A hidden hero in public health infographics?

A chart from Harold T Larsen’s 1924 paper.

In 1924 Harold T Larsen wrote some words that still very much ring true today:

“Are long, monotonous columns of figures statistics if they do not stimulate interest, thought and action? In public health work, perhaps more than in any other field, the matter of presenting figures so that they compel the attention of casually interested people makes the answer to that question worthy of careful consideration”.

How many communicators and designers of public health data wrestle with that question 90 years on? I suspect a lot of us will hold up our hands!

Larsen goes on to say how important the individual is in public health, concluding that “any method of presenting facts that will excite his interest and increase his knowledge of preventive medicine is of value. The use of clear but unusual graphical representations which will arrest his attention and make him think are both justifiable and worthy of use”

Whilst we know much more today about what people understand in terms of graph design for health (see http://www.vizhealth.org for some well tested guidelines), we still don’t know much about what grabs people’s attention or even ‘excites’ them. Can health statistics even be exciting for instance? These are still important questions and I think it’s important to credit Larsen with some foresight. He was making these statements in the United States around the same time that Otto Neurath in Vienna was working on his famous Isotype systems with the aim to make data more compelling and easy to understand. Larsen’s work, in terms of academia, appeared to have little impact (according to Google Scholar it has only been cited 4 times).  Whilst we’re probably all aware of the ‘famous’ public health visualisations of the past from John Snow or Florence Nightingale, Larsen’s voice is almost silent today.

His paper is not a particularly easy read and reflects the time it was written. It has none of the ‘snappiness’ of today’s popular and shared content. Instead the paper requires slow reading and a quiet appreciation of the carefully hand rendered visuals.

He presents some intriguing formats such as the spire graph shown below.

Larsen’s Spire chart (with two values in each ‘spire’) from 1924 juxtaposed with Nigel Holme’s much more recent and well known ‘Monstrous costs’ chart.

He praises this unusual format since it draws attention to its top, guiding the eye to the peak. Though rare to make an appearance these days (and not found in Harris’s ‘Information Graphics: A Comprehensive Illustrated Reference’) it does have a resemblance to the ‘monster’ imaginative made by Nigel Holmes. The chart at the top of this page, given a splash of colour, would sit comfortably within Taschen’s ‘Information Graphics’ weighty tome.

Larsen certainly had some views which cause concern. His views on colour, for instance, are misguided – “Colours in graphics embrace a fallacy not widely recognised”. This is not an empirical paper (how many existed in 1924?) but it’s one of the few papers from a by-gone era that treat the public as being worthy of graphics that engage. He also highlights some of the debates that we continue to discuss such as the ‘controversy’ over use of the third dimension in graph design.

I’d definitely recommend it as a read and I’d class it as a hidden gem in the history of public health graphics.

Larsen, H. T. (1924). GRAPHS IN PUBLIC HEALTH REPORTS. American Journal of Public Health, 14(7), 585-591.

And here’s a link to the paper itself:


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