Tip sheets

Journalists and experts have written about covering issues around social determinants and presented discussions on the topic at AHCJ conferences and workshops. This is a collection of the most useful and relevant tips. Click the title of the tip sheet that interests you and you will be asked to login because these are available exclusively to AHCJ members.

Featured tip sheet

When covering disparities in maternal mortality among black women, consider payment reform 

December 2019
Black women in the United States suffer from maternal mortality that is 30% to 40% higher than that of their white counterparts, according to the federal Centers for Disease Control and Prevention. 

Many health journalists who cover health disparities and women’s health issues have covered disparities in infant mortality, yet we don’t often do a deep dive into what happens to the survival of women of color during pregnancy, delivery and the year after giving birth.

The awareness of the disparities in pregnancy-related deaths for black women is bringing about change at the policy and legislative levels. Andrea King Collier has some suggestions for how to cover these changes.

Look for additional tip sheets based on subject:

Aging

Built environments

Community development

Data

Disparities

Drug use

Finding sources

Health and nutrition policy

Health promotion

Medicaid

Rural health

Sexual orientation

STDs

Aging

Resources for reporting on the health care needs of older LGBT adults

December 2016
Three things have come together to throw a spotlight on the health care needs and challenges of older adults identifying as lesbian, gay, bisexual, or transgender.

In this tip sheet, Eileen Beal explains why and shows how that means there’s more demand than ever before to better cover the health and care needs of what until recently had been a “marginalized minority.”

She also offers a number of specific story ideas and an extensive source list - with contact information.

Mental health needs of aging prisoners is a fruitful area for coverage

November 2016
All but a relative handful of incarcerated persons in the United States go home. But those sentenced to longer – if not lifetime – prison stays mainly account for an increasingly older population in state and federal correctional facilities.

While the federal Bureau of Justice Statistics has been tracking that surge, it has not tallied the prevalence of mental illness among prisoners who are aging. Moreover, aging persons — imprisoned or not — are at greater risk for certain mental illnesses.

A comparatively small coterie of university researchers, alongside physicians and others providing care for those behind bars, say older inmates’ mental illnesses run the gamut. These researchers and clinicians have begun, even if incrementally, to try to empirically measure mental health problems among aging inmates, adding, they say, to what is a relatively small body of research about this group of individuals.

Resources for reporting on the dental health crisis among poor adults

May 2016
Adults with incomes below 100 percent of the federal poverty level (FPL) are three times more likely to have untreated tooth decay than adults with incomes above 400 percent of the FPL.

More than one third of poor elders have lost all their teeth – compared with 16 percent of those with incomes at or above 200 percent of the FPL. These and other facts come as reminders that poor oral health places a disproportionate burden upon poor adults in the United States, the nonpartisan Medicaid and CHIP Access and Payment Commission concluded in a report to Congress on the status of adult Medicaid benefits around the country.

Diversity in aging: Putting gray in the rainbow

May 2012
Journalist Paul Kleyman explains that older adults from “minority” racial and ethnic groups often encounter different health problems and require different responses than the majority white population. To help health reporters cover our increasingly diverse older population, this tip sheet includes four key concepts and helpful links intended to point the way toward more ethnically representative – and interesting – stories. 

Built environments

Going Upstream: Tips for Finding Health Stories in the Built Environment

August 2013
Journalist William Heisel shares some nuggets from Health and the Built Environment, a webinar featuring Dr. Rishi Manchanda, author of "The Upstream Doctors." Manchanda makes the case for training a new generation of “upstreamists”–medical practitioners who look upstream to address the social determinants of health. You can follow links to videos and presentation slides from the webinar, moderated by journalist Taunya English, who produced a series of stories looking at how environment affects health for WHYY in Philadelphia.

Community development

Housing and Health: Finding Stories and Getting the Reporting Right

August 2014
Megan Sandel, M.D., M.P.H., an expert on the impact of housing on child health, says journalists would do well to broaden the conversation about health care to include questions about social support – especially support for safe, affordable and stable housing. This tip sheet includes key stories to pursue and critical insights on the housing-as-health-care trend.

Sandel is an associate professor at the Boston University Schools of Medicine and Public Health and former pediatric medical director of Boston’s Healthcare for the Homeless program. She co-authored the first national report on housing and child health and has worked with public health authorities to create links between housing inspection offices and the health care system.

Community development and health

October 2013
At a Place Matters conference in Washington, D.C., Harvard professor David Williams, Ph.D., talked about the need for cooperation between the community development industry and health leaders. He cites examples of what's working in Nebraska, Minnesota, the San Francisco Bay Area, Atlanta, New Orleans.

Promise Zones

November 2013
The federal Promise Zones initiative is awarding funds to help cities create jobs, leverage private investment, increase economic activity, expand educational opportunities, and improve public safety in historically disadvantaged neighborhoods. The Obama Administration will designate 20 communities over the next four years. In a web forum, academics, advocates and policy makers talked about how community revitalization can promote health equity. The forum was sponsored by Joint Center for Political and Economic Studies and PolicyLink.

Data

Here’s how to mine census data to better cover the health-gap story

November 2016
If you are covering the social determinants of health care, chances are you will need some data on areas such as income and gender that can influence health. One place to find everything from the number of doctors in a particular part of the country to demographic information on veterans is the U.S. Census Bureau. This federal agency culls data not only from the U.S. Census taken every ten years but also from a host of other more frequent surveys.

The bureau’s American Fact Finder tool lets users search for a specific set of characteristics for a particular community such as housing, income, poverty and race. It also offers various maps, charts and other visual data.

Drug use

Covering STDs: What reporters need to know

December 2018
After decades of decline, the number of people diagnosed with many sexually transmitted diseases in the U.S. began steadily rising in 2000. Five years ago, the number of cases sharply increased. Between 2013 and 2017, STD cases were up 31 percent.

The reasons for the increases are multi-faceted. They include decreased public health funding, lack of understanding about how STDs spread, social stigma, less access to health care and fewer health provider screenings. Social determinants also play a role in which populations are more at risk of exposure to an STD and whether they get treatment. Further, the opioid epidemic has been associated with increase in STDs among pregnant women, said David C. Harvey, executive director of the National Coalition of STD Directors during a Nov. 1 AHCJ webcast.

Learn more about the increase, story ideas, sources and experts to tap into for your reporting.

How to leverage social media to cover the opioid epidemic in small-town America 

October 2017
By establishing a strong following on Facebook through relentlessly covering the issue on her profile, Heather Wolford branded herself as the "go to" local reporter for coverage of heroin and opioid-related topics. When the public thinks of the heroin crisis, they feel comfortable enough to reach out and share information with her.

Don’t trust Facebook? Well, in a county of about 70,000 residents, news travels fast. And it travels on social media. To cover something as taboo as opioid addiction in small-town America, you must leverage social media.

Wolford shares some tips on how to manage your social identity (mostly through Facebook), and other ways to become a “go to” resource for your area.

Behind Washington’s promises to tackle opioid abuse 

April 2016
In any election year, you can bet that politicians will pay a lot of attention to voters’ concerns. The stakes are even higher in a presidential election year, which is one reason why – after years of relative silence on a rapidly growing opioid epidemic – Congress and the Obama administration have recently started rolling out a variety of solutions.

In this timely tip sheet, AHCJ member Alicia Ault offers colleagues some tips to covering the growing national issue.

She includes background on the issue, as well as what legislators, the White House and other government institutions are doing and story ideas for reporters to pursue.

Ideas for covering the impact of drug abuse on pregnant women

December 2015
My story for The Atlantic, Into the Body of Another, looked at how mothers in many states were receiving lengthy prison sentences for abusing their fetuses by using drugs while they were pregnant. Leaving aside the life-at-conception issue, among the things I learned was that drugs differ in the levels of harm, if any, they can cause fetuses. What’s more, many states simply do not have the rehabilitation beds necessary to treat all the drug addicts within their borders, pregnant or otherwise.

Disparities

When covering disparities in maternal mortality among black women, consider payment reform 

December 2019
Black women in the United States suffer from maternal mortality that is 30% to 40% higher than that of their white counterparts, according to the federal Centers for Disease Control and Prevention. 

Many health journalists who cover health disparities and women’s health issues have covered disparities in infant mortality, yet we don’t often do a deep dive into what happens to the survival of women of color during pregnancy, delivery and the year after giving birth.

The awareness of the disparities in pregnancy-related deaths for black women is bringing about change at the policy and legislative levels. Andrea King Collier has some suggestions for how to cover these changes.

Debunking claims that immigrants bring infectious diseases to U.S.

December 2018
President Trump, along with immigration opponents, repeatedly assert that immigrants are bringing infectious diseases to the U.S., but never provide any data to back up their claims.

That is because virtually every public health expert says there isn’t any evidence that this is the case.

Learn more about how our public health system works to keep infectious diseases from entering the country and get resources to debunk this link between immigration and infectious diseases, here are some experts on the topic and links to recent stories.

Issues to consider when reporting on oral health during pregnancy

November 2018
Maintaining good oral health during pregnancy is important to the overall health of women as well as their children, an interdisciplinary team of health care experts stressed in a respected 2012 national consensus statement on the topic.

“Evidence suggests that most infants and young children acquire caries-causing bacteria from their mothers,” said the authors of report sponsored by the National Maternal and Child Oral Health Resource Center at Georgetown University.

Learn more about the benefits of good oral health during pregnancy and the obstacles that many women face in obtaining care. 

Reporting on food insecurity and older adults

August 2018
The problem of food insecurity is growing worse as our population ages and socioeconomic disparities increase.

Food insecurity is not just worrying about getting the next meal. It is a strong predictor of chronic disease and diabetes, heart disease, stroke and lung disease, say the experts at Meals on Wheels America. Older adults already have higher health care costs and take more medications compared with the rest of the population; these economic realities really squeeze low-income older adults. In addition to worsening physical health problems, poor nutrition can also contribute to mental health problems such as anxiety and depression.

Tips for covering poverty and geography

June 2016
New studies are backing up a basic assumption about wealth and health and in the United States: It matters where you live. Geography contributes to social mobility, health disparities and the income divide.

Policymakers and politicians are taking note, but with such a complex topic, how can journalists make a difference?

Three recent reports help explain the numbers and show where the discrepancies lie. Carolyn Crist outlines the reports and then some questions and issues for reporters to look into.

Resources for tracking geographic disparities in organ transplants

August 2015
When it comes to organ transplants, where people live has a lot to do with when they receive care.

I explored geographic disparities in access to kidney and liver transplants in May in the first part of an ongoing series, “Living On: Improving The Odds of Organ Transplants,” supported by an AHCJ Fellowship on Health Care Performance.

As the interactive map with the series shows, the median wait time for a kidney transplant is more than six years in much of Texas and Pennsylvania but less than 18 months in Mississippi and Nevada.

Finding sources

Need a certain type of patient to add life to your story? Here are some tips

April 2016
Patient voices bring an added dimension to health care stories, but connecting with patients meeting certain demographics often can be more challenging than locating medical experts.

Lisa Esposito shares some tips about how she goes about finding patients whose stories she can tell, including ways to find patients among certain ethnic, gender and age groups such as African-Americans or seniors.

Health and nutrition policy

Issues to consider when reporting on oral health during pregnancy

November 2018
Maintaining good oral health during pregnancy is important to the overall health of women as well as their children, an interdisciplinary team of health care experts stressed in a respected 2012 national consensus statement on the topic.

“Evidence suggests that most infants and young children acquire caries-causing bacteria from their mothers,” said the authors of report sponsored by the National Maternal and Child Oral Health Resource Center at Georgetown University.

Learn more about the benefits of good oral health during pregnancy and the obstacles that many women face in obtaining care. 

A road map for exploring the crossroads of nutrition and health

July 2016
An apple a day keeps the doctor away – providing we can eat it.

Oral health predicts whole body health, and is one of the 12 leading indicators for the U.S. Department of Health and Human Services’ Healthy People 2020 initiative. Research aimed at gaining a fuller understanding of the relationships between oral and systemic diseases and conditions continues.

The World Health Organization emphasizes the role diet and nutrition play in oral health, including its influence on craniofacial development, risk of oral infections, cancer and dental and periodontal disease.

Nutritionist and writer Melinda Hemmelgarn offers some things that journalists should know to raise awareness of risk, lead consumers to care and promote the critical role of diet and nutrition in protecting oral health.

Supporting Americans’ efforts to eat well and watch their weight

April 2014
At Health Journalism 2014, Margo Wootan, Ph.D., director of nutrition policy at the Center for Science in the Public Interest, gave a trenchant report on the dramatic shifts in food marketing and its impact on the American diet, particularly among children. A third of children's calories now come from restaurant meals which, on average, are loaded with almost twice as many calories as meals from home, she reported. This tip sheet from her talk notes the recent successes in improving kids' eating habits, and it outlines her organization’s push for menu labeling and restrictions on food advertisements targeting children.

Wootan has coordinated and led efforts to require calorie labeling at fast-food and other chain restaurants, require trans fat labeling on packaged foods, improve school foods, reduce junk-food marketing aimed at children, and expand the nutrition and physical activity program at Centers for Disease Control and Prevention. She has a doctorate in nutrition from Harvard University's School of Public Health.

Health Policy Brief: Health Gaps

August 2013
Health and longevity are driven by factors such as race, gender, educational attainment, and ZIP code “that should not make a difference,” Catherine Dower observes in this health policy brief produced by Health Affairs through a grant from the Robert Wood Johnson Foundation. Dower provides a concise backgrounder on health disparities, a rundown of the policy implications, an informed look at what the future holds, and links to more in-depth research.

Health promotion

Avoiding the ‘Trinity Trap’ when reporting on health promotion 

April 2014
Health care is but one element of what makes the biggest difference in health outcomes – social factors play a far more significant role. Income and its distribution, education, employment, social supports, housing, nutrition, and the wider environment — what we have come to know as the social determinants of health – are the most powerful predictors of wellness and longevity. This has been understood for centuries, and empirically validated in recent decades with study after study demonstrating significant inequalities in health outcomes between wealthy and disadvantaged populations.

Why is it that, when we talk about health promotion, we still get stuck talking about the "Trinity Trap" of smoking, diet and exercise when we know that social factors have the biggest influence on health outcomes?

Family doctor and medical professor Ryan Meili discusses the importance of understanding the social determinants of health. 

Medicaid

Understanding how health advocates, legislators are wrestling with Medicaid work requirements

March 2018
Republican-controlled states are taking a fresh look at the subsidized expansion of Medicaid under the Affordable Care Act following a major shift in the federal government’s stance on 1115 demonstration waivers.

The Department of Health and Human Services’ recent green light for work requirements, drug tests, premiums and other policies rejected by previous administrations is attracting the interest of states that already expanded Medicaid and are now looking to tighten restrictions on the program, as well as states that never expanded Medicaid in the first place.

But for states looking to implement the newly-allowed restrictions, many difficult questions lie ahead.  Here’s a guide to understanding some of the economic and ideological battles playing out in the states.

Is Medicaid managed care coming to your state? Keep these coverage tips in mind

January 2018
As Medicaid managed care spreads, it is important for reporters to understand how it works and where to get the information we need to do solid accountability reporting about it.

Although research is mixed about whether managed care saves money for states, programs have exploded nationwide because health plans typically are paid a fixed amount per enrollee, which helps states predict their costs for the year.

This is an important story to follow in your state. Kristen Schorsch explains six things to pay attention to.

Sexual orientation

Careful language important when reporting on transgender health issues

November 2018
Using appropriate terminology when reporting on medical studies is important not only for the sake of accuracy and clarity but also to avoid causing harm to populations with specialized, but often misused, terms. Such is the case with transgender people, whose experience with language is often already fraught when they must navigate misgendering with pronouns and outdated, inappropriate terms such as “transsexual.”

Tara Haelle provides a quick guide to terms you need to be familiar with, along with a link to a more extensive guide.

Resources for reporting on the health care needs of older LGBT adults

December 2016
Three things have come together to throw a spotlight on the health care needs and challenges of older adults identifying as lesbian, gay, bisexual, or transgender.

In this tip sheet, Eileen Beal explains why and shows how that means there’s more demand than ever before to better cover the health and care needs of what until recently had been a “marginalized minority.”

She also offers a number of specific story ideas and an extensive source list - with contact information.

Keep these things in mind when writing about LGBT health coverage

March 2016
Each minority group has its own special health care concerns and issues, but does LGBT health mean more than HIV and AIDS? When Andrew M. Seaman looked deeper, he found complex issues that impact one of the smallest and most diverse populations.

What’s somewhat unique about the LGBT community is that it spans all other populations, like those based on race or social and economic status. Despite the acronym, lesbian, gay, bisexual and transgender people also all face different health care barriers and needs. As the United States increases legal protections for LGBT individuals, it’s crucial that reporting on emerging health care issues and medical evidence is sound.

Covering the special health issues that LGBT seniors face

January 2016
A growing subset of the senior tidal wave known as the “gray tsunami” are those who identify as gay, lesbian, bisexual or transgender.

LGBT seniors increasingly are living out of the closet, yet remain largely invisible in government statistics. Few national health surveys include questions about sexual orientation or gender identity, leaving researchers to only guess at the true size of the nation’s LGBT older adult population.

In this tip sheet, Matthew S. Bajko explains some of the unique health issues that LGBT seniors face, such as social isolation and housing issues. He also offers stories ideas, contact information for sources and some relevant research. 

Things to consider when reporting on the health of LGBT – and ‘Q’ – youths

November 2015
There are a variety of risk behaviors and inherent health risks that LGBTQ young people experience. LGBTQ youths often are marginalized by family or friends, and we know that marginalized populations in general are at a higher risk for mental health and substance abuse issues. This group also is less likely to get care, especially care in which they may need to acknowledge their status to a provider.

In this tip sheet, Lawrence D’Angelo, M.D., M.P.H., division chief of adolescent and young adult medicine at Children’s National Health System in Washington, D.C and director of the Youth Pride Clinic at Children’s, offers some advice on talking with LGBTQ youth, some of the special health and privacy concerns they face and resources for journalists.

Rural health

Wealth of ideas for covering rural health issues from AHCJ conference

June 2015
There’s a lot to unpack from daylong conferences and AHCJ’s Rural Health Journalism Workshop this summer was no exception. About one dozen presenters offered their expertise on everything from the impact of cultural barriers on mental health to luring doctors to work in sparsely populated areas.

For those already covering rural health, it provided some new angles and expertise for future stories. For reporters new to the beat, the workshop provided a wide view of issues particular to the health of those living outside urban America.

The Rural Health Gap

January 2012
In the context of health reform, Timothy D. McBride, Ph.D., professor and associate dean for public health at Brown School of Washington University provides a quick overview on how factors such as education, race, ethnicity, age, poverty, and access to services contribute to the “rural differential” in health status.

Trauma

Resources for covering how adverse childhood experiences affects people's lives

Janice Lynch Schuster

July 2017
Since the late 1990s, researchers have known about the negative effects of adverse childhood experiences (ACEs) on adult health, particularly their dose-related effect on risks for several major conditions, including cancer, heart disease, lung disease and suicidality.

For those just getting started in looking at the issue, AHCJ member Janice Lynch Schuster pulled together some basic tips on covering it, drawn in part from an event hosted by the Aspen Institute, a nonpartisan educational and policy organization based in Washington, D.C.  as well as a panel at Health Journalism 2017.

Some advice when interviewing victims of mental or other trauma

September 2016
Mental trauma, like many health subjects, can require a special sensitivity to report about, especially when dealing with its victims.

Journalists are not immune from the experience of interviewing victims, and may be unsure how to manage their own emotions and response.

Here are some tips for health journalists when interviewing people who have experienced one or more traumatic events.

STDs

Covering STDs: What reporters need to know

December 2018
After decades of decline, the number of people diagnosed with many sexually transmitted diseases in the U.S. began steadily rising in 2000. Five years ago, the number of cases sharply increased. Between 2013 and 2017, STD cases were up 31 percent.

The reasons for the increases are multi-faceted. They include decreased public health funding, lack of understanding about how STDs spread, social stigma, less access to health care and fewer health provider screenings. Social determinants also play a role in which populations are more at risk of exposure to an STD and whether they get treatment. Further, the opioid epidemic has been associated with increase in STDs among pregnant women, said David C. Harvey, executive director of the National Coalition of STD Directors during a Nov. 1 AHCJ webcast.

Learn more about the increase, story ideas, sources and experts to tap into for your reporting.

Getting up to speed on the latest news on HIV 

December 2017
HIV is a treasure trove of story ideas. In a companion tip sheet, Heather Boerner listed some things she thinks general news coverage about HIV gets wrong, along with how to correct those mistakes.

Here she shares what you need to know getting started covering the new science of HIV.

Neutral and accurate: Covering HIV in the modern era

December 2017
If you care about the health of communities, about social determinants of health, or about health policy, HIV is a treasure trove of story ideas. But in Heather Boerner's years of covering HIV, for publications including The Washington Post, The Atlantic, Medscape and PBS NewsHour, there are lots of things that she thinks general news coverage about HIV gets wrong. 

See what they are and how to improve your coverage of this important topic.