In telling stories on health disparities, three-dimensional stories prove key

Health stories typically focus on a single health condition or research area at a time, but as anyone who’s spent time trying to understand public health knows, health problems usually don’t occur in a sociological vacuum.

To explain community health issues honestly and accurately, journalists need to tell a community’s larger story and explain how myriad factors contribute to its overall health.

During the six months I worked on “Crossing To Health,” my 2015 National Fellowship series, I looked at the health disparities between two adjoining Kansas counties through the lens of health research, community history and the personal stories of the people who live there. 

While KCUR and other media outlets occasionally report on aspects of population health in Johnson and Wyandotte counties, mine was the first reporting that I’m aware of that tried to explain how the social determinants of health — the complex interaction of economics, education, race, history and culture — have led to such a wide variation in health outcomes between the two counties.

Making connections

At the outset, I knew I would have no trouble finding data. Information from the Robert Wood Johnson Foundation’s annual county health rankings, reports from the state health department and numerous health research groups were plentiful. However, I wanted to make sure the disparities in the numbers reflected the actual concerns of the communities.

Sadly, I found that many of the nonprofit health organizations and researchers were unaware of or unwilling to talk about matters they didn’t directly deal with. Many of them seemed surprisingly out of touch with the communities they claimed to serve and were loath to discuss community health with the level of directness I was seeking.

Seeking community members who were interested in talking about these issues, I attended health fairs, farmers’ markets, parks and church services. Wyandotte County, which has poorer health outcomes, has a reputation for being somewhat disconnected, so I was gratified to find many people who took great pride in the community and were working hard to improve it.

The county is often portrayed on TV as a violent, chaotic place, so I often found myself having to patiently explain myself, my station and my project before community members agreed to speak with me.

Many residents lead somewhat hectic lives, and my interviews were frequently delayed or cancelled. I learned early on that I needed to work hard at keeping the lines of communication open and maintaining the trust and interest of my sources.

Individual and community health problems often carry a stigma, and many subjects were reluctant to talk, concerned that they might damage their reputations or those of their families or communities.

But when I explained that one of the aims of the project was to explore how health disparities might be overcome, many of those concerns disappeared. Community members often had no problem discussing health issues in the context of finding solutions. After so much news coverage that had portrayed the community as hopeless or helpless, they were eager to contribute to coverage that was more positive and constructive.

Telling the story

Although I spoke with many local and national experts, few of those voices made it into the final product.

This was partly due to time constraints, but more to the point, I wanted the project to be about the communities themselves, not abstract academic research or theory. In a nutshell, it was important to me to make sure the stories sounded like and reflected life in those communities.

Few individuals and families living with grave health concerns like to think of themselves as victims. Often, however, they are portrayed that way, quoted only about their suffering and the harm they’ve experienced.

This turns people into one-dimensional characters. In my project, I sought to depict not just the struggles these people faced, but also their humor, their hope, their wisdom.

I took the same approach in my depiction of neighborhoods beset with social, economic and health problems, choosing to focus on residents who were proud of and hopeful for the places they called home.

Beyond content

In mid-January 2016, the series of five stories aired simultaneously on public radio stations and other news outlets throughout the state of Kansas. Locally, stories were the subject of three call-in talk shows on our station, a communitywide engagement session, video elements on the local PBS station and extensive social media promotion.

Several of the stories were picked up by national and regional health outlets, including Kaiser Health News and the public radio program Side Effects. One story was cited in an editorial in the Topeka Capital Journal on the need to address racial disparities in infant mortality.

Although many health experts working in Kansas would argue there’s a strong need for more publicly funded health programs in Wyandotte County, I did not expect my project to lead to state-level policy changes.

Kansas health experts have been strong and consistent in advocating for funding and help, but after huge tax cuts enacted in 2013, the state’s governor and legislature have generally opposed increasing funding for public health.

Rather, the project is more likely to help inform health foundations and other funders about the need to address local and regional health disparities and advance promising solutions.

Perhaps more important, I’m hopeful these issues will now be better understood by Kansas citizens, helping to inform their understanding of health issues when they pull the lever in the voting booth and interact with elected officials.

Read Alex Smith’s fellowship series here.