As you most likely know, infant mortality is and has been a very real and pressing issue for Milwaukee, particularly in comparison to the rest of the state and the country. UWSMPH and the Wisconsin Partnership Program have initiated a three city initiative, gathering the human capital of our communities and putting resources into the planning of strategic plans to systematically address the issue and funding to implement the plans. The Milwaukee Journal Sentinel has also taken on the issue this year and will be providing in-depth coverage of the various risk and protective factors.
The challenge I pose here for discussion is to identify a statistic, comparison or some way to relate this issue or some angle of the issue to the Milwaukee residents- who may not be directly affected. If we want to make significant change in our community around infant mortality or any public health issue, we will need to start shifting the conversations towards addressing the social determinants of health and systems or environmental issues that either support or place barriers on the behavior change we seek in public health. Is there some way to bring the issue or the social determinants of health into our everyday life?
Let me share an example from authors of the book Made to Stick: Why Some Ideas Survive and Others Die, Dan and Chip Health. I think their example provides a nice narrative model for how to bring the enormity of data to an understandable and impactful level….
“It's possible to create intuition without losing shock value. In the film Super Size Me, documentarian Morgan Spurlock mentions a media campaign that encourages kids to eat five fruits and vegetables per day. Its ad budget is $2 million. Meanwhile, McDonald's annual ad budget for the United States is around $750 million. That's a ratio of 375 to 1. That may help explain why your daughter is more likely to beg for a Happy Meal than a fruit salad.
Spurlock could have gone one step further. His ratio is good -- better than millions and billions -- but we still haven't pulled it inside the frame of daily life. So suppose your 5-year-old daughter watches three hours of cartoons every Saturday morning and sees two McDonald's commercials per hour. Every Saturday, then, Ronald McDonald engages her six times.
How long will it be before your daughter sees a fruits-and-veggies commercial? She'd wait about 14 months to see the first one, and she'd have a driver's license before she saw 10 of them (the same number of McDonald's ads she'd see in two Saturdays).
A good statistic is one that aids a decision or shapes an opinion. For a stat to do either of those, it must be dragged within the everyday. That's your job -- to do the dragging. In our world of billions and trillions, that can be a lot of manual labor. But it's worth it: A number people can grasp is a number that can make a difference.”
Now you have the idea, can we work together to come up with one or more examples of a good statistic that can shape opinion and make a difference in Milwaukee?
Share your ideas and thoughts here. If you want to share your views but don’t want to post here, please email wipopulationhealthfellows@gmail.com.
Read more for background or details about the issues facing Milwaukee as they relate to Infant Mortality.
-David Frazer, MPHCenter for Urban Popuation Health
David, Thanks for the provocative question.
ReplyDeleteSome of the Fellows have been working on a related question - how to encourage news stories that provide a contextual, rather than episodic picture of public health issues. I won't ignore your question about how to make the numbers of infant deaths more tangible, but, in the case of infant mortality, I wonder if providing a real picture of the lived experience among African Americans in Milwaukee might be more meaningful. For example, stress related to racism has been discussed in the literature on disparities in birth outcomes. What is the every day lived experience of cumulative exposures to racism for African American women in Milwaukee and their families? Camara Jones and colleagues have discussed the importance of measuring this in birth outcomes studies (e.g., MATERNAL AND CHILD HEALTH JOURNAL
Volume 13, Number 1, 29-39, DOI: 10.1007/s10995-008-0357-x
“It’s The Skin You’re In”: African-American Women Talk About Their Experiences of Racism. An Exploratory Study to Develop Measures of Racism for Birth Outcome Studies
Amani Nuru-Jeter, Tyan Parker Dominguez, Wizdom Powell Hammond, Janxin Leu, Marilyn Skaff, Susan Egerter, Camara P. Jones and Paula Braveman). There have been focus groups also conducted in WI that might have really important information to highlight (through the UW Lifecourse Initiative). What about describing the lived context of racism induced stress, lack of access to jobs, decent housing, childcare, healthcare, green space - all the things that add up over the lifecourse as Lu and colleagues point out? Perhaps the MJS series is doing this to some degree?
In terms of your numbers/statistics question - to make either absolute or relative numbers (and the disparities across groups) more tangible, what about using a visual image - e.g., families sitting on porches - how many children would be missing/lost from the picture....
just some initial thoughts...
Marion