GH 482 AB

4 February 2021

Community Outreach Exercise #1

ENGAGING A LARGE POPULATION ON U.S.
MORTALITY AND THE COVID-19 PANDEMIC
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By Ali Lo and Lauren Witty

A graphic from the office of Washington Gov. Jay Inslee that encourages mask use in June 2020.

OBJECTIVES
The goal for this project was to present information about the increase in U.S. mortality and the
U.S.’s dismal response to the SARS-CoV-2 (COVID-19) pandemic to a large virtual audience on
the Left Coast, which consists of portions of Canada, Alaska, Washington, Oregon, and
California.

OUTREACH PLATFORM
To achieve this, we attempted to engage a wide audience within the Left Coast by creating an
infographic that we distributed to university public health programs and local/ state public health
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departments within the region, totalling 44 institutions. We believed that utilizing the audience of
these institutions would allow us to reach people who were interested in learning more about
health and could incite further discussion and action on the existing health disparities in the US.

Description

Graphic Design

To share the information with a large virtual

audience, we chose to utilize a series of
infographics titled the “COVID-19 Olympics: A
Global Comparison of Health.” The graphic
highlighted the United States, Canada, Australia,
and Japan, providing a comparison of each
country’s COVID-19 response before showing
that the patterns seen throughout the global
pandemic were not unique to the virus itself but,
rather, the institutional issues that each country
faces. To further emphasize this point, we showed
that the United States was ranked #49 in life
expectancy before showing additional statistics
related to the health status of the country: #55 in
maternal mortality, #1 in incarceration rate, and
#1 in COVID-19 deaths. Finally, to ensure clarity,
we stated that health was not determined by how
much a country spends on healthcare, as other
policies and institutions determine most of health
before the healthcare system even becomes
involved in the situation.

To support our argument, we utilized the

metaphor of a track race, in an effort to draw on
the feelings of community and national pride
associated with the Olympics. We hoped that this
metaphor would be easily digestible and would encourage people to act upon these health
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injustices. Additionally, the graphic helped highlight that, while health is not a race, it is not an
area that the US is doing particularly well in. However, the chosen metaphor does run the risk of
minimizing the importance of American health by comparing it to a simple track race.

Preparation and Execution

Since university public health programs and local/ state public health departments have existing
audiences, we chose to contact them and ask them to distribute our graphic. This way, we would
be able to reach beyond our personal social networks and effectively target our region, the Left
Coast. Furthermore, by sharing the information through a public health program or department,
we were hoping to help establish more ethos with our audience which would help legitimize our
statements within an era of misinformation.

We contacted 44 institutions with the hopes of them sharing our graphic.

● Alaska (4)

Alaska Health and Social Services; University of Alaska Anchorage; Anchorage Health
Department; University of Alaska Fairbanks

● Canada (1)

UBC Public Health

● Washington (21)

UW Public Health; GlobeMed Club at the UW; Washington State Department of Public
Health; Clallam County Health Department; Jefferson County Health Department; Grays
Harbor County Health Department; Pacific County Health Department; Wahkiakum
County Health Department; Kitsap County Health Department; Mason County Health
Department; Thurston county Health Department; Lewis County Health Department;
Cowlitz County Health Department; Clark County Health Department; Skamania County
Health Department; Whatcom County Health Department; Skagit County Health
Department; Snohomish County Health Department; King County Health Department;
Pierce County Health Department

● Oregon (10)

Oregon Health Authority; University of Oregon Public Health Minor; Oregon State
University Public Health; Oregon Health and Science University; Multnomah County
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Health Department; Washington County Health Department; Clackamas County Health

Department; Lane County Health Department; Marion County Health Department;
Tillamook County Health Department

● California (8)

California Department of Public Health; UC San Diego Public Health; UCLA Health;
L.A. County Health Department; San Diego County Health Department; Orange County
Health Department; Riverside County Health Department; San Bernardino County Health
Department

If possible, our initial

contact was through
Facebook Messenger as
this would allow us to
contact the parties
involved in maintaining
their social media pages.
Furthermore, on their
Facebook pages, many
institutions stated that
they replied to messages
within a day. If this form
of communication was
unavailable, we elected
to email or submit a
message via the
department’s contact
form.

Rationale

Since we wanted to strategically target our American Region, the Left Coast, we decided to
utilize existing departments and institutions to assist us. This would help to ensure that we
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reached the largest possible audience, numbers and diversity of viewers that were unavailable to
us via our individual social networks.

Furthermore, this would help the legitimacy of our project as the graphic would be published by
a reputable source. While we opted to include citations, it can be very difficult to tell what is and
is not reliable. Therefore, by including citations and getting the approval of these institutions, we
have provided viewers with a trustworthy source of information about the US and its health
failures.

RESULTS and REFLECTION

We chose to measure our results by comparing how many departments and institutions responded
and chose to publish our graphic. While we were successful in sharing our graphic, not
everything worked according to plan.

Results

While we were successful in engaging particular institutions, we did not receive as many positive
responses as we had initially hoped to. Out of the 44 institutions that we contacted, we received
responses from 3 as of 4 February 2021. The 3 institutions, clubs and departments that elected to
publish our graphic were the University of Alaska Fairbanks, UW GlobeMed, and UC San Diego
Public Health. The other 39 institutions elected not to publish our graphic or did not respond to
us. However, we are still in communication with the UW Public Health Department and Cowlitz
County Public Health in hopes of publishing the graphic at a later date.

However, we may have been a bit naive in the beginning. We thought that it would be relatively
easy to at least get a response from each institution, but we did not account for inboxes being
overwhelmed due to COVID-19 inquiries, local public health departments turning off all forms
of virtual contact, nor for places choosing to ignore us. Many of the messages we received stated
that the department was understaffed and asked us to not send “unsolicited” emails/ messages.
But, we also had many positive interactions: We worked with the public health department at the
University of San Diego to alter the graphic for their social media pages and were also invited to
encourage students at the University of Washington to register for and present at a virtual public
health conference through the University of Alaska Fairbanks.
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Takeaways
Looking back, our graphic did not explicitly state next steps for our audience. While we did
include citations, allowing individuals to further research the topics, we did not include a “next
step” slide at the end. We did consider this while drafting the outline of the graphic. However, I
think that we struggled with this because we were looking for solutions, not further steps for
research or learning. And, it is very difficult to find solutions to these problems. They are not
easy. They are institutional issues that need to be addressed through, arguably, the political sphere
as they require the restructuring of institutions and social programs. As a result, we were not
exactly sure how to summarize a “next steps” slide.

Reflection

Unfortunately, our project did not work out exactly like we had planned. However, we were able
to publish our graphic through some institutions and reach an audience that would be inaccessible
to us on our own, classifying this project as a success. Sharing this information with students at
UCSD and the University of Alaska Fairbanks may even inspire them to look further into health
within the US, and could help build a strong new generation of public health workers.

Advantages and Disadvantages

While this format did allow us to reach a large, diverse audience that would be inaccessible to us
through our individual social networks, it also presented challenges. Since it did not rely on us
publishing the information ourselves, we had to depend on other institutions to respond to our
inquiries and elect to publish our graphic. While we understood this concession while we were
drafting our proposal, we did not fully account for the current state of the world. As we are in the
midst of a global pandemic, many of these institutions are being flooded with questions and
comments from the public. This led to a few organizations opting to turn off Facebook
Messenger and remove their email addresses from their website, leaving a contact form.

Critiques
While we are very proud of being able to publish our graphic on certain social media platforms,
allowing us to reach a broader audience and specifically target that audience, most of our
engagement required individuals to read and interact with the graphic. We wanted it to be
thought-provoking, however we did not create a platform to encourage discussion or create a
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slide outlining next steps. While a discussion may be impossible due to us relying on others to
publish our graphic within their time frame, we could have included a slide outlining areas of
action.

Furthermore, we were able to complete the project again, we would probably try to create a
specific slide for each region, outlining where their state falls within the COVID-19 (and health)
Olympics in hopes that this would further encourage these public health social media platforms
to share our graphic.

Finally, we should have sent out our initial emails earlier as that would give institutions more
time to respond. We gave them four business days. And, while we are not exactly optimistic
about more time increasing our response rates, as we were able to see that some of our messages
were read on Facebook Messenger but no response was received, it does not hurt to try and wait
a little longer. We could have also drafted specific follow-up emails. While this would address
the issues of departments being understaffed and receiving a deluge of messages, it may help to
increase our response rate by bringing us to the top of their mailbox again.

REFERENCES
Altman Drew. Understanding the US failure on coronavirus—an essay by Drew Altman BMJ
2020; 370 :m3417

Belluz, Julia. “We Finally Have a New US Maternal Mortality Estimate. It's Still Terrible.” Vox,
Vox, 30 Jan. 2020,
www.vox.com/2020/1/30/21113782/pregnancy-deaths-us-maternal-mortality-rate.

Bremmer, Ian. “The Best Global Responses to COVID-19 Pandemic.” Time, Time, 12 June
2020, https://time.com/5851633/best-global-responses-covid-19/.

Country Comparisons: Life Expectancy at Birth. CIA World Factbook.

https://www.cia.gov/the-world-factbook/field/life-expectancy-at-birth/country-compariso
n.

“COVID-19 United States Cases.” Johns Hopkins Coronavirus Resource Center,

https://coronavirus.jhu.edu/.
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Egede, Leonard E., et al. “Structural Racism, Social Risk Factors, and Covid-19 - A Dangerous
Convergence for Black Americans: NEJM.” New England Journal of Medicine, 17 Sept.
2020, www.nejm.org/doi/full/10.1056/NEJMp2023616#article_citing_articles.

Office of Washington Gov. Jay Inslee. [Individuals wearing protective masks]. NW News
Network.https://www.nwnewsnetwork.org/post/covid-19-heats-washington-gov-inslee-an
nounces-statewide-mask-requirement.

“States of Incarceration: The Global Context.” Prison Policy Initiative,

www.prisonpolicy.org/global/.