How storytelling can help public health officials combat distrust, skepticism

Since the COVID-19 pandemic began, public health experts and scientists have struggled to get some segments of the public to heed their warnings about the importance of following public health measures aimed at controlling the spread of the virus.

Lise Saffran, an associate teaching professor at the MU School of Health Professions, studies public health and earned a master's degree in fine arts and creative writing from the University of Iowa Writer's Workshop. In a recently published commentary titled "Public health storytelling practice," she explains how storytelling can help public health officials resonate key messages with their intended audiences. Below are her comments:

Stories are more than just numbers

As scientists and public health officials, we need to first understand we are telling a story when we are speaking to the public, whether we realize it or not. We tend to just relay data, but we cannot just assume the data speaks for itself.

One powerful tool is metaphors. In the context of tracking the spread of COVID-19, an example could be thinking of case numbers being monitored in specific regions not as "Big Brother" watching over us, but rather as a smoke alarm. We may not always smell the smoke, but we need to know when there is smoke circulating nearby so we can help protect ourselves and others.

Another example could be when public health officials relay trends about COVID-19 case numbers to the public. Instead of simply stating that case numbers remained fairly steady one week and sharply rose the next week, an effective metaphor could be describing a sink that has water dripping slowly from a faucet one week and quickly overflooding the next week.

Employing that empathetic creativity and imagination helps our stories become more memorable and less abstract.

'Flat' characters versus 'round' characters

It can be tempting to label those who sometimes fail to comply with public health measures as simply selfish or evil individuals who just don't care, but effective storytelling requires putting aside assumptions and trying to understand why complex, multi-faceted human beings are making certain choices in a particular context.

For example, college students across the country were naturally excited to socialize with friends after coming back to campus during the fall semester of 2020 after their spring semester was halted abruptly by the onset of the COVID-19 pandemic. Some chose to socialize outdoors given the evidence that the coronavirus tends to spread more easily indoors, but in the cold wintertime, that outdoor socialization proved to be difficult. To help address these concerns, Northeastern University, for example, installed dozens of outdoor firepits and propane heaters.

Rather than simply labeling college students who choose to socialize during a pandemic as reckless and unsympathetic, remember that socialization is particularly important for the mental health and development of young adults.

Telling a more complete story not only highlights the complexities of an issue at hand, it also can lead to strategies to address the issue, as shown by the outdoor firepits at Northeastern University. In a TedTalk titled "The danger of a single story," Chimamanda Adichie said, "The single story creates stereotypes, and the problem with stereotypes is not that they are untrue, but that they are incomplete, they make one story become the only story."

Social determinants of health

Finally, it is crucial to take a step back and recognize that social and structural determinants of health, such as education levels and socioeconomic status, influence behavior far more than individual choices. As Americans, we tend to think of ourselves as individuals making individual choices, but research shows a person's behavior varies widely depending on the context that person is in.

This applies to all aspects of public health, not just COVID-19. Before telling someone to stop smoking cigarettes, it would be wise to consider the stresses that person might be under at work, school or home that is causing the urge to smoke in the first place. Rather than telling someone to exercise more, consider if the person lives in a neighborhood with sidewalks available to exercise on. Empathy goes a long way when considering the circumstances disadvantaged people find themselves in, often by no fault of their own.