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Reporter’s piece targets impact of poverty on children, community Date: 11/11/15

Brie Zeltner

By Susan Heavey

Brie Zeltner has been covering northeast Ohio’s health care industry for more than eight years at The (Cleveland, Ohio) Plain Dealer. But earlier this year her work garnered fresh attention when she became the inaugural winner of the Urban Health Journalism Prize.

Her 2014 piece took a deep dive into the effects of poverty on children’s health in the city. She combed several databases to create a critical snapshot of poverty and its impact on births, asthma, behavior and stress, among other health issues. She also took a closer look at local efforts and programs aimed at mediating the impact and addressing the city’s health gaps among its youngest residents.

Sponsored by the New York Academy of Medicine, the new award recognizes stories that highlight the specific health issues facing people in urban areas across the United States, including pieces that examine the social determinants of health and health disparities. While no deadline for submitting 2015 stories has been announced yet, people interested in entering can keep an eye on the prize’s website as well as the academy’s blog.  

Below is our conversation with Zeltner about how she went about pulling together her award-winning piece:

Q: Your 2014 article, “More than half of Cleveland kids live in poverty, and it's making them sick,” won the inaugural 2015 Urban Health Journalism Prize. Did you set out to tackle a story specifically addressing a city-based health issue?

A: Not exactly. The story was part of the daily coverage of my beat, but also an effort to begin to redefine that beat. In Cleveland, we’ve seen the same staff declines as the rest of the journalism industry over the past few years. We used to have six health reporters on our team, and when I wrote this, we were down to two. This story was the beginning of my effort to refocus on an area that I had long thought needed more coverage – poverty as a public health concern.

Q: The article draws on information from a lot of resources. What advice do you have for combing through all the available data out there? Were any particular sources useful to you for the piece?

A: The foundation of the story was a single jarring statistic from the U.S. Census Bureau. Anyone with a little patience and know-how who is looking for a data-based story won’t find a richer source of information than this agency’s numbers. For those with less patience (or time), a lot of nonprofit organizations also analyze Census statistics to produce their own reports. The Annie E. Casey Foundation, for example, updates its Kids Count Data Book with the most recent Census data on kids at a state and city level, and it’s easy to search. The foundation’s data was an invaluable resource for the big picture. Local sources, including state, city and county health departments can also help fill in the gaps.

Q: How hard was it to find state and city-based data on health disparities?

A: It’s getting easier to find this information because of the increased attention on the influence of socioeconomic factors on health. In Ohio, for example, the state department of health is funding an effort called the Ohio Institute for Equity in Birth Outcomes, which is raising awareness and trying to combat the racial disparity in the state’s infant mortality rates. Nationally, CityMatCH, a membership organization of urban maternal and child health programs, is also bringing attention to the same issue. Increased attention means more sources for data and analysis.

Photo: Lynn Ischay, The Plain Dealer

Q: At the same time, national databases and reports can seem overwhelming. How did you drill down in all the numbers for data related specifically for your city's area of coverage? Any tips for reporters looking to find a key data?

A: Many reports, like Casey’s Kids Count Data Book and Child Trends’ massive Data Bank indicators, are pretty easy to search now. When a report comes out, it’s helpful to ask if there’s a state-specific version, which will often highlight your state’s position on health issues relative to the rest of the country. Then look for the relevant nonprofit groups and health organizations in your communities to see if they’re putting out their own reports or releases based on the local data. They’ll usually have a staff member who has taken the time to drill into the statistics and can respond to questions about your area.

Q: One thing your piece does is offer a pretty holistic view of the health of Cleveland's children and the obstacles they face. Was it difficult to write a story with such a broad view while still supporting it with specific facts? How did you go about organizing the piece?

A: It’s usually easier to write about a little piece of a problem. But my goal was to help people get an overall sense of the myriad reasons why having so many poor children in our city and state has such a negative impact, not just on the kids themselves but on the rest of the community as well.

I tried to organize the piece by examining the effects of poverty over the lifespan, starting with birth. It’s certainly not the only way to approach it, but with a topic so broad, it was helpful.

I also intentionally devoted a substantial section of the story to potential solutions, because I’m well aware of how entrenched and overwhelming these problems feel to most readers. All of the follow-up reporting I’ve done since has been focused on solutions as well.

Q: If you had to call out any of the issues you touched on in the piece – you mention toxic stress, asthma and birth weight, just to name a few – for further reporting and stories, which would you sound the alarm on, so to speak? What's not getting enough attention or scrutiny by reporters, editors or policy makers?

A: All three have received a lot more attention this past year. It’s heartening to see people trying to understand the connections between income inequality, the lingering effects of racist housing policies, substandard housing, violence and stress, and how all of these affect health in our cities. All of these issues need more attention, though. As health reporters in American cities, we need to unflinchingly examine and explicitly state the deep historical, racial and economic roots of the health issues that face our urban communities.

Q: You talked to a lot of experts for the piece. How do you approach and talk to health policy experts, researchers and academics to get them to talk about their work in a way readers can understand?

A: Researchers and doctors have their shorthand, and sometimes I just ask them to slow down and define terms, and then define them again. It may seem like a nuisance to the person being interviewed, but it’s a great service to readers.  

Q: Your story in September 2014, and won the New York Academy of Medicine award for Urban Health Journalism in May. What impact have you seen in Cleveland since its publication?

A: Using that story as a platform, I was able to redesign my beat. I am now in the midst of reporting on a number of the public health topics that I touched on in that first story.

In June, I published a series of stories about chronic asthma in Cleveland children and a cost-effective preventive measure that can help reduce emergency room visits and medication use by addressing housing issues.

In October, I published a series on lead poisoning with my colleague, Rachel Dissell, again with the goal of highlighting preventive solutions that are working to keep kids safe. Soon, I’ll be doing the same for infant mortality.

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.

Note: AHCJ Executive Director Len Bruzzese was a judge on the prize’s selection committee.