Tim Ken Mackey

University of California, San Diego | UCSD · Global Health Program - Department of Anthropology

Corruption has been described as a disease. When corruption infiltrates global health, it can be particularly devastating, threatening hard gained improvements in human and economic development, international security, and population health. Yet, the multifaceted and complex nature of global health corruption makes it extremely difficult to tackle,...

Three years have passed since the FDA announced that it had detected counterfeit versions of the injectable anticancer drug bevacizumab (Avastin®, Genentech, USA) in the US drug-supply chain. Following this discovery, almost 1,000 FDA warning letters were sent to physicians and medical practices in 48 different states and two US territories, as mor...

The World Health Organization now relies upon voluntary contributions tied to specific projects, underwriting 75% of operations. A resulting cacophony of non-governmental, foundation, and private sector actors have emerged overlapping and fractionating WHO programs. In this expanding world of "global health organizations," WHO's role must be redefi...

Counterfeit drugs are a global problem with significant and well-documented consequences for global health and patient safety, including drug resistance and patient deaths. This multibillion-dollar industry does not respect geopolitical borders, and threatens public health in both rich and resource-poor nations alike. The epidemiology of counterfeit...

No formal system exists to review trade restrictions imposed during international public health emergencies rapidly. Failure to put one in place creates disincentives for surveillance and reporting, thereby undermining protection efforts. The 2003 SARS outbreak exposed weaknesses in global governance that caused uncoordinated public health and econ...

Importance Cannabis-derived products (CDPs) are widely available and diverse. A classification of product and flavor types is necessary to establish a foundation for comparative research, although research aiming to classify cannabis in its variety of products, flavors, and cannabinoid compounds based on public online e-commerce data is lacking. O...

Background Explanations for why social media users propagate misinformation include failure of classical reasoning (over-reliance on intuitive heuristics), motivated reasoning (conforming to group opinion), and personality traits (e.g., narcissism). However, there is a lack of consensus on which explanation is most predictive of misinformation spre...

Background Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires furt...

Background During the COVID-19 pandemic, the rapid spread of misinformation on social media created significant public health challenges. Large language models (LLMs), pretrained on extensive textual data, have shown potential in detecting misinformation, but their performance can be influenced by factors such as prompt engineering (ie, modifying L...

Background Manually analyzing public health–related content from social media provides valuable insights into the beliefs, attitudes, and behaviors of individuals, shedding light on trends and patterns that can inform public understanding, policy decisions, targeted interventions, and communication strategies. Unfortunately, the time and effort nee...

This qualitative study assesses the quality, amount of active ingredient, and characteristics associated with counterfeiting of semaglutide purchased from illegal online pharmacies without a prescription.

BACKGROUND Recent reports of hospitalization associated with Diamond Shruumz products, a mushroom-containing product, has led to a manufacturer’s recall that restricts the sale, distribution, and accessibility of this new and emerging psychoactive product. This study sought to assess the continuing online availability of this product in a diverse e...

Objective: This study examines abortion-related discourse on Twitter (X) pre-and post-Dobbs v. Jackson ruling, which eliminated the constitutional right to abortion. Study design: We used a custom data collection tool to collect tweets directly from Twitter using abortion-related keywords. We used the BERTopic language model and examined the top...

BACKGROUND During the COVID-19 pandemic, the rapid spread of misinformation on social media created significant public health challenges. Large language models (LLMs), pretrained on extensive textual data, have shown potential in detecting misinformation, but their performance can be influenced by factors such as prompt engineering (ie, modifying L...

BACKGROUND Manually analyzing public health-related content from social media provides valuable insights into beliefs, attitudes, and behaviors of individuals, shedding light on trends and patterns that can inform public understanding, policy decisions, targeted interventions, and communication strategies. Unfortunately, the time and effort needed...

Background Many clinical trials fail because of poor recruitment and enrollment which can directly impact the success of biomedical and clinical research outcomes. Options to leverage digital technology for improving clinical trial management are expansive, with potential benefits for improving access to clinical trials, encouraging trial diversity...

Background: The online pharmacy market is growing, with legitimate online pharmacies offering advantages such as convenience and accessibility. However, this increased demand has attracted malicious actors into this space, leading to the proliferation of illegal vendors that use deceptive techniques to rank higher in search results and pose serious...

BACKGROUND Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires furt...

Background: Illicit substance sales facilitated by social media platforms are a growing public health issue given recent increases in overdose deaths, including an alarming rise in cases of fentanyl poisoning. However, little is known about how online users evaluate what features of social media posts convey safety, which can influence their intent...

Background E-cigarettes have emerged as popular products, especially for younger populations. However, concerns regarding health effects exist and there is a notable gap in understanding the prevalence and nature of adverse events. This study aims to examine the rate of adverse events in individuals who use e-cigarettes in a large sample. Methods...

The spread of misinformation and conspiracies has been an ongoing issue since the early stages of the internet era, resulting in the emergence of the field of infodemiology (i.e., information epidemiology), which investigates the transmission of health-related information. Due to the high volume of online misinformation in recent years, there is a...

Introduction Unregulated and potentially illegal sales of tobacco, nicotine, and cannabis- products have been detected on various social media platforms, e-commerce sites, online retailers, and the dark web. New end-to-end encrypted messaging services are popular among online users and present opportunities for marketing, trading, and selling of th...

Introduction Throughout the COVID-19 pandemic, underserved populations, such as racial and ethnic minorities, were disproportionately impacted by illness, hospitalization, and death. Equity in clinical trials means that the participants in clinical trials represent the people who are most likely to have the health condition and need the treatment t...

Background Despite pediatric populations representing a smaller proportion of COVID-19 cases and having a less severe prognosis, those belonging to racial and ethnic minority groups are at an increased risk of developing more severe COVID-19–related outcomes. Vaccine coverage is crucial to pandemic mitigation efforts, yet since the start of the COV...

Introduction There has been a rapid proliferation of synthetic nicotine products in recent years, despite newly established regulatory authority and limited research into its health risks. Previous research has implicated social media platforms as an avenue for nicotine product unregulated sales. Yet, little is known about synthetic nicotine produc...

Background Governments are passing laws to restrict the sale of flavoured tobacco products (FTPs), but retailer compliance with such policies may vary. This study compared tobacco retailer compliance with local ordinances restricting the sale of FTPs across various localities in Southern California. Methods Attempts to purchase FTPs from a random...

Background The online pharmacy market is growing, with legitimate online pharmacies offering advantages such as convenience and accessibility. However, this increased demand has attracted malicious actors into this space, leading to the proliferation of illegal vendors that use deceptive techniques to rank higher in search results and pose serious...

BACKGROUND The online pharmacy market is growing, with legitimate online pharmacies offering advantages such as convenience and accessibility. However, this increased demand has attracted malicious actors into this space, leading to the proliferation of illegal vendors that use deceptive techniques to rank higher in search results and pose serious...

This study characterizes online marketing of unauthorized electronic nicotine delivery systems (ENDS).

Introduction In 2019, the state of Massachusetts signed into law the first statewide sales restrictions of flavored ENDS/tobacco products for both physical and online shops in response to a previous executive order to curb E-Cigarette, or Vaping Product, Use Associated Lung Injury (EVALI) cases that were surging throughout the nation. Methodology...

Background: Cancer patients often face multiple comorbidities and are at risk for various mental health conditions and substance use disorders. Tobacco/nicotine dependence (TND) is a known risk factor for poor health outcomes and has been associated with psychiatric disorders including substance use disorder. However, the specific relationship betw...

In 2019, the U.S. Food and Drug Administration (FDA) approved emtricitabine and tenofovir alafenamide (Descovy) as another option for HIV pre-exposure prophylaxis (PrEP) prevention for high-risk adults and adolescents. With the introduction of this new PrEP, millions of current users on emtricitabine and tenofovir disoproxil fumarate (Truvada), ano...

Background: An infodemic is excess information, including false or misleading information, that spreads in digital and physical environments during a public health emergency. The COVID-19 pandemic has been accompanied by an unprecedented global infodemic that has led to confusion about the benefits of medical and public health interventions, with s...

Public trust in medical institutions is essential for ensuring compliance with medical directives. However, the politicization of public health issues and the polarized nature of major news outlets suggest that partisanship and news consumption habits can influence medical trust. This study employed a survey with 858 participants and used regressio...

Introduction: The debate over the legal status of many cannabis- and hemp-derived products, including delta-8 tetrahydrocannabinol (THC), is in question. Although low concentrations of delta-8 THC are legal at the Federal level, many states have implemented their own regulations to both allow and restrict its use and sale. Of concern, sellers with...

Background Social media has emerged as a critical mass communication tool, with both health information and misinformation now spread widely on the web. Prior to the COVID-19 pandemic, some public figures promulgated anti-vaccine attitudes, which spread widely on social media platforms. Although anti-vaccine sentiment has pervaded social media thro...

Here we present a blockchain-backed token recognition system to reward the contributions that academics make to the scientific ecosystem. Recognition is important in science but current methods, systems and incentives are limited. Specifically, the traditional focus on narrow publication metrics means diverse contributions are not captured, while b...

Introduction: The state of California has enacted progressive anti-tobacco policies, including Proposition 56 in 2016. In response, the alternative and emerging tobacco product (ATP) industry has increased its political activity. This study explores the association between the proportion of people voting against Proposition 56 and tobacco/ATP reta...

Background The opioid epidemic has had a devastating impact on youth from American Indian and Alaska Native (AI/AN) Tribes and Villages, which also experience disparate suicide rates. The use of publicly available social media data originating from AI/AN communities may enhance public health response time to substance use disorder (SUD)-related ove...

This study seeks to identify and characterize key barriers associated with PrEP therapy as self-reported by users on social media platforms. We used data mining and unsupervised machine learning approaches to collect and analyze COVID-19 and PrEP-related posts from three social media platforms including Twitter, Reddit, and Instagram. Predominant t...

Background Access to tobacco products, including vape products, from local brick-and-mortar stores influences the exposure, uptake, and use of these products in local communities. Methods Licensed tobacco retailers in California were classified as specialized tobacco/vape stores or non-specialized stores by obtaining categories published on Yelp....

BACKGROUND An infodemic is an excess of information of varying quality, including false or misleading information and/or ambiguous information, that spreads in digital and physical environments during a public health emergency. The COVID-19 pandemic has been accompanied by an unprecedented global infodemic that has led to confusion about the benefi...

Background An infodemic is excess information, including false or misleading information, that spreads in digital and physical environments during a public health emergency. The COVID-19 pandemic has been accompanied by an unprecedented global infodemic that has led to confusion about the benefits of medical and public health interventions, with su...

Introduction Throughout the COVID-19 pandemic underserved populations, such as racial and ethnic minorities, were disproportionately impacted by illness, hospitalization, and death. Equity in clinical trials means that the participants in clinical trials represent the people who are most likely to have the health condition and need the treatment th...

The effects of COVID-19 on tobacco use and cannabis has been variable, and it is unclear the extent to which factors affecting changes in tobacco and cannabis use differ. The purpose of this study was to identify the COVID-19-related factors that affect changes in tobacco and cannabis use during the pandemic. Focus groups with 114 young adults in C...

Introduction: Tobacco retailer density may be associated with greater youth initiation and reduced success during quit attempts; however, the extent to which tobacco retailer density has changed overtime across multiple categories of retailers has not been reported. Methods: Data on licensed tobacco retailers within California from 2015-2019 wer...

Introduction: Previous studies have identified numerous adverse events experienced with use of electronic nicotine delivery systems (ENDS), or e-cigarettes. Much remains unknown, however, about adverse event frequency, duration, and response experienced by users. The purpose of this study was to inductively characterize ENDS-attributed adverse even...

A case-control study was conducted between 12/01/2021–01/31/2022 to identify factors which increase risk for COVID-19 among athletes in the National Basketball Association (NBA). Behavioral factors and stadium attendance significantly decreased time to COVID-19 infection, but local COVID-19 rates were not associated in a multivariable model.

Social media has been documented as widely used for initiating online sales of illicit drugs such as opioids. However, not much is known about how affordances of social networking sites (SNS) influence how dealers advertise their supplies. To explore this topic, social media posts across 5 online platforms (Google Groups, Instagram, Twitter, Reddit...

Background: There was an estimated 100,306 drug overdose deaths between April 2020 and April 2021, a three-quarters increase from the prior 12-month period. There is an approximate six-month reporting lag for provisional counts of drug overdose deaths from the National Vital Statistics System, and the highest level of geospatial resolution is at t...

Background Antimicrobial resistance is a significant global public health threat. However, the impact of sourcing potentially substandard and falsified antibiotics via the internet remains understudied, particularly in the context of access to and quality of common antibiotics. In response, this study conducted a multifactor quality and safety anal...

Electronic nicotine delivery systems (ENDS) are the most used tobacco products among middle and high schoolers in the United States (U.S.). Familial relations and access play a major role in uptake among adolescents; yet the role of social media in this phenomenon in the context of communities impacted by tobacco-related health disparities is under...

Technological advances have enabled the rapid generation of health and genomic data, though rarely do these technologies account for the values and priorities of marginalized communities. In this commentary, we conceptualize a blockchain genomics data framework built out of the concept of Indigenous Data Sovereignty.

BACKGROUND Social media has emerged as a critical mass communication tool, with both health information and misinformation now spread widely on the web. Prior to the COVID-19 pandemic, some public figures promulgated anti-vaccine attitudes, which spread widely on social media platforms. Although anti-vaccine sentiment has pervaded social media thro...

Introduction: The urgent need to acquire medical supplies amidst the COVID-19 pandemic has led to bypassing of controls that govern the global pharmaceutical supply chain, increasing the risk of corruption. Hence, promoting anti-corruption, transparency, and accountability (ACTA) in supply chain and procurement has never been more important. The a...

Introduction: Though university smoke-free and tobacco-free campus policies have been proliferating across the US, compliance and enforcement remain challenges. This study examined perceptions and behaviors of employees and students who used tobacco products on tobacco-free campuses, to better understand policy non-compliance. Methods: Students...

Background TikTok is a microvideo social media platform currently experiencing rapid growth and with 60% of its monthly users between the ages of 16 and 24 years. Increased exposure to e-cigarette content on social media may influence patterns of use, including the risk of overconsumption and possible nicotine poisoning, when users engage in trendi...

Introduction Exposure to pro-tobacco and electronic nicotine delivery system (ENDS) social media content can lead to overconsumption, increasing the likelihood of nicotine poisoning. This study aims to examine trends and characteristics of nicotine sickness content on Twitter between 2018–2020. Methods Tweets were collected retrospectively from th...

BACKGROUND Synthetic cannabinoids are a significant public health concern, especially among incarcerated populations due to increased reports of abuse. Recent news reports have highlighted the severe consequence of K2/Spice, a synthetic cannabinoid, on the prison population in the United States. Despite regulations against cell phone use, inmates u...

Background Synthetic cannabinoids are a significant public health concern, especially among incarcerated populations due to increased reports of abuse. Recent news reports have highlighted the severe consequences of K2/Spice, a synthetic cannabinoid, among the prison population in the United States. Despite regulations against cell phone use, inmat...

Simultaneous expansion of the Internet and increased globalisation of the pharmaceutical industry have meant medication can be accessed transnationally from both legal and illicit sources. This has coincided with the rise of substandard and falsified medicines (SFMs) online. These products fail to meet regulatory or quality standards and/or are con...

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Background Health advice in the wake of the COVID-19 pandemic has called upon the public to re-evaluate risk associated with recently routine behavior. However, differences in demographics, situational circumstances, and psychological dispositions create inequities in how people are able to respond to risks presented by the virus. Method Within a...

Smoke- and tobacco-free university polices have been expanding throughout the United States. In spite of the benefits of such policies, policy compliance remains a challenge. A better understanding of campus community enforcement approaches is needed to inform future policy implementation to bring about greater adherence to university smoke- and to...

Various tobacco vendors, including alternative tobacco product sellers, are listed on the popular crowdsourced business listing platform Yelp. Yelp is used to rate and choose tobacco, electronic nicotine delivery systems (ENDS) goods/services and includes self-reporting of user experiences with shops and products. We cross-referenced California Dep...

Objective: We sought to determine school and community characteristics associated with proximity to tobacco and ENDS storefronts within a 0.5-kilometer radius in California. Methods: A list of licensed tobacco retailers was obtained from the California Department of Tax and Fee Administration; retailer names and addresses were used to scrape Yelp i...

BACKGROUND Among racial and ethnic minority groups, the risk of HIV infection is an ongoing public health challenge. PrEP (pre-exposure prophylaxis) is highly effective for preventing HIV when taken as prescribed. However, there is a need to understand experiences, attitudes, and barriers of PrEP for racial and ethnic minority populations, and sexu...

Background Among racial and ethnic minority groups, the risk of HIV infection is an ongoing public health challenge. Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV when taken as prescribed. However, there is a need to understand the experiences, attitudes, and barriers of PrEP for racial and ethnic minority populations and s...

Background Increased public health and regulatory scrutiny concerning the youth vaping epidemic has led to greater attention to promotion and sales of vaping products on social media platforms. Objectives We used unsupervised machine learning to identify and characterise sale offers of electronic nicotine delivery systems (ENDS) and associated pro...

Objective The objective of this study was to develop an inductive coding approach specific to characterizing user-generated social media conversations about transition of use of different tobacco and alternative and emerging tobacco products (ATPs). Results A total of 40,206 tweets were collected from the Twitter public API stream that were geocod...