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The Holes in Our Maps: Making Health Needs Visible

The Holes in Our Maps: Making Health Needs Visible

  • An Allegory for Navigating Public Health Interventions

In a quaint little town nestled amidst rolling hills, there lived a young adventurer named Mahia. She possessed a curious spirit and an insatiable thirst for knowledge. One day, her grandfather bestowed upon her a weathered and dusty map—an heirloom passed down through generations.

With anticipation dancing in her eyes, Mahia unfurled the aged parchment. To her dismay, she discovered the map had numerous holes, rendering portions illegible or damaged beyond repair. She could still discern the major landmarks and roads, but vital details were missing, leaving her to rely on guesswork and intuition to navigate the unknowns.

Much like this map, the data and tools we use to navigate public health issues have prominent holes. Vast portions of what is known about the health of populations, the effectiveness of our interventions, or the ability to measure progress are punctuated by data gaps or altogether missing. Simply put, the data and tools we use to navigate the most complex and challenging public health issues of our time are hindered by data gaps and unknowns.

Just like the missing fragments on Mahia’s map hinders her ability to chart the best course of action, poor data quality poses a similar obstacle to creating effective public health strategies and interventions. Consider a 2019 report by the Kaiser Family Foundation, showing that data on social determinants of health, such as income, education, and employment, is often limited or not collected. The report found that only 19% of electronic health records contain information on the social determinants of health, and only 11% of hospitals routinely screen patients for these factors. This is despite SDOH being cited as affecting as much as 50 percent of county-level variation in health outcomes.

Further still, Mahia’s map was ineffective in grappling with data invisibility – where entire populations are miscategorized or altogether missing in the data. This is evidence of a central issue into representation and inclusion as policy decisions are made with flawed or biased data that over or underestimate the impact to different communities.

Determined to overcome this hurdle, Mahia embarked on a quest to uncover the missing pieces of her map. She sought the aid of wise elders, intrepid explorers, and knowledgeable locals, all possessing fragments of information that, when pieced together, would complete the bigger picture.

As Mahia gathered more information, she shared her findings with public health officials and researchers, fostering a culture of open dialogue and collaboration. Together, they acknowledged the limitations of their data and recognized the importance of actively seeking out the missing pieces. As a result, they began implementing innovative approaches to gather more accurate and comprehensive data, involving the community as partners in their journey.

Over time, the map of Mahia’s town started to take shape. The missing fragments were filled in, revealing a clearer path toward effective public health interventions. Armed with a clearer understanding of their community’s needs, the public health officials and researchers devised targeted programs founded in data tailored to address the unique challenges and opportunities that improve the well-being of each community.

Mahia’s quest served as a beacon of hope, demonstrating that even in the face of imperfect data, progress could be made. The community’s commitment to bridging the gaps in knowledge and embracing transparency became the driving force behind their success and led to values that helped bridge these unknowns:

  • Missing and unknown data must be identified and named before they can be confronted;
  • Partnering with communities to collaborate on solutions that fit their unique needs is more effective than a top-down approach, infusing health equity strategies so communities are partners in designing solutions that fit their unique situations;
  • Centering programs around the importance of fostering a culture of openness, transparency, and incentivizing data sharing within and across organizations. We need to ensure policy advances the incentives to share data rather than hoard it;
  • Harness the power of interdisciplinary research and partnerships across sectors and tap into the collective resources of communities, businesses, and healthcare providers alike.

With newfound optimism, Mahia continued her explorations, armed with her patched-up map and the profound realization that the journey towards a healthier community required ongoing collaboration, adaptability, and an unwavering belief in the power of shared knowledge.

And as she ventured forth, Mahia’s footsteps left an indelible mark—a testament to the transformative power of understanding and the endless possibilities that lay beyond the holes in our maps.

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