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You Can’t Spell Numbers Without Numb?
A Guide to Excelling at People-Person Math

Do you consider yourself a numbers-person?

Probably not.

No, odds are you are proudly a people-person.

Still, virtually everyone who reads this is surrounded at their work by numbers and probably judged by them: vaccination rates, disease statistics and oh, yeah, budgets. And those numbers influence more immediate numerical concerns, like performance ratings and compensation. Yes, we are living in a material world – count on it.

And that’s why I took the advice of Dr. Scott Hamstra, STChealth Medical Advisor and big brain, and picked up the book Making Numbers Count by Stanford B-school prof Chip Heath and science writer Karla Starr.  The point of the book is to get better at using numbers by using fewer of them. Indeed, the book includes this surprising advice: “AVOID NUMBERS.”

The logic of this is that our brains aren’t built for numbers, but rather for visuals, and by visuals, let’s hope nobody wants more flow charts; no, what we seek are mental photographs. We’ve all heard “one picture is worth a thousand words.” But, so too, one picture is worth a thousand numbers… no, wait, hold on… that’s more numbers.  So, it’s tricky. Even so, as the book declares early on, “Math is no one’s native tongue. At best, it’s a second language picked up in school through formal teaching. The more you can relay your message in the native song of your people – without math – the better.”

This means, the authors suggest, translating numbers into visuals. The book offers many examples, including some useful health-related ones. For instance, they show a chart translating the size of a tumor from centimeters to familiar food items:

1 cm = pea

2 cm = peanut

3 cm = grape

And so on, up to

10 cm = grapefruit

And then there are the translations of social distancing during Covid, where health departments found lively ways to express “about six feet,” often using local objects for comparison:

Canada: One hockey stick

Florida: One adult gator

San Diego: One surfboard

Montana: One fishing rod

Hoping to find a nice visual of one of these, I came across this eccentric one from the BBC, for some reason upping the ante on memorability by adding a naked man brush off…

Another of the author’s translation tricks is humanizing and/or personalizing the data. For instance, when trying to describe an animal’s ability, it becomes a mental picture like converting the jump of a frog to a basketball player:  Instead of, “A frog can leap several times its own body size,”; you’d say, “If you could leap like a frog, you would be able to dunk the ball from the 3-point line… actually from the 3-point line around your opponent’s basket.”

Often, however, the numbers you’re avoiding aren’t merely expressing a distance or size, and thus are not so readily translating into a visual. There’s the one “translation” that has come back to me multiple times since reading the book: the difference between a million and a billion. Here the authors describe teaching number translation to grade school kids:

We’ve seen sixth-graders (11 year-olds) get excited about knowing the difference between a million seconds and a billion seconds. A million seconds is 12 days from now, the next pizza day in the cafeteria. A billion seconds is 32 years, unfathomably far off in the future (the 11 year-old will be 43!), past high school and college and first jobs and over the horizon into the boring years of chauffeuring kids and heart attacks.”

I don’t know about you, but “billions” are so commonplace that, for me, they’ve started to lose any proportion – hey, million/billion/schillion. But, the translation that excited sixth graders snapped me back to the reality of size.

And here’s another one that stuck with me:  The authors turn this sad-but-not-surprising fact, “A very small percentage of Fortune 500 CEOs are women,” into this eye-opener: “Among Fortune 500 CEOs, there are more men named James than there are women.”

Or, remember when everyone was talking about “Six Sigma” as the goal for reducing defects/errors? Here’s how the authors humanized that one..

Instead of merely defining Six Sigma as “3.4 defects per million objects,” they offer this alternative: “To achieve Six Sigma as a baker, imagine baking a batch of two dozen chocolate chip cookies every night. You could do that for 37 years before baking a cookie that is burned, raw, or doesn’t have the  perfect number of chips.”

THE POINT

There are countless examples, but here’s the point: The authors, Heath and Starr, created a book that, while having a schillion numbers, does not have a single visual printed on its pages; yet, it contained dozens of memorable mental pictures. So the book serves as a challenge: when reporting results, take the time to attempt to translate your numbers into pictures. Can that number be concretized, humanized, personalized, foodified, sportified, geographified or otherwise turned into something that might charm the mind’s eye? Do that and even people-persons will pay attention to your numbers.

STATS OF THE MONTH

Community Immunization Stimulants?

By Bill Davenhall, Geomedicine Analyst

Rural America seems to face stronger immunization headwinds then their urban counterparts, and some of that has to do with the site location of primary care physicians (PCPs). CDC studies suggest that rural America has significantly lower immunization rates and when a PCP physician shows up in a rural community, immunization rates increase. Uneven physician distribution would suggest that PCP site location is a top determinant in impacting immunization rates and, subsequently, the overall  success in getting both children and adults immunized in many rural parts of the US. The contextual data would also suggest that other non-medical factors begin to impinge on that choice of location.

Two factors loom large in any rural community – and represent major challenges to the immunization ecosystem.

#1. Attraction and Retention of PCP’s in the rural community (however geographically defined). Attracting and retaining a PCP is not an easy task for any rural community, and many communities don’t have a variety of incentives to attract physicians. Site location decisions are also impacted by educational loan repayment incentives that may only solve a temporary community PCP shortage.

#2. Competition of Urban Environments.  Some non-medical issues can be difficult to negotiate: an array of family employment opportunities, availability of  lifestyle amenities, educational choices for children, and many other non-negotiable “needs” of a family.

(One example: I currently reside in what I would call a “transitional” medical geography – halfway between rural areas  and dense urban areas – but many PCPs  in my community commute daily an hour or more to get to my more rural community and are not usually around my community on weekends.)

The chart below gives you a hint where PCPs are not in the right geographical location, statistically. (The data are according to HRSA, the United States Health Resources Services Administration, and Kaiser Family Foundation). HRSA reports that, as of end of the year 2024, there were approximately 13,000  PCPs that are needed in a different geographical location. If you want to give your immunization rates a better chance of increasing, you’d recruit additional PCPs (and their families) into your rural communities.  Keep in mind that the PCPs’ decisions as to where to “practice” starts long before they exit medical school — there are studies that report that physicians don’t move too far away from their birth place, where they went to high school, where they sought medical training or residency programs, or where they may have developed close friendships and met future spouses. This should signal to any reader that getting any (or perhaps additional) PCPs into your rural communities will require a lot of work ahead of time on the many non-medical  “delighters” that will  bolster  your communities health-seeking future and immunization rates.

If you live in a PCP shortage area, please let us know what your community does to get or retain your PCPs — we would appreciate hearing more about what works!

As always I appreciate 2nd opinions.

Primary Care Unmet Needs

December 31. 2024