What Rural Health Taught Me About Storytelling Infrastructure

Rural health is not metropolitan health shrunk down. It is its own beautiful, complex ecosystem. 

I learned this working with Chelsey Canavan and the Center for Advancing Rural Health Equity at Dartmouth Health. It takes so much knowledge from the community to learn what health actually looks and feels like in that community. It’s different bit by bit. Community looks different. Access looks different. Transportation looks different. We can’t just say this is the shrunken version of what other folks are doing.

Chelsey reached out a few years ago because CARHE wanted to increase awareness and commitment to addressing about rural health equity issues. Not the big headline stuff, but the smaller things going on in communities that promote or hinder health and wellbeing. As she put it: “Social isolation is a problem, but actually there are 30 different really cool programs going on that no one talks about or they’re not visible.”

Traditional ways of working don’t capture the successes. The numbers don’t tell the story.

Small Numbers

In rural contexts,  a really important program might be helping a very small number of people, but the ripple effects of that impact might uplift the entire community. 

When impact doesn’t show up in data, we need something to share with decision makers and policy makers who are deciding on these programs. We need them to see that impact isn’t just in the numbers, it’s also in the lived experience of people accessing care.

I say it all the time: for all the beauty that data adds to our lives, data is never going to give us goosebumps. It’s never going to stick with us the way a story will. Having storytelling infrastructure might be the difference between crucial programs being viable and funded, or being cut off because they don’t show up in the numbers.

Broadly Defining Care Work

One thing I really loved about this project was how we broadly defined care and caring work. It took us a while to figure out the right language. But we knew we couldn’t just think about and include traditional healthcare workers. 

People exist in the real world where they’re getting information and services from a whole variety of places. It might be a community health worker, but it might be someone at a social service agency. It might be someone volunteering and making meals for a neighbor. It might be someone doing no or low cost home improvements to keep people in their homes.

These are folks who might not even consider themselves care workers. But we see them in those roles that are so important.

The Stories That Came Through

During our work together, we ran trainings for community members providing all types of care. We trained them on why it’s important to tell their stories, and how story needs to be married to data to create a healthy ecosystem.

Then we had days where people could come in and tell their stories. We shared those back with them too, so they could use them in their own advocacy or communications.

The folks who showed up had an immense array of experiences, from homebirth midwives to peer recovery coaches to home improvement specialists. 

Storytelling as Trust Building

When we work for large organizations with such a reach in the community, bringing in someone from the outside can be a helpful bridge of trust building. It can help translate between the large organization and the community they serve.

Chelsey said something important about this: “Especially when it comes to healthcare and health equity, there is distrust in healthcare systems for a whole variety of reasons. Going into a community and saying “share your story with us” can be sensitive for certain people and certain populations. That third party voice of like, we’re doing this but we’re partnering, can really help with that trust building and openness to sharing in a way that maybe people otherwise wouldn’t.”

What Rippled Out

Chelsey told me something that made me so happy. After this work, after the stories were shared and disseminated, other partners started saying, “This is super cool. We wanna do this too.”

That’s one of the best ways to know if people saw value in something. People trying to do more of it.

I think the best way to have people see themselves as storytellers (which we all are) is to just play them a story of an everyday storyteller. Then they’re like, “Well then you should know this.” It prompts more storytelling. “If you know that about that part of the system, you should know my part.” It’s like, yeah, absolutely, come on over. We’ve want to hear from you.

Flooding the Airwaves

Chelsey and I also talked about what happens when authentic stories don’t fill the space. In a vacuum, false narratives and misleading stories will fill it. We’ve seen this in public health so starkly.

Public health as a field has not done a great job historically of getting out and telling stories. What we can do is flood the ecosystems and the channels with true, authentic human stories told in the voices of the people who are experiencing it. Then, we have an abundance of stories that build on each other to create this narrative of what life is really like.

Public Health Communications Are Too Precious

I often say that public health can be so boring in our communications because we’re so precious about it. We’re like, well we have to get it exactly this right and it has to meet this comms goal and we can’t quite say it that way.

No. We actually just need to say things in a way that people can hear them and resonate with them. The way public health talks to people right now is not how anybody talks or absorbs information. You have to have an MPH or even a DrPH to decode what this really simple message should be.

Story can capture all of that nuance and tell that really complex story without getting sidetracked with minute details. Our job serving communities is to talk to them how they talk. Not to say, no, you have to adjust to our communication style.

Training Is Really Demystifying

So often people ask, how do we do this? And I think the training process is actually just more of a demystifying process. You know how to do this. You know how to talk to people. You know what’s compelling. It’s a very human process that there are so many ways to operationalize and make part of your organizational DNA. You have the skills. We just demystify all of what’s been added on that makes it seem unattainable.

Chelsea put it this way: “It’s like, this is a thing I’ve done in my personal life. How do I do it professionally? How do I use it strategically?”

Letting Go of Control

There’s often this misconception that we can’t meet our comms and advocacy and strategy goals if we let storytelling come in. If we let go of our talking points and messaging.

I promise: the stories you get will further support you in meeting all of those goals more than the current messaging that’s in place. Because it’s that true community experience that shows us our blind spots. It brings out the truth. It connects with decision makers and policy makers.

There’s apprehension about letting go of control a little bit. But the looser we hold storytelling (and again, with processes, with goals in mind), the more likely we are to meet actual goals than if we try to confine it to talking points and train people on how to tell the story just so.

People need frameworks and support. We can do that. But then there’s this point where you just have to let the unknown happen. And in that unknown is the real magic that meets our goals, forwards our strategy, all of these things. That little bit of letting go of control makes it all possible.

Not a Tear Down

One more thing. Organizations can be weary of what might be said. And then they hear the stories and it’s like, you live in a community of folks who’ve had varied experiences with your organization, but also depend on it. They had their babies there. They were held by it. Those are beautiful stories.

Our goal is thriving communities. Let’s listen to the ways those communities are thriving. And continue to build on that.

It’s not a tear down situation.

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Okay, let’s get serious about bringing story & strategy into your organization. Below are a few ways we can partner, and, of course, you can reach out if you want to collaborate in a remixed sort of way:

+ Story Lab Sessions: Tailored strategy mapping to chart your organization’s storytelling journey, followed by a comprehensive brief with guidance to implement the findings from our session. These sessions are perfect for organizations ready to take their first steps or needing focused guidance on specific initiatives.

+ Story Hour: Real-time support, guidance, and peer learning through a suite of trainings and regular calls. These group sessions provide ongoing support and practical insights for implementing storytelling initiatives in your organization

+ Customized Collaboration: Long-term, tailored support for comprehensive organizational transformation. We’ll work closely together to integrate storytelling deeply into your existing processes. This is designed for organizations looking for in-depth support designing, implementing, and learning from storytelling initiatives.

+ Intensives & Retreats: Individually designed intensives for your staff retreats and training blocks to engage your staff in a process that centers their experiences and connections to their work through story. Great for organizations looking for a unique, connective experience for their team.

Entangled Health can be in your ears, too! Listen to the show wherever you tune into podcasts.

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