Public Health Ideas with Heather Corcoran

Sandro Galea: Tell us how you came to be doing the work you’re doing. What path led you to design?

Heather Corcoran: A quite circuitous one. As a kid, I moved around all the time. My dad was in the Navy and I read a lot. When I went to college, I studied English, but I took this incredible class in my sophomore year, which I often tell undergraduates at WashU, that was set in this print shop on campus, and I started printing letterforms. All these things that I had read suddenly took on this very visual form. And I sort of realized in the moment of that, that my life would have something to do with that. I’ve been making visual, typographic stuff ever since.

Fast forward to WashU, which has been such a perfect place for me because it’s this interdisciplinary space and incorporates so many fields. I’ve been able to work with a lot of different subject matter and combine more analytical interests with more open-ended poetic writer-type interests.

SG: [In 2011,] you worked with colleagues in public health and cancer prevention at WashU to create a new interface for presenting cancer rate data. […] How did a project like that come about? And what emerged?

HC: Well, first of all, I will say that I think it came together by a happy accident. [Professor] Matt Kreuter, who was a fairly new faculty member to WashU at that point, was lost in our building or wandering in the halls or something. Gradually we were introduced by people in the school and, as I recall it, had a lot of conversations about data visualization from very different perspectives. He was interested in visualizing cancer surveillance data, asking a question about: could we get people to understand this data better, and also, could we get them to care about it more?

He had a lot of examples of things that had already been done, sort of researcher-to-researcher. The question was: could we pivot all of that toward a public audience and make it meaningful somehow? He was wonderful about helping us to figure out the funding and application aspect of this, because this was really new to the [Sam] Fox School, which was actually fairly new at that point […] We put together this grant proposal that was wide in its possibilities for these experiments that we were hoping to run. And we got funding and then it was really exciting.

We had a few years where we were building all of these different things. And the interface that you’re talking about was one of those things, which was really a model for how could we display rates from a given place about a given kind of cancer? And then the individual units within the states would be able to customize what they wanted that to reveal.

We tested it with 750 residents of the state of California using a California example. We had a partner there, too. It was great because we learned that people did understand the data much better, sort of following general design principles and some of the ideas that we were investigating.

What we also learned that I think links to where things have gone since is that just because you can get somebody to understand something better doesn’t mean that they care about it more. So, we still had this challenge of like, but why is this relevant? For whom is this relevant and how do we attract people’s attention? That’s still an ongoing work. I think of people like Penina Laker and the kind of work that she does in community as a really incredible extension of that kind of thinking; how do we get that base level engagement? I feel like we’re working on both of those things in a way, attention and, also, retention or understanding.

SG: You know, I think anybody listening to this probably is interested in effective data visualization, effective design […] How would you distill key principles for effective data visualization?

HC: OK, so I’ve got one my biggest principle […] And that I would call hierarchy. What’s the most important thing? And then what are all the supporting things?

We talk to students about this all the time. It can be very hard to commit to what is the most important thing for us to understand or take away from what we’re looking at or what we’re hearing or what we’re experiencing.

A lot of times visually, we accomplish that by making it in the biggest thing that we see or in a Western culture, it might be the thing that’s in the upper left-hand corner, the place where we would go to naturally read something.

Or it’s the thing that has the most contrast, meaning it’s the darkest thing on the lightest background or the lightest thing on the darkest background.

There are a variety of tools or ways that we can direct or attempt to direct the attention of the audience. But then I think the hierarchy is also not just about what’s big. It’s about what isn’t big. What is small or secondary, but still important? And then, maybe, what doesn’t need to be there at all? I think we all love our content and our material, and it can be quite hard to let go of. Actually, for the person that you’re talking with, some of that is noise. It really is more than they can absorb or think about.

Part of that idea of hierarchy is also managing what is at the granular level and discarding what can be discarded and then carefully grouping and organizing what’s left over.

SG: We’ve been talking a lot lately about public health, trust in public health. And I think there’s a general feeling in the field that in part the challenges that we have struggled to communicate. From your perspective, what’s the role that data visualization and design can play in that communication? To what extent are they part of a solution for the field going forward?

HC: I think that principles of data visualization specifically can help to establish and maintain credibility and trust over time. And I think that there’s basic principles of thinking about how you present data consistently. Things like how scales are used consistently and that there’s a commitment to an honest presentation of whatever that material is over time.

I think there’s also credibility built through kind of name recognition and identity and a kind of careful management of that. If you become trusted as a trusted partner over time, then if that material is well presented and they’re a good partner and people are used to looking at that and understanding the way that the information is presented, then they will tend to return to it and trust it.

SG: I think what you’re talking about is immensely appealing for anybody who’s interested in getting ideas around public health out into the world in a way that is trusted and embraced by the population.

So, I think if I were listening to this, I would say, OK, that sounds great, but how do I do this? How does someone in public health actually partner with someone like yourself? Which let’s face it, these are pretty different worlds, different conceptual worlds. In some respects, we almost have different languages in our training and our practice. […] How does one build such a collaboration in a way that’s productive the way you’ve been able to do that?

HC: Well, I don’t think it’s easy for anyone. So, I think it’s important to say from the outset, “OK, this is not a simple thing that we just sort of didn’t do.” It’s challenging and I think we’ve made as a university a lot of progress in various areas by many people over time.

To me, the most important part of this is do the people around the table, are they actually really invested in what is important to the people in the other field? I think it’s easy to say, “Oh, but we like you and we want you to be successful.” I have no doubt that we all feel that way about each other. […] I mean something different from that, which goes a step beyond.

Can we get to a point where I can understand and care about Matt Kreuter’s behavior grids that he makes? […] Can I understand that well enough to get what he needs from a project for it to be meaningful to move public health? And, at the same time, can the public health people understand what something needs to be to be a compelling design problem? […] I don’t think we’re so far removed, but I think we have to care enough to go pretty deep on what the goals are of the other side of the table.

SG: My last question: what gives you hope in the moment?

HC: Well, it’s a challenging moment in many ways. I would say personally for me that I am incredibly blessed to have gotten to live and work for such a long time in the field that I love. And, so for me, the ability to make visual things, to make them by hand, to write, to then digitize them, to just create. I have stacks of books; I keep making, keep making. It’s that.

It’s the power to have your own voice in the conversation, as hard as it’s getting, I think is a pretty incredible gift.