Gubrium Advocates for Greater ‘Narrative Complexity’ in Public Health Responses to Crises

Aline Gubrium, professor of health promotion and policy, examines the relevance of broader narrative contexts when developing public health responses to illness and disease in an invited essay appearing in the June 12 issue of The Lancet.

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In the article, co-written with her twin sister, Erika Gubrium, of Oslo Metropolitan University, in Oslo, Norway, the authors take aim at the overly simplistic messaging frequently found in public health campaigns. They argue, “COVID-19 has made it abundantly clear that responses based on biomedical knowledge alone are not enough. Responses must also recognize and adapt to ongoing social, institutional, and political contexts…. Public health responses aimed at reducing risk need to consider how individual decision making might be shaped by these relational contexts.”

An expert in the use of participatory digital, visual and narrative research methodologies in support of public health research, intervention and advocacy, Gubrium and her co-author expand on this argument, noting the possibilities offered by using a narrative approach to better understand how individuals make meaning of and respond to illness. This enables researchers to account for the experiences of marginalized communities, minoritized group identities, and other political, as well as the social contexts affecting individual and social responses to COVID-19.

“Such a framework might be instructive for understanding the rather limited political mobilization there has been in differing political and social contexts in response to the extensive socioeconomic health inequalities made hypervisible during the pandemic,” they write.

Gubrium and Gubrium note that researchers have effectively used the participatory narrative approach of digital storytelling to alter the balance of power in health promotion, arguing that these methods “could also provide necessary information for crafting responses to COVID-19 that are adjusted to varied life experiences, and are thus more effective.”

They conclude that “COVID-19 has revealed a blurred conceptual divide between illness and wellness; between medical and social risks; between safety and harm. Narrative contexts such as the workplace, the home, schools, the community, and health-care settings have shifted in meaning in this pandemic. These changes continue to shape the way we think about and respond to COVID-19. In the short-term, public health campaigns might consider how narrative contexts and personal meaning-making shape how people understand and respond to calls to ‘stay safe’ in the face of the pandemic. In the longer term, accounting for narrative complexity with reference to wellness, illness, and disease is crucial if we are to develop effective and socially just public responses to health crises.”