Visual story-telling: do you know or do you think?
May 22, 2023
One of the most important data questions of all time is: do you know? or do you think?
And one of the easiest traps to fall into is: I think, therefore I know.
Visual story-telling can be great but it can also mislead. Deception sometimes happens when readers are nudged to "fill in the blanks" with stuff they think they know, but they don't.
A Twitter reader asked me to look at the map in this Los Angeles Times (paywall) opinion column.
The column promptly announces its premise:
Years of widening economic inequality, compounded by the pandemic and political storm and stress, have given Americans the impression that the country is on the wrong track. Now there’s empirical data to show just how far the country has run off the rails: Life expectancies have been falling.
The writer creates the expectation that he will reveal evidence in the form of data to show that life expectancies have been driven down by economic inequality, pandemic, and politics. Does he succeed?
The map portrays average life expectancy (at birth) for some mysterious, presumably very recent, year for every county in the United States. From the color legend, we learn that the bottom-to-top range is about 20 years. There is a clear spatial pattern, with the worst results in the south (excepting south Florida).
The choice of colors is telling. Red and blue on a U.S. map has heavy baggage, as they signify the two main political parties in the country. Given that the author believes politics to be a key driver of health outcomes, the usage of red and blue here is deliberate. Throughout the article, the columnist connects the lower life expectancies in southern states to its politics.
For example, he said "these geographical disparities aren't artifacts of pure geography or demographics; they're the consequences of policy decisions at the state level... Of the 20 states with the worst life expectancies, eight are among the 12 that have not implemented Medicaid expansion under the Affordable Care Act..."
Casual readers may fall into a trap here. There is nothing on the map itself that draws the connection between politics and life expectancies; the idea is evoked purely through the red-blue color scheme. So, as readers, we are filling in the blanks with our own politics.
What could have been done instead? Let's look at the life expectancy map side by side with the map of the U.S. 2020 Presidential election.
Because of how close recent elections have been, we may think the political map has a nice balance of red and blue but it isn't. The Democrats' votes are heavily concentrated in densely-populated cities so most of the Presidential election map is red. When placed next to each other, it's obvious that politics don't explain the variance in life expectancy well. The Midwest is deep red and yet they have above average life expectancies. I have circled out various regions that contradict the claim that Republican politics drove life expectancies down.
It's not sufficient to point to the South, in which Republican votes and life expectancy are indeed inversely correlated. A good theory has to explain most of the country.
The columnist also suggests that poverty is the cause of low life expectancy. That too cannot be gleaned from the published map. Again, readers are nudged to use their wild imagination to fill in the blank.
Data come to the rescue. Here is a side-by-side comparison of the map of life expectancies and the map of median incomes.
A similar conundrum. While the story feels right in the South, it fails to explain the northwest, Florida, and various other parts of the country. Take a look again at the circled areas. Lower income brackets are also sometimes associated with high life expectancies.
The author supplies a third cause of lower life expectancies: Covid-19 response. Because Covid-19 was the "most obvious and convenient" explanation for the loss of life expectancy during the pandemic, this theory suggests that the red areas on the life expectancy map should correspond to the regions most ravaged by Covid-19.
Let's see the data.
The map on the right shows the number of confirmed cases until June 2021. As before, the correlation holds somewhat in the South but there are notable exceptions, e.g. the Midwest. We also have states with low Covid-19 cases but below-average life expectancy.
What caused the decline of life expectancy in the U.S. - which began before the pandemic, and has continued beyond - is highly complex, beyond what a single map or a pair of maps or a few pairs of maps could convey. Showing a red-blue map presents a trap for readers to fall into, in which they start thinking, without knowing.