Public Health, Polio, and Pandemics: Fear and Anxiety about Health in Children's Literature

"[I]t is often during public health crises that adult assumptions about children are brought to the fore as they seek to educate, empower, and control children through texts produced to address health concerns."

The impact of the COVID-19 pandemic resulted in the rapid global digital publication of numerous English-language children's picture books designed to inform child readers about public health concerns and how children could contribute to halting the spread of the disease. This article analyses picture books dealing with the COVID-19 pandemic published digitally in English-speaking countries in the first six months of 2020, comparing them to depiction of two other public health crises: in Britain following the First World War and in the United States (US) during the 1950s polio outbreak. (This summary will focus on the polio analysis.) The goal of the investigation is to understand how children are positioned to take individual responsibility for community public health issues.

In the context of COVID-19, initial public health information suggested that children were less likely to die from or be severely impaired by the coronavirus than older adults, yet they were identified as vectors of transmission within families, schools, and communities. Children's picture books about COVID-19 responded by pointing out that children are better than adults in terms of their ability to fight the disease. In fact, several of the books surveyed represent children as active participants - good citizens - in promoting healthiness around them by not only listening to advice but also helping to spread health information. In Jasper and Tabitha Play a Trick on the Coronas, for example, two children tell others about the coronavirus, which has a global impact: "The whole world was so thankful that Jasper and Tabitha taught them how to get rid of the Coronas". In addition to following the health rules identified by doctors and scientists, children are encouraged to influence others' choices regarding their health behaviours.

Where the polio epidemic of the 1950s was concerned, children were the ones at risk of becoming infected and suffering because of it. Thus, public health education aimed at children focused on encouraging hygiene, handwashing, avoiding environments where the risk of infection was high, and accepting the vaccine when it became available. As noted here, acquiring and sharing knowledge is a key part of the health messaging in pandemic picture books. In the case of COVID-19, books reassure the child readers that scientists, doctors, and nurses are working hard to develop a vaccine and encourage them to rely on medical authorities for health advice, as evidenced by the credentials listed next to many of the authors' names. Similarly, child audiences in the mid-twentieth century were expected to place their trust in scientists. For example, written in simple language, The Polio Man (Rowland, 1961) not only recounts Dr. Jonas Salk's journey to the discovery of the polio vaccine but also communicates advice about good hygiene and the importance of vaccination.

Reflective of the image above, as the researchers note: "Many of the texts discussed in this article contain illustrations, which are often an important feature of children's literature. In these public health texts, the illustrations include anthropomorphism and humour to reassure children about their ability to fight disease, stay healthy, and return to health....[However,] [t]he novels about polio do not feature anthropomorphism, and the few illustrations that are included are realistic line drawings devoid of humour, but one of the educational public health videos, Soapy the Germ Fighter (Avis Films, 1951), features a man dressed as a bar of soap."

In the case of polio, children's literature sometimes took a different angle from educational forms of public health messaging. For instance, in polio stories about young sufferers, the child's character is forged through illness rather than by managing to avoid it: "children's polio stories showcase the trials and triumphs of recovery - where physical prowess is an indicator of psychological willpower and a drive to succeed and reintegrate into society. The protagonists, who have had polio, must overcome their feelings of self-pity, self-doubt, awkwardness, and loneliness to lead a fulfilling life. The children learn to stop seeing themselves as victims of the disease and accomplish something."

Reflecting on the historical comparisons, the researchers describe a shift in the texts in the way children's roles and responsibilities in relation to health and health education are conceptualised from the first decades of the twentieth century to the present day. For example, in the polio materials, children are subject to infection and suffering, whereas in the COVID-19 picture books, children are framed as remarkably resilient and resistant to disease. "In all cases, however, the child is put into action in various ways in relation to disease. They must remain vigilant and stay home, actively go out to share health information, or pursue healthy habits....However, these texts are also connected by the manner in which the child is positioned as an agent of change and education who contributes to a healthy environment for all."