science & technology Category

The Disconnected Human


In this mini-series we look at the phenomenon of paradox and some of the prominent ones in our social world. Today we look at human disconnection in the face of mass-urbanization, globalization, social media and information technology and why so many feel so isolated in a world pushing ever-more interconnection.

It is possible to have a wristwatch that is connected to a phone which also connects to your online social network platforms, a heart rate monitor, earphones and maybe even the appliances in your home. We do not lack for connections, but we do often lack connectedness.

As it turns out, connectedness matters. Laboratory and clinical research on addiction (summary), has suggested that it is as much a problem of social connection as biochemistry. Those who are socially isolated experience a higher degree of, and experience with, addiction. Loneliness, in psychological terms, refers to the absence of connection and communication with others and both negative affect and cognition resulting from this. Loneliness is not just a social issue, it gets under the skin  (pdf) with research pointing to pathways for harmful biochemical changes among those who are lonely.

Still, how is it that we are in an age of increasing global urbanization (pdf) whereby more people are living closer to each other, exposed to more people than ever before, and yet there is a parallel increase in loneliness? How can it be that we have more tools — ones that are mobile, instantaneous, and easy to use — that can share rich media with nearly everyone we know at nearly any time of day and still find ourselves isolated?

This paradox is all by design — whether intended or not.

Disconnecting the social graph: Facebook

Facebook is a classic example of how to design isolation into a tool aimed at promoting connection. Once a college tool for meeting and connecting friends, it now serves as a news media source, community organizing tool, general communication platform, organizational home page, text message system and photography album. It’s ever-changing, sophisticated algorithm ensures that every login to Facebook is different, aside from the current format of seeing top post followed immediately by an ad, the next top posts, more advertising, and so on. When you need to find something explicit, it’s very hard and that’s by design. The more connections you have, the harder it is to find material and maintain those connections without having to sift through material that, ironically, disconnects you from the purpose of your visit.

This all helps keep you on the site and coming back.

But this very aspect of having to come back frequently, to see different things each time, and to have to root through social and marketing ephemera to get to something that feels social is what isolates us. Yet, the intermittent reinforcement that comes when you log in and find just what you want the moment you open the screen is based on a crude, but powerful set of psycho-biological principles that anchor behaviour to the pleasurable feel of dopamine that rushes through the brain when you get that social media high. Add in everyday stress and the cortisol it releases and oxytocin hormone rush that come when we connect and you’ve got the perfect ghost-in-the-machine scenario to keep you locked on to this tool that offers you the hope of connection.

Now Facebook is aiming to integrate it into its other properties like Instagram and WhatsApp presumably to integrate this experience and your data along with it. This has the added benefit of Facebook of doing what other marketers already do and that is follow me everywhere I go on the Internet and reminding of me of more things to buy, consume and connect to, which will only add (paradoxically) to my sense of disconnection. Other social media platforms do this differently, but nearly all of them offer a variant of the same sort of stimuli aimed at keeping you posting pictures, exchanging messages, and sharing content.

Stimuli addiction

A powerful post by my friend, colleague and fellow designer, Medina Eve, wrote a deeply personal, provocative piece on living with ADD as an adult and the lost generation of souls who share her circumstances. Her brave, detailed story chronicles how she, like many young women in particular, have struggled with focus due to ADD and reaping the benefits that come with it, despite being an incredibly productive, intelligent, engaged person. Her story provides a first-person account of a social epidemic and paradox on how the ability to connect to so much means there is little ability to connect deeply to many of the things that matter and the incredible isolation that this engenders.

When the world offers too much to pay attention to (or filter through), we get too little in return.

ADD is at its core is an addiction to stimuli. It is the bodymind getting overwhelmed with the amount of stimulation we have around us which reduces our ability to filter, ignore and reject stimulation of various sorts coming at us. If you have any doubts about how much stimuli we are exposed to practice a mindful meditation where you aim to simply pay attention to what’s around you and what’s in your head. It can be remarkable that everyone doesn’t have it.

This is also a problem I’ve certainly battled and continue to battle with limited success and I am certainly not alone. This addition to the stimulation around us, particularly through socially-connected media and our explicit and ambient technologies that facilitate it all, is not only making us less connected, it’s also making us less human. And this is also by design.

Stimulation by Design

A look at the image below provides an illustration of how we design for stimulation. Imagine the holiday season and the Covent Garden Market in central London. All around there is music, food, bustling crowds doing holiday shopping and business, shopkeepers and buskers selling everything from entertainment to handbags to Lebanese street food, and the air filled with the scents of perfume, various cuisines from around the world, and an air of cedar from the holiday wreaths. All of this is lit up and decorated as the crowds jam through the stalls, eateries and cafes to take it all in. This is what Covent Garden wants and it is why people come from all over the world to take it all in. If there were no people, less ‘stuff’ and less activity it wouldn’t be attractive, which is why not all of London’s markets look like this.

But thankfully for us all, we can’t take Covent Garden with us. We have the option to disengage from it in a way we don’t with social technology.


The Holiday Crowd at Covent Garden

What you will also see among this bustle are families walking together, friends gathering over a drink, and individuals roaming through the market, maybe even stopping to take a picture or two. For those who are enjoying this space, I suspect they are doing so because it’s special. While London is a very crowded, colourful city, it’s not this crowded or colourful all the time (although that is changing, too).

But what happens when the energy of the crowd and the space turn against us? Most of teh time, human beings adapt. I am sure if you were to bring someone from even 100 years ago they might break down at the experience of all this stimulation, because they aren’t used to it. Many of us are, or are we?

Social disconnection and its sequalae may be pointing to the paradox present in our question to create more stimulation and feedback opportunities by loosening our ability to connect to the very things that are at the heart of much of this stimulation: pleasure and the connection to our own humanity.


Giving up the Internet: A case study

Comedian Louis C.K. has a funny, poignant reflection on what we lose in this stimulated world during a guest spot on the Conan O’Brien show.

Kids don’t build empathy through interactions and building the ability to be yourself, with yourself; the kind of experiences you can only have without technology. What a powerful thought.

Louis C.K. was so concerned about what technology was doing not only to his kids, but himself that he ‘quit the Internet’ altogether as you can see in the segment below.

What Louis C.K did was design the conditions in which he used (or didn’t use) technology. His aim was to create, improve, and remedy the experiences he had with his children and found a way to do it. Aside from some tech support from his daughters he did this all alone. The reward was increased connection to his family, however what we don’t know was what cost there was in disconnecting. Maybe that cost was worth the doing.


Invisible problems, invisible solutions?

The point here is that design is often best when it’s invisible. It’s what makes the stimulation economy so insidious because it’s reach is everywhere, yet is often not noticed, thus making it a very successful design. The challenge, if we wish to channel the stimulation and influence what we have in our lives and to increase the connectedness in which this paradox of connecting tools present, is to design equally invisible solutions.

That is the focus of what is to come in this series along with a deeper exploration of connectedness and its shadow, loneliness.

Photo credits: Disconnect by Randy Heinitz used under Creative Commons License via Flickr. Thanks for sharing your work Randy.

Covent Garden at Christmas by the author

Our Paradoxical Age


If there was a word we could use to define the current times, paradox would certainly have to be a leading candidate. Can we learn to love this seemingly maddening force or are we doomed to accept this emergent complexity? This first in a series looks at some of the paradoxes of the day, what they might mean for our society and how we might live with them. 

paradox |ˈperəˌdäks|


a statement or proposition that, despite sound (or apparently sound) reasoning from acceptable premises, leads to a conclusion that seems senseless, logically unacceptable, or self-contradictory: a potentially serious conflict between quantum mechanics and the general theory of relativity known as the information paradox.

• a seemingly absurd or self-contradictory statement or proposition that when investigated or explained may prove to be well founded or true: in a paradox, he has discovered that stepping back from his job has increased the rewards he gleans from it.

• a situation, person, or thing that combines contradictory features or qualities: the mingling of deciduous trees with elements of desert flora forms a fascinating ecological paradox.

If you think we’re living in strange times you’re not alone. Technology and its influence on our social world has produced things, ideas, encounters that only a few years ago would seem utterly preposterous if not impossible. Self-driving cars, drone delivery, digital social networks and video telephony, as remarkable as they are, have been somewhat pre-saged by science fiction and in a Jetsons-esque manner seem somewhat plausible to those who’s imaginations are sufficiently rich or their attenuation to popular culture sufficiently robust.

What I am talking about are the less dramatic or technologically sophisticated , but powerful shifts that have come from new products and services that are moving from the occasional ‘once-in-a-blue-moon’ kind of occurrence to something common and regular. This is producing paradoxes in droves, which is presenting conundrums for social scientists, policy makers and citizens alike.

Pokemon Go and the case of the walking dead-or-alive(?)

The above photo was taken July 11th in Toronto, Canada. I was walking upon a square when I noticed nearly everyone — dozens of people (with more coming every minute) congregating at the square to look at their phone. Unbeknownst to me at the time, five days earlier a game called Pokemon Go was released in Japan and the United States (a game that would not be released in Canada for another six days so these individuals were all using a version they’d obtained through some kind of digital work-around). These people were all chasing Pokemon characters who happened to “be” in that square.

The Pokemon Go craze had just ignited and the phenomena wouldn’t hit the mainstream news for another day or two so I was left wondering what was going on and thinking how sad it was that one of the nicest days of summer to date was being spent by so many standing looking at their phone. I took some pictures, made some inquiries and was left amazed, confused and slightly depressed all at the same time.

To call Pokemon Go a game seems misleading. So does calling it a community, a phenomenon, a technological marvel, a marketing coup, a social convener, a public health risk, a public health benefit or a waste of time. It’s something completely new and it brings with it a number of puzzling, odd and paradoxical qualities as noted in the piece below from The Pipe Dream Meme.

As one man reports: “I’m not the most physically fit person, obviously, but I have walked more since this game has come out than I have in my entire life” He goes on to talk about how he knows more about his city than ever did before thanks to Pokemon Go, a video game that involves a person being focused on their screen, not the actual city around them even though what is on the screen is based on the physical city (and country and cemeteries and…) that is the foil for the hundreds of Pokemon characters to live through a handset.

Whether you consider the thousands of people walking around your city staring at their handset the walking dead (as disconnected from the world) or the living (as engaging with the world, differently) is a matter of perspective.

Paradox thy name is Pokemon.

Extensions of humanity to what?

Marshall McLuhan wrote (PDF) that the medium is the message and that the tools and technologies embedded in that media initially extend our humanity then culturally envelopes humanity by making us an extension of it. A simple look at capitalism and the use of money as a means of negotiating our sense lives illustrates this as McLuhan points out.

“Money has reorganized the sense life of peoples just because it is an extension of our sense lives. This change does not depend upon approval or disapproval of those living in the society.”

McLuhan cites the work of Carl Jung to support his thesis by drawing on a quote that illustrate the insidiousness of system of paradoxes and what they can have on a society:

Every Roman was surrounded by slaves. The slave and his psychology flooded ancient Italy, and every Roman became inwardly, and of course unwittingly, a slave. Because living constantly in the atmosphere of slaves, he became infected through the unconscious with their psychology. No one can shield himself from such an influence (Contributions to Analytical Psychology, London, 1928).

Thus by enslaving others we ourselves become enslaved.

Perhaps no better example of this paradox is in the way we’ve created tools to learn, exchange information and automate activity — making our work much more efficient — and finding ourselves either overworked or out of a job entirely. We’ve created a capitalist consumption system that relishes in efficiency in order to provide us with more of what we want and need to survive, thrive and be happy and we seem to put ourselves out of work; create stressed over-work for many of those who have jobs; destroy the planet (which is the only place to live), disconnect us from society and ourselves; and in a manner that contributes to mental health disorders along the way.

Things ought to be amazing — and in many ways they are — but the horrors created along with this are as notable and significant not only for our life today, but the future of the planet. This is the paradox of plenty.

Creating stupidity through knowledge

The problems we’ve created from consumption would be manageable if it was simply an issue of lack of knowledge. Solving knowledge-based problems is pretty straightforward: you find the right information, package it appropriately to the right audience, and ensure you deliver that message at the right time and place. This is the basis behind the knowledge transfer model and second generation of knowledge-to-action theories. Ask any marketer and they’ll tell you that while there’s no one way to do this and it does take work and experimentation, the mechanics are pretty straightforward.

Yet, knowledge (and truth, which is linked to this knowledge), is losing its power to sway people in the information society, which is based largely on the production / consumption / use of knowledge. As we have more access to more knowledge about something we are often less informed and more likely to discount the very thing we are using to make decisions. Paradoxical, isn’t it?

The ascendency of Donald Trump from real estate developer/reality TV show host/beauty pageant promoter to Republican candidate for the President of the United States is as good of an example as you’ll ever find. Irrespective of whatever policy positions you might hold, it’s impossible to deny that his track record of outright lies is beyond the pale. Or maybe it’s not impossible and that’s the problem.

Clay Johnson wrote about this phenomenon and drew parallels between our obesogenic culture and that of information consumption. He was inspired by an encounter with a protester in the early days of what would become the ‘Obamacare’ movement who had a sign saying “Keep your government hands off my Medicare” and recalls the circumstance in his book The Information Diet:

I spoke to this protestor about his sign. He seemed rather well educated — sure, he was angry, but he was not dumb, just concerned about the amount of money being spent by the current administration…This man did not suffer from a lack of information. Yet he had failed to consider the irony of holding a sign above his head asking government to keep its hands off a government-run program. To him, it made perfect sense.


So what’s to be done? Anything? That’s what I’ll explore in the next post.

The more we get together


As we forge ever-greater connections online to each other and the world of ideas the thinking was that we would be far better off, more tolerant, educated and wise and yet there is much evidence to suggest this isn’t the case. What does it mean to come together and how can we do this that brings us closer rather than driving us further apart? 

The more we get together, the happier we’ll be – lyric from popular song for children

Like many, I’ve grown up thinking this very thing and, for the most part, my experience has shown this to be true. However upon reflection, I’m realizing that most of this experience is related to two things that could reveal a potential flaw in my thinking: 1) I’m thinking of face-to-face encounters with others more than any other type and also 2) most of the relationships I’ve formed without aid of or post use-of the Internet.

Face-to-face interactions of any real quality are limited in nature. We only have so many hours in a day and, unless your job is extremely social or you live in a highly communal household complex, we’re unlikely to have much interaction with more than a few dozen people per day that extends beyond “hello” or something like that. This was explored in greater detail by anthropologist Robin Dunbar, who determined that our social networks are usually capped at 100 – 250 individuals. Dunbar’s number (the commonly held mean number of people in these networks) is commonly considered to be 150.

Why does this matter? When we engage others online, the type of interactions and the number of ideas we engage can be far larger, or at least is certainly different in how those relationships are managed. We see comments on discussion boards, social media posts, videos and pictures shared online, and are exposed to media messages of all types and through myriad news (official, professional and otherwise) sources. Ethan Zuckerman, who I’ve written about before, has written extensively about the paradox of having such incredible access to diversity in the world and yet we often find ourselves increasingly insular in our communication patterns, choosing like-minded opinions over alternative ones.

Looking ahead by looking back at Marshall McLuhan

Journalist Nicholas Carr, who’s written extensively on the social context of technology, recently posted an interview with Marshall McLuhan from 1977 speaking on his views about where media was going and his idea of “the global village”. His piece, the global village of violence, was enlightening to say the least. In it, Carr points to the violence we are committing in this global village and how it doesn’t square with what many thought were the logical outcomes of us connecting — and does so by pointing back to McLuhan’s own thoughts.

McLuhan’s work is often a complicated mess, partly because there is a large, diverse and scattered academic culture developed around his work and thus, often the original points he raised can get lost in what came afterwards. The cautions he had around hyper-connection through media are one of those things. McLuhan didn’t consider the global village to be an inherently good thing, indeed he spoke about how technology at first serves and then partly controls us as it becomes normalized part of everyday life — the extension becomes a part of us.

As is often the case with McLuhan, looking back on what he said, when he said it and what it might mean for the present day is instructive for helping us do, just as his seminal work sought to help us do, understand media and society. Citing McLuhan, Nicholas Carr remarked that:

Instantaneous, universal communication is at least as likely to breed nationalism, xenophobia, and cultism as it is to breed harmony and fellow-feeling, McLuhan argues. As media dissolve individual identity, people rush to join “little groups” as a way to reestablish a sense of themselves, and they’ll go to extremes to defend their group identity, sometimes twisting the medium to their ends

Electronic media, physical realities

These ‘little groups’ are not always so little and they certainly aren’t weak. As we are seeing with Donald Trump‘s ability to rally a small, but not insignificant population in the United States to join him despite his litany of abusive, sexist, inflammatory, racist, discriminatory and outwardly false statements has been constantly underestimated. Last week’s horrible mass shooting in Orlando brought a confluence of groups into the spotlight ranging from anti-Muslim, both anti-gay and gay rights, pro-gun, along with Republican and Democratic supporters of different issues within this matter, each arguing with intensity and too often speaking past each other. Later this week we saw British MP Jo Cox murdered by someone who saw her as a traitor to Britain, presumably on account of her position on the pending ‘Brexit’ vote (although we don’t yet know the motivation of the killer).


There are many reasons for these events and only some that we will truly know, but each matter points to an inability to live with, understand and tolerate others’ viewpoints and extreme reactions to them. The vitriol of debate on matters in the public sphere is being blamed for some of these reactions, galvanizing some to do horrible things. Could it be that our diversity, the abundance of interactions we have and the opportunities to engage or disengage selectively

If this hypothesis holds, what then? Should we start walling off ourselves? No. But nor should we expect to bring everyone together to share the tent and expect it to go well without very deliberate, persistent, cultivation and management of relationships, collectively. Much like a gardener does with her garden, there’s a need to keep certain things growing, certain things mixing, certain things out and others in and these elements might be different depending on the time of year, season, and plants being tended to. Just as there is no ‘one garden’ style that fits everywhere, there is no one way to do ‘culture’, but some key principles and a commitment to ongoing attention and care that feed healthy cultures (that include diversity).

As odd as this may sound, perhaps we need to consider doing the kind of civic development work that can yield healthy communities online as well as off. We certainly need better research to help us understand what it means to engage in different spaces, what types of diversity work well and under what conditions, and to help us determine what those ‘simple rules’ might be for bring us closer together so, like the childrens song above, we can be happier rather than what we’ve been becoming.

Complexity isn’t going away and is only increasing and unless we are actively involved in cultivating and nurturing those emergent properties that are positive and healthy and doing it by design, and viewing our overlapping cultures as complex adaptive systems (and creating the policies and programs that fit those systems), we put ourselves at greater risk for letting those things emerge that drive us further apart than bring us together.


Photo credit: Connections by deargdoom57 used under Creative Commons License via Flickr. Thanks deargdoom57 for sharing your work!


Social innovation, social inclusion

Inclusion means everyone

Social innovation is about bringing new ideas, products and services out into society with others for social benefit and improving the lives of our communities. While not every innovation will benefit everyone, there is a need to examine more deeply the question of who benefits(?) when we consider social innovation and that means taking some hard looks at who we are innovating for. 

On August 15th 2015 the New York Times ran a feature story titled Inside Amazon, which looked at the corporate culture inside one of the largest, most innovate retailers in the world. In the piece written by award-winning journalists Jodi Kantor and David Strietfeld, they interview more than 100 current and former employees of Amazon and find a culture that is fast-paced, exciting, dynamic, creative and sometimes cruel, relentless in its expectations of its employees, overwhelming and harsh. What was interesting is that many interviewees spoke in conflicting terms about working for the company which offered great compensation and a stimulating workplace with lots of opportunities to grow while simultaneously burning them out and challenging their sense of self in the process of delivering feedback that wasn’t always experienced as constructive.

Across the news aisle we find another example of innovation in the news. In the September issue of the Walrus Magazine, editor-in-chief Jonathan Kay returns to the front lines of reporting with a feature story called Uber v. Taxi (or The Truth about Uber on the cover), which takes a comparative examination of changing business models and culture around cars-for-hire comparing tech start-up Uber with the traditional taxi model. The piece involves Kay signing up to be an Uber driver and also completing the City of Toronto taxi school to get a first-hand look at both systems from the perspective of driver and passenger. In an interview on CBC Radio, Kay was asked about the differences between the two and commented on how Uber was working well for the young, the mobile and able-bodied whereas traditional taxis were left with the others, creating a gap in income and opportunity between the two services:

That’s where drivers make a ton of money. Uber is taking that. Taxis are being left with older people, people with special needs, people who require wheelchair access and the visually impaired. Those are the people who require special training and vehicles that taxi fleets can provide but that’s not a particularly profitable part of the trade. Those trips take a lot of time and effort and passenger care. There’s not enough money on the table left for the taxi drivers to make a living.

Innovating for whom?

What these two stories have in common is that it profiles the way innovation spaces can divide as much as unite. On the surface, we see two examples of ways in which new thinking, careful product design and marketing, and a focused attention on user experience can generate value for consumers. However, what they also illustrate is that what is perceived as value is largely contingent on whom it is being asked and that this perception is not a minority position. This is not a case of blacksmiths getting outraged at the dwindling market for horseshoes due to the automobile or manufacturers of picture tubes castigating people for buying digital televisions. This is a case of entire segments of the population being left out.

Both of these examples are based on age to illustrate a point of commonality.

In the case of Uber, its the young, urban professional who does well by its innovative model. It’s the person who has few things to carry, needs little assistance, and likes to travel to the popular places where there are many others like them, which creates an ideal marketplace. For taxis, they are being asked to go to out-of-the-way places (like doctors appointments), deliver people and their parcels (for people who aren’t highly mobile), and are bound by a set of rules that Uber is not to ensure that they assist those who need it in using their service. Uber gets the cream of the market, while taxis are left with what’s left and that is mostly older adults.

But what ‘older’ means is a matter of perspective as we see with Amazon. As the reporters explain, old age isn’t what it once was:

In interviews, 40-year-old men were convinced Amazon would replace them with 30-year-olds who could put in more hours, and 30-year-olds were sure that the company preferred to hire 20-somethings who would outwork them. After Max Shipley, a father of two young children, left this spring, he wondered if Amazon would “bring in college kids who have fewer commitments, who are single, who have more time to focus on work.” Mr. Shipley is 25.

Every innovation produces ‘winners’ and ‘losers’, but what is striking in both articles is that the ‘winners’ are a very narrow band of the population, young, urban professionals. A look across what we often gets heralded as innovation (pick up any issue of Fast Company magazine to see it) and you’ll see a world dominated by (mostly) young, (mostly) white, (mostly) male, (mostly) middle class, and (mostly) tech-driven innovations that come from places and cultures like Silicon Valley. Facebook, Apple, Google, Uber, AirBnB — they are all based in Silicon Valley.

How we design innovations and the cultures we create in that process can have enormous implications. Are we creating our own silicon valley for social innovation?

“Slamming the Door on Silicon Valley”

Jess Zimmerman, writing in The Guardian, remarked on how Silicon Valley’s culture is one of entitlement and male hegemony, pointing to work of women’s groups aimed at making the work culture in the valley more female-friendly. Even though Sheryl Sandberg’s Lean In is a product of that environment, it not of that environment. “The Valley” is an environment that fosters both Uber and Amazon (which is should be noted is based in Washington State and not Silicon Valley, but nonetheless is part of the same cultural milieu discussed here). That ethos is one that is characterized by cultures of hard work, long hours, dynamism and youth. As a result, a path dependence is created based on the design specifications proposed at the start and leads to products that are, no surprise, a reflection of their makers.

Facebook’s features of ‘extreme openness’ as evidenced by it’s settings that make it hard to keep things private and rules against using pseudonyms can be traced back to Mark Zuckerberg’s dorm room at Harvard and his personality and personal belief system about what social life is to be like. As a result, Zuckerberg’s design has influenced online interactions of more than one billion users worldwide and continues today.

So what does this have to do with social innovation? Consider the literature — wide in scope, thin in detail as it may be — on social innovation methods and tools from social labs to design thinking. What we might find is an incomplete list of items that looks something like this:

  1. Be bold, bring wild ideas to the table and lots of them to the table; no idea is a bad idea
  2. Co-create with others
  3. We live in a VUCA (Volitile, unpredictable, complex, ambiguous) world and need to work accordingly
  4. Flat organizational structures work best for innovation
  5. Innovation doesn’t happen during 9-5, it happens anytime
  6. Information technology will leverage creative innovation potential everywhere, anywhere: it always wins
  7. You have to ‘move fast and break stuff‘, including the rules

The list can go on.

While I have  belief in what is contained in this list, it’s a restrained belief. Each of these points (and there are many others) can be upended to illustrate how social innovation can exclude people, ideas, cultures and possibilities that are as harmful as helpful. As I’ve argued before, social innovation has embedded in it an ethic of social justice if it’s to truly be a true social innovation. This requires attention to the ‘winners’ and ‘losers’ of innovation in ways that go beyond a call to innovate and change, it means paying attention to the cultures we impose through the innovation process.

Do we place too much emphasis on disruption vs harmony?

Where is the role for contemplation in the speed to create new things?

Is there a place for an introvert in the innovation table?

While innovative ideas might not respect the 9-5 clock, many paycheques, office spaces, commuter schedules, daycares and employee benefits do, what does that mean for those who rely on this?

Are these values those of innovation or those of a particular type of innovation from a particular context?

The Trickle of Innovation Streams Through the Valley

If we are to adopt social innovation on a wide scale we need to create a culture of innovation that is more than just a new version of a trickle-down model. Indeed, as Geoff Mulgan from Nesta writes, innovation has the potential to be another ‘trickle down theory’ that rewards the most advantaged first and then eventually to others in some modest form, creating inequities.

Yes, we now know much more about how to cultivate buzzing creative industries, universities, knowledge intensive industries and so on. But we have almost nothing to say to around half of our population who face the prospect of bad jobs or no jobs, and look on with dismay and envy at the windfall gains accruing to the elite insiders.

Silicon Valley is currently the place of privilege in the innovation world. If you have the privilege of not needing add-ons to your taxi ride, require assistance or have to drive to a neighbourhood that’s off the beaten path or have to pay by cash, Uber is great. If you can work flex hours and long hours, are gregarious and extroverted, and aren’t temporally limited by the needs of a spouse or partner, children, a loved one who requires care, or pets (that can’t be brought to work for obvious reasons — and I’m thinking of you cat owners) then a place like Amazon is maybe for you.

When we use these spec’s as our models to design innovation more widely, including social innovation, we create systems that exclude as much as include and that might get us innovations, but not necessarily real social ones.

The Power, Peril and Promise of Health Journalism

Online Prescription Concept

The Toronto Star, Canada’s most widely read newspaper known for its investigative reporting gifted anti-vaccination audiences armament by using poor science to point to a spurious connection between an HPV vaccine and illness. The issue points to journalism’s power to shape the discourse of health issues and it points to the power, promise and peril associated with good (and not so good) science reporting. 

With great power comes great responsibility – Uncle Ben, Spiderman

It started with a story

On Thursday February 5th, 2015 the Toronto Star, Canada’s most widely read newspaper that has a reputation for solid investigative journalism, published an story that connected the experience of young girls and negative health effects with the receiving the Gardasil HPV vaccine. The story was immediately and widely criticized by experienced science journalists and health professionals alike, who argued that it was based on terribly flawed science.

The Toronto Star’s reaction was to defend itself, arguing in many different fora that they indeed mentioned that there was little scientific evidence that supported the link between the vaccine and the negative health effects being discussed in the article. The problem is that these links are buried deep in the article and certainly are not its focus: the hypothesized harms are.

Two days later, the Star published a follow-up op-ed letter which was authored by two health professionals and co-signed / supported by dozens of Toronto’s leading physicians condemning the original article. However, by that time the damage is likely to have been done and one more bit contribution to the fictitious ‘evidence’ for vaccine harms had been added to the anti-vaccine movement’s war chest.

Perpetuating harm

This matter of poor reporting is not a trivial issue. The fraudulent science performed by Andrew Wakefield linking autism to vaccines helped spur an evidence-thin anti-vaccination movement. Today, we are seeing the resurgence of diseases once thought to be eliminated in North America (like measles) because so many people are not having their children vaccinated. Jenny McCarthy is among the celebrities who have taken up the cause of anti-vaccination and has written about and spoken at length about what she sees as the connection between autism and vaccines, using her son’s experience as an ‘example’. Oprah Winfrey, perhaps unwittingly, gave McCarthy a platform to speak about her beliefs on her show offering wider possible credibility to something that has been thoroughly discredited in the scientific literature (PDF).

For the Toronto Star, it was bad enough that the story was published — and is now online, likely for all time in various forms thanks to the Web — but what made it worse was that the Star was so vigorous in its defence of it, unwilling or unable to recognize their role in public health. Medical evidence champion, author, physician and columnist Ben Goldacre was among the many who counter-attacked, pointing to what he called The Star’s ‘smear campaign‘ against the story’s critics.

For an interesting discussion of the issue of just how the Star got it wrong, listen to Vox health reporter Julia Belluz, interviewed on the CBC’s radio show The Current. Belluz, a past MIT Knight Journalism Fellow, is one of a dwindling number of journalists who understand the practice of reporting, science, and medicine and wrote a stellar critique of the Toronto Star article, but as importantly makes the case for why there is a need for specialized, trained, supported journalists out there doing this kind of work.

…and health

I’ve argued in the past that journalism is very much a pillar of public health. When it fails, so does public health. Journalism is not and should not be an arm of public health for the very independence that good, professional journalism strives to maintain is a reason it’s often called the fourth estate, keeping governments and other forces in check to ensure they are not abusive. Yet, that distance is also what makes it a part of public health. Public health is better for journalism and journalism certainly can benefit from health stories as they continue to be popular and sought after by readers.

As a group, scientists and many clinicians are not great at communicating what they do, why their research is important to others outside their field, and what the implications of their findings are for the public and science as a whole. Some are, most are not. It’s for this reason that the entire sub-field of health sciences focused on knowledge translation, exchange and mobilization has emerged. Just as we value the ability of a graphic designer to make visuals come alive, so too have we learned to value those with the skills to communicate information well and that is what journalists are trained and paid to do. They are a big part of this process, or at least should be.

Healthy journalism, healthy science, healthy people

Science journalism is too important to be ignored. There is much skepticism of journalists by scientists and clinicians and indeed, as the Toronto Star shows, journalists sometimes get things wrong. But its one thing to get it wrong through errors of judgement or interpretation it’s quite another to get things wrong by design. The Toronto Star has some good health reporters, but they weren’t the ones on this story. Nor did they bring in the health reporters to consult on this or other health professionals prior to publication– at least as far as one can tell.

The importance to the public’s health of good reporting requires that health and science journalists have more than a rudimentary knowledge of the topics they are covering. What’s strange is how we understand this with our sports reporting, weather forecasts and foreign correspondents. You wouldn’t watch someone who has little understanding of a sport covering it in depth, would you? It’s one thing to read scores, it’s another to provide investigative and deep coverage of a game if you don’t know the players, the rules, the criteria for quality and success and so forth.

Why do we do this with health journalism and science?

Yet, journalism is under pressure and no doubt the Toronto Star, for whatever genuine contrition they experience from what happened, have to like that they are being talked about. The reason is that journalism is under threat for market reasons, the Internet and the changing ways we get our news. It is, as Jürgen Krönig wrote way back in 2004, “A crisis of the Fourth Estate”. That crisis is only getting worse.

As anyone interested in public health, we need to take actions to ensure that the fourth estate is protected, supported and not ignored. Our health might just depend on it.

Image: iStockphoto, used under licence.

300: Crises in Complexity, Opportunities in Design

Designing ideas

Designing ideas

In 2009 Censemaking was launched as a platform to explore issues in complexity and ways we can make sense of it to design for better futures and a sustainable world. After 300 posts it has become evident that there is much more to write as we see ever-new crises from complexity and ever-greater design opportunities to deal with it all.

As I was reflecting on what to write for my 300th post  for Censemaking I found myself — as I often do — drawing some connections between disparate experiences as I started my daily reading and listening. Within moments of sitting at the table with materials, turning on the radio, and scanning online I found the following semi-related stories:

  • On the Stack, the Internet radio show about magazine publishing on Monocle 24, panelists were exploring the crisis of reporting that comes from citizen journalism and the generally lower quality of photography and detail that comes when professional work gets pushed out for reasons of economics and expediency;
  • This followed a profile of Ghost Lab – a hands-on architecture program that runs every summer to teach architects ways to link what founder Brian McKay-Lyons calls “the world of ideas and the world of things”  – a space that many designers are surprisingly disconnected from;
  • In the Globe and Mail newspaper (tablet edition), a column by Kathryn Borel, writes on reading both Miley Cyrus and Syria and the sanctimony that comes when we judge what is worthy reading;
  • The brilliant web comic The Oatmeal has circulated an insightful, funny and sad piece looking at what it takes to draw people’s attention to Syria’s conflict and the crises it promotes;
  • An email exchange from a group of colleagues — journalists and scientists — on how to collectively present the state of research and journalism to an audience of policymakers and peers at the upcoming Canadian Science Policy Conference;
  • Thumbing through two new magazine options that seek to bridge the gap between science, design, and public affairs by relying on quality content and publishing than advertising (The Alpine Review and Nautilus – below)
Premiere Issues of Nautilus & The Alpine Review

Premiere Issues of Nautilus & The Alpine Review

Within each of these categories is a reflection of some form of crisis — an unstable situation affecting many people — particularly the worlds of science, journalism, politics, publishing, policy, and design.

Patterns of complexity

This motley collection of tidbits loosely connects science, design, public affairs, knowledge translation and communication, and the complexity that comes when they intersect. It seems fitting that this greeted me as I sat down to write post #300.

The Censemaking name is a riff on both the name of my social innovation consultancy (CENSE Research + Design) and the term sensemaking that is a trans-disciplinary field / practice of making meaning from complex, divergent data points and experience (which is what I help my clients, collaborators and students do). It has been a vehicle that has allowed me the freedom and pleasure to explore the knotty intersections of these disparate areas of practice and scholarship that don’t fall under any particular umbrella, yet are things that are wrestled with in health promotion, industry, publishing and media, social services, policymaking, the military and social enterprise (to speak of a few).

And as I often do, I find the strangest threads are often the most useful in understanding complexity and our world.

Taking Miley Cyrus seriously

That I would even put those four words above together above might have already turned you off, but stick with me. While the Miley Cyrus reference in the above list of media notes might be the most disparate of them all, complexity science teaches us that there is often gold in looking at weak signals and Miley Cyrus might be the best example of that in this list.

In a week where the once Hannah Montana actor and singer has garnered enormous attention in the media for her moves, her behaviour and her attitude at last weekends’ MTV Video Music Awards, particularly her performance with singer Robin Thicke it seems there is little left to discuss. Or not.

Some media sources commented on Ms. Cyrus’ actions as a tasteless media ploy.

Others jumped on the fact that it was Miley Cyrus who got all the flack for the acts performed while Robin Thicke, a married father, gets away with little public condemnation despite being the main performer of a song with a deeply sexist, near misogynistic lyrics, message and related video.

The Belle Jar Blog points to how Miley’s appropriation of black culture is a racist and patriarchal act that deserved the real condemnation as much as any sexual act that it was associated with, something that only adds to the slut-shaming says the Washington Post who nevertheless seek to question the fuss.

Reading and contemplating Miley’s performance could at once be seen as juvenile, offensive, and racist, while also represent shrewd marketing, behaviour not inconsistent with previous VMA awards and its time-honoured practice of female sexualization to draw eyeballs (and commentary) , and a situation reflective of a woman growing up at a time and place where the lines between activities rooted in a particular racial, ethnic, geographic, socio-demographic heritage are — no pun intended — quite blurred and may be genuinely obscured to her.

This is a rather banal, yet clear example of the way complexity and wicked problems rise up from an interconnected, multimedia, 24/7, global culture of communication that we’ve created for ourselves. Miley is at once a perpetrator, a victim and a bystander all at the same time. She is a social construction and a real person who is accountable for what she says and does (but to whom and for what?). That is complexity in the modern age of public engagement, expression and media.

It’s one example. We are facing similar thorny, hairy issues with vaccination, big data, chronic disease, community planning, social media, journalism’s independence and viability, educational policy and the structure of learning, private-public partnerships for social benefit and beyond. There is no simple answer or simple problem. Sensemaking is a way to understand complexity and then determine what it means.

Designing compelling futures

When you know better you do better – Maya Angelou

Better knowing is the biggest step towards better doing. Sensemaking complexity means looking broadly and deeply, consulting widely and taking the time to reflect on what it means. Being mindful of our time, and its disruption, is critical.

What comes from that is the possibility not just to understand our world, but to shape it into something we deem to be better for us all. This motivation to shape is what makes us human. We are the one species that creates for enjoyment, expression, and practical need. We are makers and designers and often both at the same time.

Design is the conscious intent to shape things while design thinking is a means of engaging complexity to foster more effective designs. We cannot control complexity, but we can design for it (PDF) and work with the emergent patterns it produces. This process of design for emergence and developmental design, which brings together sensemaking, structured feedback through ongoing developmental evaluation, and foresight methods allows us to take account of complexity without letting it take hold of us. It helps us make the world we want, not just accept the world we get.

Thank you

Thank you to all of my readers — the tens of thousands of people who have come to Censemaking since it started and the many of you who come regularly and share it with the world. In a world of attention scarcity, I am deeply appreciative of you spending some of your time with my work.

I am a believer in what popular math video-blogger Vi Hart says about blogging: do it for yourself.

Create your own audiences.  I am honoured to have been able to create the audience I have; thank you for being a part of it. I hope to continue to provide you with things to contemplate and help you make sense of.

I look forward to the next 300 posts and finding new ways to navigate and contemplate complexity and design for innovation.

Image: Thinkstock used under license & Cameron Norman

Developmental Design and The Innovator’s Mindset

Blackberry Swarmed By Ignorance

Blackberry Swarmed By Ignorance

Blackberry, once the ‘must have’ device is no longer so and may no longer even exist. Looking back on how the mighty device maker stumbled the failure is attributed to what was done and not done, but I would argue it is more about what was unseen and not thought. Ignorance of the past, present and future is what swarmed them and a lack of developmental design in their culture.

Today’s Globe and Mail features the above-pictured story about how and why Blackberry lost out to Apple’s iOS iPhone and Google’s Android powered phones due in large part to their focus on their stellar enterprise security system and failing to consider what would happen when competitors yielded ‘good enough’ models.  It’s a tale years in telling and what may be the beginning of the end of the once globally dominant Canadian tech leader.

Getting out

Those I’ve known who’ve worked for Blackberry describe a culture devoted to engineering excellence above all, which emphasized technical superiority and attention to the technology over the users of that technology. Perhaps if more of those engineers got out a more beyond their own circles they might have noticed a few things:

  1. Facebook, Twitter and social media sites that all seemed fun at first were quickly becoming more than just pastimes, they were being used as communications tools for everything from family and friends to work;
  2. Cameras were being used to capture photos and videos, share them and edit them (like Instagram and now Vine) for purposes beyond social, but also to take photos of PowerPoint presentations at events, brainstorming whiteboards and prototypes;
  3. The rich media experience provided through other devices meant that the keyboards were less important — typing faster and easier was being weighed against screen dimensions for videos, photos and interactive content;
  4. Workers were passionate enough about these new tools that they would bear the cost of their own phone to use these tools and carry two devices than just rely on a Blackberry if they were required to have one.

I saw this phenomena all over the place. Embedded in this pattern were some assumptions:

  1. Email was the most important form of productivity. (This might also include learning);
  2. Email was fun;
  3. Email got people communicating

Few people I know like email anymore. We tolerate it. Almost no one who is in the work world gets too few emails. Email is a useful and highly embedded form of communication; so much so as to nearly be a form of dominant design in our business communications.

What a little anthropological research on RIM’s part would have produced is some insights into how people communicate. Yes, email is the most pronounced electronic method of communication for business, but it doesn’t excite people like a video does or engage conversation like Twitter can or enable re-connection to close peers or family like LinkedIn and Facebook do. These are all platforms that were lesser served by the Blackberry model. What that means is that email is vulnerable to those things that attract people.

In complexity terms rich media is an attractor; it organizes patterns of activity around it that stimulate creativity in the system. This meant that a lot of positive energy was being directed into these new means of engagement over others and that when given the opportunity to choose and use a device that supported this engagement better people (and eventually the firms they worked for) began to opt for them over Blackberry.

Ongoing innovation

Developmental design is a process of incorporating the tenets of design thinking with developmental evaluation, strategic foresightbusiness model innovation and contemplative inquiry. It means constantly evaluating, assessing, designing and re-designing your product offerings as things change and developing a constant attentive focus on where you are, where you came from and the weak and strong signals that indicate shifts in a culture.

This is a new way of doing innovation development, evaluation and strategy, but it is the necessary ingredient in a space where there is high levels of complexity, rapid churn in the system, and high demand for action. Increasingly, this is no longer just the domain of high tech, but banking, retail, healthcare, education and nearly every system that is operating in multi-jurisdictional environments. When we (the customer, patients, students…) were very much the same, we could treat our system simply. Now the ‘we’ is different and the systems are complex.

Developmental design is the praxis of innovation.

What would Steve Jobs do?

It is interesting to note that today is the day the bio-pic on Steve Jobs is released into theatres. Jobs knew developmental design even if he never named it as such. He famously ‘got out’ in his own, unique way. He went for walking meetings rather than sat in boardrooms. He watched what people did and channeled his own passion for creating things into a company culture that was designed to create things to help people create things. To that end, he was among the most outstanding innovators of the last 50 years.

Yet, Jobs and his team were good at paying attention to where things had gone (the computer), where they were (increasing bandwidth capability and demand with the Internet), and where they were going (decentralized production). Thus we had a number-crunching machine turned it into a suite for personal creativity (Mac), which spawned a music player (iPod) and online store (iTunes), which led to a multimedia communications handset (iPhone), which inspired a handheld tablet (iPad).

Apple is the most valued tech company in the world because of that vision, one that has been questioned in light of Jobs’ passing on and new leadership in place at the company.

Blackberry is not unique. The leaderboard in consumer mobile technology has changed from Motorola to Nokia to RIM (Blackberry) to Apple to Samsung (Android) in less than 15 years. That is enormous churn in a sector that touches over three quarters of the world’s population directly (more than toilets). While perhaps an extreme case, it is becoming a model to pay attention to for other industries on different scales.

Ask yourself: Are you Blackberry today or Apple yesterday?

If you apply developmental design to your work, you’ll have your answer.

The Knowledge Metric in Education


Higher education is asking itself some big questions and making substantive changes to the way it sees itself and produces value for society. Education is increasingly being rationalized, which calls into question the metrics that are being used to judge how resources should be allocated. In a previous post, I looked at the jobs metric. Now, it’s time to look at the knowledge metric.

Just the facts

Education writer and teacher Will Richardson‘s TED Book Why School is a provocative read for those connected to teaching or just interested in schooling. While it focuses largely on grade school, the issues are the same for universities and colleges particularly as the primary and secondary students of today are tomorrow’s graduate and professional learners. Richardson questions the role of the school as institution in its current form suggesting that if the status quo — one characterized an information delivery warehouse — is maintained there is little need for schools to exist at all. Yet, if the education within schools is focused on asking better questions and learning when to apply knowledge, not just what knowledge to apply, there is hope.

The current trend in school reform is towards Common Core Standards, which emphasizes specific forms of knowledge, ‘facts’ and asks that students be able to recall such content when required. Under this model, the role of the teacher is one of content manager and facilitator rather than guide or mentor and students are prepped for the tests of their knowledge (memory) rather than be asked to demonstrate its application to anything outside of the test.  It is this model that many proponents of online education embrace, because the Internet is a fabulous content delivery system and education can be literally programmed and delivered to students directly without the ‘noise’ that teachers introduce to the signal. Under this model, educational content can be delivered cheaply and widely to support uniform intended effects among learners.

Richardson argues for reforming schools to something closer to the alternative model that was advanced by educational reformer and philosopher John Dewey. Richardson writes:

“In this version of reform, schools and classrooms are seen as nodes in a much larger learning network that expands far beyond local walls. Students are encouraged to connect with others, and to collaborate and create with them on a global scale. It’s not “do your own work,” so much as “do work with others, and make it work that matters.” To paraphrase Tony Wagner, assessments focus less on what students know, and more on what they can do with what they know. And, as Dewey espoused, school is “real life,” not simply a place to take courses, earn grades, amass credits, and compete against others for recognition. There lies the tension.

This second path is simply not as easy to quantify as the first. Developing creativity, persistence, and the skills for patient problem solving, B.S.-detecting, and collaborating may now be more important than knowing the key dates and battles of the Civil War (after all, those answers are just a few taps on our phones away), but they’re all much more difficult to assign a score to. I’m not saying that a foundation of content knowledge isn’t still important. To communicate, function, and reason in the world, students need effective reading and writing skills, as well as a solid foundation in math, science, history, and more. But I’m convinced we must revise the overreaching coursework requirements we place on students — requirements created at a time of scarcity, by the way. And we desperately need to revisit the thinking we’ve developed around assessment that, as Harvard researcher Justin Reich says, “optimizes the measurable at the risk of neglecting the immeasurable.””

Facts vs Problems

The knowledge metric is flawed because it assumes that content solves problems. It also presumes that the curriculum teaches the right knowledge for the right problems and that those problems can be known in advance. Let’s look at these.

One need only look to cigarette smoking as an example of how knowledge alone doesn’t always solve or prevent problems. One would be hard pressed to find anyone over the age of five who doesn’t know that sticking a lit tube of anything in their mouth and sucking on it isn’t at least somewhat unhealthy (and most know it is very unhealthy). An individual’s knowledge of smoking’s effects on physical health may not be complete, but it is often sufficient to inform the decision to quit or not start the unhealthy habit. And yet, citizens in highly educated countries like the United States, Canada and the U.K. smoke more than 1000 cigarettes per year per capita (and over 2700 per capita in places like Russia). These are not countries lacking in information on tobacco and health.

Using students’ ability to recall content makes the presumption that what is contained in a curriculum is what they need to know when they leave their program of study (at least as a start). While it may be somewhat true for students in the humanities and languages, it becomes highly problematic for those in dynamic fields or emergent areas of practice, which is becoming more normal than rare. There is no doubt that a corpus of key concepts, skills and ‘facts’ is useful, but the manner in which this knowledge can and may be applied is changing dramatically. For example, social media has upended communications in ways that very few health professionals are trained for. Journalists are particularly aware of the role that Twitter and related tools have had on their profession.

It also presumes that the content itself is relatively static. Certainly, curriculum renewal is something that most learning institutions engage in, but the primacy of content itself as the driver of education also assumes that the foundation for that knowledge is solid and can be applied today in the manner it was applied yesterday. In dynamic conditions, that isn’t often true. Further, the relevance of knowledge is framed by the problems to which that knowledge is applied. Genetic information, for example, can be incredibly useful when framed against tests that have high confidence, predictability and value to people, yet without such a context it is largely useless to those non-scientists who have it.

Areas of social innovation — which are expanding dramatically in number and scope — illustrate the problem of changing context well. This is a field characterized by problems, problem solving and novelty (which is what innovation is all about). Standard approaches don’t apply easily or at all when we are faced with high levels of novelty. Thinking and re-thinking the problem frame, knowing what to find, where to find it, and the skills to integrate relevant knowledge together is something that is not captured in the knowledge metric. Yet, it is those skills that will lead innovation. Knowledge translation professionals know this and so do knowledge brokers.

Are we designing our educational programming to advance on the kind of design issues of problem framing, finding and solving that our world is facing? Or are we simply taking content that can be obtained through books, the Internet and other materials, repackaging it and creating expensive warehouses of information that take learners out of the world and out of context in the process?

I don’t suggest that universities and continuing education programs stop delivering content, but if knowledge is the metric by which they are judging their success then it behooves educational administrators and funders to justify why they can do it better than other tools. What made sense when content was a rare commodity makes little today when it is overflowing in abundance for little or no cost. Universities and post-graduate training programs have an opportunity to re-imagine education and have the tools to do it in a way that makes learning more powerful and relevant for the 21st century should they choose to change their metrics of success.

Designing education

How might we take the enormous talent trust that exists among university faculty (and their students) who co-locate (physically, virtually or in some combination) in a school and develop the skills to not only address problems of today, but prepare everyone for possible challenges in the future?

How might we integrate what we know, identify the knowledge we need, and create systems to take advantage of the talent and creativity of individuals to make universities, colleges, and post-professional training venues for innovation and inspiration rather than just content delivery vehicles?

What kind of metrics do we need to evaluate this kind of education should we choose to develop it?

These are questions whose answers might yield more learning than those focused on what knowledge students have when they graduate.


Image source: Shutterstock.

The Fourth Estate of Health and Medicine

Who Will Hold Evidence To Account?

Journalists occupy an important, yet often unacknowledged, role in the health system by providing a dispassionate account of the system’s strengths, weaknesses, and opportunities to the public. It is through journalists that much of the research we scientists and practitioners produce gets communicated to the audiences likely to use them. This fourth estate is also a  place where hard questions can be asked and answered, holding governments, business and the health system itself to account because journalists operate apart from this space, unlike scientists and clinicians. We are at risk of losing this and it’s time to consider what that means for our collective health and wellbeing.

Disrupted Media

The news business is going through a massive upheaval, part of a larger overall disruption in media. Many newspapers are reducing the size of their print offerings, publishing less frequently or ceasing operations altogether.

This reduction in the capacity and size of the fourth estate begs two simple questions: Who will hold health scientists, clinicians, pharmaceutical companies, health product manufacturers, and policy makers to account? and who will tell the stories of science, health and medicine in public?

While we have some activist academics doing great work on influencing broader audiences like policy makers, they are exceptions not the norm. Stanton Glantz, a major tobacco control champion from UCSF who taken to blogging as a means of communicating to professionals and the public directly, is one of these such people. But Stan is atypical and holds a tenured position at a major university, something he’s acknowledged protected him when pursuing issues of evidence withholding from the tobacco companies in the 1990’s and beyond. Many faculty (particularly younger ones) are not this secure and even fewer independently funded scientists are. Academia is changing and not in ways that favour security and stability, which has implications for the kind of stories that get told.

Journalists have traditionally relied on protection from their publisher or producer under the name of journalistic freedom (the fourth estate) as a key pillar of their profession. It’s hard to imagine the Watergate scandal coming to light had Bob Woodward, Carl Bernstein and the other reporters working for the Washington Post, Time Magazine and New York Times not had the resources, stability and support provided by their newspapers . But what happens when these resources are no longer available or there are no institutions to support journalists in serving as watchdogs to hold people or institutions to account for what they do and don’t do?

Are ‘Monkeys in Coats’ A Healthy Story?

It’s been suggested that the Internet will take care of this. Citizen journalists, armed with camera-laden handsets connected to social media will fill the news gap. For example, it was citizens, not journalists, who first captured the story of Darwin the monkey, dressed in a shearling coat, walking around an Ikea parking lot in Toronto that went viral on a global scale on December 10, 2012. This is great for those interested in simian fashions and retail adventures, but the reason it was captured was because the story was obvious and in the face (or at the ankles) of those who told it. (For those of you not familiar with Toronto, coat-wearing monkeys are not typically seen at shopping centres or anywhere around town for that matter.)

Health and medicine is not the same as monkeys wearing coats (no matter what kind of joke you want to make). There is nuance, debate and reason that requires sustained attention and focus that someone with an iPhone and Twitter account is less likely to convey. Reasoned arguments for citizen journalism’s potential suggest it can complement the work of traditional journalism, not replace it. Yet, is this belief in one form (citizen journalism) undermining support for the other (traditional journalism) and serving as a fix that ultimately fails? If free-and-easy content is available, how likely are publishers willing to pay for professional work? Particularly if the choice of stories of one group (e.g., monkeys in coats) are more likely to garner the kind of attention that drives advertising than that of another (e.g., health care financing). Only one of these stories will impact our collective health.

Why does this matter? Trained journalists are required to be good communicators to a broad audience, scientists are not. Clinicians are slightly better, but decades of research has shown it is still highly problematic across areas of practice. This will not be solved overnight, if at all. Scientists and clinicians have told me they are already burdened with enough job expectations and adding knowledge translation skills to that list is asking too much.

As I have argued previously, there is a valued place for synthetics in research: those are who are good at taking ideas and weaving them together into an accessible narrative. Journalists are ideally suited to play or support this role. They do the job that many scientists can’t or won’t do and have better to tools, skills and strategies to do it. They write in a style that is suited to broad audiences in a way that suit those audiences’ needs, not what funders, disciplinary traditions, universities, or scientific peers demand (without evidence that those methods of communication are effective). There are reasons why journalists assess the reach of their work in the thousands and social scientists in the dozens (by citations in their field of practice).

Going Deeper to See Clearer

Although we have more information about health available to us than ever before, this may not be healthy for patients. The potential for those uninformed about medical diagnostics, evidence, and the nature of health itself to make poor choices based on incomplete, incorrect or overwhelming information is high. Further, without the kind of dispassionate examination of evidence in a synthetic manner that is tied to the way in which that evidence is expressed in the world through public opinion, policy making and healthcare practices, we lose a major accountability mechanism and means of informing public discourse.

In October I co-delivered a workshop on health evidence for students at the University of Toronto with the 2012 Hancock Lecturer and journalist Julia Belluz. Julia writes the Science-ish blog for Macleans Magazine and is an Associate Editor with the Medical Post. Julia`s lecture was on the role that social media plays in our health system and how its power to leverage the attention of the masses — for good and ill — is shaping the public understanding of health and medicine often in the absence of evidence for effects of conditions, processes, and practice. The lecture is summarized online on Science-ish beginning here.

Reading through the lecture notes one sees a depth of study that would be unlikely to be found anywhere within the formal health system. The reasons are that it blends evidence with commentary, observation with carefully selected sources, and takes a perspective that seeks to inform a wide, not narrow audience in both practical and intellectually stimulating ways. Taken together, this is a collection of activities that are not within the scope of practice for scientists and practitioners. There are reasons why the greatest contributors to public discourse on many scientific issues has come from journalists, not the scientists who generate the research. They tell the story better.

Malcolm Gladwell, Steven Johnson, Mitch Waldrop, Julia Belluz, Andre Picard and others are a big part of the reasons most of the those who vote to support funding of science, who donate to research-related causes, and fight for policies to keep us healthy know of the research that backs those ideas up.

Imperfect as journalism is, it serves the public when done with integrity. It’s worth spending some time considering what can be done to support the fourth estate so it supports us.

Photo credit: DBduo Photography on Flickr used under Creative Commons Licence.

Have We Turned the Page on Social Science Research for Health?

Turning the Page on Social Science and Health Research

Over the last two weeks social science researchers across Canada began receiving the decisions from last autumn’s competition for a Social Science and Humanities Research Council (SSHRC) funding award. SSHRC is the principal funder of social science research in Canada, although notably is not in the business of funding heath-related research, which is supposed to be funded by the Canadian Institutes for Health Research (CIHR). [Full disclosure: I currently hold grants from both of these organizations]. The problem is that CIHR was born from a policy and programming body and the former Medical Research Council and has a rather awkward relationship with social science research given its medical focus. It has funded some social science programs, but not in a manner that has enabled social scientists to comfortably explore the range of issues that they might have under traditional SSHRC funding programs, particularly when social issues are not always obviously health issues (e.g., poverty, education) and can easily be dismissed as not being relevant in spite of the evidence that they are.  Yet, SSHRC has decided to forgo any funding of health-related projects due in part to the absence of funding to support it when there are presumably options through CIHR or the disease-specific health charities like the Canadian Cancer Society, the Lung Association and others.

Yet, these options are not suitable. In a manifesto entitled “The end of medical anthropology in Canada” a group of leading social scientists painted the picture of the situation in grim terms in University Affairs. Although medical anthropology is the focus of the piece, the authors might as well be speaking for social sciences in general:

Health is inherently social and cultural. SSHRC has always understood this; CIHR, we fear, does not. We face the possible extermination of one of the most vibrant, high-demand and policy-relevant health disciplines, the only scholarly field that places culture at the centre of the analysis of health and that characteristically does so in both national and international contexts. In a multicultural, settler society with a substantial aboriginal population, and in a world where health is at the core of developmental, political and social issues in so many countries, where Canada otherwise wishes to have an impact, does this make any sense?

This brings me back to the beginning of this post and the announcement of the results of the last competition. Looking at the funding numbers released by SSHRC, a discouraging picture emerges. In 2011-12, 37 per cent of all applications in the open competition were deemed fundable, yet only 22.5 per cent were funded. These numbers are similar t0 2010-11, when 36  per cent were deemed fundable and 22 per cent were funded. What is not mentioned in these numbers was the level at which these grants were funded in the first place. I am a 2010-11 recipient of funding from SSHRC — meaning my grant proposal was within the top 22 per cent of all applications for that year — and the amount I received was approximately half of what I requested. That means that I had to take half of my budget and throw it away. So yes, I was successful providing I did either half of the research or found money elsewhere. I did the latter and my pocketbook is none the better for it.

Consider the implications of this change in funding. With one in five projects funded and many of those that are funded at levels well below what was requested the motivation for researchers is one of the first casualties. Researchers know that funding is tight and that it is highly competitive, but few alternative sources for research grants that lay outside of specific disease-focused areas, social scientists young and old are faced with little option. This creates another set of affected parties: students and trainees. Research funding not only supports the scientists themselves in many cases (see my previous posts on this), but those seeking to become scientists themselves or those who seek to get better acquainted with research. In health sciences and policy, this means just about everyone enrolled in such programs.

Now consider all of this in light of a trend towards increasing graduate education numbers. At the academic institution I am affiliated with (like many of its peers), the enrolment numbers are set to nearly double across many of the professional programs associated with health practice and policy in the coming years. Increased demand for training opportunities from the public has created a means for universities to cash in. Of course, what these students will do when they get there is unclear (let alone when they graduate), but it cannot be much in the way of research — at least as it pertains to social science and health. The funding is simply not there to support the kind of broad-based inquiry into the social factors that influence health, illness and well-being anymore. We have, as I call it, reached ‘the Turn’.

The Turn is that point where the system changes irrevocably towards a new direction. It is like a ‘tipping point‘.  Dwindling numbers of social scientists working from funding from an institutional budget (e.g., tenure-stream faculty positions) + a doubling of the student cohort * half of the research dollars makes for rather toxic math. The Turn will fundamentally shape the way social science inquiry is done and the kind of questions that get asked. As question foci change, the quality of the research shifts, and the depth of inquiry is reduced, so too will the real impact that social science has on our health.

The gap between what we know, what we do, and what we can do to prevent illness, treat sickness, and promote well-being will grow.

Anecdotally speaking, this trend is not unique to the social sciences, but it is amplified in this domain. Social sciences in Canada and abroad are consistently funded at lower levels than that of basic research (see here for a starting point). But what is interesting is that many of the problems that we face within health require social science knowledge and research to address and social science — from knowledge translation, social network studies, technology adoption, innovation, management, to policy implementation and beyond .

Prevention of disease and chronic illness is often a social phenomenon (e.g., hand washing). Even the act of taking the best of basic science and translating it into practice or policy options (or other scientific research) is a social act that draws on social science research to execute. Social determinants of health are social in nature and require social science to understand their impact. Designing the policy and programmatic interventions that support creating a healthier society also falls to social science research and practice.

What will our health landscape look like without the ability to take what we know and translate it into action? Worse yet, what if we simply are unable to even know what to do because the research and evidence isn’t there in the first place to translate into anything? Without another turn towards something more positive in our research support, we are about to find out.

* Photo Turn the Page by Miaboas used under Creative Commons License from Deviant Art.

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