The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
The Fund identifies and shares policy ideas and analysis to advance state health leadership, strong primary care, and sustainable health care costs.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is is a foundation that works to improve population health and health equity.
October 14, 2020
Blog Post
Michael Mintrom
Ruby O'Connor
Nov 7, 2024
Nov 4, 2024
Oct 24, 2024
Back to The Milbank Blog
What role has storytelling played in the successes and failures of state government responses to the COVID-19 pandemic? In an article published recently in Policy Design and Practice, we analyzed the policy narratives of the governors of the four largest US states. Here, we discuss lessons from that study, using evidence from the policy narratives of the governors of six states–California, Indiana, Massachusetts, New York, Ohio, and Washington—from the first months of the pandemic.
In policymaking, narratives are stories constructed to persuade key constituents to support specific policies, even if those policies, such as mask-wearing and business and school closures, are not immediately appealing. With the COVID-19 crisis, people in many states have been persuaded to give up some freedoms temporarily to limit the spread of the virus, thereby achieving better future outcomes, both for themselves and for the broader society.
From assessing the COVID-19 policy narratives of governors across the United States, we draw three lessons.
Lesson 1: Consistent messaging. A narrative that has a consistent, overarching message about how and why a policy or set of policies is being implemented helps people appreciate why changes are occurring and how they—and their actions—can support those changes.
New York Governor Andrew Cuomo’s daily briefings saw him serve as a unifying and trusted voice. His focus on cooperation and empathy, as well as evidence, enabled him to create a policy narrative that traversed ideological and state boundaries and provided a rationale for the implementation of tough restrictions.
Similarly, Massachusetts Governor Charlie Baker consistently emphasized the human element in his narrative. Baker presented the idea of states as “families” that put aside differences and work together in times of crisis. Drawing from this concept, he hired outreach staff for contact tracing—rather than rely only on digital tracing—underscoring the narrative of community and connection.
Lesson 2: Craft the message for the local context. To be effective, policies need to be accepted in the local context where they are being implemented. The narrative around these policies must appeal to, and resonate with, a variety of people in that environment.
In California, Governor Gavin Newsom created an inclusive message especially for Californians. Gov. Newsom frequently referred to California as a “nation-state,” likely to strengthen internal ties in California. Simultaneously, he sought to assert California’s independence by separating Californians and their proactive response to the virus from what was happening—or not happening—at the federal level.
Indiana Governor Eric Holcomb likewise carefully crafted his message for his citizens. In talking to his fellow Hoosiers about “Getting Indiana Back on Track,” Gov. Holcomb acknowledged those who had died from COVID. “Let us never, ever, forget for one second that the …. Hoosiers we have lost to this disease are not numbers. They are our grandparents and parents and children … our friends and neighbors and loved ones. Each life was precious.” He praised the “discipline and actions of 6.7 million Hoosiers” who had worked together to mitigate the effects of the virus. And, invoking the Gettysburg Address, Gov. Holcomb resolved that the recent loss of lives would lead his administration to “be cautious and make the best decisions for Hoosiers based on the situation.” His message was that the state was both working alongside, and for the benefit of, all Hoosiers.
Lesson 3: Align talk with action. No matter how compelling a narrative and how engaging its delivery, if the implemented policies contradict it, then public trust and cooperation will wane. The narratives that accompany policy implementation must accurately explain the policy decision. Likewise, policy actions must support the narrative.
Washington State reported the first case of COVID-19 in the United States. Washington Governor Jay Inslee was quick to react, relying on data and creating a coordinated response that revolved around expert advice, support, and communication and privileged the health of citizens above all. By enacting policies that aligned with his narrative, Gov. Inslee’s response was clear and consistent, leading to relatively good outcomes for the state. Those policies included data-driven decisions about returning counties to business as usual.
Before Ohio suffered a major outbreak, Governor Mike Dewine called for the statewide closure of schools making the state the first in the nation to do so. When others pushed to reopen the economy by Easter, DeWine pushed back. His narrative consistently prioritized health and focused on data. His policies have done the same, even in the face of criticism from both inside and outside Ohio.
The three lessons drawn here from how governors across the United States have responded to the COVID-19 pandemic can apply in other policymaking contexts, too. Wherever possible, policymakers should strive to create consistent messages, crafted to local conditions, that align talk with action. Policy narratives do not necessarily have life and death impacts. But—as this crisis has reminded us—sometimes they do.