“Nothing replaces being in the same room face-to-face breathing the same air and reading and feeling each other‘s micro-expressions.” ~ Peter Guber
According to the Diffusion of Innovation Theory, I fall within the early majority section of the bell curve. I have no qualms with accepting the early majority title. I appreciate innovators and early adopters — two groups preceding my cohort along the Diffusion of Innovation — in how they discover initial bugs fraught within new devices, set the stage for tweaking initial ideas toward greater practicality and provide valuable feedback on which formatively evaluating public health interventions is built.
For example, I was not among the first to purchase an iPhone. I did not readily appreciate the value the device added on so many levels — eventually I did and purchased an iPhone 4. From then onwards, I have upgraded my iPhone every other generation. I have owned an Apple TV for three years. I purchased a MacBook Air to get me through the MBA program, which Larry has confiscated for his professional use. I am currently typing this blog on my iPad Pro — which I also use to take copious handwritten notes with my Apple Pencil among other professional duties. Since every man should have a nice watch, my partner purchased me an Apple Watch – Series 3. These products meet my needs, adding value to how I navigate my professional and personal worlds — accusations of drinking Apple’s Kool-Aid from friends and colleagues notwithstanding.
With all my Apple products offering seamless interactions with mountains of information and diverse people around the world, I still read traditional books at my leisure. I print hard copies of documents to proofread them — usually with a red ink pen. I write reminders on Post-Its instead of setting reminders via Siri by barking them at my iPhone, iPad Pro or Apple Watch. With all things exist points of diminishing return. In today’s digitized world, communicating with stakeholders and managing partnerships via video conferencing, social media and other forms of electronic exchanges has shown its effectiveness — with a point of diminishing return not being openly and honestly discussed.
Scholars, scientists, and opinion leaders alike spent many years convincing the masses of Earth’s roundness. By some accounts, Earth’s spherical shape was accepted as fact as early as 600 BC – with Pythagoras, Aristotle and Euclid attesting to our planet’s circularity at that time. As the powers of the Internet exponentially strengthened, talks of a flat Earth resurfaced as themes of motivational speeches, buzzphrases while chitchatting, and value-adding business propositions among other overtures. Discussions morphed into business practices and global public health interventions made possible (in part) by digitization and the increased Internet connectivity it facilitated.
Civil aviation also played a significant role in globalization by greatly decreasing global travel time. Digitization transformed how companies pursued new growth — entering markets once deemed too geographically far removed, economically unstable or socially incompatible with American consumerism overall and companies organizational cultures in particular. Additionally, consider those of us working remotely 100% of the time. Digitization allows us to work from any location with a reliable and robust enough Internet connection — rather its in Cape Town, South Africa or Fairbanks, Alaska. Our careers epitomize weisure (work + leisure) — tour the world while you work, all you really need is an Internet connection!
Digitization has unleashed financial capital into destitute regions of the globe, pulling millions of people out of abject poverty. Flattened Earth practices have created record profits, while eradicating millions of jobs through automating rote processes and outsourcing jobs to cheaper labor markets — an increasingly destabilizing trend I will discuss in a separate blog. Digitization keep products and services synonymous with our standards of living under mutiny-inducing prices.
Furthermore, advances in technologies mimicking face-to-face meetings allow us to interactively communicate with business partners, global health trainees, or domestic public health allies, electronically sharing resources as needed. Digitization ensures year-round access to certain produce (a “benefit” that remains under debate), which now can be hand delivered to your home after requesting it via an iPhone app. Despite the undeniable benefits digitization has bestowed upon humanity, it should neither entirely supplant nor reduce beyond repair rudimentary human functions such as face-to-face, social interactions.
Of the many reasons I earned an MBA, expanding my professional network beyond that of the public health profession has shown to be one of the more consequential. Learning from my MBA cohorts with different backgrounds, career motivations and marketplace perspectives has enhanced my interpretations of community needs and shaped how I approach crafting public health intervention. For instance, during the program an MBA cohort shared her lessons learned around digitized communications being lauded as a cure all for global travel woes and tightly stacked Outlook calendars.
According to her professional experiences, partners have begun to balk at the notion of foregoing personal, face-to-face conversations and meetings. She shared accounts of international partners severing contacts given face-to-face meetings were not prioritized. Even with drastic improvements in the picture and sound quality of video conferencing, I understood her point as digitized communications credited with flattening the Earth have reached a point of diminishing return in some corners of the business sector — which may or may not be typical. While unremarkable to some, noodling on her revelation brought additional factors into focus. As one journalist in cable news often warns, “watch what they do, not what they say.”
Even though said journalist referenced unscrupulous politicians when uttering those words, I understood her quote from a different, less critical angle. In watching what they do – whether they are business partners, political allies, or community stakeholders – non-verbal cues can be the most informative modes of communication. Body language (e.g. eye movements, posture and breathing patterns) helps discussants and strategic planners alike gauge the receptivity of their proposals in real-time. Digital tools may not adequately relay such feedback. Elevator speeches and negotiations can take a different direction when certain non-verbal cues indicate they should, as can brainstorming sessions, decisions to allocate funding, and assigning leads to launch certain projects among other high stakes agreements. Lastly, making the effort to physically show-up for people has historically been the ultimate manifestation of respect, appreciation and commitment.
The public health profession has not been immune to the lure of digitization, having shaped how we fund, plan, implement, evaluate and scale interventions. With resource-starved projects, dwindling staff, and evolving public health threats, digitization offers cost effectiveness, higher productivity with less human capital, and nimbleness in making near real-time decisions to diffuse possibly life-threatening situations. Digitization equips epidemiologists and biostatisticians with more powerful evaluative and analytical tools. Such enhanced capabilities identify nuanced emerging trends, weighing contributing factors influence on adverse health outcomes, and measuring the effectiveness of interventions deployed to address them. We utilize Twitter, numerous webinars, and Zoom meetings daily. However, somewhere along the public health interventional continuum, digitization loses value — and does so more acutely in certain region of the country. Digitization has a point of diminishing return that seems less forgiving in public health.
Rural health may illustrate digitization’s point of diminishing return most clearly. People residing in rural areas experience disproportionately high rates of tobacco use, opioid misuse, and obesity among other public health issues (e.g. declining life expectancy). Rural residents also have more difficulty accessing healthcare providers and often lack connectivity to the Internet or have slower, less reliable connections. Admittedly, cell phones with Internet capabilities are nearly ubiquitous — yet may not be resourceful enough to carry out critical public health functions needed to improve countryside dwellers’ health.
Physically showing-up to plan, execute, and evaluate public health interventions remains the most effective means of garnering buy-in and support from opinion leaders and respected community sectors (e.g. local nonprofits, civic organizations, churches). The results of robust data sets churned out by influential academic institutions require local data — anecdotal or otherwise — to accurately contextualized risk factors. In some instances, data sets are not available for jurisdictions lower than the state level — whereas local data collected by various community sectors may be helpful. Local data may not be as sophisticated as the highly digitized forms from academic institutions yet may be just as valuable. Face-to-face involvement with key leaders in various community sectors is the best — not only — way to gain access to local data.
Rural community sectors and the people they represent prefer investing time to become acquainted, which eventually get them to a point of trusting you. The very essence of digitization rests on expediting and/or simplifying partnership development. More often than not, this preference for partnership development holds irrespective of data sets robustness, storage capacity of cloud-based services, or the volume of electronic documents covering a specific public health phenomenon. Refrain from accepting the belief priority populations residing in rural areas should be grateful public health professionals care enough to improve their situations. I cannot tell you the number of times I have heard people say “they should be happy we care,” “who else do they have to do this for them” or some other condescending, misguided rhetoric.
Having grown up in a rural setting, I should clarify people in those regions are not necessarily Laggards. Digitization has its place in rurality; which is not as readily perceptive as it would be in some of America’s megalopolises. The key is finding the right fit, which should not be misconstrued as public health mission creep. Swooping-in while wielding shiny devices, uttering broken text/Twitter shorthand which is commonplace in digitized communications, as well as digging your heels in “what the data say” will almost guarantee a failed public health intervention.