From Numbers to Narratives: Using Data Storytelling to Close Chronic Disease Disparities

Author: Jamirra Franklin

Chronic diseases are the leading cause of death and disability in the United States. (Urban Institute, n.d.) Roughly three in four adults live with at least one chronic condition, and more than half live with two or more. The impact of chronic diseases affects more than just the individual. Families and caregivers absorb a parallel burden, with research linking chronic-condition caregiving to reduced quality of life and higher rates of depressive symptoms among both patients and the people caring for them. (Pinquart & Sörensen, 2007) At the community level, chronic disease strains local health systems, reduces workforce participation, and deepens existing inequities. 

Additionally, managing chronic diseases places a substantial economic burden on the health system. Diabetes alone accounts for roughly a quarter of all U.S. healthcare spending, and chronic disease overall consumes close to 90% of the nation's annual healthcare spending. (Centers for Disease Control and Prevention [CDC], 2024a) Understanding the wider impact of chronic diseases beyond the data helps make data more meaningful and relatable. It highlights that addressing health disparities is not solely an individual's responsibility, but it is a collective effort that affects entire communities. By working together, we can drive meaningful and lasting changes.  

What the Research Shows

Clinical data, including diagnoses, laboratory values, and treatment outcomes, has long served as a cornerstone for understanding and addressing chronic disease. But research increasingly shows that biology only tells part of the story. Social determinants of health, the non-medical conditions in which people are born, grow, live, and work, heavily shape a person's risk of developing a chronic disease. (CDC, 2024c) Chronic stress, experiences of racism, and socioeconomic strain are all linked to elevated risk of hypertension and other chronic diseases, independent of genetics. (Cuevas et al., 2021) Focusing on these determinants lets researchers see beyond the biological level of chronic diseases and towards the patterns and root causes that drive them.

This is where public health data comes in. Surveillance systems, community health assessments, electronic health records, and behavioral and population health surveys each help identify trends, flag disproportionately affected populations, and connect quantitative findings to lived experience. Public health data enables us to identify populations at the highest risk and map health disparities geographically, providing a more comprehensive picture than clinical records alone. It helps us understand not only how many people are affected, but also where they are affected and the conditions that contribute to those outcomes.

The Disparities the Data Reveals

When viewed through a broader public health lens, disparities in chronic disease become increasingly apparent. Black adults experience hypertension at substantially higher rates than white adults, with prevalence estimates of approximately 58–60% compared to about 44% among white and Hispanic adults. (Ogedegbe et al., 2023) These disparities extend beyond prevalence alone. Black adults are also more likely to develop hypertension earlier in life and experience more severe complications. As a result, they face significantly higher rates of morbidity and mortality associated with hypertension-related conditions. (Cardiometabolic Health Congress, 2024)

Diabetes follows a similar pattern: Black and Hispanic adults are roughly 60% more likely to be diagnosed than white adults, with the highest rates of all occurring among American Indian and Alaska Native populations. (Health Affairs, 2023) These gaps are caused by structural and systematic barriers on top of environmental and socioeconomic ones. Neighborhoods with few full-service grocery stores or safe places to exercise, limited public transportation to clinics, underinsurance, and historic disinvestment in certain communities all shape health outcomes long before a diagnosis is made. Many communities of color experience lower wages and less consistent health insurance coverage, which can make it difficult to access and afford treatment. Financial pressures may also force individuals to continue working while managing illness. (Health Affairs, 2023) Together, these factors can worsen health conditions and reinforce the disparities that already exist.

Turning Data Into Story

It is one thing to know that three in four adults live with a chronic disease. It is another to understand the factors that contribute to these outcomes. This is where storytelling plays a role. Data helps identify disparities, storytelling provides context, and public health interventions help address the underlying causes.  

Connecting statistical evidence with lived experiences of individuals and communities allows data to inform meaningful action. This connection can guide lifestyle changes, shape policy decisions, and improve approaches to prevention and treatment. It also helps build empathy among policymakers, healthcare leaders, and stakeholders. When people better understand the human impact behind the numbers, data becomes a catalyst for action. 

Meaningful progress depends on partnering with communities throughout the process. This includes sharing findings with the populations represented in the data and ensuring their perspectives are incorporated into decision-making. By engaging communities as partners rather than simply subjects of analysis, public health efforts can be more responsive, equitable, and effective.

Once data is grounded in lived experience, it points directly toward action. Public health responses built on this foundation include community-based prevention programs, health education initiatives, screening and early-detection efforts, and care coordination programs. These approaches are most effective when they are culturally responsive and developed in partnership with the communities they serve. Two such examples illustrate how this approach works in practice.

Hypertension Control Through Community Health Workers. 

Data consistently shows higher rates of hypertension among underserved populations and communities that face barriers to accessing healthcare. (Kim et al., 2023) One effective response has been the expansion of community health worker (CHW) programs. CHWs are trusted frontline professionals who help connect community members to healthcare services, resources, and support. (National Heart, Lung, and Blood Institute [NHLBI], n.d.) By serving as a bridge between healthcare systems and the communities they serve, CHWs can improve access to care and promote healthier behaviors.

Team-based care models that incorporate CHWs have been associated with improved blood pressure control through health education, community outreach, and support for lifestyle changes related to physical activity, nutrition, and smoking cessation. (Kim et al., 2022) Research has also demonstrated that CHW-led interventions can improve cardiovascular risk factors, including blood pressure and cholesterol levels, while enhancing quality of life for patients and caregivers. (The Community Guide, 2024, Brownstein et al., 2024) The growing recognition of their impact is reflected in workforce trends. As of 2024, the U.S. Bureau of Labor Statistics estimated that approximately 65,000 community health workers were employed nationwide, with employment projected to grow by about 11 percent through 2034. (U.S. Bureau of Labor Statistics, 2024) This growth underscores the increasing demand for community-based approaches that address chronic disease through trusted relationships and local engagement.

Diabetes Prevention Through Food Is Medicine. 

Nationally, well over 100 million American adults are living with diabetes or prediabetes combined. (CDC, 2024d) Data can pinpoint the neighborhoods facing both high prevalence and limited access to healthy food, and increasingly, public health responses are meeting that gap directly through "Food Is Medicine" programs that treat access to nutritious food as a clinical resource rather than a lifestyle nicety. One such program, Abbott's Healthy Food Rx, delivers home-delivered, recipe-based food boxes and nutrition education to people with diabetes in Stockton, California, where roughly 60% of the population lives with diabetes or prediabetes. (Abbott, 2025) One randomized controlled trial found that participants significantly increased their vegetable consumption compared with a control group and reported significantly greater improvement in self-reported physical health over six months, with meaningful A1C improvement across both groups. (RTI International, 2025) 

Conclusion

Public health data does more than identify chronic disease disparities. It highlights who is affected, the factors contributing to inequities, and where resources and interventions are most needed. When combined with the lived experiences and perspectives of community members, data becomes a powerful tool for informing action.

This combination of evidence and community insight enables public health professionals to develop interventions that are both effective and equitable. It helps ensure that programs, policies, and services are responsive to the needs of the populations they are intended to serve. Ultimately, translating data into meaningful narratives can transform information into action, helping to reduce chronic disease disparities, improve health outcomes, and build healthier communities for all.

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