Research Action Design
Durham Community Health Indicators Project
Gallery Project Statement
The Durham Health Indicators Project is an experiment in fostering conversations about the impact that evictions, over-policing, racism, chronic stress and the built environment have on people’s health and well-being.
In 2017, Durham County’s Department of Public Health made a formal request for the Duke University Health System to use their electronic medical records to release census tract and blockgroup level information about chronic disease incidence, starting with diabetes. Because the Duke Health’s system includes both of Durham County’s hospitals, as well as our major community health center, this data release effectively covered the majority of the County’s population, and provided much more detail on geographic differences in chronic disease than what was previously available.
The Health Indicators Project launched as a partnership between Durham’s Public Health Department and DataWorks NC (with assistance from Research Action Design), to figure out how to present this new information to Durham County’s residents in a way that would both avoid stigmatizing particular neighborhoods or groups of people, and give residents across the city actionable information to advocate for better health for their neighborhood. We spent nearly a year in a process of co-design–meeting with community health workers and conducting participatory workshops in some of the neighborhoods which had the most evident health disparities.
At the workshops, we led gallery walk activities where we shared a variety of infographics, photos, drawings, comics and newspaper articles about the impact of space, place and race on health. We asked residents to flag which factors, and which media, they found most relevant, and then to take part in a consensus workshop answering the question “What factors influence the health of people living in this neighborhood?”
One of the major learnings from those workshops was that residents preferred to engage with comics, drawings and narrative rather than maps or charts. The platform we built uses drawings (by illustrator Saif Wideman) and narrative text to give a sketch of daily life and health conditions in different areas of the city. Viewers can toggle between different neighborhoods to see how the streetscape changes from neighborhood to neighborhood, and they can also scroll to read about determinants of health in more detail. The site is mobile-friendly and available in both Spanish and English.
Because conversations about health and the built environment can end up making a tacit argument that white spaces are healthier, while stigmatizing majority-Black neighborhoods, we chose not to highlight comparisons between neighborhoods, but instead to dig into each neighborhood as a particular place, and include racism as a category influencing health.
We designed the website with the idea that it could be a tool for sparking conversations, both online and in in-person workshops, so each individual neighborhood profile can be printed for use by health educators or community activists. Indeed, one of the most gratifying outcomes of the project, so far, has been finding that the “Our neighborhood” link on a local church website leads directly to their profile in the health indicators site.