As I take on my new role at NICHQ as leader of a national initiative to reduce infant mortality, I find myself in a struggle very familiar to those of us in public health who focus on promoting the health and wellbeing of entire communities – that is, how to maintain the public’s engagement and interest in the health priorities we are championing. Given the many priorities and important issues that are competing for our collective attention, it is easy to understand how policy makers and the public become numbed to the recurrent “calls to action” and the exhortations to pay more attention to: domestic violence, bullying and teen suicides, opiate addiction, gun violence, breast cancer, diabetes, obesity, prematurity and infant mortality…and the list goes on. All of these issues are incredibly important and for those families and communities who are touched by them, each leaves a lasting legacy of sorrow and lost potential. If all of these causes (and more) are worthwhile, how do we make gains on any when the initial response might be to lament that we can’t do everything?
When faced with seemingly overwhelming challenges, humans can be very effective at partitioning the huge into the feasible. The first step is maintaining our faith that our efforts, when thoughtfully and creatively applied, can actually change outcomes. Once we have that confidence, then we need to gain the attention of our communities and key stakeholders whose insights and collaboration are required for our efforts to be successful. How do we break through the cacophony of dire statistics and grave warnings about so many “epidemics”?
I believe we need to adjust our language, not to substitute our appropriate reliance on data with sensationalized attention grabbing headlines, but rather to make the problem more concrete for those who don’t confront it every day.
Infant mortality is a good case in point. The US rate of 6 deaths per 1,000 live births doesn’t really have much tangible meaning to the general public. In fact, if anything, six seems like a pretty small number. But what about 24,586? That is the number of US infants who died before their first birthday in 2010. This is the equivalent of about 1,000 kindergarten classrooms of children that will never be filled. Recognizing that not all infant mortality is preventable, the question then becomes not what do we do with the number six, but how many of those kindergarten classrooms can we commit to filling with children who are healthy, happy and ready to learn. Suddenly the problem and the motivation to fix it become more real. For a state with an infant mortality rate of 9.7 per 1,000, a 20 percent decline to 7.7 would be incredibly impressive in the world of public health. But realistically, how many people will really be excited by a change from 9.7 to 7.7? For most, that hardly seems like a change at all. Yawn – turn the page, flip the channel and move on. But if we were to say that this equates to saving three entire classrooms of future kindergarteners, it might pique more interest. People can visualize a classroom of giggling kindergarteners, while describing a change from 9.7 to 7.7 has none of the same power to evoke our basic human desire to protect our offspring.
Thinking of our social “epidemics” in this way changes the discussion from statistics to people, from counting to compassion. It will help the public better understand the issue, commit to solutions, and recognize and applaud successes – and, most importantly, support more efforts to save the next classroom of children and the next.