examines the creation and development of Cleveland, Ohio’s health care through the lens of women’s activism. This multi-faceted project analyzes the civic, social, voluntary and professional networks of women that underlie the development of Cleveland’s health care systems. Utilizing webs of social connections, health care pioneers launched and sustained organizations to fill health service gaps. Their influential networks crossed, and at times were limited by, generational, racial, class, and gender boundaries. Women’s roles include: volunteer and professional caregivers and providers; administrators; founders; funders, patients; and advocates. This research is structured around the impact of networks rather than individual leaders. Through previously unrecognized and collective action, Cleveland women adopted and transformed national and international trends to improve the delivery of medical care.
Cleveland is a Midwestern urban center located on Lake Erie. It was created in the late 18th century during a survey of “The Western Reserve”, a federal allotment of land within the Northwest Territory, given to Connecticut to compensate for losses during the Revolutionary War. Cleveland profited from western migration, the rise of the industrial economy and 19th Century transportation technologies; Steam boats and railroads made Cleveland the first major port in the Midwest. The city has played a role in ethnic immigration, the Underground Railroad and the Great Migration. From the founding of its first “hospital”, a marine barracks built in 1813 for the ‘War of 1812’ soldiers, to the internationally renowned Cleveland Clinic that exists today, medical care has played a prominent role in the city. A wide range of institutions have practiced, delivered, and advanced health care. Public, philanthropic, educational and heritage institutions have preserved this history. These factors make Cleveland an excellent location to study the role of women in the creation and transformation of health care practices and systems.
DPHF17 WHCC Mapping Project
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Aim of the Project
“Women and Health Care in Cleveland” (WHCC) has examined many types of ‘connections’ between Cleveland’s institutions and individuals, delivering this content through traditional papers and presentations. For example, we presented a poster for the inaugural poster session of the “Berkshire Conference on Women’s History” (2011), which compared Membership on the Boards of Cleveland health institutions in 1930 and 2009 emphasizing male/female ratios.
This sub-project offers the opportunity to apply Digital Humanities Methods to WHCC project content. It will be illuminating to see these connections of “Women and Health Care” in addition to reading about those links.
“A narrative description isn’t always the best tool for conveying information to an audience; just as you wouldn’t want to see a table of temperatures over time when a simple line chart would do, you don’t want a two-page description of communities in a network when a simple visualization would do.” (Weingart, DeMystifying Networks)
Lincoln Mullen proposes further rational for application of digital processes,
Mapping has many uses for humanities scholars. Humanists sometimes use maps to tell stories by tracking the movement of individuals and groups through space and time. Another kind of humanities mapping focuses on “deep mapping,” which seeks to demonstrate how the multiple meanings of places is constructed. A third kind of humanities mapping is driven by data analysis: it seeks to use information, often but necessarily quantitative, to understand spatial patterns in our sources. Most of these forms of maps can be thought of either displaying or discovering knowledge. Sometimes the aim of the map is to present the answer to a question, other times it is to attempt to ask a question and find out the answer. Like any research process, mapping leads to a cycle of asking and answering questions, which in turn lead to new questions. (Lincoln Mullen, “Spatial Humanities Workshop “)
I am testing, a small sample of cleaned and prepared WHCC data. Mapping & other digital visualization processes may produce new questions and previously unimagined connections. Mullen describes the intellectual progression of cleaning, preparing and processing data. Application of this methodology will definitely frame our understanding of the existing network in new ways. This trial effort is designed to test the validity of our data structure and its applicability to digitization and mapping methods.
2. Sources: Project Trial Data Set
The WHCC materials were originally formulated in an Excel spreadsheet. This spreadsheet has been compiled through several research projects and presentations.
In addition to the WHCC Corpus data, major reference resources for Cleveland include the
- Encyclopedia of Cleveland History;
- The Cleveland Memory Project;
- Western Reserve Historical Society;
- Cuyahoga County Archives;
- Cleveland Public Library.
The WHCC Excel spreadsheet was converted to a Google Sheet for ease of collaboration among project members. The sheet is comprised of 753 names of persons involved in care professions, activities or organizations active in Cleveland from approx. 1830-1870. The individuals are cross listed by 29 categories including their, addresses, gender, activities and associations (family, professional, religious, philanthropic, etc.). The data was accumulated and compiled during various research projects.
The Trial (Filtered) Data Set is comprised of a portion (135 complete and cleaned address records) of Clevelanders actively involved in the Soldier’s Aid Society during the Civil War. This list includes names, spouse names, marital status by title, professional titles, gender (M/F), birth/death dates, and addresses. Additional relationships include: business, religious, charitable, political and educational. (Of the 26 categories, seven are related to addresses for mapping information). A substantial portion of time for this DPHF17 project has been spent reorganizing, cleaning and supplementing the information that had been gathered in order to create a clean data set that could be loaded into visualization software. Cleaning involves removing stray marks, punctuation, partial and repeated information. Reorganizing consists of revising and eliminating groupings so they are isolated and meaningful categories for mapping. The main supplemental effort was completing and standardizing address references.
In order to create viable locations for the CARTO mapping tool, I used a geocoding tool from Texas A&M Geoservices. The Street Address was aligned, City, State (Zip was left blank as Cleveland has several Zip Codes currently). This identified data set was uploaded into the Texas A&M Geocoder, which produces latitude, longitude and geocode identifiers. This information was then re-inserted into the Google Sheet.
The sheet was converted to a .csv format (microsoft ‘save as’) for loading into visualization tools. Once the .csv data file was created, it could be uploaded to both CARTO & PALLADIO in the same format.
3. Project Mapping & Test Visualizations
CARTO
The CARTO mapping application software enables the creation of maps based on GIS locations. Once the map is created, CARTO allows analytics through the use of layers, widgets, pop ups and other options. CARTO is also a professional tool for business analytics. Refer to the website and CARTO Blog for examples of mapping and visualizations.
WHCC is using CARTO to visually locate WHCC people and the locus of their activities in Cleveland. This base map is a current (2017) GIS constructed map. The WHCC Trial Data Set was uploaded into CARTO to produce the following examples of visualizations:
MAP OF INDENTIFIED AID WORKERS The activists in Cleveland medical care (c1860-1870) centered around participation in the Soldiers Aid Society. This map features pop up windows with the Aid Worker’s record for each point. The 19th Century locations are displayed on a current map. The next phase of the project will allow the full data set to be located onto a 19th Century layer.
MAP OF CHARITY BY GENDER Gender is significant in the WHCC project as we are establishing the connections of Women to institutions, businesses and other women in their care-giving roles
MAP OF CHARITY BY CHURCH This map displays the church affiliations of Cleveland’s 19th Century medical activists on a current map. The map can also be parsed by the church representation within a specific charity.
PALLADIO
Palladio is a network analysis platform designed by a team at Stanford University with a (National Endowment for the Humanities) grant. The suite of analytic tools utilizes data processes to assist humanistic inquiry. The signature project created during the development of these tools is the Republic of Letters. Palladio was essentially built to support a historical project.
“Palladio is tool for reflective practice. It is an environment that supports thinking through data. Like so many historical sources, the correspondence metadata at the heart of “Mapping the Republic of Letters” is incomplete in unpredictable ways. Historians work with fragments of information from the past, not complete data sets. The discipline does not offer models against which to test hypotheses. Instead, tools need to support scholars in building an understanding of the historical material through working with it. To create Palladio, we had to externalize what is a very internal, individual, thought process.” Palladio “about”
The WHCC Trial Data Set was uploaded into PALLADIO networking software in order to build interpretive visualizations of the WHCC relationships. Working with this tool enabled augmented identification of and reflection on the connections already established in tabular form. Spatial patterning helps clearly define the complex relationships involved in WHCC data. Using the Trial Data Set, the following visualizations have been created:
This Graph shows which addresses are connected to the charitable organizations. It also defines by grouping, the number of individuals connected to each organization. The large center network with the most connections is the SAS (Soldiers Aid Society proper) which was run by women and connected to the most addresses. The smaller but still large network up and to the right is the SAS HM (Soldier’s Aid Society Honorary Members). These would be men and businesses. The networks connect by spousal partners between the SAS and SAS HM. The Ladies Temperance Union and the Women’s Christian Temperance Union have multiple members represented, while there are single or dual connections to other charities.
Organizational involvement and participation by a specific or both genders can be identified in this image. The size of the nodes indicates the volume of participation. The large upper node is women and the charities in which they participate. The row of nodes indicates the charities involving both men and women. The networked node in the lower left corner indicates the charities in which men are participating.
Embedded in this visualization is a reflection on how charities are connected to religious institutions and by gender. The large central node is women in SAS and the churches and other charities in which they are involved. The SAS HM is men as is the smaller SAS node to the right of the SAS women.
4. DPHF17 WHCC Mapping: Project Conclusions
SOFTWARE COMPARISON
CARTO is a versatile tool for “mapping on a map” (locating spatial information on a flat surface). ‘Mapping’ can also be visual thinking or the organization of an idea. PALLADIO uses “mapping” to explore patterns and relationships in ideas and networks. Organizing the data into map-able forms requires painstaking preparation. Using these tools requires patience and conceptual thinking. Carto maps are particularly helpful in thinking about the placement of institutions and people and how that impacts their relationships and the institutional dynamics. Palladio’s network visualizations bring new insights into connections between identified elements being analyzed. It creates images of density, ratios, time and allows the user to explore ideas in a visual image by interchanging elements from the database. These tools have differing strengths and weaknesses, but both contribute “pictures” that help define and demonstrate complex ideas.
WHCC INTERPRETATIONS
The CARTO map highlights attention to the fact that mid 19th century Cleveland is a relatively small place. Pockets of residence are located within a block of Public Square and only a few activists come into the city from outlying areas.
Since the Soldiers’ Aid Society was Cleveland and Northeast Ohio’s vehicle for getting supplies (medical, subsistence and personal) to the Civil War troops, it is quite amazing that so few men were involved. The density of connections is not that surprising given the small size of the city and limited means of transportation during the period. However, the evidence that some churches are quite involved in this “public service” and others are not is interesting. A future iteration of this mapping project will overlay a map of the church locations which will provide more insight to how neighborhoods affect involvement in activities. It is also a change from modern Cleveland to observe how the participating businesses are condensed on Superior and Euclid Avenues. All of these interpretations require reflection due to the limited scope of the test data and the logical observation that perhaps we know more about the central city residents, because that is the area where directories were made and records kept.
PROJECT SIGNIFICANCE
Given the time frame and my own lack of experience utilizing DH tools; the ability to create a sample set of WHCC data and produce sophisticated mapping and visual artifacts is quite impressive. This project has successfully introduced a new realm of tools for exploring the WHCC connections and demonstrating these connections in an accessible way to general audiences. It has also demonstrated the need to shore up some areas of WHCC research and introduced new themes to be considered – particularly what are the circumstances that bring the outliers into the central city? What role do the individual boarding houses play in network affiliations? I believe changes in the network will become even more evident as WHCC is able to stack period layers.
Local digital resources including the Cleveland the Cleveland Memory Project and Cleveland Public Library’s extensive digital collection are relatively new resources. Since WHCC is complex and multi-institutional, it is quite possible that more structured “national” databases (the census, tax records, shipping records, etc.) could supplement the local databases that have served as the primary resource for this project to date. Collaboration is a key aspect of the production of knowledge using these new tools and mirrors the aggregate ‘community’ history that is now possible to achieve by using them. Better collaboration will provide a better history of our city. Even this small test project has enhanced my understanding of the larger project, has moved forward the collection of accessible digital resources in the community and has stimulated a hope that WHCC can provide a bridge of engagement with past that connects to a fuller understanding of the present, on which we can build a future.
Notes
Manovich, Lev. “Database as a genre of new media.” AI & Society 14.2 (2000), p. 176-83)
Terras, Melissa. “Digitization and Digital Resources in the Humanities.” In Digital Humanities in Practice, ed. Claire Warwick, Melissa Terras, and Julianne Nyhan. Facet Publishing, 2012.
Special Thanks to Jimmy E.W. Meyer, Co-Director WHCC & Russell Lenahan, Software Developer, Epic Systems for advice and assistance with formulating and preparing WHCC data for visualization processing.
