Introduction
We begin 2026 with a well-known paradox: there has never been so much data about collective life, yet we think less and less as a population. I reiterate an insight by Daniel Innerarity from a recent article in El País: “Thinking tires us, and that’s why scandal often rules public debate.” This shift has taken a very concrete form in public health: the dominance of the numerator and the neglect of the denominator.
The Mental Economy
Our brains are not designed to sustain uncertainty or read complex data; they prioritize the salient over the invisible and the nearby over the abstract. The “availability heuristic”—our tendency to estimate risks based on how easily examples come to mind—is not a moral failing; it’s an energy-saving mechanism (Tversky, A., & Kahneman, D. 1973). For the brain, closing off options requires less energy than keeping them open. Closure provides a sense of control and reduces anxiety.
In practice, we prefer numbers that can be grasped at a glance over those requiring further inquiry into “how many.” The numerator shouts as an event, while the denominator whispers as structure. This preference is not solely biological; it’s exacerbated by our current social and informational regime.
Public Health’s Methodological Foundation
Public health initially aimed to transform scattered events into collective understanding: observing time series, comparing territories, ordering causes, detecting disparities, and deliberating priorities. Its purpose was practical: care, not dramatic narratives. For this, it needed tools: registries, classifications, rates, and denominators—not to standardize life but to make it visible in its populational dimension (Rose, G. 1985).
The Dominance of the Numerator
Over time, public health’s methodology crossed paths with another logic: goal-setting management and political communication. The numerator found its home. Counting is auditable, producing phrases fitting into discourses: “we attended X,” “Y decreased,” or “Z increased.” The denominator, however, compels discussion of uncomfortable topics: need in populations, access, underreporting, and territorial disparities. The denominator assigns responsibility, not accolades; hence, it becomes mentally and politically invisible.
The numerator serves a legitimate purpose: dimensioning operational load, planning resources, scheduling staff, vaccines, or beds. Hospitals don’t operate on rates but volumes. Denying this is naive. The issue arises when the numerator transitions from a planning tool to a unit of public truth: when counting replaces proportion, production supplants need, and success is narrated as “we did” without specifying “for how many.” The numerator manages; the denominator prioritizes with justice. Separating them impoverishes: one without the other results in propaganda or technocracy.
Implicit Biases and Structural Issues
Many public health biases are adjustments. Measuring output without a denominator of need results in efficiency narratives without real coverage. Reducing numbers to absolute values without accounting for demographic changes fabricates success or failure merely through time’s passage. When case definitions change, the numerator changes; however, if the narrative avoids this complexity, variation is read as virtue or disaster based on convenience. The figure doesn’t lie; the deception emerges when it’s separated from its denominator’s context.
Implicit biases, both cognitive and social, worsen the problem. Who accesses the system? Who gets diagnosed? Who’s registered? Disparity not only determines illness but also statistical visibility. When certain groups are excluded from the denominator due to precarity, language, migration, or violence, public health paints an incomplete picture of the world, acting as if it’s complete—the harshest form of betrayal.
The Need for Judgment Literacy
The standard response to these issues is data literacy. However, I believe more is needed: judgment literacy—a practice of attention, doubt, and proportion that returns the denominator, uncertainty, and the responsibility of comparing without betraying. If presented as an individual skill (“learn to interpret rates”), the structural problem is reduced to personal responsibility. To meet 2026’s demands, we need tools that regain attention sovereignty, not process more information but restore control over attention; not adapt to routine but disrupt it with questions that reinstate structure.
Judgment literacy means learning to tolerate complexity’s discomfort: postponing closure, saying “not yet,” transforming doubt into methodology, and sustaining what the era insists on resolving immediately. It’s not about revering uncertainty but acknowledging it. The antidote to the availability heuristic isn’t technocratic coldness but a critical habit: whenever a numerator tries to dominate conversation, counter with its denominator.
Who Needs Judgment Literacy?
The audience for judgment literacy should include the public, journalists, communication experts, politicians, students, and professionals. Data literacy alone won’t suffice because many mechanisms reward the numerator. If only the public is educated, the rules producing headlines without denominators remain intact. If only professionals are educated, the media’s scandal economy persists. If only communicators are educated, the institutional architecture of counting goals remains unchanged. We need judgment literacy as environmental policy: redesigning incentives, formats, and rituals.
Avoid hubris: the goal isn’t teaching communication but co-creating a responsible risk standard. Communicators master language and rhythm; public health provides data structure and limits. The alliance is straightforward: the numerator shouldn’t go solo. Each figure should declare “of how many, over what time, in which population, and with which definition.” This doesn’t kill the narrative; it makes it fair and human. It restores proportion to drama, preventing intensity from substituting risk magnitude.
References
- Han, B.C. (2012). La sociedad del cansancio. (Trad. de A. Domingo). Herder Editorial
- Rose, G. (1985). Individuos enfermos y poblaciones enfermas. International Journal of Epidemiology,14(1), 32–38.
- Tversky, A., & Kahneman, D. (1973). Availability: A heuristic for judging frequency and probability. Cognitive Psychology, 5(2), 207–232.
*The author is a Tenured Professor in the Department of Public Health, Faculty of Medicine, UNAM, and an Emeritus Professor in the Department of Health Measurement, University of Washington.
The opinions expressed in this article do not represent the position of the institutions where the author works. [email protected]; [email protected]; @DrRafaelLozano
