The Check Up: How health journalism can blend statistics and storytelling

Hi, I’m Elijah de Castro, The Sentinel’s health reporter. Welcome back to The Check Up, where I bring you the latest at the Monadnock Region Health Reporting Lab.

Like other industries, health care is increasingly driven by numbers, data and algorithms; in our for-profit health system, understanding what’s really going on requires careful and deliberate analysis of prices, market dynamics and massive numbers. So how do journalists distill this information in a way the average person understands?

To the average person, myself included, data and other numbers are flat and inanimate sources of information. This might explain why more than half of Americans feel that the health care system treats them as a number rather than a person, according to a 2024 IPSOS poll.

Take, for example, the budget reconciliation bill that President Donald Trump signed into law in July, which contains roughly a trillion dollars in cuts to public health care. Early estimates suggest that 11 million Americans will lose health insurance as a result, according to the Congressional Budget Office. These numbers are so large it’s almost dizzying to think about.

Trying to understand the scale of a roughly $1 trillion cut to public health care funding is somewhat akin to attempting to understand the size of the observable universe, or how unlikely it is to buy a winning lottery ticket. Thanks to the way the human brain has evolved, large numbers defy our comprehension. Two Stanford psychologists wrote about this in a 2022 article in The Conversation, in which they explored why it’s so hard to imagine the number of deaths from COVID-19. In it, they write that “the brain is optimized to recognize small quantities because smaller numbers are what people tend to interact with most on a daily basis.”

That’s where storytelling comes in. Unlike large numbers, narratives and storytelling are part of human nature, and predate mathematics and quantitative evidence. Narrative gives us emotions to feel, and can help illuminate the path we’re walking by asking qualitative questions, like “why?” and “how?”. But without statistics as a guardrail, narratives can spiral off into misinformation and logical fallacies.

When engaging storytelling meets with well-stewarded statistics, the truth becomes much easier to metabolize. A good example of this strategy in health journalism is “Denied by AI,” an investigative series by the health publication STAT. The series uncovered how health insurers are using predictive learning algorithms to deny patients payment for care on a scale that affects millions of people. But the story was grounded in the experience of one woman in a nursing home with a broken shoulder who was denied payment for needed care.

That’s the approach The Lab is taking in an upcoming investigative series looking at New Hampshire’s elder care system. This package of articles will delve deeply into a complex and nuanced issue affecting thousands of seniors throughout the Granite State, grounded in the story of two Keene residents’ experience.

After this package, we’ll be turning our attention to two rapidly approaching issues in health care. The first is the anticipated expiration of Affordable Care Act subsidies at the end of the year, which would double health insurance premiums for those who receive insurance through ACA marketplaces, according to KFF. This issue is at the center of the ongoing government shutdown, and will affect roughly 50,000 Granite Staters, NH Bulletin reported. The second is the withdrawal of certain Medicare Advantage insurers from the state, which will begin in 2026 and will affect roughly 77,000 people in New Hampshire, according to the N.H. Insurance Department.

But we’ll need local stories and narratives to ground these big numbers. If you have coverage through ACA marketplaces, or through Medicare Advantage, and are bracing for these changes, please reach out to me.

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