Tuesday, November 26, 2019

Storytelling about Public Health, Immigration and Power

Here is a headline for you to consider:
CDC Recommended that Migrants Receive Flu Vaccine, but CBP Rejected the Idea
With a different headline and presented in a different order, the same facts and even the same text would tell a different story.

This is how the story in the Washington Post by Robert Moore starts out:
As influenza spread through migrant detention facilities last winter, the Centers for Disease Control and Prevention recommended that U.S. Customs and Border Protection vaccinate detained migrants against the virus, a push that CBP rejected, according to a newly released letter to Congress.
In Washington, I guess that's what this story is about: a battle between agencies, political conflict, and, with any luck, a cover-up and a scandal.  It's about power.  And who will be blamed when the outbreak inevitably occurs.

I noticed a couple of other stories embedded in this same article; it made me wonder about the editorial choice to put the political story first.  First of all there is the story of the individual immigrants and their families who suffer.  Terrible:
An 8-year-old Guatemalan boy died of the flu while being detained near El Paso in December, a month before the CDC’s vaccination recommendation. In the months after CBP rejected the recommendation, at least two children — one in El Paso and one in Weslaco, Tex. — died after being diagnosed with the flu in Border Patrol custody, autopsy reports showed. 
So now Moore has established a frame for the reason we cannot immunize immigrants at the border.  We should immunize them because it's "unconscionable" not to.  It is a moral argument:  two deaths are two too many and it doesn't matter that they are not citizens.  And then, against that moral argument, we get the pushback:
“CBP has significantly expanded medical support efforts, and now has more than 250 medical personnel engaged along the Southwest border. To try and layer a comprehensive vaccinations system on to that would be logistically very challenging for a number of reasons,” she said.
In a super-partisan climate polarized by immigration, public services, taxes and ethnic nationalism, this is a losing battle.  It seems to be a zero-sum game, costing American citizens millions to provide high-cost services for a few unwanted immigrants.  But that's not the end of the story.  In fact, there's a completely different narrative built into the same article.  It's just not easy to spot because it doesn't make sense in that initial frame.
“The system and process for implementing vaccines — for supply chains, for quality control, for documentation, for informed consent, for adverse reactions — is complex, and those programs are already in place at other steps in the immigration process as appropriate.”
In other words, it may be possible to reuse a lot of infrastructure that is already there to dramatically reduce the cost.  We're not really told anything about the scale of these systems and the relative costs.  If you read it carefully, it undermines the political story Moore starts with.  But many readers will miss it entirely because it does't fit in the narrative.

But we're missing an even larger story here:  the benefits to American citizens of the proposed vaccination program.  This is the last paragraph in the story:
A new report from the Brookings Institution warns that risk factors such as lackluster sanitation, overcrowding and poor nutrition are creating a “perfect storm” of conditions in CBP detention facilities that could lead to severe outbreaks of the flu and other communicable diseases. The report recommends vaccinating detained migrants as a way of limiting outbreaks.
Unexplored is the connection between outbreaks in these detention facilities and one that threatens every American.  Perhaps it is in our interests to vaccinate immigrants at the border.

With a different headline and presented in a different order, the same facts and even the same text would tell a different story.  Here is a different headline for the story that would begin with that paragraph instead of ending with it:
Threat of Influenza Outbreak from Inadequate Healthcare and Crowded Conditions at Border
Compare that to the original:
CDC Recommended that Migrants Receive Flu Vaccine, but CBP Rejected the Idea
Interesting, no?  

If we were to name that bias, what would we call it?  A liberal bias?  I think not.  We have an attention problem.  It's easy to tell a compelling story about the suffering of individuals, an unenlightened Administration and conflict between powerful interests.  It's a lot harder to connect the dots and show how costs can be managed and, even more importantly, how EVERYONE would benefit from improvements to the vaccination program at the border we already apparently have.


stefanoq said...

Here's my post on Facebook:

I've been following the story of vaccinating detainees at our Southern border for some time now. A friend of mine from CDC pointed me to this article in the Washington Post. It got me thinking and led me to a blog post. It's a (very brief) story of facts, two headlines, one article and editorial choice.

Consider the difference between this headline, on one hand: "CDC Recommended that Migrants Receive Flu Vaccine, but CBP Rejected the Idea."

And then think about this one as an alternative headline for the SAME STORY: "Threat of Influenza Outbreak from Inadequate Healthcare and Crowded Conditions at Border."

There even a few more narratives that can be constructed on the same basis. All of them are based on the same facts. All of them would be TRUE. Some of them might be considered deceptive, especially if they completely ignored other points of view and made no concessions to other narratives.

This is the nature of communication, in my opinion; bias is a choice and cannot be avoided. But that's not the same thing as lying to support a FALSE NARRATIVE. We're in deep trouble when so many of us, even those who are highly educated, cannot tell the difference.

Rich T said...

We all bemoan what on the surface appears to be the inattention and disengagement of the average voter. But as you've done, if we look closer, there is a framing problem on the part of the news providers. In the extreme it's a question of how often the news is presented in a comprehensible manner. Consider the news as it's offered through the different media. If one were to rank the different media - AM radio news, FM radio news, local TV news, national network news, newspapers, news magazines, in my opinion the degree to which a comprehensible story is presented would run in the direction I've listed them, all the way from "rip and read" at one extreme to actual responsible journalism at the other. Of course there are exceptions. In my opinion NPR and PBS make a more honest and complete attempt to tell as complete a story as possible through a humanistic, democratic lens (which is why they're accused of bias by those who are neither), by reporting fewer stories and much more in depth, presenting experts with different political biases.

Beyond the issue of completeness and circumspection, as you've demonstrated, the headline and structure of the story are often presented in a way that reinforces the known prejudice of the media outlet's subscribers, so even when journalism is professional and responsible, any story can be told in a way that amplifies a political bias at the expense of a more nuanced and complete truth. I think the Christian Science Monitor and The Wall Street Journal used to do a pretty good job of avoiding the tendency to slant headlines and stories this way. I haven't read the Monitor in a long time, but I would expect it still maintains its less partisan approach. The Journal is now in Murdoch's stable, and I stopped paying it attention as I saw an increasing bias. The NY Times and Washington Post are waging war - and the tendency toward propaganda - as a counter to Fox News, etc, seems unavoidable. As in any war, truth is the first casualty.

stefanoq said...

Thank you, Rich.