Graphic Public Health by Meredith Li-Vollmer

At the Graphic Medicine Conference in July, I got Meredith Li-Vollmer’s Graphic Public Health: A Comics Anthology and Road Map. As a public health professional, I must first emphasize how much I appreciate the term "graphic public health" as opposed to "graphic medicine" that the author employs. It seems more inclusive and representative.

The book is much more than an anthology. It collects comics written, edited, and commissioned by Li-Vollmer in her professional capacity as a member of a metropolitan health department, but it also shows how comics can be used as a health communications tool and walks us through the process of their creation. A selection of comics is shown at the beginning of each chapter, followed by a study of how the comics accomplish their communication goals, as well as some backfround on their development.

The first four chapters feature comics used in different areas of public health: health literacy, risk communication, health promotion, as well as advocacy and activism. This is how Li-Vellmer explains the role of comimcs in health literacy efforts:

“They [comics] offer multiple modes for conveying information in a single encounter, and the dynamic visual and textural elements have the potential to garner attention. But the power of comics is more than the explanatory power and attractive visual appeal of illustration and text. Comics over distinctive possibilities for exploring public health issues through narrative storytelling. They tap into how an issue makes people feel and how it plays out in their realities. Whether or not people engage with public health messages may only minimally be about the clarity of information. They receive a message within the context of their emotional states, their social worlds, in the specifics of their own positionality. Does the message stimulate an emotion? Does it relate to the world as they experience it? The possibilities that comics offer to evoke a response, create connections, and stimulate empathy are the most compelling reasons to use comics for health literacy. By drawing the reader into the social and emotional dynamics of a health message, comics can foster a deeper level of engagement.”

Climate Changes Health, written by Meredith Li-Vollmer, artwork by Mita Mahato, 2019.

Comics also play an important role in risk communication. We can practice “mental rehearsal” through the images, which involves thinking through less likely events in advance, such as pandemics or bioterrorist attacks. As in the case of graphic memoirs of disaster survivors that emphasize personal experience, they can inspire us to be prepared for emergencies and help us act more quickly when we are under stress. Importantly, comics bring more empathy to risk communication, which is considered an effective strategy. Li-Vollmer writes:

"The combination of image, words, and sequence makes the comics medium uniquely suitable for communicating in times of crisis, when critical life and safety messages must be easy to comprehend. They can highlight aspects of emergency situations that resonate, and they can engage people through stories about survival, interpersonal bonding, heroism, and hardship."

Survivor Tales: In Deep Water, written by Meredith Li-Vollmer, artwork by David Lasky, 2010.

Because of their adaptability, capacity for explanation, and visual appeal, comics are effective tools for health promotion. This is particularly true today, when a lot of content competes for a finite attention. I especially appreciated how the chapter's examples demonstrated how a comic strip can be used for much more than just sharing it on a health department website or on social media. It can also be printed on materials like postcards, posters, and banners to reach a larger audience. Comics can also be easily adapted into animated and narrated videos. In this section, Li-Vollmer also touches upon the importance of evaluating comics that promote health:

“Obviously, there is a need for more evaluation of comics for health promotion, including the comics that I have helped produce. As health behavior changes are difficult to attribute directly to exposure to health communications, qualitative evaluations that focus on consumers' reactions and readings of health promotion comics could be particularly illuminating. This type of evaluation could direct health communicators to possibilities for comics to spark a deeper level of engagement in health promotion materials.”

Youth Story, from Don’t Hang on to Meds, written by Meredith Li-Vollmer, artwork by Tatiana Gill, 2018.

The comics for advocacy and activism, dealing with health coverage and the work of the Seattle/King County Clinic, which is free and only operates once a year to provide healthcare for those who cannot afford it, really touched a chord with me. Both because of my background in health policy and because I am an immigrant, and I’m frequently concerned about the cost of care.

Because of the emphatic nature of comics, readers can more easily experience multiple perspectives on the impact of public policies on health:

“Discussions at the big-picture level may not connect with wide audiences, but down at the ground level are stories about real people. Their health is defined by the resources for healthy living that are available (or absent) in their neighborhoods, the prospects they have for education and employment, and the opportunities or barriers created by the policies at the play where they live.”

“Using comics, we can tell individual stories that shed light on these larger systemic issues without reducing the issues to matters of individual-level responsibility.”

George by Owen Curtsinger, 2016.

Felipe by Tatiana Gill, 2018.

The final chapter focused on creating public health comics based on advice the author would have given herself when she first began writing and creating comics for health communication. Li-Vollmer walks us through the steps of creating such a comic, including defining communication objectives, identifying target audiences and key messages, collaborating with artists, and distribution. The information was extremely useful, and this will be my go-to book when it comes to graphic public health projects.