The media can take on many forms. Television, radio and the press have been supplemented by the advent of the internet, along with activist and specialist publications, in informing the public about issues of everyday life. So it is surprising that on looking into what research has been conducted into the media’s reporting of health issues, there is relatively little that tells us how they do so, how likely it is that they will report them accurately and how much its influence affects the public’s perception of such issues.

Concerning global health, there is even less. To begin, defining what comes under the global health banner has its own problems. A few texts and articles have mentioned the media’s reporting of issues surrounding vaccination and infectious disease. Avian influenza is the most recent example of a major global health issue reported widely in all forms of media, but as yet there has been no analysis of this coverage. Infectious disease and vaccination are traditionally areas that receive a lot of media coverage for one reason or another, and some of the coverage of these issues has been analysied. Examples include, MMR(1-3) and Pertussis(4) vaccinations, the advent and continuing plight of HIV/AIDS(5) and the original ‘great influenza’ of 1918-19 (6).

Medical journals will inevitably report such issues more widely than the mainstream media. Furthermore, we are taught to see global health as being influenced or directly affected by issues of politics, economics, education and international relations. So when looking at ‘global health’ issues in the media where do we draw the boundary? For the purposes of studying media coverage of global health issues, it must be kept to reports directly involving health to avoid an impossible and unfocused task.

What has been written on how these issues have been covered in the media has not been complimentary. Local newspapers in numerous cities around the United States downplayed, or in some cases failed to mention, the extent of the influenza epidemic in 1918(6). The majority of media coverage surrounding the MMR controversy failed to make clear that evidence lay in favour of the vaccination not causing Autistic Spectrum Conditions (ASC) or Inflammatory Bowel Disorders (IBD)(1, 3). During the late eighties and early nineties, a debate arose surrounding the role of the HIV virus in causing AIDS. It has been noted that the role of the media in the rise of Peter Duesberg in the
public consciousness was substantial(5).

But to decipher how much the media influence public opinion on these issues is much harder. Coverage of an issue can be shown to balance in certain ways. One study has even shown that a locality subject to a campaign against MMR vaccination had significantly lower rates of MMR coverage than its surrounding areas(7). Compare this to the justified terror and panic that spread through American cities during the great influenza pandemic, where corpses were rotting in houses because of the backlog in undertaker’s parlours. Despite the lack of press and radio coverage or proclamations that the spread of the virus was minimal, the public knew better and became distrusting of what they read and heard in these mediums(6).

But a causal link between media coverage and human behaviour is not possible through such studies and observations. It would take surveys from the public of what influences their opinion and studies of opinion in comparison to what information individuals are exposed to. These kind of studies have begun to appear, albeit with a broader focus than the media’s influence alone(8). Only with this kind of data could the true influence of the media be discovered, as well as informing health professionals what other factors come into play from the public’s point of view.

Alarming representations of disease in the media are not new phenomena

Why Study the Media?
Why do we need to know to what extent the media influences public opinion? For this you must look no further than the MMR controversy. In the beginning, scientists engaged with the media, keen to get there message across that there was no link between MMR vaccination, ASC or IBD. But as the years rolled out the controversy would not die, the press coverage of the debate increased and these very scientists grew weary of misrepresentations. This weariness eventually led to them refusing to engage in such public debate. Without this side in the public debate putting their argument across, they risked allowing their message to be blurred or lost. But they had tried to engage with these sources of information to the public in the early years, with varying degrees of success and frustration.

If we knew how seriously we should take the media’s influence, whether it be twisting our statements or giving us honest coverage, would effect the public’s perception, then the scientific community could invest its efforts and energy appropriately. If it were the case that the media influences the public, the question then arises as to how these efforts and energies would be best used. There are, as far as it seems, two lines of action. The first is to use the media as a means of propaganda. Shout our message the loudest, be interviewed as much as possible, play the media game. The second would be to that of engagement with the industry. In all the controversies mentioned above, it has never seemed to be suggested that speaking to journalists, indeed even research into what drives their coverage, would be useful. In my mind this is the only way we can hope to understand how an issue will be reported and hence how it will influence the public.

This is not big brother on behalf of scientists. Its aim is not to control what is and is not written in the press. Rather, when an issue surrounds more than triviality, when life and death are the issue at hand, the media should be able to lay out the facts and the bigger picture, in whatever simple or complicated means it deems necessary for its audience. It is not satisfactory to just report a new piece of scientific research. The bigger picture of evidence, the research’s implications towards that evidence and the integrity of the research itself are all things that the public can understand – it is not only the scientific community that can grasp such concepts of analysis. But we should be prepared to explain them to those who tell our findings and to those who are told, and be aware of how these explanations will be conveyed.

An recent workshop at Alma Mata’s Global Health Directions (GHD) 2 conference in Edinburgh this December explored issues of media coverage such as subjects that are traditionally covered and how they are portrayed. It also looked at how the media can be studied and how through this we can learn from previous coverage of health issues for the future. The conference’s focus was on health worker migration, and this area’s presentation by the media will also be focused on.

2. Zetterstrom R. Flawed reports of immunization complications: consequences for child health. Acta Paediatrica. 2004;93(9):1140-3.

3. Lewis GB, Burke D, Trinick SJ. Can you believe what you read in the papers: Was the reporting of the MMR controversy in the national press fair and factual? Media analysis. Leeds: School of Medicine; 2005.

4. Gangarosa EJ, Galazka AM, Wolfe CR, Phillips LM, Gangarosa RE, Miller E, et al. Impact of anti-vaccine movements on pertussis control: the untold story. The Lancet. 1998;351:356-61.

5. Epstein S. The debate that wouldn’t die. Impure Science: AIDS, Activitism and the politics of knowledge. London: University of California Press; 1996. p. 174-6.

6. Barry JM. The Tolling of the Bell. The Great Influenza. New York: Penguin; 2004. p. 297-367.

7. Mason BW, Donnelly PD. Impact of a local newspaper campaign on the uptake of measles mumps and rubella vaccine. Journal of Epidemiology and Community Health. 2000;54:473-4.

8. Roberts KA, Dixon-Woods M, Fitzpartick R, Abrams KR, Jones DR. Factors affecting uptake of childhood Immunisation: a Bayesian synthesis of qualitative and quantitative evidence. The Lancet. 2002;360:1596-99.

Gaz Lewis
Travel Health, Alma Mata
Gareth.Lewis@almamata.net