Why it’s so essential to find real people for your health policy stories

Let’s face it: News stories about health care policy can get dry, boring and have eyes glazing over in no time. Often missing from these well-written articles that typically do a good job of explaining policy and legislation are real people and real stories of hardship, turmoil and often, heartbreak. 

Lack of access to health care is a real issue for millions in California. And many of these people are working Californians, often immigrants, sometimes undocumented. So, when I embarked on the USC Center for Health Journalism News Collaborative project with health journalists from across the state, I was determined to find the stories of real Californians whose voices don’t often get heard.

The ‘fear factor’

However, what I learned very quickly as I started working on my stories, is that getting people to talk about their health challenges and their troubles when it comes to accessing health care can be extremely difficult. First, there is the “fear factor,” a lot of which can be attributed to the Trump Administration’s public charge rule, which could deny green cards to immigrants who use social services such as food stamps, cash assistance, or public housing. There is widespread fear, particularly in immigrant communities, that they could be deported or denied a green card because they are using social services.

When I went into the Korean American community to speak with undocumented individuals who go to federally qualified health centers to meet their health care needs, I struggled to find one patient who was willing to speak with me. Language was a barrier when it came to convincing potential interview subjects about the goal of the story or my intentions. And it was difficult to convey through a translator. 

I was fortunate to eventually find Steve Kang, a visitor to the Kheir Clinic in Los Angeles’s Koreatown, who not only agreed to talk with me, but also gave me permission to use his name. Kang is undocumented and has never had health care since he came to the United States 15 years ago. He heard about the Kheir Clinic a few years ago and has since been coming in to treat his high cholesterol and eye problems. Kang, however, refused to be photographed.

Working on this story gave me a clear view of the unique challenges undocumented Koreans face when it comes to accessing health care. One woman, also undocumented, did not treat her breast cancer for four years because she didn’t know English and had trouble getting help. She was saved by the Korean Community Services clinic in Buena Park, which connected her to the services she needed. But not before the cancer almost killed her. Ellen Ahn, the clinic’s executive director, says this is a tragic yet common storyline in the many cases she sees on a regular basis.

Marginalized communities

This project also gave me the opportunity to go into communities that face the worst kind of challenges when it comes to accessing health care services. The transgender community in Southern California, which has a large number of undocumented individuals, is an example of such a community that suffers in silence.

I spoke with a number of transgender women who had fled their native countries (Mexico and Central American nations) because of hate and prejudice. They came to the United States because they believed they could live here without fearing for their lives. But it hasn’t worked out that way. 

The transgender women I interviewed had to get their health care services through federally qualified health centers as well. They were able to get hormones at reduced prices without insurance and on a sliding scale. But, some of them said, the Trump administration’s public charge rule has scared them and that they’ve resorted to buying hormones and drugs off the street, which had had serious, sometimes, fatal side effects.

Getting the voices of these women helped highlight the unique challenges faced by transgender people. Hormonal therapies for gender transitions could run thousands of dollars. Laser hair removal, an important part of the transition, can be even more expensive. In addition, the need for mental health and therapeutic services tends to be particularly high in the transgender community, given the emotional issues and social stigmas they routinely encounter.

Finding stories of hope

Some stories were more hopeful than others, particularly the work of a community clinic in Santa Ana that is providing alternative treatments and preventive care to the underserved Latino community in the area. Community members benefit from acupuncture clinics, reiki (spiritual healing) sessions and group classes that teach participants about healthy eating, exercise and healthy lifestyles. 

These classes even go shopping together at local supermarkets. The clinic has built a kitchen where chefs are invited to give healthy cooking demos. Those who participate can take the food they cook with them. About 20% of people who come to this clinic are undocumented and uninsured and a larger percentage is on Medi-Cal. 

The power of personal stories

While anecdotes and personal stories may be challenging to obtain because of people’s doubts and apprehensions, they are certainly worth pursuing, especially with projects such as this, where stories can help clarify the policy issues and paint a picture for readers. Here are a few lessons I learned as I tried to get these stories from the field:

• Be honest about the purpose of the story and the angle you want to take. I found that sharing some of my thoughts about how I plan to write the story put my subjects at ease. They were able to see that my mind was open and I wasn’t there to vilify them or portray them as victims.

• Make your subjects feel as comfortable as possible. Being an immigrant myself, I was able to identify with some of their experiences, although mine were nowhere near as challenging or traumatic as theirs. But, as I shared some of my struggles with the immigration process, they got more comfortable about sharing their struggles with me. One of them even said she felt at ease because she believed I could relate to her life experience.

• Make sure they understand that a story published with their name and photograph may have repercussions. I let my subjects know in no uncertain terms that their story would run statewide and could very well attract attention. Some heard that passed on the opportunity to speak with me, fearing deportation. I did not worry about it because I did not want any of my subjects to, for example, face the threat of deportation and be caught off guard because they didn’t know the scope of this article and where it would appear. I have deep admiration for my sources who took this risk despite their vulnerable immigration status. It’s because they felt so strongly about the issue of health care access.

Above all, I’ve come away with a deeper understanding of health care policy — especially as it relates to the uninsured in California — because I had a chance to talk to these folks who are living it every day of their lives. As a reporter, you tend to be most grateful for those times when you are graciously allowed into people’s lives. That’s a level of trust and responsibility I do not take lightly.