Richard Hoffman
Washington Post health columnist Abigail Trafford, who recently spent six weeks as a fellow at the Harvard School of Public Health’s Center for Health Communication, is no stranger to the School. Having received the Harvard Journalism Fellowship for Advanced Studies in Public Health in the early 1980s when she was a reporter for U.S. News & World Report, Trafford felt not the slightest hesitation when the opportunity arose for her to return last winter. “What you find at the School are lively minds dealing with intractable problems,” she says. “I wanted to know what people who were looking at global health issues were saying. Besides, for a journalist, it was a great opportunity to take a break and get out from under the pressure of deadlines.”
For Trafford, that pressure included 14 years worth of deadlines while serving as health editor of the Washington Post. These days she writes a regular column, “Second Opinion,” for the same paper. She is also available every Tuesday afternoon in a feature called HealthTalk, which readers access via the Post’s Web site. As a columnist, Trafford is committed to tackling the kinds of things other health writers aren’t addressing, including the accessibility and affordability of health care. “There is an almost tangible sense of meltdown in the current delivery system,” she says. “While it remains possible for individuals to receive good medical care, when you look at it from a public health perspective, from a population standpoint, we’re in trouble.”
According to Jay Winsten, director of the Center for Health Communication, the fellowship that drew Trafford to the School is designed to assist journalists in mid-career who want to pursue public health issues in depth, generally for a series of articles or a book. “Abbie left here in the ’80s to create what is arguably the premier Health Section of any newspaper in the country at the Washington Post,” he says. “In a very real sense she invented the genre. She has certainly set the standard and developed a model for others.” Other recipients of the Center’s Journalism Fellowship have included Philip Hilts, who wrote Smokescreen: The Truth Behind the Tobacco Industry Cover-up, and Laurie Garrett, author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance. “Journalists greatly enhance the discussions that go on here,” says Winsten. “The fellows bring a firsthand awareness of the ways in which the media shapes public awareness and public opinion.”
A young journalist in the ’70s, Trafford found herself among a cadre of bright young reporters covering the Apollo space program. A stringer for Time magazine and the Washington Post, she learned valuable lessons about the complex interactions of science, economics, and politics, not to mention the human drama of the astronauts and scientists involved. The experience afforded her a unique view of the ways that money and politics exert their influence on policy. When the Apollo program wound down, Trafford moved into medical and science circles. The medical–industrial complex was just beginning to emerge as a force in American life, and in order to cover it, editors needed journalists who could grasp the complex interplay of forces at work.
During her first visit to the School in the ’80s, Trafford found herself
not only in the midst of exciting public health issues like neo-natal care and
medical technology but at the center of thorny ethical questions with direct
bearing upon the quality of life for individuals. She began to see that as a
writer her real value was in being able to bring together ethical issues and
personal stories and to put a human face on policy matters that are often discussed
in abstract terms. “When you look at medical care as being at the center
of all these things: technology, ethics, economics, politics, science, and culture,
you become interested in the idea of value in health care,” she says. “You
begin to ask different questions when you see that the forces at work create
winners and losers.”
In the aftermath of a series of school shootings, Trafford became extremely
interested in children’s mental health issues and teen violence. During
her residency at the School last winter she spoke with David Hemenway about
guns, violence, and mental health and with Deborah Prothrow-Stith about her
work on the origins of violent and destructive behavior. Her interest took her
off-campus as well, to Boston Medical Center’s pediatric emergency room.
What she found there triggered her outrage, and her subsequent column has drawn
significant and continuing attention to the plight of the city’s mentally
ill teens, especially those whose families do not have the wherewithal to seek
private psychiatric treatment.
Trafford gears her column toward individuals reading at the breakfast table or on the commuter rail. But because her columns appear in the flagship newspaper of our nation’s capitol, some of these readers also happen to be policymakers. “As a writer, I try to be a voice for the voiceless, mostly the young, the poor, the old,” she says. Recent commentaries have been influenced by her conversations with Harvard researchers like Lisa Berkman, whose inquiry into the personal importance and public health significance of connection and friendship struck Trafford as especially important and one that people too often ignore. So she wrote a column about it. “I have no particular expertise,” declares Trafford. “I’m not a doctor or a scientist. I’m a writer, and I see our current health care situation as a metaphor for our times. These are the stories of who we are and what we deem important. I care about these stories because I care about people.”
In a recent piece, “The Growing Challenges for Public Health,” Trafford likens the population to a single patient with “560 million legs. And as many eyes, kidneys, and thumbs. Mostly the vital signs are good.” She goes on to note, however, that patient compliance is always an issue and that this composite patient remains “conflicted, moody, and often in denial on medical issues.” Rx for the body politic: regular reading of Abigail Trafford’s informed, intelligent, and compassionate columns.
Harvard Public Health Review Winter 2002/text version
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