Enhancing the public impact of ethnography

Abstract

This special issue concludes with pragmatic advice for ethnographers seeking to have an impact on public perceptions of health problems, and to influence public policy. We asked four people with different disciplinary perspectives – an academic anthropologist who launched a popular interest anthropology magazine, a journalist for an internationally cited newswire, a policy maker-cum-visual-ethnographer, and a health official in a national government agency – a single question:

What is an immediate step that ethnographers of health might take to affect social change?

Publish in Popular and General Education Presses

Emily Martin

Professor of Anthropology, New York University

Founding Editor, Anthropology Now

I have long seen ethnography as useful for educating broader publics. In The Woman in the Body I analyzed the account of menstruation in early editions of the women’s health movement classic, Our Bodies, Our Selves (Collective, 1984) which was much the same as distressing medical text books’ accounts of menstruation as failed production (Martin, 1987, p.229). Eventually the message got through to the women’s health movement and subsequent editions of Our Bodies, Our Selves were rewritten to reflect this (Collective,1998). Just as gratifyingly, a children’s book reflecting knowledge of the misleading stereotypes in the canonical story of the egg and the sperm has recently been published (Silverberg, 2012).

More recently I developed a graduate course in “Anthropology and its Publics”. I have taught it on my own and jointly with Leith Mullings at the City University of New York. We introduced students to classic works on intellectuals in the public sphere, to different forms of practicing anthropology in collaboration with fieldwork interlocutors, and to specific genres of writing for the public, such as the Op-ed. To achieve this last, we are indebted to training from The Op-ed Project, an organization that runs highly effective workshops on how to write an Op-ed.¹

Weber cautioned against demagoguery – or any form of politics – in the classroom because the professor has authority over the student and can punish his or her failure to conform. But he went on to say that in a public meeting it is your “damned duty” to enter the fray and express your personal point of view (Weber, 2004, p.20). It is for this reason among others that I have put energy during the last decade and more to develop a general interest magazine for anthropology. This product cannot determine how it is used: it can be bought, borrowed, or stolen; it can be read and shared or ignored and discarded. Hence it is a forum in which the lessons each researcher wishes to conclude from the ethnographic method can be espoused in as convincing a way as possible. Anthropology Now is, in 2012, in its 4th year. It is growing in circulation and reach, both in its print form and its web form. Growth in circulation has been helped by the General Anthropology Division of the American Anthropology Association, which recently adopted Anthropology Now as its official journal and by JSTOR, which accepted the magazine into its electronic offerings. A large number of faculty and graduate students have given labor (editing, organizing, promoting, soliciting, designing) and original materials (essays, photographs, book reviews, field notes, poems, memoirs). Dean Birkenkamp, president of the independent publishing company, Paradigm Publishers, has enabled financial backing because he believes in the efficacy of anthropology to shed original light on public issues.²

Our collective goal is both to show the public what the labor of ethnography actually is (a social/cultural version of an archaeological dig or fossil exploration) and to illustrate some of the conclusions anthropologists have reached about matters of social justice in contemporary life. We believe that these interventions into the “marketplace of life” will lead to many forms of social change (Weber, 2004, p.25). The audience for anthropology is also growing internationally. Anthropology Now has been in correspondence with the UK Royal Anthropological Institute about the newly established provision for high school students to take an A-level exam in anthropology: this means that anthropologists are developing a curriculum for anthropology in UK high schools, an exciting prospect that I hope will inspire anthropologists in other countries as well.³ For example, the meetings of the American Anthropological Association in Chicago in 2013 will feature “Anthropologists Back to School,” a program to bring scholarship in anthropology into the Chicago public schools. The Back to School program focuses on African history; Anthropology Now articles in print and on the web have covered current issues such from the Haitian earthquake to climate change and shed unconventional light on the cultural meaning of such things as football or Hopi songs. In these times when public values, critical thinking, and liberal arts education are all under attack, we should cherish this sign that the perspective of anthropology is gaining a wider audience, and as a result, is expanding the public’s vision of what is socially and politically possible.

Build a Following Online

Gideon Litchfield

Global News Editor, Quartz

Former Media Editor, The Economist

The early-to-mid twentieth century saw the rise of an ideal: the perfectly detached, dispassionate, “objective” journalist, who would never express a point of view or favor any side in a dispute. Aside from the reality that writing and editing always inherently involve some level of subjectivity, most journalists would acknowledge that a version of “advocacy journalism” is on the rise. Credibility used to be equated with a neutral point of view; increasingly, it is equated with having a view and making a credible case for it. This creates an evident opening for the socially and politically engaged ethnographer.

How should an engaged ethnographer disseminate her thick description? In the past the choice was between writing a book, which was likely to get published but reach relatively few readers, and crafting a long article for one of a few select popular magazines, where it might reach millions but had little chance of getting published. Now, the internet has handed ethnographers a powerful set of tools for publishing, disseminating and promoting their work without the help of the media outlets they once relied on. My experience working on the development of online journalism at The Economist and more recently at Quartz (http://qz.com), a new online publication, suggests that there are increasing opportunities for publishing both short-form and long-form writing.

Practical publishing tips for ethnographers

A good general approach to creating and maintaining an online presence is to publish a mixture of frequent short and infrequent long materials. (This is known in some journalism circles as the “stock and flow” method.) The purpose of the short, frequent items is to gain a following and a reputation as a source of interesting material online. This has the effect of raising the profile of the subject you are studying; raising your own profile in the eyes of the media (journalists are more likely to hear about and seek out someone with a large online presence); and making it easier to promote the infrequent, more substantial pieces of work when you publish them.

For short-form publishing, Twitter is one obvious place to start. If there is frequent news or popular articles that relate broadly to your field of interest – and particularly to the social issues that you wish your work to affect – maintain an active Twitter account and tweet links to these stories. The goal is to become a useful resource for news on that subject.

Instagram/Tumblr.

The web also gives the ethnographer more freedom to use a variety of visual formats. Good photography (for which space is always severely limited in print) or snatches of video or audio can bring a place and its people to life. If the circumstances permit, post regular photos or short snippets of video from a field trip on one of these platforms. These can be accompanied by short extracts from field notes.

Blogs or op-eds.

An op-ed in a major paper can be influential, but it’s hard to get published. A blog on your own personal site or a site like the Huffington Post (which grants blogging rights relatively liberally) can be a useful place to post your thoughts on a current event affecting your area of study without having to jump through the media’s hoops. Even if these aren’t widely read at first, they serve as much to establish your voice and area of interest online – which, again, is useful when journalists come looking for you – as to influence discussion at any given moment. Semi-regular writing will also help you hone the format and framing required for things you post to reach a wide readership.

For longer-form publishing, look to use “thick description” to write compelling stories from fieldwork that educate a lay audience about the issue you’re researching while also vividly describing the lives of your subjects. It helps to focus on a small number of key characters and describe an evolving relationship between them (for instance, a conflict followed by its resolution), or to focus on just one character (one of your subjects, or you) and write about the arc of a personal evolution or journey he or she undertook (for instance, from hope to disillusion, or from a desperate situation to a solution).

Besides the traditional magazines, sites that publish long-form articles include Matter (readmatter.com), Medium (medium.com), the Baffler (thebaffler.com), Byliner (byliner.com), Aeon (aeonmagazine.com), the Atavist (atavist.com), and Narratively (narrative.ly). Read each site for a sense of the kinds of articles it publishes and contact the editors to pitch and discuss ideas. You may also consider using a platform such as Creatavist (creatavist.com) which makes it easy to publish stories with a mixture of text, photography and video in an attractive format. These sites are hungry for good-quality writing, but often can’t pay much for it, which makes them receptive to contributors such as academics, who are getting paid by someone else.

With both short and long publishing, think about the “shareability” of each item you publish – the likelihood that people will want to share it with other people via social media. Unless you are publishing on a very widely-read website (and even then), the success of any piece of content online depends more than anything on how widely shared it is. There are many online guides to improving shareability; perhaps the single most important thing is to refine the wording of headlines and tweets to stoke the reader’s curiosity.

Mastering these methods takes assistance and practice. But the combination of ethnographic time, the changing concept of journalistic credibility, and the shifting business models of online media together give ethnographers an opportunity to use their narrative skills to greater effect than ever before.

Narratives to Build Conceptual Models

Mehret Mandefro

Former White House Fellow and Special Advisor to the U.S. Federal Veteran’s Administration

Faculty Fellow, Department of Anthropology, Temple University

Adjunct Professor, Department of Health Policy, George Washington School of Public Health and Health Services

President, Truth Aid

The translation of research into policy is not simply a matter of having the evidence-base to support a particular decision. It also requires synthesizing the information and persuading others that acting on the evidence at a particular time makes sense. In an environment defined by competing demands this can be a difficult task. Ethnography is well-suited to meet this challenge because it mobilizes an increasingly valuable resource in the policy domain – people’s stories. Interpreting evidence to convince policy makers that now is the time means being very clear, simple, and persuasive and nothing does this like a well-crafted story. Stories translate more effectively to policy makers then numbers do because they more readily persuade.

This makes the rich stories we tell as ethnographers important tools for policy-making. The value of these tools in translating research to policy, in particular, lies in their ability to simplify complexity. The power of ethnography as a method lies in its robust ability to capture context and convey complexity in narrative form. Successful ethnography accomplishes this by doing analytic work through construction of narrative. Yet its narrative form is appealing to policy makers because stories are increasingly being used in the policy making process as communicative tools that synthesize divergent streams of data.

A recent example from a federal effort to address the psychological health of military families illustrates these observations. Presidential Study Directive-9 (PSD-9) was an unprecedented attempt to establish a coordinated and comprehensive Federal approach to supporting the well being of military families. An important focus of this effort was enhancing the psychological health of the military family. The primary challenge the sub-committee responsible for drafting the psychological health recommendations faced was making sense of the data on the mental health of returning Veterans from the Iraq and Afghanistan wars and active duty Service Members and extrapolating what this meant for strengthening the resilience of military families. To meet this challenge, committee members had to synthesize volumes of studies into a core message about resilience that was actionable. This involved an iterative process of trying to understand, as a committee, what the data meant and generating narratives about mental health that could be used to communicate these findings to the National Security Staff responsible for oversight and translation.

Among the narratives used about mental health was a story about a returning Veteran from the Afghanistan war who was struggling to readjust to life at home but did not meet the clinical criteria for post-traumatic stress disorder (PTSD). This story served as a departure point to discuss the population of returning Veterans and active duty Service Members who are experiencing psychological health disturbances, what many in the Department of Defense community refer to as “post-traumatic stress”, without meeting clinical criteria for a formal diagnosis. This is a watershed area in the mental health policy world that provides a foundation for promoting interventions that strengthen resilience. For the purposes of the sub-committee’s work this particular narrative clearly conveyed the limits of diagnostic criteria and what this may mean for prevention and unmet need.

This led the psychological health sub-committee to develop a visual conceptual model of a system of care for behavioral health that could be used in conjunction with the narrative. The conceptual model included a wide spectrum of services from prevention to treatment of serious mental illnesses and was used to convey the core message about what the Federal approach to building resilience should prioritize. This conceptual model became the guiding framework for the final set of recommendations and a tool that anchored all efforts to reframe mental health as an issue of prevention.

This example highlights two lessons. First, by explaining complexity, ethnography offers health policy related translation efforts a method that is equipped to meet the challenges of making evidence-based policy in an era where making sense of conflicting and countless studies is a first-order limitation. Second, ethnographers interested in doing this work must pay special attention to producing useable knowledge that lends itself to translation efforts. Incorporating tools like visual conceptual models into the ethnographic repertoire would go a long way in helping ensure that ethnographic knowledge is tapped to help polices work better for people they intend to serve.

Publish Mixed Methods Reports In Policy Journals

Farah M. Parvez

Medical Director, Office of Correctional Public Health, New York City Department of Health and Mental Hygiene

Medical Officer, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention

Disclaimer: “The opinions expressed by the author contributing to this journal do not necessarily reflect the opinions of the Centers for Disease Control and Prevention or the institutions with which the author is affiliated.”

As the Director of a program that conducts health policy, program implementation, research, and evaluation work in New York City jails, I read the articles in this Special Issue with great interest. For public health practitioners, researchers, and policy makers working in correctional settings, incarceration is viewed as a public health opportunity, and responsibility, to improve the health and well-being of both our correctional population and the larger community to which they inevitably return (Glaser & Greifinger, 1993; Greifinger, 2007). The fundamental challenge for us is how best to accomplish these goals.

Rising health care and public health costs have led to the need for “evidence-based” policy, programs, and research to prioritize and justify expenditures and improve health and public health outcomes (AbouZahr, 2011; Eliott & Popay, 2000; Institute of Medicine, 2008). Historically, public health practice and policy have, in great part, relied upon the discipline of epidemiology, which primarily uses quantitative methods to characterize the distribution of diseases within populations, elucidate causal relationships between exposures (e.g., individual behaviors) and health outcomes, and inform the development, implementation, and evaluation of health promotion and disease prevention interventions (Goodson & Vassar, 2011; Jack, 2006). Randomized clinical trials, widely considered the gold standard and highest quality of evidence, and cost analyses are other important tools for policy makers, reflecting the ideal that scarce public resources should be invested in policies and programs that have demonstrable positive outcomes and efficacy (Bryman, 2007; Rhodes, Stimson, Moore, & Bourgois, 2010; Stenius, Makela, Miovsky, & Gabrhelik, 2004; Task Force on Community Preventive Services, 2005). Policy makers rely on the best available evidence to inform policy and program planning; quantitative methods are perceived to best provide objective evidence or criteria by which to develop and evaluate health and public health policies and programs.

In recent years, however, there has been a change in how public health practitioners, researchers, and policy makers view the determinants of individual and population health and thus the methods needed to address them (CDC, 2010; Koh, 2011; WHO, 2008). There is a growing recognition of the value of ethnography to health and public health policy making, particularly related to correctional populations (Curry, Nembhard, & Bradley, 2009; Noyes, Popay, Pearson, Hannes, & Booth, 2008; Stenius et al., 2004; Wacquant, 2002). Ethnography produces rich data on people’s perceptions, beliefs, experiences, and behaviors to facilitate a better understanding of a problem and how it could be resolved and provides a different kind of “evidence” than quantitative data (Curry et al., 2009; Gagliardi & Dobrow, 2011; Jack, 2006). Ethnography enables policy makers to better understand people’s experiences and to gain empathy, which is particularly important for correctional populations whose behaviors are often viewed in a simplistic or negative manner. It can help identify and fully explore barriers, facilitators, and unanticipated outcomes of policies and programs and lead to the development of new approaches not discovered using quantitative methods. If the intended research outcome is to inform health care and public health policy, then, whenever possible and appropriate, an integration of ethnographic and quantitative methods is preferable. A mixed-method approach combines the strengths of both methodologies while minimizing the weaknesses and may provide the best strategy for developing and evaluating policy and programs (Curry et al., 2009; GAO, 2003; Hammersley, 1992; Jack, 2006; Noyes et al., 2008; Onweugbuzie & Leech, 2005).

Recommendations for qualitative researchers

Policy makers need to have more readily available access to qualitative research. Qualitative researchers should consider publishing in peer-review journals which relevant policy makers are more likely to read. Perceived challenges (e.g., difficulty getting a “qualitative” paper into a “quantitative” journal) and journal word limits may make publication of qualitative or mixed methods papers difficult (Bryman, 2007; Rhodes et al., 2010; Stenius et al., 2004). Guidance for ethnographers on publishing qualitative research in policy oriented journals may be helpful in overcoming some of these challenges (Barbour & Barbour, 2002; Evans, 2002; Harden, 2010; Noyes et al., 2008; Seale & Silverman, 1997; Stenius et al., 2004). In addition to publications, qualitative researchers could share relevant data with policy makers by presenting at our local or national conferences or setting up specific meetings to share findings that might be of interest. Of importance is initiating and sustaining collaboration and dialog between researchers and the users of the research findings. Given the time constraints of policy makers and staff in funding agencies, it is important for qualitative researchers to succinctly articulate their main findings and to provide specific and detailed policy recommendations. Only through the translation of research into practice can public health achieve its goals of preventing disease, prolonging life, and promoting health and well-being.