Attention capitalism has generated design processes and product development decisions that prioritize platform growth over all other considerations. To the extent limits have been placed on these incentives, interventions have primarily taken the form of content moderation. While moderation is important for what we call "acute harms," societal-scale harms -- such as negative effects on mental health and social trust -- require new forms of institutional transparency and scientific investigation, which we group under the term accountability infrastructure. This is not a new problem. In fact, there are many conceptual lessons and implementation approaches for accountability infrastructure within the history of public health. After reviewing these insights, we reinterpret the societal harms generated by technology platforms through reference to public health. To that end, we present a novel mechanism design framework and practical measurement methods for that framework. The proposed approach is iterative and built into the product design process, and is applicable for both internally-motivated (i.e. self regulation by companies) and externally-motivated (i.e. government regulation) interventions for a range of societal problems, including mental health. We aim to help shape a research agenda of principles for the design of mechanisms around problem areas on which there is broad consensus and a firm base of support. We offer constructive examples and discussion of potential implementation methods related to these topics, as well as several new data illustrations for potential effects of exposure to online content.
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