Reporter must adapt after deep dive into STD disparities hits roadblock: Staff layoffs

When I set out to cover the subject of disparities in sexually transmitted diseases, my motivation was born out of frustration with the news coverage of record rates of gonorrhea, chlamydia and syphilis. Invariably, the annual publication of STD data by the U.S. Centers for Disease Control and Prevention would be followed by a chorus of headlines lamenting the historic highs. Few outlets elevated the voices and stories of individuals most affected by STDs.

As a former daily news reporter, I understood the deadline pressures these news outlets face. With the luxury of time afforded by the 2018 California Fellowship and the support of my senior fellow, I prepared to immerse myself in this under-explored world.

As veteran journalist Ted Conover, author of “Immersion: A Writer’s Guide to Going Deep,” observed in a 2016 interview with the Columbia Journalism Review, “Immersion tells the reader: This is no drive-by. I did more than get a quote. I lingered and I listened. I got to know them as multidimensional.”

I sought to explore a curable STD, but one with serious consequences: congenital syphilis. Congenital syphilis is passed in utero from mother to fetus. Left untreated, as many as 40 percent of congenital syphilis cases end in stillbirths.

I live near Los Angeles County, where cases of congenital syphilis rose 733 percent between 2012 and 2017, according to public health figures. As with many STDs, people of color bear a disproportionate burden. In 2017, black women and Latinas in Los Angeles County accounted for 84 percent of congenital syphilis cases.

My goal was to find one or more of these women and share what I’d hoped would be a rich, meaningful exploration of the complexities driving this epidemic. What role did health disparities play? How was the county helping these women and their surviving newborns? Was it enough?

In 2017, around 40 congenital syphilis cases were reported — in a county of 10 million. While my ideal source wasn’t one in a million, she was about one in a quarter-million. Perhaps I should’ve raised this question far sooner: Was my confidence in reaching one of these women misplaced?

As Conover acknowledged, “access is often the hardest for younger journalists — it can be a real challenge getting people to ‘let you in,’ particularly if you’re not on assignment from some recognizable news source and don’t yet have a track record.”

Still, I’d reported on the much-stigmatized world of abortion rights for nearly three years. I’d gained the trust of anti-abortion activists and pregnant people who’d had abortions. I remained confident I’d find the needle-in-the-haystack source.

Then I lost my job.

Laid off and suddenly without an income — and frankly a bit rudderless, too — I was forced to regroup. I no longer had spare hours to dial STD clinics, public health nurses, substance abuse counselors, and homeless advocates. Some had encountered women with congenital syphilis but feared connecting me due to patient privacy. I’d hoped to finally win their trust, but now I didn’t even have the name of a newsroom behind me.

If I couldn’t tell my dream story, what story could I tell? Through what outlet? And how quickly?

The story that was ultimately published in California Health Report looks at a novel program in Los Angeles County. The public health department hired veteran drug reps to sell local OB-GYNs on the notion of repeated syphilis testing during pregnancy. After this repurposed salesforce visited more than 400 doctors last summer, the number of third-trimester syphilis tests nearly doubled, according to a county survey. Catching syphilis at this stage is crucial to preventing transmission from moms to newborns.

My story also exposed the high cost of syphilis medicine, insurance that won’t cover the cheapest and fastest syphilis test, providers who aren’t quite sure when to test for syphilis, and vast health disparities that create a vicious cycle.

Through interviews with public health nurses, I explored why one-third of women with congenital syphilis had never received prenatal care. With substance abuse common in this population, a pregnant woman who’s trying to get clean may delay prenatal care for fear of being “hooked into the system,” county public health nurse Monica Munoz told me.

“So the fear of all of that makes a person not want to seek care,” said county associate medical director Shobita Rajagopalan. “And it’s a vicious cycle.”  

Here are a few takeaways from my experience:

Cultivate resilience: Newsrooms announced 11,878 job cuts in 2018 alone, the highest number in almost a decade. With even digital-first outlets like Buzzfeed shedding jobs, there’s likely no end in sight. You have no choice in this work climate but to become the doomsday prepper for your journalism career. Whether it’s a side hustle or plan B, you’ll weather setbacks better when you’ve prepared for the rough patches.

Keep pitching: Believe in yourself and your story. I pitched six national editors before my story found a home at a California outlet that focuses on health disparities. The questions I heard from editors along the way not only helped to reframe the piece, they also exposed reporting holes, which I addressed in subsequent pitches. As each week ticked by, I viewed my pitch with a more dispassionate eye. The distance freed me to beef up strong story elements and scrap weak ones.

Don’t let the perfect be the enemy of the good: At some point, you need to gather what you’ve reported — all those notebooks, transcripts, and Google docs — and piece together a story. It might not be the narrative you once were wedded to, but mine for gold in that mass of reporting. What can you explore that’s new? What underreported ideas can you illuminate? What forgotten reporting nuggets are inked on a page somewhere? Your discoveries may surprise you.