2004spring

THE MEDIA’S ROLE IN REDUCING HEALTH DISPARITIES
Hazel A. Seivwright, M.S., M.P.A., Long Island University Beverly P. Lyons, Ph.D., R.D., Long Island University Introduction
In 1985, the US Department of Health and Human Services (USDHHS) issued thefirst comprehensive report on the health of U.S. minority populations showing excessmortality among Blacks compared to Whites in heart disease, cancers (especiallyprostate, lung and breast), HIV in Black males and strokes in females (USDHHS,1985). These conditions are worsened by hypertension, smoking, high cholesterol,obesity, diabetes, substance abuse, and risky sex (USDHHS, 1985). The reportconfirmed the existence of chronic disease and death among at-risk minoritypopulations and a predisposition for increasing morbidity and mortality amongBlacks. The National Vital Statistics Preliminary Report for 2000 reports similartrends nearly 20 years later (Minino & Smith, 2001). Some scholars suggest thatlack of health awareness, multiple risk factors, low educational attainment, andexisting sub-cultures that breed a mistrust of the medical system further exacerbatepoor health among Blacks and contribute to health disparity among minorities(Feldman & Fulwood, 1999).
In an effort to reduce health disparities, scholars suggest overhauling the health caresystem and recommend increased focus on changes in the social, economic andenvironmental stressors of Black communities. Further, they stress that identifyingthe health-seeking behaviors of Blacks is an important step in the process ofunderstanding the minority community (Feldman & Fulwood, 1999). The promotionof health will need to involve the evaluation of cultural and social mores as well ashealth beliefs and values.
One feature of health-promotion is the concern with marketing wholesome lifestylepractices that lead to longevity and a reasonable quality of life. It also includesdiscouraging practices that run contrary to healthful living. Those who marketproducts within Black communities must be fair in their advertising practices anddiscontinue the longstanding promotion of products that destroy rather than promotehealth. In the year 2000, Attorney General Jay Nixon of Missouri championed aneffort against tobacco companies for their “predatory marketing” of cigarettes inpredominantly Black neighborhoods (Stern, 2000). An example of an ad that seemsto distort the truth about health promotion is GlaxoSmithKline’s advertising campaignfor the HIV medication Combivir®, launched in January 2003, which featuresbasketball Hall of Famer Earvin “Magic” Johnson on billboards, subway posters Perspectives
and ads in magazines and newspapers. The campaign runs in cities like New York,Los Angeles, San Francisco, Miami, Washington, D.C., Chicago, Philadelphia,Houston, Atlanta and Newark, N.J. (Polier, 2003; Dickinson, 2003), where thepresence of persons of color and the incidence of HIV/AIDS are high. Althoughseen largely as a positive campaign, it did provoke some reaction that the ad minimizesthe dangers of high-risk behavior. The claim is that by depicting a healthy-lookingJohnson with his message of “Staying healthy is about a few basic things: a positiveattitude, partnering with your doctor, taking my medicine everyday,” (Combivir®ad seen in New York City subway) one need only take a pill to be well. New adsappearing in February 2003 stated that Johnson was not cured but is keeping apositive attitude and taking his HIV medications, an apparent effort to counteractthe claims and dispel the myth that Johnson was cured.
The U.S. Surgeon General and the National Institutes of Health, among other policy-making groups, have issued initiatives aimed at reducing disparities among minorities.
In view of these initiatives countered by controversial ads promoting risky behaviorsin Black communities, it is important to examine disparities on an even morepragmatic level and to find out whether or not the manufacturers of food and healthcare products have joined forces with policy makers in their attempt to improve thehealth of the population in general, and the health of minorities in particular. Sinceadvertisements in print media (Kurtzweil, 1998) such as magazines provide detailedinformation about many food and health care products (Mazis & Raymond, 1997)that contain health claims aimed at influencing purchasing decisions (Andrews,Netemeyer, & Burton, 1998), this study analyzes the content of four popularmagazines by examining the frequency with which advertisements appeared thatpromoted products that might have a positive influence on health and well-being.
Content analysis was used to represent the conceptualization of the influence ofprinted advertisement on purchasing decisions. This type of analysis was chosenbased on the assumptions made by scholars who have done similar studies (Barr,1989; Hill & Radimer, 1996; Klassen, Wauer, & Cassel, 1990; Lord, Eastlack, &Stanton, 1987, 1988).
Data for the study were drawn from two magazines that historically appeal to arelatively large White audience — Good Housekeeping and Reader’s Digest — andtwo magazines that appeal to a relatively large Black audience — Ebony and Jet(Mediamark Research, Inc. 1999-2000). All magazines were published in the year2000. Issues of the magazines for the months of January, April, July, and Octoberwere selected to allow for the inclusion of products advertised on a seasonal basis.
Mediamark Research, Inc. (MRI) reports provided audience demographiccharacteristics for each magazine.
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Results and Conclusions
Based on results of content analysis, 353 health-related ads were identified from thefour magazines for the year 2000. Of this number, 12% were in Jet, 15% in Ebony,31% in Reader’s Digest, and 42% in Good Housekeeping. For all four magazines,the higher percentage of ads (36%) focused on products that alleviate or controlsymptoms. A similar percentage of ads (35%) focused on products that maintaingeneral health. Twenty-four percent of ads focused on promoting nutrition, ascontrasted with only 5% of ads that focused on disease prevention.
Figure 1 shows the percentage of health-related ads in Ebony, Good Housekeeping,Jet, and Reader’s Digest by the type of ad and its location in each magazine. Ofdisease prevention ads, 11% were in Jet, 16% in Reader’s Digest, 26% in Ebonyand 47% in Good Housekeeping. Both Ebony and Jet had 21% of ads that focusedon general health maintenance, compared to 23% in Reader’s Digest and 35% inGood Housekeeping. Of ads that promoted nutrition, 7% were in Jet, 9% in Ebony,35% in Reader’s Digest, and 49% in Good Housekeeping. Finally, of the ads forproducts that alleviate/control symptoms, 7% were in Jet, 12% in Ebony, 38% inReader’s Digest, and 43% in Good Housekeeping.
Altogether, these findings indicate substantially fewer ads with a health-related focusin magazines that have a high Black audience than in magazines with a high Whiteaudience.
Implications and Limitations
As a widely used form of media, magazines bear a certain responsibility as an agentof communication. The Kaiser study conducted in 1999 found that ads raised theawareness of health problems and their available treatments, as well as encouragedpatients to seek more information. Patients with severe health problems wereidentified as being more likely to discuss a prescription drug with their doctor afterhaving seen a related ad (MacRae, 2002). The implications suggest that forms ofmedia, including magazines, share part of the burden for improving efforts in healthcommunication. The Robert Wood Johnson Foundation, a philanthropic organizationdevoted to improving the health and health care of all Americans, made severalrecommendations at a 1998 conference on “Communicating to Improve Health.”Among the recommendations were creating a center for social marketing andsupporting research to study changes in health behavior through philanthropicinitiatives (Foundation releases report, 1998). We suggest that a similar initiative beembraced by the publishers/editors of the magazines featured in this study and health-related companies who advertise in those magazines.
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Figure 1 . He alth-Related Ads in Ebony, Good Housek eeping, Jet & Reader's Digest for
January, April, July & October 2000
Prevents disease Maintains general Promotes nutrition Al eviates/controls Ads identified
Our research did not attempt to determine how and why advertisements are submittedto magazines or selected for publication. Such an analysis would be important in afuture study. It would provide a conceptual framework for the extent to which themagazines’ selection of ads are governed by the content and mission of theirpublications, appeal to readership, financial and profit-making considerations, andpersonal judgment or editorial license.
This type of effort on the part of magazine publishers will require, as a first step,acknowledging their role in marketing health. As agents of health literacy, they needto see themselves as a vital part of social communication and change. With this newvision, their mission then becomes how best to convey health information viaadvertisement selection. A preponderance of, for example, cosmetics ads indicatesthat a magazine, that could otherwise show health ads, has chosen not to promotepatient health benefits and does not share in the “mission to improve” the community’shealth. The choice of ads made by Jet and Ebony ignores the idea that minorityreaders can benefit from being informed about health products. The value judgments/ Perspectives
censorship decisions made by editors when deciding on ads for a publication must,therefore, be re-evaluated.
As a second step to this process, magazines need to undertake a more aggressivepursuit of health advertising. They may also need to do studies of their readership toidentify the effects of health commercialism. The involvement of pharmaceuticalcompanies is equally important. They may need to conduct cost-benefit analyses toestablish profit gains to be made by marketing to minority communities. The benefitsof such efforts on the part of both magazine publishers and the pharmaceuticalcompanies would include cost savings, impact on health policy, health promotion,health education, and the good will derived from being part of the effort to reversethe health disparity (Adler & Newman, 2002). At a time when the US population isgrowing increasingly older, disparities in health awareness and access to health careare even more important and must be addressed now to decrease excess morbidityfor minorities later.
Please direct all correspondence to Hazel A. Seivwright; Library Administration;Long Island University; Brooklyn, NY 11201. 718.488.1020;[email protected]. References
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Source: http://www.rcgd.isr.umich.edu/prba/perspectives/springsummer2004/seivwright.pdf