Watching the remarkable Xeni Jardin tweet her mammogram and cancer diagnosis, then blog eloquently about it, then crowdsource opening up her own MRI data makes me ask: Why are we so secretive about sickness and health? And what do we lose because we are?
The answers to the first questions are fairly obvious. First, we keep our sicknesses secret, we say, because we fear we could lose insurance. Except insurance companies force us to reveal our medical histories anyway. And let’s hope that Obamacare — may it survive the Supreme Court — succeeds in outlawing the denial of health coverage due to preexisting conditions. Next, we fear that we could lose jobs. Except in cases where a condition would affect job safety, shouldn’t employers be told that they cannot discriminate on the basis of health? Whether or not society chooses to address these issues through legislation, my point is that it’s possible to do so.
The other reason we keep sickness secret — the bigger reason — is stigma. We don’t want people to know we’re ill. But in this day and age, why should anyone be ashamed of being sick? To be clear, I am not saying that anyone should ever be forced to reveal health information. But why should our norms, stigmas, and economic considerations force us not to reveal it?
Imagine if we didn’t feel compelled to hide our illnesses. Imagine if we could be open about our health. What good could come of that?
We could learn more about correlations, which could yield information about causation and even cures. Given large data sets, we could find out that people who get a disease share common behaviors or characteristics. We might gain the opportunity to discover an environmental cause to a local outbreak of, say, breast cancer, enabling a community to fix the condition and prevent more cases.
Of course, I want to emphasize the conditional: correlation *could* help. One data point is never meaningful: That I’ve contracted one heart condition and two cancers since being at the World Trade Center on 9/11 is meaningless — unless there are many others in the same boat, and even then, one mustn’t jump to conclusions about causation. Still, more data is always better than less.
With openness about health, we could do a better job connecting people who share conditions to get information and support and each other. I am on the board of Learning Ally, formerly Recording for the Blind and Dyslexic, and at our last meeting, I was struck by the barriers that stigmas put in the way of young people getting the organization’s help. I heard how getting our software on iPods has helped more kids use the service because they no longer have to carry around a special device that marks them as different — stigma. I heard a mother say that school officials warned her that her child would be labeled — stigma — if she got him appropriate services, but she said she’d eagerly embrace the label if it got her son the help he needed.
On my blog, I’ve been in a debate about the recommendation by a government panel that men shouldn’t be given the blood test for prostate cancer anymore because, statistically, it hasn’t been shown to save lives. That’s because medical science can’t yet distinguish between fast- and slow-growing prostate cancer. I say men should get the test. I say we should be talking openly about our prostates as women have fought to talk about breast cancer. More information and communication is always better than less.
The real question is what men choose to do when they find out — through a biopsy following the blood test — that they have cancer. Perhaps more men should choose what the doctors call watchful waiting over surgery. But, you see, the problem is that we don’t have *enough* data to make a good decision. I want to know, based on the largest possible population, how long it took prostate cancer to spread after it was found. Then I could decide how long to watch and wait. But I don’t have that information. So I chose to get the cancer out of me. I could make that choice only because I had the test. I had my own data. If I had the data of millions more men, I could make wiser decisions.
How could get get more data?
Step one is to encourage men to talk about their prostates — and, yes, sorry, their penises — so we disarm the stigma about it and get more men to be aware and get tested and share their experience.
Step two is to create the means to open up and share as much health information as possible so researchers, doctors, and hackers can dig into it and find correlations and patterns and questions worth pursuing, perhaps leading to answers.
When I talk about the principles of an open society in Public Parts, this is what I mean. Rather than reflexively declaring that sharing information about ourselves — our bodies as well as our thoughts and actions — is dangerous, we must stand back and ask what benefit could come from such data, now that we have better technological means to open it up, gather it, and analyze it.
Only then can we balance the benefits and risks and decide, as a society, how open we want to be, how open we should and need to be — and why. That is the kind of discussion about privacy and our changing norms I’d like to hear. Let’s not just talk about what can go wrong now but also what could go right.
: LATER: Some added links:
* Larry Smarr quantifying his own health.
* On being a medical data donor.
* Give us access to our own health data, online.
If I may be so bold and greedy to suggest something to fill that new Kindle, Nook, iPad, iPod…..
* Public Partson Kindle
* Public Parts on Nook
* Public Parts on Google ebooks
* Public Parts on Audible
* Public Parts is not yet available on *Kobo* (until I have a hissy fit).
* Public Parts on Apple iBook
* Public Parts on Sony
* * * * *
* What Would Google Do? on Kindle
* What Would Google Do? on Nook
* What Would Google Do? on Google ebooks
* What Would Google Do? on Audible
* What Would Google Do? on Kobo
* What Would Google Do? on iBook
* What Would Google Do? on Sony
We got some big news at CUNY this week: We are approved to offer what we believe is the first MA in entrepreneurial journalism.
Last spring, we already taught our first class of full-time entrepreneurial journalism students, awarding certificates. But now we also have the ability to award MA degrees to students who complete the CUNY J-school program plus a fourth entrepreneurial semester. This comes under the auspices of the Tow-Knight Center for Entrepreneurial Journalism at CUNY.
My colleague Jeremy Caplan and I teach four courses: MBA in a box in the media context (Jeremy’s qualified to teach that; I’m not); a course in disruption in media (that’s what I teach); the incubator as a course (the core of the curriculum is the students’ development of their own businesses and for that we the faculty and mentors meet individually with them and meet as a group to compare issues, problems, and solutions); and a technology course (this semester, we plan to work closely with General Assembly for some of that curriculum and are bringing in Nancy Wang and Jeff Mignon to work with students). In addition, the students do a project as an apprenticeship with a New York startup.
We are about to admit our 15+ students for the spring term, most of them professionals seeking the certificate (and in some cases a second career) with some students from our regular journalism program (they’ll be the first to earn the MA in entrepreneurial journalism).
This comes right after the fifth annual jurying for our regular entrepreneurial course, offered in the MA in journalism, in which a dozen students created their own business plans and a jury awarded seed funding from a Tow-Knight grant.
At CUNY, we are constantly changing our curriculum, updating it as reality in media shifts, as we learn new lessons, and as we see what works and doesn’t work in helping students reach their goals. That can be unsettling for both students and faculty but there’s no choice about change.
This week, coincidentally, I was contacted by two searches for journalism school deans (it appears to be open season on the species as there are even more of these jobs open). I’m not going for and certainly doubt I would be offered either, but I did offer recommendations to one of them and that caused me to take a look at the curricula for various journalism programs in the nation. There are some neat new courses and methods (e.g., via @underoak, UNC’s master’s in technology and communication). But what struck me about journalism curricula is how little some of the courses appeared to have changed, even now. What does it mean to teach magazines these days?
Jeremy and our colleagues Peter Hauck and Jennifer McFadden sat down last week and played the game of 52-card-pickup we regularly play at CUNY, rethinking what we’re teaching and how. For example, we are going to emphasize prototyping and project management more than we had. In the admissions process for this spring, we not only wanted a diverse group of students and perspectives but also of businesses, from hyperlocal content businesses to disruptive platforms. In the other arms of the Tow-Knight center, we are supporting research in new opportunities and needs in journalism to help guide students and the industry as they propose new ideas to fit new needs. And with our growing incubator, we are bringing in new services to help both students’ and outside entrepreneurial ventures.
Of course, elsewhere at CUNY, change continues apace. For example, my interactive colleague Sandeep Junnarkar and others have been shepherding into the curriculum new courses on data visualization and a modular course in coding for journalism. We find ourselves constantly managing tension between journalism and tools (always fighting to make sure the former is not overcome by the latter).
Getting a new degree in entrepreneurial journalism is just one milepost in a constant process of trying to stay an inch ahead of the snowball. I’m proud and grateful to work with an administration — Deans Steve Shepard, Judy Watson, and Steve Dougherty — and with a faculty who support this endless creative tsuris.
WASHINGTON–Federal Trade Commission Chairman Jon Leibowitz today announced a record fine against Santa Claus for violations of the Children’s Online Privacy Protection Act.
“Mr. Claus has flagrantly violated children’s privacy, collecting their consumer preferences for toys and also tracking their behavior so as to judge and maintain a data base of naughtiness and niceness,” Leibowitz said. “Worse, he has tied this data to personally identifiable information, including any child’s name, address, and age. He has solicited this information online, in some cases passing data to third parties so they may fulfill children’s wishes. According to unconfirmed reports, he has gone so far as to invade children’s homes in the dead of night. He has done this on a broad scale, unchallenged by government authorities for too long.”
Claus was fined $2 million and ordered to end any contact with children. Prior COPPA fines include $1 million against now-virtually-unknown social site Xanga, $400,000 againstUMG Recordings, and $35,000 against notorious toymaker Etch-a-Sketch.
The FTC action follows similar complaints against Claus brought by European privacy authorities. European Commission Vice-President Viviane Reding has complained about Claus holding data on children outside of EU data-protection standards in North Pole server farms. German head of consumer protection Ilse Aigner has called for an investigation of Claus’ use of Google Street View in navigating his Christmas Eve visits. German Federal Commissioner for Data Protection and Freedom of Information Peter Schaar has demanded that Claus give children, naughty or nice, the right to be forgotten in his data base. And Thilo Weichert, head of the privacy protection office in the German state of Schleswig-Holstein, demanded that German web sites take down any Facebook “Like” button referring to Claus.
Meanwhile, Canadian Privacy Commissioner Jennifer Stoddart has attempted to bring together an international coalition of privacy officers opposed to Claus’ practices. In California, Claus has been threatened with severe penalties for nonpayment of the state sales tax. And the UK has vowed that Claus will be detained and could face extradition should he set foot in any English chimneys on Christmas Eve.
Reaction to the FTC decision was mixed in Washington. Republican presidential candidate Rick Perry vowed to kill the Federal Trade Commission, relieved that he had finally recalled the final agency he had marked for death. Rival Newt Gingrich suggested that Claus apply for U.S. citizenship, “having contributed much to U.S. industry by stimulating greed at all ages; we need more Clauses and more spending to fix this Democrat-ruined economy.” Ron Paul suggested that Claus set up a Liberatarian nation at the North Pole and offered to run for office there. Herman Cain, whose candidacy remains on hold after allegations of sexual improprieties, said that he “always wondered why the old coot didn’t get in hot water for plopping kiddies on his lap; seemed a lot creepier than anything I ever did.” President Barack Obama refused comment.
From his North Pole headquarters, Claus said through a spokesman that he endeavored only to fulfill children’s dreams. “I regret that the world has come to this: treating any adult who wants to make a child happy as a dangerous stranger,” he said. “The problem with our modern world is not technology but fear, suspicion, and cynicism.” He vowed to continue his Christmas mission of joy. “What’s the worst they can do to me?” he asked, “cookie me?”
As I ponder the future of The New York Times, it occurred to me that its pay meter could be exactly reversed. I’ll also tell you why this wouldn’t work in a minute. But in any case, this is a way to illustate how how media are valuing our readers/users/customers opposite how we should, rewarding the freeriders and taxing — and perhaps turning away — the valuable users.
So try this on for size: Imagine that you pay to get access to The Times. Everyone does. You pay for one article. Or you pay $20 as a deposit so you’re not bothered every time you come. But whenever you add value to The Times, you earn a credit that delays the next bill.
* You see ads, you get credit.
* You click: more credit.
* You come back often and read many pages: credit.
* You promote The Times on Twitter, Facebook, Google+, or your blog: credit. The more folks share what you’ve shared, the more credit you get.
* You buy merchandise via Times e-commerce: credit.
* You buy tickets to a Times event: credit.
* You hand over data that makes you more valuable to The Times and its advertisers (e.g., revealing where you’re going on your next trip): credit.
* You add pithy comment to articles that other readers appreciate: credit.
* You take on tasks in crowdsourced journalistic endeavors: credit.
* You answer a reporter’s question on Twitter and the reporter uses your information: credit.
* You correct an error in a story: credit.
* You give a news tip or an idea for an article The Times publishes: credit.
Maybe you never pay for The Times again because The Times has gained more value out of its relationship with you. If, on the other hand, you hardly do any of those things, then you have to pay for using The Times.
I’ve been thinking about this, too, in light of a few other trends I’ve seen with newspapers online. First, some that are trying meters are finding that very, very few readers ever hit the wall (which papers are setting at anywhere from 1 to 20 pages). That so few hit the wall is frightening. It means that most readers don’t use these sites much. That’s nothing to brag about. Engagement is criminally low. Second, I’ve seen many sites that get a surprising proportion of their traffic from out of their markets — traffic that is valueless (or even costly, in terms of bandwidth) to sites that sell only local ads. This comes from following a goal of pageviews, pageviews, pageviews — brought in with search-engine optimization — rather than valued relationships.
After hearing a few such stories, I suggested that a site with a meter might want to reward local readers by giving them more free content and charge out-of-market readers by charging them sooner.
You see, that values the local reader over the remote reader. My idea for the reverse meter values the engaged reader over the occasional reader — and even rewards greater engagement. And therein lies, I think, the key strategic skill for news businesses online: understanding that all readers are not equal; knowing who your more valuable readers are; getting more of them; and making them more valuable.
Now I’ll tell you why my reverse meter won’t work: When I spoke with all our journalism students at CUNY about their business ideas on Friday, I asked how many had hit the Times pay wall — many — and how many had paid — few. Abundance remains the enemy of payment. There’s always someplace else to get the news. The Times can make its present meter work because (a) it’s that good [the Steve Jobs exception that proves the rule], (b) it’s still sponsoring — that is, giving a free ride — to its most valuable readers, though that is supposed to end soon, and (c) its engagement is still too low and thus many readers don’t even confront the wall (that needs to change).
So never mind the idea of the reverse meter, but retain the lesson of it: Value should be encouraged, not taxed. Readers bring value to sites if the sites are smart enough to have the mechanisms to recognize, exploit, and reward that value, which comes in many forms: responding to (highly targeted and relevant) ads; buying merchandise; contributing information, content, and ideas; promoting the site…..
The key strategic opportunity for news sites is relationships — deeper, more valuable relationships with more (but not too many) people. Engagement.