive psychology and semiotics. This research highlights the contextual significance of AI recommendations as a mediator in creating new communication practices. Findings confirm that young adults often choose practices that would enhance their digital representations according to AiRS’ dominant patterns and categories. AiRS impacts individual interpretations and practices and can further affect social and cultural levels. (shrink)

News media have transformed over the last decades, there being increasing numbers of online news suppliers and an increase in online news consumption. We examine how reporting on immigration differs between popular German online and print media over three crucial years of the so-called immigration crisis from 2015 to 2017. This study extends knowledge on the framing of the crisis by examining a period covering the start, peak, and time after the intake of refugees. Moreover, we establish whether online and (...) print reporting differs in terms of both frame occurrence and variability. The period of the crisis provided an ideal test to see whether the focus of media reporting differed between online and print sources. Employing a most- similar- cases design based on online and print versions of three major German news outlets, we extract the dominant frames in almost 18,500 articles using algorithm-based topic modelling. While results indicate that many frames are more visible in either online or print media, these differences often do not follow theoretical expectations. Furthermore, online media are dominated by particular frames and, hence, show less diversity than print media. However, important key events happening during our period of investigation do not affect overall diversity of frames. (shrink)

Saunders has recently claimed that “identical quantum particles” with an anti-symmetric state (fermions) are weakly discernible objects, just like irreflexively related ordinary objects in situations with perfect symmetry (Black’s spheres, for example). Weakly discernible objects have all their qualitative properties in common but nevertheless differ from each other by virtue of (a generalized version of) Leibniz’s principle, since they stand in relations an entity cannot have to itself. This notion of weak discernibility has been criticized as question begging, but we (...) defend and accept it for classical cases likes Black’s spheres. We argue, however, that the quantum mechanical case is different. Here the application of the notion of weak discernibility indeed is question begging and in conflict with standard interpretational ideas. We conclude that the introduction of the conceptual resource of weak discernibility does not change the interpretational status quo in quantum mechanics. (shrink)

Propositional logic has been recognized throughout the centuries as one of the cornerstones of reasoning in philosophy and mathematics. Over time, its formalization into Boolean algebra was accompanied by the recognition that a wide range of combinatorial problems can be expressed as propositional satisfiability (SAT) problems. Because of this dual role, SAT developed into a mature, multi-faceted scientific discipline, and from the earliest days of computing a search was underway to discover how to solve SAT problems in an automated fashion. (...) This book, the Handbook of Satisfiability, is the second, updated and revised edition of the book first published in 2009 under the same name. The handbook aims to capture the full breadth and depth of SAT and to bring together significant progress and advances in automated solving. Topics covered span practical and theoretical research on SAT and its applications and include search algorithms, heuristics, analysis of algorithms, hard instances, randomized formulae, problem encodings, industrial applications, solvers, simplifiers, tools, case studies and empirical results. SAT is interpreted in a broad sense, so as well as propositional satisfiability, there are chapters covering the domain of quantified Boolean formulae (QBF), constraints programming techniques (CSP) for word-level problems and their propositional encoding, and satisfiability modulo theories (SMT). An extensive bibliography completes each chapter. This second edition of the handbook will be of interest to researchers, graduate students, final-year undergraduates, and practitioners using or contributing to SAT, and will provide both an inspiration and a rich resource for their work. Edmund Clarke, 2007 ACM Turing Award Recipient: "SAT solving is a key technology for 21st century computer science." Donald Knuth, 1974 ACM Turing Award Recipient: "SAT is evidently a killer app, because it is key to the solution of so many other problems." Stephen Cook, 1982 ACM Turing Award Recipient: "The SAT problem is at the core of arguably the most fundamental question in computer science: What makes a problem hard?". (shrink)

This study argues that contemporary theology needs a reconceptualised form of metaphysical theology to readdress this question of universality. In order to develop such a new metaphysical theology, de Jong turns to the work of Karl Rahner and Edward Schillebeeckx. Presenting a new perspective on their theological methods, he demonstrates that these theologians employ a dialectical interplay of hermeneutical and metaphysical arguments yielding a modest theological metaphysics. Crucially, these thinkers recognise that acknowledging hermeneutical conditions does not need to end in (...) particularism. Instead, Rahner and Schillebeeckx argue that the infinite variety of particular human experiences can act as potential encounters with the universally self-revealing God. Retrieving these modest forms of theological metaphysics reminds contemporary theology that it is possible to think about universality from within particularity. Balancing the intelligible and mysterious nature of God, Rahner and Schillebeeckx show how a modest theological metaphysics contains its own self-critical hermeneutical disciplining. This renewed understanding about the earlier use of metaphysics opens up new avenues of thought for fundamental theologians that do not want to shy away from the difficult question of the universality of God. (shrink)

Spatiality, Sovereignty and Carl Schmitt: Geographies of the Nomosis an edited volume by Stephen Legg. The book was published in the midst of accruing attention to the issues of space and order in the writings of Carl Schmitt. The objective of the book must, therefore, be understood as a critical analysis of the different ways Schmitt’s concepts can inform and have informed the study of geopolitics. This review will provide a critical summary of the main themes in the book and (...) analyse the arguments made for and against using Schmitt. I will additionally assess the ways in which Marxist Geography can benefit from critically engaging with Schmitt. It will be argued that a critical engagement with Schmitt should start from a contextualised position and a subsequent fertile negation of his thinking. (shrink)

Saunders has recently claimed that ``identical quantum particles'' with an anti-symmetric state (fermions) are weakly discernible objects, just like irreflexively related ordinary objects in situations with perfect symmetry (Black's spheres, for example). Weakly discernible objects have all their qualitative properties in common but nevertheless differ from each other by virtue of (a generalized version of) Leibniz's principle, since they stand in relations an entity cannot have to itself. This notion of weak discernibility has been criticized as question begging, but we (...) defend and accept it for classical cases likes Black's spheres. We argue, however, that the quantum mechanical case is different. Here the application of the notion of weak discernibility indeed is question begging and in conflict with standard interpretational ideas. We conclude that the introduction of the conceptual resource of weak discernibility does not change the interpretational status quo in quantum mechanics. (shrink)

Facial electromyography research shows that corrugator supercilii ('frowning muscle') activity tracks the emotional valence of linguistic stimuli. Grounded or embodied accounts of language processing take such activity to reflect the simulation or ‘reenactment’ of emotion, as part of the retrieval of word meaning (e.g., of “furious”) and/or of building a situation model (e.g., for “Mark is furious”). However, the same muscle also expresses our primary emotional evaluation of things we encounter. Language-driven affective simulation can easily be at odds with the (...) reader’s affective evaluation of what language describes (e.g., when we like Mark being furious). To examine what happens in such cases, we independently manipulated simulation valence and moral evaluative valence in short narratives. Participants first read about characters behaving in a morally laudable or objectionable fashion: this immediately led to corrugator activity reflecting positive or negative affect. Next, and critically, a positive or negative event befell these same characters. Here, the corrugator response did not track the valence of the event, but reflected both simulation and moral evaluation. This highlights the importance of unpacking coarse notions of affective meaning in language processing research into components that reflect simulation and evaluation. Our results also call for a re-evaluation of the interpretation of corrugator EMG, as well as other affect-related facial muscles and other peripheral physiological measures, as unequivocal indicators of simulation. Research should explore how such measures behave in richer and more ecologically valid language processing, such as narrative; refining our understanding of simulation within a framework of grounded language comprehension. (shrink)

This paper examines the main orthographic innovations of the early Islamic orthography in comparison to the Nabataean orthography and traces through new epigraphic evidence when and where these innovations came to be used. It is shown that a number of them clearly develop already in the pre-Islamic period. Besides this, the paper looks at the complexities of Arabic orthography and morphophonological spelling as it is reflected in the Quranic orthography as well as pre-Islamic inscriptions and argues that the early Islamic (...) orthography represents the continuation of a developed Hijazi scribal tradition. (shrink)

Awjila Berber is a highly endangered Berber variety spoken in eastern Libya. The minimal material available on it reveals that the language is in some respects very archaic and in others grammatically unique, and as such is of particular comparative and historical interest. Fieldwork has been impossible for decades due to the political situation. Recently, however, several inhabitants of Awjila have set up a Facebook group Ašal=ənnax (“our village”), posting largely in Awjili. Analysis of this partly conversational corpus makes it (...) possible to extend our knowledge of the language, yielding unattested words and constructions. Examination of its grammatical features also reveals that these posters’ usage is heavily influenced by Arabic, showing language attrition absent from earlier data; even subject-verb agreement has been extensively reworked. In both respects, this study casts light upon the uses and limits of social media as a source of linguistic material. (shrink)

We argue and demonstrate that an emphasis on outperforming others may lead to perverse effects. Four studies show that assigning other-referenced performance goals, relative to self-referenced mastery goals, may lead to more interpersonally harmful behavior in an information exchange context. Results of Study 1 indicate that assigned performance goals lead to stronger thwarting behavior and less accurate information giving to an exchange partner than assigned mastery goals. Similarly, in Study 2 performance goal individuals more subtly deceived highly competent opponents relative (...) to lowly competent opponents, who received more blatant treatment. Finally, Studies 3 and 4 show in methodologically complementary ways that tactical deception considerations may account for the interpersonally harmful behavior of performance goal individuals. (shrink)

We argue and demonstrate that an emphasis on outperforming others may lead to perverse effects. Four studies show that assigning other-referenced performance goals, relative to self-referenced mastery goals, may lead to more interpersonally harmful behavior in an information exchange context. Results of Study 1 indicate that assigned performance goals lead to stronger thwarting behavior and less accurate information giving to an exchange partner than assigned mastery goals. Similarly, in Study 2 performance goal individuals more subtly deceived highly competent opponents relative (...) to lowly competent opponents, who received more blatant treatment. Finally, Studies 3 and 4 show in methodologically complementary ways that tactical deception considerations may account for the interpersonally harmful behavior of performance goal individuals. (shrink)

Music can reduce stress and anxiety, enhance positive mood, and facilitate social bonding. However, little is known about the role of music and related personal or cultural variables in maintaining wellbeing during times of stress and social isolation as imposed by the COVID-19 crisis. In an online questionnaire, administered in 11 countries, participants rated the relevance of wellbeing goals during the pandemic, and the effectiveness of different activities in obtaining these goals. Music was found to be the most effective activity (...) for three out of five wellbeing goals: enjoyment, venting negative emotions, and self-connection. For diversion, music was equally good as entertainment, while it was second best to create a sense of togetherness, after socialization. This result was evident across different countries and gender, with minor effects of age on specific goals, and a clear effect of the importance of music in people's lives. Cultural effects were generally small and surfaced mainly in the use of music to obtain a sense of togetherness. Interestingly, culture moderated the use of negatively valenced and nostalgic music for those higher in distress. (shrink)

In this paper, we argue that the characteristics of digital platforms challenge the fundamental assumptions of value sensitive design (VSD). Traditionally, VSD methods assume that we can identify relevant values during the design phase of new technologies. The underlying assumption is that there is onlyepistemic uncertaintyabout which values will be impacted by a technology. VSD methods suggest that one can predict which values will be affected by new technologies by increasing knowledge about how values are interpreted or understood in context. (...) In contrast, digital platforms exhibit a novel form of uncertainty, namely,ontological uncertainty: even with full information and overview, it cannot be foreseen what users or developers will do with digital platforms. Hence, predictions about which values are affected might not hold. In this paper, we suggest expanding VSD methods to account for value dynamism resulting from ontological uncertainty. Our expansions involve (1) extending VSD to the entire lifecycle of a platform, (2) broadening VSD through the addition of reflexivity, i.e. second-order learning about what values to aim at, and (3) adding specific tools of moral sandboxing and moral prototyping to enhance such reflexivity. While we illustrate our approach with a short case study about ride-sharing platforms such as Uber, our approach is relevant for other technologies exhibiting ontological uncertainty as well, such as machine learning, robotics and artificial intelligence. (shrink)

The current study investigates whether self-talk phrases can influence behavior in Ultimatum Games. In our three self-talk treatments, participants were instructed to tell themselves (i) to keep their own interests in mind, (ii) to also think of the other person, or (iii) to take some time to contemplate their decision. We investigate how such so-called experimenter-determined strategic self-talk phrases affect behavior and emotions in comparison to a control treatment without instructed self-talk. The results demonstrate that other-focused self-talk can nudge proposers (...) towards fair behavior, as offers were higher in this group than in the other conditions. For responders, self-talk tended to increase acceptance rates of unfair offers as compared to the condition without self-talk. This effect is significant for both other-focused and contemplation-inducing self-talk but not for self-focused self-talk. In the self-focused condition, responders were most dissatisfied with unfair offers. These findings suggest that use of self-talk can increase acceptance rates in responders, and that focusing on personal interests can undermine this effect as it negatively impacts the responders’ emotional experience. In sum, our study shows that strategic self-talk interventions can be used to affect behavior in bargaining situations. (shrink)

The ongoing COVID-19 pandemic and resulting health and economic crisis has caused major disruptions in the functioning of food systems and revived the discussion on what forms balanced, effective and responsible crisis management. As part of its thought leadership and its social responsibility in times of crisis, WUR is uniquely placed to contribute to the scientific knowledge base and data collection mechanisms required for early recognition and rapid response. In addition, WUR takes on the challenge to generate timely insights into (...) the possible scenarios for the prevention of a crisis and during and after emergencies to enable our clients and stakeholders to make informed decisions. Lastly, WUR can provide a better understanding of the mechanisms of spillover, and tangible and practical tools to help reduce the risk of spillover events from occurring, prevent pathogen spread, or mitigate the impacts of a future pandemic. In its research institutes and university, WUR brings together expertise in human, animal, plant and environmental health, the global agri-food system, economics, social sciences, food safety and security, ethics, and policy. Here, in the knowledge that COVID-19 will not be the last pandemic, we present WUR’s ambition and capabilities towards an integrated global multi-stakeholder approach to the prevention and management of potentially pandemic diseases, across the four phases of crisis management; prevention, preparedness, response, and recovery and learning. (shrink)

Marijn van Putten’s Quranic Arabic is an illuminating and highly original addition to important scholarly articles on the study of Qurʾānic linguistics and the.

Photo ID 72893750 © Rawpixelimages|Dreamstime.com ABSTRACT Solidarity is a concept increasingly employed in bioethics whose application merits further clarity and explanation. Given how vital cooperation and community-level care are to mitigating communicable disease transmission, we use lessons from the COVID-19 pandemic to reveal how solidarity is a useful descriptive and analytical tool for public health scholars, practitioners, and policymakers. Drawing upon an influential framework of solidarity that highlights how solidarity arises from the ground up, we reveal how structural forces can (...) impact the cultivation of solidarity from the top down, particularly through ensuring robust access to important social determinants of health. Public health institutions can support solidarity movements among individuals and communities by adopting a lens of social justice when considering public health priorities and, in turn, promote health equity. INTRODUCTION Over the past two decades, scholars have invoked the concept of solidarity when assessing a wide range of topics in bioethics, from CRISPR-Cas9 technology to organ donation to structural racism.[1] However, the growing literature on solidarity has not fully examined the roles and responsibilities of institutions and governments in fostering solidarity, especially regarding public health measures that implicate entire populations. We argue that it remains unclear how public health institutions should engage with solidarity and how their engagement will affect public health and its ethics. We first take Prainsack and Buyx’ three-tiered framework as an analytical starting point.[2] We then explore how public health institutions can foster solidarity by carefully considering factors that may bolster it on an interpersonal, community, and national scale. We conclude that public health institutions should adopt a lens of social justice to promote solidarity at the interpersonal and community levels, thereby promoting equity in future public health efforts. BACKGROUND Calls for solidarity in bioethics raise longstanding normative questions about the nature and limits of our duties to one another and how to weigh autonomy over considerations of justice.[3] Though the term is diversely applied, Prainsack and Buyx propose a potentially unifying definition in the 2011 Nuffield Council report, “Solidarity: Reflections On An Emerging Concept in Bioethics.” The report defines solidarity as an activity involving “shared practices reflecting a collective commitment to carry financial, social, emotional, and or other ‘costs’ to assist others.” Their conceptualization also includes important features that distinguish solidarity from other values like empathy or altruism: solidarity emphasizes action rather than mere internal feeling and recognition of connection as motivation.[4] Bioethicists have since applied this conceptualization when analyzing issues in public and global health, given that population-level efforts need cooperation from individuals and communities. Prainsack and Buyx further note that solidarity is relevant in bioethics discourses about justice and equity, in support of providing aid to low- and middle-income countries, and as a value exemplified by European welfare states.[5] Other bioethicists have argued that promoting solidarity can contribute to community engagement, partnership with Tribal communities, and global health equity.[6] Most recently, scholars have applied solidarity as a lens to assess the COVID-19 pandemic, highlighting the pitfalls of national mitigation efforts and global disparities in disease outcomes.[7] I. Solidarity at Three Levels It seems impossible to foster solidarity in public health if we cannot identify it in general contexts. Prainsack and Buyx articulate three levels of solidarity: interpersonal solidarity, group solidarity, and legal or contractual codifications of solidarity.[8] They argue that each level inherently informs the one ‘above’ it in a unilateral direction. In other words, solidarity is fundamentally a bottom-up phenomenon. Solidarity among individuals influences group norms, which then have the potential to shape policy and institutional practice.[9] Within the Prainsack and Buyx framework, it would seem nonsensical to posit how solidarity might be expressed vertically or from the “top down.” It appears intuitively odd to imagine how a government entity might ‘be’ in solidarity with a person or group if solidarity requires some cognition about their condition per Prainsack and Buyx’ definition. Some have argued that solidarity does not seem like something that one can impose, as instances of it arise from agents recognizing and acting upon some bond rather than in response to a command. Indeed, people may be rightfully hesitant to engage in solidarity if the official messaging is overly paternalistic or coercive.[10] However, some authors have countered that governments can express solidarity through enacting structural and policy changes, though it is ambiguous how these actions are distinct from a justice-driven approach.[11] If a bottom-up approach is thus the most practical means of achieving policy that reflects solidarity, then it does not add much to public health. Institutions would be ineffective without the population’s initiation of the corresponding social norms. However, we find this conclusion overly pessimistic. Fostering a culture of solidarity to improve public health has potential merit. Prainsack and Buyx’ framework overlooks how public health actors can influence solidarity between individuals and across communities. To clarify, we agree with the view that solidarity is a bottom-up phenomenon. Solidarity may not be able to originate in a top-down fashion, but we suggest that public health institutions can take a more active role in providing the public with accurate information, promoting social justice, and intervening in the social determinants of health. II. The COVID-19 Pandemic as a Case Study Lessons learned from the ongoing COVID-19 pandemic support our argument. The pandemic deepened socioeconomic disparities in the US and hindered access to vital resources such as food, housing, and healthcare.[12] Prainsack recently noted: “[n]ext to the immediate health effects of the virus, poverty and grave inequalities have been the root causes of human suffering during the pandemic.”[13] Prior to the pandemic, many rural and low-income populations lacked reliable access to the internet and devices like laptops or smartphones. This continued lack of access restricts the flow of information and prevents people from accessing telemedicine services.[14] Preexisting social, political, and health inequities worsened health outcomes among many marginalized racial and ethnic groups. It is well-documented that communities of color, including Black, American Indian or Alaska Native, and Latinx populations, had greater COVID-related mortality and morbidity due to the effects of structural racism.[15] Although federal US agencies such as the Centers for Disease Control and Prevention enacted laws that provided safety nets (e.g., the Federal Eviction Moratorium), the majority of such programs have ended, leaving many with little assistance and the threat of further hardship.[16] These disparities are relevant because Prainsack, Buyx, and others note that solidarity arises from agents recognizing and acting on some perceived attainable collective goal(s). Income inequality and disparate access to food, education, and health care may lead people to consider public health goals unattainable. This could limit the desire to work toward those goals collectively.[17] The existing literature on collective action theory supports this intuition. It emphasizes that structural conditions, such as an absence of perceived hope for social change among a group, can lead to low ‘group efficacy’ and little willingness to cooperate, both within and across socioeconomic strata.[18] The pandemic spurred countless messages from public health agencies. The messaging did not recognize or attend to the different material realities and circumstances of the US population. How can people feel comfortable getting vaccinated if they deeply distrust the government, including public health institutions? How can people remain motivated to wear masks and distance themselves if they cannot afford basic necessities and work jobs without adequate pay and leave policies? We ask these questions to illustrate how socioeconomic disparities can marginalize people if they feel ignored, apathetic, or resentful of those better off or those in power whom they perceive to “not be doing enough.” This marginalization precludes the formation of solidarity. There are instances when a population has disparate access to resources and social capital, but solidarity may still emerge from a shared goal or vision for the future. For example, a heterogeneous population living in the same town may come together to protest an environmental injustice that impacts their water supply with the common goal of securing access to safe drinking water. However, many populations in the US failed to recognize shared goals of this kind during the COVID-19 pandemic. A significant minority of the US population was reluctant to acknowledge the severity of COVID-19 infection and thus refused to participate in efforts to mitigate its spread. Even between groups who shared the goal of slowing COVID-19 transmission, the methods were widely debated. Approximately 20 percent of the adult population eligible for vaccination remains unvaccinated.[19] Governmental bodies responsible for disseminating information, coordinating the allocation of resources, and establishing guidelines have a large role in mediating these disagreements and intervening in socioeconomic conditions that impact people's ability and willingness to engage in solidarity. III. Solidarity, Social Justice, and the Role of Public Health Institutions Adopting a lens of social justice provides further insights into how public health actors impact solidarity. Powers and Faden argue that the “foundational moral justification for the social institution of public health is social justice.”[20] Their theory of social justice has two aims. First, it ensures that everyone has a sufficient amount of the six core elements of well-being and that public health institutions are responsible for “adopting policies and creating environments” where all can flourish.[21] Second, public health institutions should distribute resources meant to promote well-being and focus on the “needs of those who are the most disadvantaged.”[22] Public health institutions should enact policies that address injustice. In doing so, public health institutions can seed the opportunity to build solidarity from the bottom up. Equipping individuals and communities with resources will foster cooperation and adherence to policies that require solidarity, such as masking and vaccination. This is consistent with arguments illustrating how institutions such as Tribal governments promote the conditions needed for their group, and especially its most vulnerable members, to flourish.[23] Addressing social determinants of health with a social justice lens will create the circumstances under which more individuals and groups can find common causes and foster solidarity. In the long run, such efforts may result in the establishment of values and practices from the bottom up. There are societal and public health preconditions required before institutions can expect their audience to act in solidarity with one another. Through their great influence over information and resources, public institutions do have the power to impact what values are most widespread. Furthermore, public health may foster trust and hope, which are important psychosocial factors that influence collective action,[24] if policies increase access to resources that promote well-being. Messaging efficacy also depends on the context of public trust, education, and whether the institutions meet one’s basic needs. Disparate messaging across different public institutions may confuse or disillusion individuals. To apply our theory of solidarity to the decision to vaccinate, a policy would be to foster conditions that facilitate access to vaccines and information about vaccine efficacy instead of imposing a top-down mandate without first eliciting public trust. IV. Counterargument Some argue that discordant public health messaging, ineffective government, and inadequate social programs can also bring people together under pressure and foster solidarity. One may argue that the most powerful motivators towards solidarity are strife and disparity, as evidenced throughout history. During the pandemic alone, political struggle and personal hardship inspired solidarity in the US, from individual neighbors helping each other to mutual aid groups forming across communities. We thus do not claim that solidarity is possible only when our government programs and public health institutions are most effective. We instead point out that solidarity can be further hindered when people feel alienated, hopeless, and pitted against each other. CONCLUSION Many competing conceptualizations of solidarity persist in the bioethics literature, and Prainsack and Buyx offer one compelling framework that public health ethicists continue to draw upon.[25] However, their framework fails to acknowledge how public health institutions impact interpersonal and group solidarity. Public health institutions can foster solidarity through actions other than mere messaging, invoking catchphrases like “we are all in this together.” Efforts to address socioeconomic preconditions and alleviate health disparities can cultivate group solidarity. As we saw during the pandemic, cooperation and solidarity go hand-in-hand with disease mitigation efforts; solidarity has clear intrinsic value.[26] As this relationship becomes more apparent, we will continue to see attempts from public health institutions to foster or invoke solidarity. Therefore, public health institutions would be remiss to ignore their role in addressing the social determinants of health. Adopting a social justice lens when planning public health interventions will clarify and strengthen their role in facilitating solidarity. Ultimately, if health disparities continue to persist or widen, it is very hard to imagine how group solidarity can ever be achieved. The widescale adoption of many public health measures needed to promote health and well-being would be conducive to solidarity. - Disclaimer: The opinions expressed are the authors’ and do not represent the views of the NIH, DHHS, or the U.S. government. Funding Disclosure: This work was supported in part by the Intramural Program of the National Institutes of Health Clinical Center. - [1] John J Mulvihill et al., “Ethical Issues of CRISPR Technology and Gene Editing through the Lens of Solidarity,” British Medical Bulletin 122 (2017): 17–29, https://doi.org/10.1093/bmb/ldx002; Ben Saunders, “Altruism or Solidarity? The Motives for Organ Donation and Two Proposals,” Bioethics 26, no. 7 (September 2012): 376–81, https://doi.org/10.1111/j.1467-8519.2012.01989.x; -Vanessa Y Hiratsuka, “SPECIAL REPORT: A Critical Moment in Bioethics: Reckoning with Anti-Black Racism through Intergenerational Dialogue A Call for Solidarity in Bioethics: Confronting Anti-Black Racism Together,” 2022, https://doi.org/10.1002/hast.1380. [2] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [3] Bob Simpson, “A ‘We’ Problem for Bioethics and the Social Sciences: A Response to Barbara Prainsack,” Science, Technology, & Human Values 43, no. 1 (January 12, 2018): 45–55, https://doi.org/10.1177/0162243917735899. [4] Barbara Prainsack and Alena Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics (London: Nuffield Council on Bioethics, 2011). [5] Barbara Prainsack and Alena Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach,” Bioethics 26, no. 7 (September 2012): 343–50, https://doi.org/10.1111/J.1467-8519.2012.01987.X. 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