Health Communication in the 90s. ERIC Digest.

If you think that news and information about health seems more and more in evidence on television and in newspapers and magazines, you are right. With the proliferation of news channels on cable television and the explosion of audience-specific, targeted "niche" (specialty) magazines, we are being informed about health matters now more than ever before. In 1991, for example, NEW YORK magazine ran a well-researched 2-part article on the best doctors and the best hospitals in the New York City area which elicited a flood of mail and kudos from readers. And the combination of the maturing of the health and environment conscious baby boomers with the arrival of the still-mysterious AIDS virus makes health communication an ever more vital issue.

DeFoe and Breed (1991) have written: "The media like health material as subjects, and the field of public health has a lot of material to fill the 'newshole'." The two researchers document several empirical studies which underscore this conclusion, quoting one authority who estimates that almost 25% of all articles in daily newspapers have at least some relation to health. This digest addresses the question of health information and reporting in the mass media, focusing on its accuracy and on some researchers' ideas for improving the quality of the health information that is disseminated. The aim, it is well to remember, is a public that is better educated about health matters.

ACCURACY IN REPORTING

One interesting and provocative study (Molitor, 1991) analyzed the accuracy of the reporting of a study which followed a group of male physicians who took 325 milligrams of aspirin every other day for nearly 5 years to see if this would reduce the incidence of death from heart attack. The study was chosen for examination by Molitor especially because it received a great deal of media coverage and because it was also published in a major medical journal. One day before the results of the study appeared in the NEW ENGLAND JOURNAL OF MEDICINE, they were reported in the national media.

Molitor's content analysis of news articles in the 5 leading national newspapers showed that (1) the research methodology used in the study was not presented correctly; (2) much important defining information was omitted; and (3) some information was sensationalized. The findings of the analysis also suggested that by incorrectly generalizing the results and by overemphasizing the importance of the study, journalists and/or their editors may have been responsible for encouraging unhealthy, risky, and even deadly behaviors in the public.

Some newspapers even gave contradictory information about the aspirin study. Four journalists relied entirely on medical professionals for their reports, while others mixed theirs with actual study results. This led to contradictory information in THE NEW YORK TIMES and in USA TODAY. Additionally, many of the medical professionals interviewed said that they were directly misquoted or that their quotes were "reinterpreted" by the reporter (Molitor, 1991).

Indeed, when the public receives information in the form of news from the media, they are always relying on a journalist to synthesize and interpret the information for them. The journalist, it should be remembered, "unlike the medical and health professional, is neither educated in the specific scientific subject matter nor in the process by which knowledge is acquired. The mass media are motivated by those factors which will sell their product. What scientific information the public is more likely to receive, as a result, is that which is interesting and entertaining, even at the expense of accuracy" (Molitor, 1991).

Another consideration is that journalists, both print and electronic, must work with time constraints and simply do not have the leisure to ruminate about the results of a study.

COMMERCIAL TELEVISION

Interestingly enough, DeFoe and Breed (1991) found that on commercial television programs, when there is a dramatic narrative story line that deals with health issues, there is much concern in the industry for authenticity. The explanation is a practical one: "If an AA meeting, for example, is pictured in an unrealistic manner, the program will receive a great deal of criticism."

In the world of network TV, soap operas, with their neverending stories and their 5-times-a-week segments (always on the lookout for new material) seem to be the preferred and most effective vehicles for embedded health messages, as well as for overt health messages (Walsh-Childers, 1991).

But radio--the most popular medium with large segments of young adults--would also appear to be an efficacious purveyor of health information. Indiana University, for example, produces "Health Scan" for public radio. This 1-minute program features a daily bulletin on health matters, and the topics range from a definition of "burping" or "sweating" to the reasons why the incidence of skin cancer is on the rise in the southern United States or the rapidity with which AIDS is entering the general population all over the world. The program is prepared by a writer-reader and always uses plain, easy-to-understand language, but is always vetted by a health or science professional from the university or the larger community. Thus, although it is geared to appeal to a broad audience, it is scrupulous in avoiding unsubstantiated or sensationalistic information.

ADVERTISING

One of the biggest problems in the education of the public is, unfortunately, the sophisticated ways in which advertisers use the mass media to market acknowledged unhealthy products. In some instances, market segmentation advertising (targeting a specific population for a message) can have adverse effects on the public's health. Schooler and Basil (1989) studied the use of billboards to advertise cigarettes and alcohol in different sections of San Francisco, documenting the fact that Black and Hispanic neighborhoods had more billboards advertising those products than either White or Asian neighborhoods. In a similar study, they examined specialty magazines (Basil and Schooler, 1990).

In both studies, the two researchers found that the tobacco and alcohol industries engage in market segmentation techniques to target their ads to the most vulnerable population. They suggest that knowledge of this industry strategy can help health communication professionals design smoking prevention and alcohol moderation programs to counter deceptive advertising more effectively (Schooler and Basil, 1989; Basil and Schooler, 1990).

Advertisers, of course, have long sent mixed messages to consumers, appealing on one side to what they see as a universal desire to be "hip" or "cool," and on the other side, encouraging the public to take care of themselves and "eat healthy." Reed (1990) studied women's magazine coverage of the dramatic increase in the eating disorders of anorexia and bulimia among young women and found that it exists side-by-side with the images of beauty and slimness perpetuated in the ads and fashion layouts of these same magazines.

AUDIENCES

Although it has long been accepted by researchers that people who are better-educated and have a higher socioeconomic status pay more attention to health messages, one study (Yows, 1991) found this not necessarily true. She found that motivation and focused exposure to health information are significant predictors of knowledge about cancer, and that the frequency of attending to media messages about health is not structurally determined, that is, predicted by socioeconomic status, education, and income. Rather, it is the result of concern about or interest in a person's own health. She also found that "correct knowledge" is accepted as that which "has expert endorsement and has been widely disseminated, especially in the media" (Yows, 1991).

Acting from a similar perspective, the National Cancer Institute has mobilized to disseminate the major health message that the nation will be healthier and wealthier by the year 2000 if we can alter personal choice behaviors (Cline, 1987; Arkin, 1989). The new focus is on prevention of illness and disease, and mass media messages encourage people to learn about cancer prevention through free booklets available from the Institute.

John Naisbitt in his 1984 best seller, "Megatrends," predicted future emphases on information and self help-increased information seeking by the public about health matters has already largely come to pass through the proliferation of the new mass media outlets mentioned at the beginning of this digest.

CNN transmits a weekly half-hour program which reviews health issues in the United States and around the world. The morning network information shows all have their "down-to-earth" doctors who opine on medical matters. At the same time, practically every local TV station now has a reporter who specializes in health information (Indianapolis, for example, regularly runs health segments prepared by its own reporters on each of its three TV stations).

Like Basil and Schooler, Turner (1985) believes that public attitudes toward health problems can be improved by the efforts of health communication professionals who can fashion message campaigns based on the social marketing theories prevalent in advertising and public relations. Her recommendation to health communicators for using the mass media effectively in promoting good health are: (1) identify the needs and interests of the intended audience; (2) conduct marketing research prior to planning a campaign; (3) target the segments of the population most likely to be responsive and then match the media with the targeted population; (4) select goals carefully and establish objectives for each message or component of a campaign; (5) create high quality messages and materials; (6) use media in conjunction with community organization, interpersonal efforts, and face-to-face instruction; (7) evaluate the messages and campaigns as part of an ongoing process; and (8) cultivate a relationship with reporters and editors so that the improvement of the health and well-being of the community will become a joint effort between media and health professionals.

REFERENCES

Basil, Michael D. and Caroline Schooler (1990). "How Cigarettes Are Sold in Magazines." Paper presented at the Annual Meeting of the International Communication Association. [ED 321 311]

Cline, Rebecca J. (1987). "Communication and Cancer: The Role of Health Communication Specialists in Achieving National Health Goals." Paper presented at the Annual Meeting of the Eastern Communication Association. [ED 282 272]

DeFoe, James R. and Warren Breed (1991). "Consulting with Media for Health Education: Some New Directions." Paper presented at the Annual Meeting of the American Psychological Association. [ED 340 072]

Molitor, Fred (1991) "How Accurate Is the Science News We Receive from the Mass Media?" Paper presented at the Annual Meeting of the International Communication Association. [ED 334 612]

Reed, Barbara Straus (1990). The Link between Mobilizing Information and Service Journalism as Applied to Women's Magazine Coverage of Eating Disorders. SCILS Research Report No. 90-21. Paper presented at the Annual Meeting of the Association for Education in Journalism and Mass Communication. [ED 328 912]

Schooler, Caroline and Michael D. Basil (1989). "Alcohol and Cigarette Advertising on Billboards: Targeting with Social Cues." Paper presented at the Annual Meeting of the International Communication Association. [ED 321 323]

Turner, Norma Haston (1985). "Effective Utilization of the Mass Media." Paper presented at the National Convention of the American Alliance of Health, Physical Education, Recreation and Dance. [ED 261 993]

Walsh-Childers, Kim (1991). "Adolescents' Interpretations of the Birth Control Behavior of a Soap Opera Couple." Paper presented at the Annual Meeting of the International Communication Association. [ED 333 517]

Yows, Suzanne R. (1991). "The Role of Perceived Threat in Reducing Health Knowledge Gaps." Paper presented at the Annual Meeting of the International Communication Association. [ED 336 771]