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Shared wisdom

Sometimes all we need is a quick suggestion from our peers to zero in on a good story. Here we turn to front-line journalists for advice, some simple insight to add to our repository of “shared wisdom.”

Do you have any tips for people who might also be interested in pursuing a story in a traumatized population that also relates to a factor specifically tied to health outcomes, such as disability?

With marginalized and traumatized populations who may not have much experience with journalists, I always start out explaining to them what their rights as subjects are (i.e., that they can tell me if they'd rather not answer a question) and how the interview will be used, along with asking if they have any questions for me. For journalists reporting a story about disability, I’d advise them to first learn about how that issue is interpreted by other members in that community. When I was reporting on Rohingya refugees with intellectual disabilities, for instance, I spoke with my translators and other contacts about how that disability is perceived. For the Rohingya, being intellectually disabled is a huge stigma — parents of these children are told that their kids are “crazy” or “mad” — so I made sure that when I went in and interviewed a family that it was away from public attention. If there’s a situation where you are reporting and need a translator, I would also make sure that translator is familiar with disability-specific language.

Wudan Yan (@wudanyan) is an independent magazine journalist based in Seattle, digging into unexpected or underreported stories about science, health, human rights, the environment, and culture.

How do you balance coverage of such an important yet devastating topics such as drug addiction with your own life and need for balance?

In the beginning, the issue emotionally weighed on me much more than it does now … I've built a thicker skin. I keep a significant distance between subjects. I don't socialize or 'help' them. My relationship stays professional, always. But they know I care. I want to help the users and I want to help the children left behind by the epidemic. But that's not my job; I'm not a social worker. I'm a journalist. I have to collect the facts to educate the public. I do carry Narcan, and I give myself room to enjoy life.

Heather Wolford covers health issues and the opioid crisis for the Cumberland Times News in Western Maryland and was a 2017-18 AHCJ Regional Health Journalism Fellow.

Your stories examine a wide range of issues that fall under the determinants of health, from Medicaid expansion to mobility. What are three areas where you see deserving more attention and why? 

Mobility, housing and literacy. You can have health insurance, but if you can’t get to the doctor – or if the nearest OB/GYN is at least half an hour away – are you really going to go? Addiction specialists are few and far between, and people who need them most live miles from the nearest doctor. We talk about telemedicine … but evidence is still coming in, and people are trying to figure out how to pay for it. Housing, meanwhile, is significant – we have more evidence coming about the effects of lead poisoning and other health consequences based on where you live. Mothers in mosquito-dense areas are at greater risk of Zika based on their housing quality. And then think of literacy: Reading a benefits package, or understanding how to enroll in coverage or use it, is not easy. Given the push toward cost-sharing (in private coverage and public), how can consumers who need care navigate the system?

Shefali Luthra (@shefalil) has reported for Washington-based Kaiser Health News since 2014, focusing on health policy, access to care and public health concerns.

What would you encourage reporters who cover infectious disease to consider that might not seem obvious? 

I’d highlight the important role that socioeconomic status plays in shaping infection risk and disease outcomes. People living in poverty often live in more crowded conditions than affluent people do and are more likely to take public transportation, both of which increase their susceptibility to infection. They may also be under more stress, get less sleep, and eat less nutritiously, all of which hinder immunity and increase vulnerability, too.

And then once people are sick, socioeconomic factors shape their prognosis. People living in poverty often have no or poor access to health care. They might feel compelled to work when sick — low-paying jobs often have strict sick leave policies — which means their ailments, might worsen while they’re also spreading their illness to their colleagues. The upshot is that people on the lowest rungs of the socioeconomic ladder are extremely vulnerable in outbreak situations, so they should be an important focus for reporters who are thinking about risks as well as outbreak responses.

Melinda Wenner Moyer is a science and health writer based in New York's Hudson Valley. She is a contributing editor for Scientific American and a columnist for Slate. She won a 2016 AHCJ Award for Excellence in Health Care Reporting. 

You've been writing about wealthy hospitals and their relationship to poor neighborhoods around them, with high disease burdens. A recent piece looked at asthma. Why did you choose this condition to illustrate this point?

Asthma is ubiquitous in low-income neighborhoods. It’s relatively easy to track in the data and the case for prevention is so compelling.

Asthma flares are very costly. ER treatment is $800 or so. Typical admission is $8,000. That doesn’t count the very high cost of kids missing school, parents missing work to take care of sick kids etc.

Contrast that with the low cost of prevention – meds training from a community health worker, a few hundred dollars for filters and mattress covers or a few thousand dollars to fix a leaky roof.

Hospitals don’t need to invent new technology or hire expensive experts to lower asthma admissions. They know what to do.

The gap between the high cost of illness and the low cost of prevention sort of screamed out as a telling example of health system failure.

Rachel Bluth (@RachelHBluth) is a reporter and the Peggy Girshman Fellow at Kaiser Health News. She recently earned her master’s from the Philip Merrill College of Journalism at the University of Maryland where she reported on health disparities in Baltimore, and her work was published on NPR.org and PBS.org. She was previously the lead political correspondent for the Annapolis Bureau of Capital News Service.

 

Jay Hancock (@JayHancock1) joined Kaiser Health News in 2012 from the Baltimore Sun, where he wrote a column on business and finance. Previously he covered the State Department and the economics beat for the Sun and health care for The Virginian-Pilot of Norfolk and the Daily Press of Newport News.

 

The social determinants of health can vary greatly by region in the United States. For the Midwest/Plains states such as Oklahoma, what do you see as the biggest challenges and areas that deserve journalists’ attention when covering health gaps?

I live in Oklahoma City, the largest city in Oklahoma. As a beat reporter at a large metro newspaper, I've found it's easy for my coverage to get too focused on the health issues in Oklahoma City. I try to be mindful about getting out to rural Oklahoma as frequently as possible. I grew up in a small town, and I always enjoy these trips. Plus, I always leave with more story ideas.

Jaclyn Cosgrove is an Oklahoma native who covered health, medicine and policy for The Oklahoman and is now a reporter at the Los Angeles Times. She has been an AHCJ member since 2012. She tweets at @JaclynCosgrove.

After spending so much time looking at the impact of poverty on a range of issues, including health, is there anything you've come away with that you think needs more attention?

Connections across beats. We're seeing more conversations in the United States about the connections between race/class and geography/poverty, and I'm encouraged by that. However, we need to include more context to explain "how we got here" in stories, even if a few sentences. Overly simplistic anecdotes contribute to stereotypes and caricatures we have of groups in the United States, particularly in relation to poverty, ethnicity and gender.

Carolyn Crist is a freelance journalist based in Georgia whose work has appeared for Reuters Health, Anesthesialolgy News, and other publications. She also curates Covering Poverty, a weekly newsletter for the Grady College of Journalism and Mass Communication, where she teaches journalism. She wrote a tip sheet for AHCJ on covering poverty and geography.

Aside from using social media to connect with readers and potential sources, what are three other key tips you would give to reporters covering health issues in more rural or suburban areas? 

Maintain good connections with the providers in the community. Social workers, therapists, doctors, nurses, executive directors, grant writers, all of them – anyone with their hand in providing resources to low-income folks throughout the region or health care providers in general. They will know who is willing to share their story and who is not. They will also know when any new funding comes into the region or leaves the area.

Heather Wolford covers health issues and the opioid crisis for the Cumberland Times News in Western Maryland. She recently wrote a tip sheet for AHCJ members on covering such drug abuse. She is a 2017-18 Regional Health Journalism Fellow.

What important factors should journalists keep in mind when reviewing CDC lead data for a local area? 

The Centers for Disease Control has data going back to 1995 from states and cities it funds. It’s important to keep in mind that some states use different testing methods (venous blood draws versus finger sticks, for example) which make it impossible to accurately compare data across states and jurisdictions. Also remember that these are not figures that can be generalized to a whole population, because testing is targeted to high-risk areas. You can get an overall picture of trends within a locale, though, and it’s a convenient spot to find all the state data in one place.

Brie Zeltner (@briezeltner) joined the Cleveland Plain Dealer in 2003 as an intern and has been covering the health care industry and hospital news in northeast Ohio since 2007. She is the 2015 inaugural winner of the Urban Health Journalism Prize.

You recently wrote about how nonprofit hospitals fared under the Affordable Care Act. What are some under-reported stories concerning these hospitals, and what suggestions do you have for reporters who have such hospitals in their coverage area?

The 2010 health law includes a provision intended to hold hospitals to a higher standard when it comes to justifying their nonprofit status. Even if the law is repealed, that kind of scrutiny probably won’t go away – but hospitals say it’s going to be a lot harder for them to fund “community benefit” programs if they have to treat more uninsured people. This creates an interesting dynamic that reporters should definitely monitor. Hospitals must do a “community health needs assessment” every three years, develop an implementation plan to address those needs and generally be transparent about what community good they provide (beyond just caring for patients). I’d advise reporters to look through the needs assessments and implementation plans to see what issues arise and how much money hospitals have put toward addressing them. Has it changed substantially? If hospitals launch new initiatives or partner with other organizations, see what kind of impact have those have had – both quantitatively and qualitatively – and whether those programs are tackling the root causes of poor health in their communities.

Shefali Luthra (@shefalil) has reported for Kaiser Health News (KHN) in Washington, D.C. since 2014. Her work focuses on health policy, access to care and public health concerns, and has appeared in The New York Times, The Washington Post, NPR and CNN Health. Prior to joining KHN, she spent two summers interning at The Texas Tribune.

What are some key aspects of the intersection of health care and the criminal justice system that journalists should focus on?

Jaclyn Cosgrove

Definitely mental health and/or addiction. In Oklahoma, we’ve seen the number of inmates with mental illness increase substantially … The following questions could lead to some interesting stories:

  • What is the size of the state prison system's mental health staff? How many psychiatrists are on staff?

  • How does the prison system address inmates who need medication-assisted treatment? When someone enters prison, does that treatment stop? 

  • What are the rates of usage of solitary confinement among inmates with mental illnesses? (They should be tracking this in some way)

  • How are inmates screened and evaluated for mental illness and/or substance use disorders upon entering prison? 

  • The Oklahoma Department of Corrections has a levels system that it uses when evaluating inmates for mental health needs. It could be interesting to see how your state prison system evaluates inmates and then look at the types of illness they're seeing and the level of severity. 

  • What types of drugs is the prison system using for treating inmates? Getting a list of the top 10 most frequently prescribed drugs could lead to some interesting stories.

Jaclyn Cosgrove is an Oklahoma native, now based in Los Angeles, who covered health, medicine and policy for The Oklahoman. An AHCJ member since 2012, she received a Rosalynn Carter Fellowship for Mental Health Journalism in 2015.  She tweets at @JaclynCosgrove.

Where are some key health areas to watch regarding the impact of changing rules and laws regarding transgender individuals?

Andrew M. SeamanThe transgender community is going to be an interesting area to watch as new policies come up for debate and ultimately become implemented. I think the main areas to watch are access to health care, including cross-sex hormone treatment, surgery and mental health services.

Stigma and bullying will be one area to watch tor among people who are transgender or other types of sexual minorities like lesbian, gay or bisexual.

 Andrew M. Seaman (@andrewmseaman) is an AHCJ member and a senior medical writer for Reuters Health in New York covering medical studies on a wide range of issues, including LGBT health. His work was recognized by the National Lesbian and Gay Journalists Association in 2015.

You’ve written about many health topics that touch on health disparities. What other aspects involving the social determinants of health need more coverage? 

Oral health and mental health are covered far less often than other aspects of care, and both of these areas would yield many good stories about health disparities.

And where there are disparities, there are often problems with the overall health system that a reporter is examining. In other words, disparities often point toward the weak link in a system.

Laura Ungar is a national/regional health enterprise reporter for USA Today and Gannett.

You’ve previously written a tip sheet for AHCJ on the intersection of poverty and health. What is one way poverty can be overlooked in health care coverage? 

Carolyn CristWhen reporters focus on class and income in the U.S., they tend to look at the extremes — the wealthy 1 percent or unemployed people below the poverty line. With the changing health care landscape, I've found it important to focus on the "working poor," or those who have jobs but can't afford health care coverage. Many members of the middle class fall in this category.

Is the Affordable Care Act opening up opportunities for them, or are they finding it more difficult to see doctors or pay deductibles? I've heard tales from both sides, and both aspects are important to cover.

Carolyn Crist is a freelance journalist based in Georgia and the author of the Covering Poverty weekly newsletter.

You recently tracked down lead levels for the Cleveland Municipal School District that found dangerously high levels of lead in the water for at least 60 schools. What tips do you have for other reporters seeking local lead data? 

Brie ZeltnerIn Cleveland, we were fortunate that our local school district decided on its own to test the water in many older school buildings before we requested the information. If your school district, or city, hasn’t taken such steps, you’ll probably need to push.

Before you get the data, make sure you talk to an expert on toxics, water and EPA regulations — it’ll save you a lot of headaches and help you ask the right questions about how the testing was done, and why. 

Brie Zeltner (@briezeltner) of the Cleveland Plain Dealer was named as one of AHCJ’s 2016-17 Regional Health Journalism fellows. The inaugural winner of the Urban Health Journalism Prize in 2015, Zeltner has been covering the health care industry and hospital news in northeast Ohio since 2007. 

A lot of your work has looked into the consumer side of health care finances as a determinant of care. What are a few health care "pocketbook" issues worth reporters' time?

Paul Kiel

I’d say this: Medical expenses can be both enormously costly and enormously complicated, and that’s a pretty bad combination. A recent Federal Reserve U.S. survey found that 22 percent of respondents experienced a major unexpected medical expense that they had to pay out of pocket in the prior year, and 46 percent of those who said they had a major medical expense reported that they currently owe debt from that expense. That’s a whole lot of people struggling with this, and this is something (dealing with insurers and providers) that can be quite confusing and frustrating.

Paul Kiel is a reporter covering consumer finance at ProPublica. His stories have looked at the role of nonprofit hospitals and others serving poorer patients, race and debt, payday loans and the foreclosure crisis. He is the author of The Great American Foreclosure Story, an e-book.

How did you find people willing to go on the record about their home-care experience for your investigation? 

One of the major challenges of the investigation was finding clients who were willing to publicly share their home-care experience. Many feared speaking out would make them a target for retaliation. 

We found our subjects in three main ways: 

  • First, we published a few early stories on troubles with home care in Ontario (including an A1 investigation of how the provincial government's efforts to give in-home personal support workers a raise had gone awry) in which we asked readers who had encountered problems with publicly funded home care to contact us. We put our email addresses at the end of the stories. 

  • Next, we approached a health-care advocacy organization that had conducted consultations across the province to put us in touch with clients they had heard from.

  • Finally, we approached opposition MPPs and local councillors to see if they would pass on the names of constituents who had asked for their help dealing with the CCACs. That's how we found the Oshawa mother and son in our lede.

Kelly Grant (@kellygrant1) is a health news reporter for The Globe and Mail in Ontario.

As an enterprise reporter, what tips do you have for fellow health writers who are searching for good story ideas and “big” pieces, especially when it comes to the more untold stories surrounding health disparities?

Laura UngarThe theme of health disparities seems to show up in nearly every health story I write. For instance, I worked with health policy reporter Jayne O’Donnell at USA Today on a big project about Medicaid that explored many problems with access to care faced by low-income Americans, particularly the working poor.

I’ve also written about oral health disparities in Appalachia and difficulties low-income people face getting access to substance abuse treatment. If you look at practically any health topic today, socioeconomic and racial disparities are an issue, pushing up health costs and keeping our nation from moving up in world rankings of health status.

Laura Ungar is the national/regional health enterprise reporter for USA Today and Gannett. An award-winning writer, she is based in Louisville, Ky., at The Courier-Journal, where she spent a decade covering medical news. Previously, she spent eight years in Delaware at The News Journal and six years at The Hartford Courant in Connecticut. Her projects have examined cervical cancer in India, prescription drug abuse in Kentucky, cancer in Delaware and a breast cancer patient's dying mission. She’s won more than 30 national, regional and local awards, including the annual company-wide prize from Gannett for long-form writing and a public health award from the Association of Health Care Journalists, among others.

You recently completed several stories geared toward patients and LGBT health care. What was one of the best resources you found to help you in your reporting?

Whitman-Walker Health was one of the first resources I turned to. Located in the District of Columbia, it was a pioneer in treating gay men with HIV/AIDS in the early 1980s. Now it provides an array of services to LGBT people from health care to legal assistance, and is quick to offer journalists time with experts who can discuss the issues. Whitman-Walker connected me to a transgender patient to interview about his transition. GLMA: Health Professionals Advancing LGBT Equality (previously known as the Gay & Lesbian Medical Association) is another great source for experts who combine professional and personal perspectives. Journalists can use GLMA’s provider directory to find local facilities. If your focus is transgender health, the UCSF Center for Excellence in Transgender Care has medical experts and a website that details comprehensive care.

Lisa Esposito (@lisaespo) is a health reporter for U.S. News, focusing on patient advice. Her recent LGBT-related stories are here and here

Your coverage of children and poverty won the inaugural Urban Health Journalism Prize in 2015. How has that impacted your view of urban health issues and journalism, and what more do you think could be done in that area? How would you encourage other health writers to get started in covering that area?

It’s not easy to work in the business that we’ve chosen to devote our time and energy to. It’s much easier to live with the uncertainty in journalism if you’re able to find a way to go after stories you really care about. I feel incredibly fortunate to have the support to do that right now.

My advice, which may not work for everyone, is that if there’s a story you want to write, go write it. If there’s an area of your coverage that you think is being neglected, shine some light on it. It’s much harder for editors to turn down passion and a finished product.

Brie Zeltner (@briezeltner) joined the Cleveland Plain Dealer in 2003 as an intern and has been covering the health care industry and hospital news in northeast Ohio since 2007. Her piece, More than half of Cleveland kids live in poverty, and it's making them sick, won the first Urban Health Journalism Prize.

Much of your work involves writing about medical studies, including some that look at LGBT health issues. What is something reporter and editors should keep in mind when reviewing studies involving these populations? 

Andrew M. SeamanReporters and editors need to pay special attention to data quality when writing about studies involving LGBT populations. Until recently, data collection among large populations rarely asked about sexual orientation or gender identity. Even today, many of the studies looking at sexual minority groups have significant limitations. For example, they may include data on sexual orientation but not sexual partners. Also, reporters and editors should know that while researchers often lump LGBT populations together, transgender and gender non-conforming people face significantly different barriers, issues and realities than gay, lesbian and bisexual populations.

Andrew M. Seaman (@andrewmseaman) is an AHCJ member and a senior medical writer for Reuters Health in New York covering medical studies on a wide range of issues, including LGBT health. His work was recognized by the National Lesbian and Gay Journalists Association in 2015.

How do you find compelling personal stories on what can be difficult health subjects to talk about?

It's definitely tricky: Usually the person has already lived through a very difficult health ordeal, and now you're asking them to walk you back through it just for a news story. Sometimes, though, people say they find it cathartic to talk about what's happened to them. I do a lot of social media call-outs seeking individuals with specific experiences. Sometimes I'll comb through online message boards or look to certain advocacy or consumer groups. If the person is unsure about being interviewed, I'll walk them through what it would mean to be quoted, both the advantages and disadvantages. A lot of people say "no," but sometimes people say "yes." Hopefully, as stigma around mental and physical health issues continues to decrease, more people will be willing to come forward and share their experiences with journalists.

Olga Khazan (@olgakhazan) is a staff writer for The Atlantic, where she covers health. She was a finalist for the New York Academy of Medicine’s 2014 Urban Health Journalism Prize.

How, if at all, did your recent wellness reporting impact you and your own thoughts or attitude toward healthy habits? 

Barbara AndersonI walked away from the series with admiration for the people I met who struggle day-to-day with a chronic illness. They aren’t willing to give up, no matter the odds stacked against them. And I gained an appreciation for programs that are accessible to people with chronic illnesses.

So many such patients are low-income and can’t pay for gym memberships and nutrition counseling to stay fit – a key part of preventing diabetes and heart disease – or buy items such as a high-efficiency vacuum cleaner to prevent asthma attacks.

Barbara Anderson (@beehealthwriter) has reported on health at The Fresno Bee since 1999. She recently published a month-long, front-page series spotlighting serious chronic conditions, taking a fresh look a programs tackling asthmadiabetesheart disease and obesity.

Several experts appear in the piece, each of them contributing solid quotes and revealing perspectives. How did you choose the experts, and did you interview others and eliminate all but the best?

Dan GorensteinPerhaps to the irritation of my editor, I talked to a lot of people. There are one or two other experts I still wish I could have included in the story. While I've done very little print reporting, print can carry the weight of lots of experts. In radio, I think the best pieces are more of a blend of experts and "real people." If you end up with too many talking heads and not enough 'story' the piece often bogs down.

Dan Gorenstein is the senior health care reporter for the public radio business show Marketplace, covering the business of health care. Gorenstein recently reported on  how a personal story can illustrate the physiological effects of stress. Prior to Marketplace, he spent more than 11 years at New Hampshire Public Radio. He’s won numerous national and local awards, including the Society of Professional Journalists Sigma Delta Chi investigative reporting award.

It's easy to blame disadvantaged people for engaging in behaviors that put them at risk for developing diabetes. In the short space of a typical news article, how do you explain the deeper environmental and social forces that contribute to higher rates of unhealthy behavior and illness in low-income neighborhoods?

Rhiannon MeyersOne of the trickiest parts about reporting my yearlong series on South Texas’ diabetes crisis was bridging the divide between what medical professionals told me and what I saw when I visited with patients.

Over and over again, I heard doctors blame our region’s high rates of diabetes and related complications on noncompliant patients unwilling to make the necessary changes to get healthy. But when I met people at their homes, attended their doctors’ appointments with them and ate dinners with them, I realized that “noncompliant” didn’t take into account all of the barriers they faced in eating healthy, exercising and managing their diabetes. How do you exercise when your neighborhood doesn’t have sidewalks and you don’t feel safe walking around outside? How do you count carbs if you don’t know how to read nutritional labels? How do you worry about your diabetes when there are so many other, more pressing concerns: How to pay rent, keep the electricity on, buy dinner? And there’s no way the doctor in the span of a 15-minute appointment could’ve seen all of these barriers their patients faced.

I’m a big believer in show-don’t-tell journalism. To illustrate the underlying social and environmental factors factoring in to our region’s diabetes crisis, I’ve spent a lot of time with sources, usually at their homes, asking a lot of detailed questions about their lives. And I employ those details in my stories to paint a picture of the social determinants of health. I think readers better understand the concept when they see it in the people I write about. I wrote about one woman who started jogging to get off insulin after her doctor warned her she would die soon if she didn’t lose weight. I went running with her one morning before sunrise. We jogged along the sidewalk in her neighborhood, dodging the cracks and the spots overgrown with weeds, which was difficult because it was really dark. There were no streetlamps illuminating the path. I subtly weaved those details into my story to show the struggles she faced in getting healthy. The anecdote wasn't long - two sentences tops - but by describing that run, readers could better understand why she was having a hard time losing weight and getting her Type 2 diabetes under control. And perhaps they could relate. Eli Saslow’s recent Washington Post piece, “Too much of too little,” which explored a food stamps diet in South Texas  mastered the concept of describing the social determinants of health through a series of compelling narratives.

What’s even more important for journalists than being able to explain these social determinants is understanding them well enough to ask the right questions and challenge those who dismiss chronic illness as strictly a matter of “personal responsibility,” another phrase I heard often in this series. Understanding how someone’s diabetes can be affected by where and how they live helped me provide richer context to my stories. It also allowed me to explore what our community is doing, and what it is not doing, to address our Type 2 diabetes crisis in a meaningful way.

Rhiannon Meyers, a reporter at The (Corpus Christi, Texas) Caller-Times, is author of “Cost of Diabetes,” a yearlong series of articles on the diabetes problem in South Texas.  She received an AHCJ Reporting Fellowship on Health Care Performance.

How did you find mothers willing to talk about being unable to buy enough diapers for their children? 

Eryn Brown

The conversations with the diaper banks helped me establish that there were many mothers and caretakers in the region who couldn’t get their hands on enough diapers.

Finding one of those mothers to talk with took a bit more legwork.

Both diaper donation groups work with partner nonprofits, who distribute diapers (usually, as an incentive for parents who complete parenting classes). I worked through one of these partner non-profits, Children's Institute Inc., to find a 41-year-old mom in Los Angeles who was willing to meet with me at her son’s daycare center and talk about her own struggles with diaper need. 

She told me that she had foregone food some days to get diapers for her baby. A friend had been arrested for stealing diapers. 

Eryn Brown, who wrote about mothers who must re-use diapers because they can't afford an adequate supply, has been a reporter since 1994. She joined the Los Angeles Times in 2006 and moved to the paper's Science and Health desk in 2010. Follow her on Twitter at @LATerynbrown.

Once the data analysis and mapping revealed vast differences in life expectancy for nearby neighborhoods, how did you find people to profile? 

Sandy Kleffman and Suzanne Bohan

We upped the ante by deciding to seek subjects living in the ZIP codes with the lowest, highest and average life expectancies, which narrowed our options but told the most powerful story. We also sought to profile a child living in a neighborhood with high asthma rates who was struggling with the condition and an adult with heart disease living in an area with high death rates from it.

This would help show how lack of access to good food, convenient transportation, decent housing and fear of crime in poor neighborhoods, among other factors, contribute to the chronic stress and exposure to pollutants which trigger these and other diseases.

We also showed how even the middle-class are affected by this health disparity, although less severely than poorer residents.

It proved challenging to find suitable profile subjects, as well as ones willing to have their lives described in newspapers. It took many dozens of calls and numerous dead ends before we finally found appropriate profile subjects.

Neighborhood groups, churches and nonprofits in these ZIP codes were called, as well as hospitals and clinics. The Alameda County Public Health Department helped find a subject in the neighborhood with the lowest life expectancy. These calls, and the many referrals they netted, finally yielded results; we found ideal subjects for all neighborhoods.

How, if at all, did your recent wellness reporting impact you and your own thoughts or attitude toward healthy habits?

Barbara AndersonI walked away from the series with admiration for the people I met who struggle day-to-day with a chronic illness. They aren’t willing to give up, no matter the odds stacked against them. And I gained an appreciation for programs that are accessible to people with chronic illnesses.

So many such patients are low-income and can’t pay for gym memberships and nutrition counseling to stay fit – a key part of preventing diabetes and heart disease – or buy items such as a high-efficiency vacuum cleaner to prevent asthma attacks.

Barbara Anderson (@beehealthwriter) has reported on health at The Fresno Bee since 1999. She recently published a month-long, front-page series spotlighting serious chronic conditions, taking a fresh look a programs tackling asthmadiabetesheart disease and obesity.