"Popular Media Helps Establish the Public Health Agenda" That's What I Said.

"Popular media helps establish the public health agenda". I just read this line in a new article from the March 2010 edition of Preventing Chronic Disease...I thought- that's what I've been talking about. I knew public health and pop culture went hand in hand!
This particular research project was inspired by the CDC/Alzheimer's Association Initiative: National Public Health Action Plan to Promote and Protect Brain Health. The authors conducted a content analysis of the four most circulated Women's magazines (Good Housekeeping, Ladies Home Journal, Women's Day, Family Circle) and Men's magazines (Men's Health, GQ, Men's Journal, Esquire). They conducted a content analysis to see how the magazines described the three strategies correlated with healthy cognitive function (physical activity, healthy diet, and social involvement).
I will say that I was slightly disappointed that there was almost no discussion of the differences in how these issues are presented in Women's vs. Men's magazines. It is always interesting to see how public health issues are marketed differently based on gender. For example, I was fascinated in graduate school to see how cigarettes and smoking have been presented over the years. For example, Virginia Slims cigarettes were advertised in Women's Magazines with slogans like "You've come a long way baby". The products were visibly thin and the slogans focused on being free and empowered.
This content analysis was also interesting however, in that it identified what strategies were being talked about. They found that both types of magazines were focusing on prevention vs. treatment (yay!) Women's articles tended to be longer and were were likely to include contact information (for websites/researchers). It seems the magazines have done their research that women are more likely to seek help for a health issue. They also found that most articles focused on healthy diet, while increasing social involvement was almost never discussed. The authors do not speculate as to why social involvement was not presented. I find that interesting (and a shame) since social support/connection is also a protective factor for other health issues (e.g., suicide).
I think this type of research has great implications for other public health work. How often are pop media channels evaluated for the content/accuracy of their public health messages? How can the evaluation of those channels/messages inform the public health agenda? My message to MPH students: "Study that qualitative analysis textbook!" We're going to be needing researchers that can analyze the content of commercials, magazines, social networking sites...it sounds like a fun job!

If you'd like to check out the article I cited above:
Friedman et al. Cognitive Health Messages in Popular Women's and Men's Magazines, 2006-2007. Prev Chronic Dis. 2010: 7(2).

The Commercials for The Heart Truth Campaign: Can We Stop "Raising Awareness" and Change the Environment Instead?

If you are a hard core Olympics watcher like I am, then you have probably been inundated with these Diet Coke commercials. They are so pretty...they have red hearts on the can...they are getting a lot of exposure during Primetime TV...and the goal is...WAIT- I have no idea what the goal is!
According to the commercial, the campaign is aiming to "raise awareness of heart health". Does this mean people should know that their heart could be healthy or unhealthy? Does this commercial give us all we need to create "awareness", or should we be directed to their website for more information? Are people supposed to do something to improve or change their current heart health status after watching?

This is the perfect example of a public health campaign that drives me crazy because it wastes valuable resources on unclear, unmeasurable, and ineffective goals.

For more information, I visited their website. Here I learned that: The Heart Truth is a national awareness campaign, sponsored by the National Heart, Lung, and Blood Institute, being embraced by millions who share the goal of better heart health for all women. The campaign not only warns women about heart disease, but it equips them to take action against risk factors.

Okay- so it sounds like the goal is to achieve better heart health for women. So that will require some actual change to achieve (e.g., increase healthy behaviors like exercise, improve treatment for heart disease, etc). However, the commercial (and most of the website) does not include a "Call to Action". A Call to Action is a clear indication of the action that you would like people to take after viewing your health communication materials. In order for people to make/change their current actions, you must do a lot more than "raise their awareness" of the problem. Awareness raising is simply an increase in knowledge. In addition to knowledge, actions/behaviors are influenced by several layers of factors. For example:

• Individual (e.g., does one feel like they are at risk for heart disease? They may not even think these commercials are applicable to them. Do they have a genetic risk?)
• Interpersonal (e.g., does their family support their wanting to make changes to reduce heart disease? Do family members provide child care so that women can exercise and attend doctors appointments?)
• **Environment ( This layer is so important! But is most frequently ignored by campaigns that are wanting to "raise awareness" among individuals. E.g., what if your neighborhood does not have grocery stores that sell affordable healthy food? What if your neighborhood isn't safe for exercise such as walking/bike riding? What if there is no affordable healthcare within the scope of the public transportation that you rely on for transit?)
• **Society/Policy (What if you do not have health insurance to cover the doctors and/or nutritionist visits that are outlined in the "Action Steps" on the campaign website?)

As you can see from the list above, I would argue that the most daunting barriers to heart health for women fall in the 3rd and 4th categories. However, we continually see campaigns focusing on changing individual knowledge about diseases. Has that ever worked in the past?! Was it enough to tell people that cigarettes were unhealthy? No- we had to look at the environment and policy issues. We had to increase the prices/tax on cigarettes and create smoke-free work places, etc. The same has been seen in alcohol prevention.

So this week when you are watching speed skating in Primetime and this adorable soda can with a heart comes on the screen...picture me rolling my eyes as I sit on the couch. Please- let's spend valuable resources on reducing the barriers that actually impede health. Let's think bigger!

Confirmed: Alexander McQueen Died by Suicide. When will Entertainment Reporters Catch on to Recommendations for Safe Reporting on Suicide?

The fashion world suffered a great loss last week. For those of you who also drool over Sandra Bullock's SAG award dress...or Sarah Jessica Parker's ensemble for the London Premiere of 'Sex and the City', you must be familiar with the designs of Alexander McQueen. The British fashion designer died by suicide last Thursday.
As I read multiple accounts of his death via various sources of entertainment news, I am continually struck by the irresponsible reporting of a celebrity suicide. In 2001, Reporting on Suicide: Recommendations for the Media, a report by the Centers for Disease Control and Prevention, National Institute of Mental Health, Office of the Surgeon General, Substance Abuse and Mental Health Services Administration, American Foundation for Suicide Prevention, American Association of Suicidology, and Annenberg Public Policy Center was released. Research indicates that the way suicide is reported in the media can contribute to additional suicides and suicide attempts. Conversely, stories about suicide can inform readers and viewers about the likely causes of suicide, its warning signs, trends in suicide rates, and recent treatment advances. The above recommendations have been developed to assist reporters and editors in safe reporting on suicide. In 2005, these recommendations were even summarized to be a quick "At a Glance" reference for reporters.
I'm highlighting what I see as a typical entertainment news story on Alexander's death and how this and stories that first surfaced late last week basically do the opposite of what is recommended for safe reporting.

What NOT to Do:

• Avoid detailed descriptions of the suicide, including specifics of the method and location. This article provides a description of the location and method of the suicide.
  
• Avoid romanticizing someone who has died by suicide. Avoid featuring tributes by friends or relatives. Avoid glamorizing the suicide of a celebrity. Many articles have simply included tributes by fellow celebrities, such as Lady GaGa, Madonna, and Sarah Jessica Parker.
• Avoid oversimplifying the causes of suicides, murder-suicides, or suicide pacts, and avoid presenting them as inexplicable or unavoidable. Although many articles have highlighted that Alexander was a survivor of his best friend's suicide three years ago (which can be a risk factor for suicide) and that he lost his mother just a week before his own death...we don't know the myriad of risk factors that could a played a role in this tragedy. Suicide is a complex system of risk and protective factors, that cannot be explored in a two paragraph article.

What TO Do:

• Always include a referral phone number and information about local crisis intervention services. I did not see this in any articles that I read.
• Emphasize recent treatment advances for depression and other mental illness. Include stories of people whose treatment was life-saving or who overcame despair without attempting suicide. Again- Nada.
• Interview a mental health professional who is knowledgeable about suicide and the role of treatment or screening for mental disorders as a preventive strategy. Um- Nope.

But not to be discouraged! Many newspapers and news reporting organizations have begun to ask for training on this issue (SPRC is a resource). However, I would argue that the entertainment news organizations are the last to follow. Are national and statewide suicide prevention organizations reaching out to places like E! News? Access Hollywood? People Magazine? I would bet that these news organizations have a much higher readership than many local/national newspapers. Advocates, are you listening? Contact these organizations! There is a desperate need to improve the safety of reporting on celebrity suicide.

Resources:
Are you feeling desperate, alone or hopeless? Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), a free, 24-hour hotline available to anyone in suicidal crisis or emotional distress. Your call will be routed to the nearest crisis center to you.

• Call for yourself or someone you care about
• Free and confidential
• A network of more than 140 crisis centers nationwide
• Available 24/7

Kevin Smith 'Too Fat' to Fly Southwest? Discrimination or Legitimate Enforcement of a Public Safety Policy?

Via Twitter and/or popular media, I am sure many of you have seen the story regarding Kevin Smith and Southwest Airlines. Kevin Smith, a New Jersey native like myself, is well known for comedies such as the 90s favorite- Clerks. This past weekend, Kevin was removed from an Oakland to Burbank, CA flight because he did not fit comfortably into the passenger seat. Kevin has since published multiple tweets documenting the humiliating experience of being kicked off that flight. He argues that Southwest Airlines was wrong in their actions- that he posed no flight/safety risks.
I would argue that even though Kevin Smith is a celebrity (so he can make a louder rebuttal to a larger audience when he feels he is wronged), Southwest Airlines was correctly enforcing a clear and specific public health/safety policy. (A policy that is certainly not unique to this airline- almost all major airlines have a similar policy with similar definitions/actions). The Southwest Travel Policy website clearly lays out FAQs for "Customers of Size" (this term varies a bit airline to airline). The policy clearly defines what it means by Customers of Size (i.e., the armrest is the definitive gauge- if the customer is unable to lower both). It also clearly defines the action that can be taken proactively by customers in this category- they can buy a second seat (this will ensure their comfort and reduce any embarrassment having to deal with this at the airport or on the flight). In an upgrade over many other airlines' policies, customers are offered a refund for the second seat if that flight does not oversell. The website indicates that 98% of extra seat purchases qualify for a refund.
The article highlighted above states that "Smith originally purchased two tickets- as he's been known to do when traveling Southwest, but when he decided to fly standby on an earlier flight, only one seat remained." Since Smith originally purchased two tickets, I would argue that he was very familiar with (1) the Southwest policy on customers of size and (2) his inclusion in that category. Therefore, his cry of discrimination is unfounded and somewhat slanderous. The purpose of these policies is not to embarrass individuals, but instead to protect the health and safety of all individuals on the flight. All customers must have ample opportunity to access plane facilities as well as emergency exits if necessary. Having clear and specific written policies should protect Southwest and their actions...and Kevin Smith should probably lay off his Twitter attack.

The Inspiration for Pop Health

Welcome! For quite some time now, I have been wanting to find a way to combine two of my greatest interests. Public Health- the area where I have formal training and experience...and Pop Culture- which I shamelessly love and enjoying analyzing. Last year, one of my Professors from Graduate School directed a project which conducted a content analysis of the media coverage of the Rhianna and Chris Brown "incident". I went to a talk she gave on the results and thought "That would be my dream job...a way to combine my love of public health and tabloids and E! News"!
I've also been inspired by several "bloggers" in my personal and professional life to jump in and give this a try. As a teaching assistant, I collaborated on a class project that used a blog called "Challenging Dogma" to display final papers and generate conversation about their central themes/arguments. A great friend and colleague blogs weekly for Psychology Today with a column called "Promoting Hope, Preventing Suicide". I've really enjoyed being a reader of that blog and forwarding on articles/stories that I think she may be interested in. So now I'm trying it myself with my own stories. Enjoy!