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Interdisciplinary Approach to Improve Representation of Most Vulnerable Communities

Published onDec 10, 2020
Interdisciplinary Approach to Improve Representation of Most Vulnerable Communities

Uncertainty has been a key part of laypeople’s experience with the COVID-19 pandemic in the United States. While there are aspects of the 2020 COVID-19 pandemic that are particular, the approach to the pandemic through established practices in epidemiology resemble previous pandemics.  Namely, how experts quantify and represent data in 2020 resembles the approach that characterizes approaches used for Influenza, AIDS, and Ebola.


Modern epidemiology is thus oriented to explaining and quantifying the   bobbing of corks on the surface waters, while largely disregarding the stronger undercurrents that determine where, on average, the cluster of corks ends up along the shoreline of risk.”

- Anthony J. McMichael, The Health of Persons, Populations, and Planets: Epidemiology Comes Full Circle

In other words, the prominence of a small collection of statistics used for monitoring disease, especially in reporting to the public, has limitations.  A person’s experience of a pandemic is complex and involves personal risk calculations, economic and health concerns for self and others, as well as emotional and physical contingencies related to a person’s overall sense of well-being and safety.  This experience is not represented by national or statewide death counts, case rates, test positivity rates, and hospital bed capacity.  Because of this disconnect between the figures reported and the lives people live, uncertainty is a rule and not an exception. 

Even though COVID-19 dashboards make certain statistics prominent, and crucially, they make graphics based on those statistics a regular part of many people’s lives, these websites do not represent a comprehensive perspective on the pandemic.  In fact,  communities that have the greatest susceptibility to infection and death (minority/low-income/tribal nations) can disappear in a wash of graphics aimed at summary over comprehension, justice, or risk calculation. 

An unintended consequence is an under-representation of these communities while  providing the appearance of thorough reporting., and disregard for inequalities faced long before the pandemic that plans of actions to contain further spread of this virus have failed. This is due to these communities being predisposed to not having access to equitable healthcare. Whether that be due to lack of insurance resulting from low-income or unemployment, thus long wait times if seen at all, long distances to hospitals with needed resources, among other socio-economic factors which amplified casualties among these communities.


Factors including:

 

  •  Lack of access to clean water at home which limits the ability to wash one’s hands 

  • Housing conditions, which are overcrowded or outdated, thus, prevent proper social distancing when one member of the household is infected (contributing to community spread)

  • Food deserts lead those who could be safe, to unwillingly expose themselves to large numbers of people who could be carrying the virus due to having to travel to nearby cities for daily needs

  • Access to facemasks if in isolated locations

  • Not everyone has a computer/internet/TV at home to rely on situation updates

  •  Absence of updates on the public health situation in a language that a vulnerable community fully comprehends (e.g., tribal languages)

 

For the most part, these factors would be thought of to be nonexistent in a developed country such as the United States; however, that is further from the truth. The thought of these factors being nonexistent in the U.S. is derived from a sense of parochialism, meaning one is expressing narrow-mindedness of one’s situation, culture, community, country, especially in an individualistic society. 

Therefore, it is clear that in the face of public health problems such as COVID-19, a mere depiction of general stats has no true impact or guidance toward what can be done to contain the situation. Since general stats lack a deeper connection to additional sources of information and an understanding of how to properly approach the problem with plans of action that are modified based on a community’s need rather than a one size fits all plan. It is thereby vital that that information and visuals presented change their approach from illustrating a situation of faceless victims to identifiable ones. Meaning there is a greater emphasis in identifying vulnerable communities that require the greatest assistance to protect and care for themselves and their families. 

 

This ‘identifiable victim effect’ leads to ‘the rule of rescue’: we will spend far more to rescue an identifiable victim than we will to save a statistical life.”


    - Peter Singer, The Life You Can Save

With today’s advanced technologies, one can accomplish marvelous things, yet, they are still tools that provide outputs based on what data a human provides and its management. Thus, if data used is not a true reflection of the population, situation, or region, then the outcome will be a source that is unreliable for experts and provides a sense of confusion for the untrained eye. As such, it is ever more critical that those with access to data, expertise, and funding create visualizations that can be clear and transparent. Not only to those who can take action but also to the general public who needs to be aware of their surrounding situation and how to proceed with safety measures that aid with containment collectively.

It is also vital that media outlets conduct thorough investigations and adequately publish updates and narratives that are honest and unbiased. Doing so allows the general public to be informed, reason through what governments are portraying, and be positively inclined to comply with actions needed to flatten the curve.

 

Ironically, perhaps, it is technology that will redeem medicine and the healing arts. But technology, as we have seen needs social medicine and other disciplines that might resist the seemingly ineluctable pull of inequality.”

 

- Paul Farmer, Infections and Inequalities: The Modern Plagues


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