This paper was presented at the Association for Education in Journalism and
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If you have questions about this paper, please contact the author
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Student paper submitted to the Public Relations Division of the
Association for Education in Journalism and Mass Communication
Christina's Doin' It…So Should I?
The Nature of Celebrity Health Advocacy and Advice in Media
Julie C. Lellis
Graduate Student
The University of North Carolina at Chapel Hill
School of Journalism and Mass Communication
The University of North Carolina at Chapel Hill
CB #3365, 392 Carroll Hall
Chapel Hill, NC 27599-3365
office: (919) 843-5792
home: (919) 967-6045
fax: (919) 962-0620
email: [log in to unmask]
Christina's Doin' It…So Should I?
The Nature of Celebrity Health Advocacy and Advice in Media
Christina Aguilera's diet—consisting of herbal tea, organic milk,
fresh fruit, soy cheese, and other non-processed food—may be a winner
for her. A headline in the February 2002 issue of Better Nutrition
conveys what her diet could mean to the rest of us, or at least
teenage girls—"maybe she's a good influence after all". It's no doubt
that a celebrity's diet or health may become as "hot" in popular
culture as her couture at the Academy Awards. Journalist Bill Moyers
is quoted with saying, "Obsession with celebrity is one of the
engines that is driving journalism" .
Celebrities in the media convey ideas, information, and opinion
regarding some of our basic needs such as health and safety. But just
what are the effects? A drastic example, but consider the
significance…Studies show that suicide attempt rates increase
immediately following reports of celebrities who take their own
lives. A "key factor" in this phenomenon might be the media coverage
. And the public won't stop watching and reading anytime soon. The
purpose of this paper is to explore the nature of coverage when
celebrities and health topics are presented together in the media.
Position: Advocacy
Similar to endorsing a cause, to advocate is to "speak and write in
favor of" a cause . Edgett goes further to describe advocacy as a
function of public relations and persuasion: "advocacy is…the act of
publically [sic] representing an individual, organization, or idea
with the object of persuading targeted audiences to look favorably
on—or accept the point of view of—the individual, organization, or
idea" (p. 1). Edgett mentions persuasion as an attribute of
advocacy—an idea often attributed to advertising and public
relations—not necessarily news media. Current debates and research
focus on whether or not news publicity is superior to advertising .
Regardless of the effects of advocacy, it's inarguable that
celebrities bring to light important health issues in our society
through media coverage. For example, Corbett and Mori's content
analysis of 1,999 media stories designed to examine the relationship
between medical activities, public events, and the coverage of breast
cancer over a 36-year period (1960-1995) revealed two peaks in media
coverage—one in 1974 and one in 1994. The increase in media coverage
in 1974 may be related to Betty Ford's announcement that she had a
mastectomy, as well as the stories of other prominent women who spoke
out about breast cancer during this time. In 1994, media coverage
highlighted the discovery of a "breast cancer gene" and a breast
cancer study in which data was falsified. The result of advocacy and
media coverage is more dollars for the cause. In this study, positive
correlations between breast cancer funding and rises in print and
television media coverage were noted.
Exemplification theory suggests that the use of exemplars in media
messages can affect issue perception by evoking emotional responses
in audiences. Images that are concrete, rather than abstract, are
more powerful, and emotional exemplars that convey risk or harm have
greater effects . While empirical study of exemplification theory is
limited, Zillmann's conceptual discussion of the theory notes that a
function of public relations may the repeated use of supportive
exemplars to achieve positive results from publics. This may be an
important theoretical foundation to use in the study of the celebrity
advocate. Consider the "Katie Couric Effect." In a study of the
impact of a week-long cancer awareness campaign aired by the Today
Show in March 2000 (media coverage featured a live colonoscopy
performed by celebrity news anchor Katie Couric, whose husband died
of colon cancer), a review of two databases containing colonoscopy
rate information before and after the campaign revealed a significant
temporary increase in colonoscopies following the campaign. The
authors of the study conclude that a celebrity spokesperson could
have a substantial impact—at least on participation in preventive
care programs .
Interaction, Involvement, and "Celebrity Branding"
Research results suggest that community health campaign messages are
received with a great level of trust because of the personal
identification with community organizations and the enhanced
persuasion effects . In a similar way, celebrities have the ability
to influence their followers. Brown, Basil & Bocarnea describe two
concepts: parasocial interaction and involvement. Parasocial
interaction can be defined as a "psychological state of involvement"
with a media personality; an audience development of a sense of
intimacy or friendship with a celebrity personality highlighted in
the media (p. 47). Identification is regarded as a persuasion process
in which audience members adopt the attitudes or behavior of
celebrities. In an ethnographic study of Elvis Presley impersonators,
for example, results indicated that people "selectively integrate the
perceived values and behaviors they see in celebrities they admire
and adopt them into their own lives" . Two studies provide clear
examples of these concepts as related to health issues.
Brown and Basil discuss the role of audience involvement in health
issues as a result of informative messages being delivered through
celebrity endorsement. Results of a questionnaire administered 10
days after Earvin "Magic" Johnson's public announcement that he was
HIV positive revealed a moderate positive relationship between
knowledge of Johnson and audience involvement. In addition, the
greater the involvement and the media exposure, the more likely
audience members were to have a personal concern about AIDS, a
concern of the risk of AIDS for homosexuals, and the expressed
intention to reduce high-risk sexual behaviors. Brown and Basil reach
the same conclusion as Cram, et al —that celebrities may be helpful
in promoting disease prevention.
In results of a survey designed to test hypotheses predicting
relationships between media exposure to Mark McGwire and parasocial
relationships, identification, and knowledge and attitudes about
child abuse prevention and the dietary supplement
Androstenedione, Brown, Basil & Bocarnea found 1) that media
exposure to McGwire was positively associated with the development of
a parasocial relationship with McGwire, 2) that, controlling for
gender, a greater degree of parasocial relationship was positively
associated with identification with McGwire, 3) that the degree of
identification with McGwire was positively associated with an
increased concern for child abuse prevention, 4) that the degree of
identification with McGwire is positively associated with the
realization that it is important to speak out about child abuse, and
5) that, controlling for gender and education, identification with
McGwire is positively associated with the knowledge of and desire to
use the dietary supplement Androstenedione. In this case, the desire
to use Androstenedione could be viewed as a negative consequence of
celebrity association with a health issue. Brown, Basil &
Bocarnea emphasize the implications of this research—that people do
indeed engage in parasocial relationships with sport celebrities and
that athletes can have an influence on the public's knowledge,
attitudes, and behavioral intentions regarding health issues. The
concept of "celebrity branding" as a form of health advocacy is
important concept that should be explored in future research.
In essence, Couric is to colon cancer as Johnson is to AIDS, as
McGwire is to child abuse and Androstenedione—a brand for a health
topic. And it doesn't seem to matter whether or not the celebrity
actually suffers from the "branded" health impairment. Healthy
celebrities, as in Couric's case, can also influence audience behavior .
The Ethics of It
The literature implies ethical responsibility on the part of two main
parties. The first is the celebrity. Celebrities who reveal their
diagnoses may have a great impact on subsequent public health
discourse. In a meta-analysis of fifteen published articles that
address the influence of "Magic" Johnson's disclosure that he was HIV
positive, results suggest that "a famous person contracting a disease
can increase issue saliency and cue individuals to revisit some
assumptions, attitudes, and behaviors about the disease" . When an
issue is salient, it is communicated in such a way that it "promotes
a particular problem definition, causal interpretation, moral
evaluation, and/or treatment recommendation" .
This impact of salient issues made so by a celebrity is approached
with some skepticism. In an article appearing in Newsweek, Cowley and
Springen discuss the roles of celebrities in transforming health and
medicine. When famous names are linked to medicine, the results seem
to be increases in funding for research and advocacy, revenue for
drug companies, and heightened attention from the public. Celebrities
may even have the opportunity to serve as "health advisors" . This is
a powerful role, and choices by celebrities who serve as advocates
should be carefully considered. In a news release regarding Cram et
al's study on the "Katie Couric Effect," a recommendation is made by
Fendrick that celebrities should work with medical professionals
when developing medical advocacy campaigns.
Tanne discusses the impact of Betty Ford's breast cancer publicity,
citing a public appreciation for openness about the disease and the
subsequent rise in breast cancer detection. While Betty Ford
advocated for the public to "see their doctors," many celebrities go
further to advocate for certain medical tests or treatments,
regardless of what medical guidelines recommend . A discussion of
Katie Couric's role in advocating for colorectal screenings at ages
younger than medical professionals recommend brings to light
important ethical considerations. Her viewpoint on colorectal
screenings could be received by publics as actual medical
recommendation . According to Hallahan's definition, a
recommendation is a "call to action" (p. 331).
The downside of this publicity is that because people respond
particularly well to celebrities, they may undergo unnecessary tests
or financial burdens. Celebrity advice could also skew the importance
of funding for certain diseases or the significance of medical
tests. Celebrities who serve as spokespersons for public health
campaigns should deliver "carefully targeted, evidence-based
recommendations" . While the literature does not directly address
the ethical role of medical professionals in assisting with celebrity
health campaigns, the need for evidence-based advocacy is present.
Media professionals are also involved in the responsible use of
celebrities and health topic coverage is the media. The use of
celebrities in media coverage of health creates an added layer of
interpretation of the celebrity as an advocate. Consider, for
instance, coverage of Nancy Reagan's controversial decision in 1987
to undergo a modified radical mastectomy as a treatment for her
early-stage breast cancer. This decision sparked controversy and many
spoke out—either criticizing the radical treatment choice of the
First Lady, or speaking in defense of patients who have the right to
make their own personal decisions. In this example, the abundant
media coverage of a celebrity's medical choice inadvertently affected
patient behavior. Nancy Reagan did not necessarily present herself in
the media as an advocate for this radical treatment, yet significant
decreases in breast-conserving surgery—considered the other, more
conservative option for women with breast cancer—were noted
immediately following the news media coverage of her personal medical
decision .
For those who report health and medical stories, these stories should
focus on interest, objectivity, the intended effect, long-term
ramifications, and the comprehensibility of the story that makes it
easy for the general public and opinion leaders to disseminate
accurate information. Stories should be supported with appropriate
data and offer the best-informed viewpoint . Even public relations
practitioners are urged to evaluate issues objectively before
becoming an advocate. In Edgett's model for advocacy in public
relations, a primary responsibilities of advocates should be the
"best interests of society" (p. 9).
Advocacy vs. Advice
The ethical implications in the literature raise some important
dilemmas regarding specific instances of celebrity affiliations with
health or disease. Answering the research questions proposed could
lead to more generalized statements about the nature of media
coverage of celebrities and health topics. In order to clarify
current trends of celebrity roles in media coverage of health topics,
the following research questions are proposed:
RQ1: What is the nature of media coverage when celebrities are
affiliated with a specific health topic in popular print media?
RQ2: What is the prevalence and nature of health advocacy and advice
in popular print media in which celebrities and health topics are reported?
Method
Without any current data to guide the formation of hypotheses, an
initial content analysis of popular magazines was performed in order
to explore the research questions. Content analysis is a widely-used
research technique in the field of mass communication research, and
may contribute to the examination of new theoretical contexts .
Sampling
Magazines are a popular and powerful source of information for their
audiences , and easily accessible for the purposes of research. In
order to represent a variety of interests—entertainment, news, and
health—three magazines, with an average circulation of 3,679,284
people, were chosen. See Table 1 for recent category, description,
and circulation information for People, Prevention, and Time magazines .
Table 1
Magazine Descriptions from the Standard Rate and Data Service
(SRDS)Consumer Magazine Advertising Source, December 2004
Magazine Title
Classification
Description
Circulation*
People
News-Weeklies
"…contains insightful, compassionate, and entertaining coverage of
the most intriguing people in our culture…" (p. 593)
3,730,287
Prevention
Health
"…a source of practical consumer health information…provides
actionable news, easy-to-follow advice and motivating ideas…" (p. 376)
3,273,076
Time
News-Weeklies
"…provides extensive reporting and analysis of domestic and
international affairs, business, science, society, and the arts,
painting a broad picture of the world we live in." (p. 598)
4,034,491
Note. Circulation is total paid based on a six month average
calculated on June 30, 2004.
For a solid representation of recent health and celebrity coverage,
the time period chosen for review was five years—January 1, 2000
through December 31, 2004. Sixty issues of each of the three
magazines—or one issue per month—for a total of 180 magazines, were
selected as the sample. Prevention is published on a monthly basis;
therefore, all issues published between January 2000 and December
2004 were included. For People and Time, which are published weekly
rather than monthly, one issue from each month during the time period
was selected at random (based partially on accessibility) for review:
28% of the 120 weekly magazine issues selected were the first issues
of the month, 24% were the second issues of the month, 24% were the
third issues of the month, and 24% were the fourth or fifth issues of
the month. The majority of People and Time issues were scanned in
their entirety by way of hard copies. If for some reason hard copies
were unavailable, microfiche or online archives were used. Prevention
was only available in online archives.
While articles less than a half-page were initially reviewed, the
information did not seem substantial for coding purposes, and these
articles were not pulled for further review. For example, the weekly
People column, "Passages," quite often reports on celebrities and
health under the subtitles "Recuperating," "Hospitalized," and
"Ailing," yet the reports are no more than a few sentences .
Sidebars with references to celebrities and health were also
excluded. All articles one half-page or longer that included mention
of both a health topic and a celebrity were pulled and copied for
coding purposes.
Coding
Celebrities were defined as such based on the content of the
articles. Articles included in the data set either 1) acknowledged
the person as being a prominent figure in society by describing his
or her occupation, political position, or role in popular culture, or
2) insinuated that the person was well-known, by using his or her
name only and providing no description of the public figure, with a
presumption that a description was not needed for the general public.
In contrast, when laypersons were described in articles reviewed,
typically the hometown or profession was mentioned to identify them
as so. For example, in an article about surgery that can assist blind
patients in recovering their vision, Lia de Firmian was described as
a "50-year-old drugstore supervisor from Santa Barbara, Calif" .
Persons who became well-known in the news because of accidents or
illness—such as Jessica Lynch—were not included in the analysis, as
their "stardom" was merely attributed to their personal story .
Health topics include a range of issues—from the mention of specific
diseases to general health advice on exercise. For the purposes of
this research a health topic was defined as any topic reflecting the
state of a person's mind or body.
A coding sheet was developed to assist with the categorization
process. Items coded included the name of the celebrity, aspects of
images associated with the article, description of the health
issue(s) reported, and celebrity roles in "advocacy," "endorsement,"
"general advice," and "specific advice." Advocacy was noted when the
celebrity was referred to in the article as having a personal
position or advocacy role (either unofficial or official) in
spreading information or viewpoints regarding the health topic.
Endorsement was noted when celebrities were quoted or identified as
being in support of specific health habits or were in support of
medications, treatment regimens, or medical procedures. General
advice was noted when celebrities offered general advice regarding a
health topic, such as "see your doctor"; specific advice is related
to the prompting of others by a celebrity to try a medical treatment
or procedure. A description of medical advice or procedures endorsed
by third parties, and the presence or absence of medical personnel
advice in the articles was also noted.
Results
A total of 92 articles were selected for analysis. All articles were
reviewed and coded according to the coding guide. The majority of
articles pulled (60 or 65%) were from People; eighteen (20%) were
from Prevention, and 14 (15%) were from Time. The presence of
articles across the years was fairly balanced: Eighteen (20%) of
those coded were published in the year 2000, 21 (23%) in 2001, 17
(18%) in 2002, 19 (21%) in 2003, and 17 (18%) in 2004.
Initial Findings
Certain celebrities were popular among the sample articles, with
three or more articles pertaining to them: eight of 92 (9%) articles
referred to Christopher Reeve; four (4%) to Michael J. Fox; four to
Rudy Giuliani (4%); and three (3%) to both Lance Armstrong and Ronald
Reagan. All additional celebrities noted in the content were
mentioned once or twice only. The majority of articles (n=87 or 95%)
centered discussion on only one celebrity. Of these 87 articles, 53
(61%) referred to male celebrities and 34 (39%) referred to female celebrities.
The health topics mentioned or discussed in the articles were varied.
Typically one health topic was dominant, although a few articles
referred equally to more than one issue/illness. For example, an
article highlighting the life of Maureen Reagan, daughter of Ronald
Reagan, referred to her advocacy for her father's disease—Alzheimer's
disease—as well as her own fight with melanoma, which eventually
claimed her life .
Health topics were entered into the database as text fields, taken
directly from the articles. These topics were later classified
according to nine categories of chronic illness indicated in Falvo's
text, Medical and Psychosocial Aspects of Chronic Illness and
Disability : 1) cancers; 2) cardiovascular disorders; 3) endocrine
disorders; 4) immune system disorders; 5) mental disorders; 6)
musculoskeletal and connective tissue disorders; 7) nervous system
disorders; 8) renal disorders; and 9) substance-related disorders.
Separate categories were created for topics of more frequent mention
which do not explicitly fit into Falvo's categories: 1) eating
disorders, including anorexia, bulimia, and obesity; 2) autism; and
3) paralysis. "Other topics," not categorized in the Falvo text and
only coded once each, include mention of coma/death , a general
exercise or health regimen , hip fracture , "emotional and physical
breakdown" , "gynecological problems" , quadriplegia , heat stroke ,
thoracic outlet syndrome , Rett Syndrome , and Tuberous Sclerosis
Complex (TSC) . When categorized, the most frequently mentioned
health topics were cancer (n=16 or 17%), nervous system disorders
(n=15 or 16%) such as Parkinson's disease, multiple sclerosis, and
amyotrophic lateral sclerosis (ALS), and eating disorders (n=11 or
12%). See Table 2 for frequencies of the health topics or diseases mentioned.
Table 2
Health Issues or Diseases Described in All Coded Articles (n = 92)*
Health Topics
n (approximate %)
Cancers**
16 (17)
Nervous system disorders**
15 (16)
Eating disorders**
11 (12)
Other topics
10 (11)
Mental disorders**
8 (8)
Paralysis
8 (8)
Substance-related disorders**
7 (7)
Cardiovascular disorders**
6 (6)
Autism
4 (4)
Endocrine disorders**
4 (4)
Musculoskeletal and connective tissue disorders**
4 (4)
Immune system disorders**
1 (1)
Renal disorders**
1 (1)
TOTAL
95 (100)
*Note. Ninety-two articles were coded, but a total of 95 health
issues or disorders were identified as primary health issues.
**Note. Categories derived from Medical and Psychosocial Aspects of
Chronic Illness and Disability (Falvo, 1999).
Advocacy/Advice Article Subset
Of these 92 articles, 32 (35%) mention or discuss celebrities and
health topics in the same article, but no evidence of advocacy roles
or advice were noted. Examples include reports of celebrity
incapacitation or death attributed to health problems, features about
celebrities' battles with mental or physical illness such as
substance abuse , references to personal or family celebrity health
issues within the context of celebrity news , or passing references
to celebrity illness within the context of stories about medical
innovation or discovery .
Sixty articles (65%) contained reference to advocacy or medical
advice and this subset was further analyzed. Of these 60 articles,
the majority (37 or 62%) were identified in People magazine, with
only 14 (23%) and 9 (15%) from Prevention and Time respectively. The
majority of the articles (n=57 or 95%) centered discussion on only
one celebrity, with gender being fairly balanced—58% being male
(n=33) and 42% being female (n=24).
Articles were coded to note the relationship of the celebrity to the
health topic. For the majority, (n=42 or 70%) the celebrity
himself/herself is associated with suffering from the health
condition mentioned. Of these 42 articles, only five (12%) articles
reported celebrities were recently diagnosed within the last year
with the health impairment mentioned. The remaining had been
diagnosed over one year ago (n=29 or 69%), or the length of time was
unknown from the article (n=8 or 19%). Four articles of the 60 (7%)
attribute the health topic to a family member of the celebrity and
nine (15%) attribute the health topic to an unrelated acquaintance.
Four articles (7%) make no mention of the relationship of the
celebrity to the health topic, and one article was not coded for this
relationship, as it referred to President George W. Bush's general
health and exercise habits .
Sixty-three health topics were represented in this subset of 60
articles: nervous system disorders (n=11 or approximately17%); eating
disorders (n=8 or 13%); cancers (n=7 or 11%), mental disorders (n=7
or 11%); other topics (n=6 or 10%); endocrine disorders (n=4 or 6%);
musculoskeletal and connective tissue disorders (n=4 or 6%);
paralysis (n=4 or 6%); substance-related disorders (n=4 or 6%);
autism (n=3 or 5%); cardiovascular disorders (n=3 or 5%); immune
system disorders (n=1 or 2%); and renal disorders (n=1 or 2%).
Advocacy
Of the sixty advocacy/advice articles, 25 (42%) mentioned an
organization in affiliation with the health topic of discussion.
Regardless of whether an organization was affiliated with the health
topic of discussion, the majority of articles (n=41 or 68%) contained
some reference to the celebrity mentioned as being an advocate in
favor of the health topic or cause. An example of a brief mention of
advocacy is in a "Pop Quiz" with Noah Wyle . This half-page report of
a brief interview opens with a statement describing how Wyle was
named "spokesman for Moving Past Trauma, a program that educates the
public and emergency-care workers about post-traumatic stress
disorder (PTSD)" (p. 18), and two of seven interview questions probed
further into Wyle's support for PTSD. Other articles, such as one
highlighting Michael J. Fox's memoir, contained longer descriptions
of the health topic—in this case, his fight against Parkinson's
disease—yet only mention briefly his role as an advocate and founder
of the Michael J. Fox Foundation for Parkinson's Research .
Advice or Endorsement
The instance of advice from celebrities regarding health topics is
limited. Only 10 of 60 (16%) articles were coded as containing
general advice to the reader regarding what to do if he or she is
concerned about himself or a loved one. For example, Tina Wesson, the
winner of the reality television show Survivor II despite her ongoing
battle with rheumatoid arthritis, has partnered with the Arthritis
Foundation to help further public education. She is quoted in a
Prevention article as giving advice to others. Wesson says, "See a
doctor right away; don't suffer through it! Find something that works
for you and lets you lead a semi-normal life" (p. 35). In People
magazine, Beverly Johnson, a supermodel and the first black woman to
appear on the cover of Vogue magazine, urges women to take control of
their own health. She is quoted in the article saying, "We have to be
in the driver's seat as far as our health goes. We have to take
interest and educate ourselves about our health…we have to not be
shy" . Being an advocate in magazine coverage does not indicate that
the celebrity will also be giving general advice. A cross tabulation
indicates that only 17% (n=7) of those celebrities who were coded as
being in an advocacy role provide general advice to readers.
Endorsement of (being in support of) specific health habits or
medical treatments or procedures was noted in 14 of the 60 (23%)
articles. For example, Patti LaBelle endorses "eating smart—[such as]
avoiding salt and fried chicken [and] eating cheese-steak sandwiches
without the cheese or the bread" in order to control diabetes .
LaBelle published a cookbook in conjunction with her role as
spokeswoman for the American Diabetes Association. It should be noted
that being portrayed as an advocate in magazine coverage does not
necessarily indicate, however, that the celebrity will also be
endorsing specific health habits. In fact, a cross tabulation
indicates that of those provide an endorsement, only 36% (n=5) were
also coded as being in an advocacy role.
No instances of specific medical advice (e.g., "You should really try
Treatment X.") from celebrities were noted. One article referred to
medical advice endorsed by a specific organization. In this case, the
advice was noted as being from Prevention (rather than the
celebrity). In reference to a yearlong campaign with the National
Osteoporosis Foundation, Prevention recommended bone-density testing
to screen for osteoporosis. Other physicians were referred to in the
article as providing advice on osteoporosis to readers .
Only nine other articles (15%) provided advice from a medical
professional. Four of these nine (44%) were identified in People and
Prevention . The references to medical professional advice, however,
were all very brief. For example, an article in People described the
controversial "Master Cleanser fast," a "no-food" regime which helped
Robin Quivers, sidekick to radio personality Howard Stern, lose 70
pounds. The majority of the two-page article focuses on how Quivers
was able to "regain her health" ; only a one-sentence acknowledgement
from a physician regarding the risks of extended fasting to achieve
desired weight-loss results is included.
The five remaining articles in which professional advice from a
medical professional was noted were identified in Time, and are of
interest because they all belonged to an ongoing column, "Your
Health," written by physician Ian K. Smith . The focus of each
article is on a consumer health issue, and Smith provides statistics,
advice, or other recommendations regarding the health topic. The use
of the celebrity reference is in the opening of each article, with
the celebrity identified immediately in the heading or subheading.
For example, the headline of an article published in 2000 reads,
"Giuliani's Choices," and the subhead: "New York City's mayor has
several options for his prostate cancer. The odds for a cure are
good" . The focus of the article is on treatment options for prostate
cancer, yet the celebrity tie to Rudy Giuliani, the mayor of New
York, is weaved throughout medical reporting and physician advice.
Conclusion
The results of this content analysis reveal several important trends.
As noted by the abundance of articles in People magazine, popular
sources such as entertainment news do not shy away from covering
important health issues. Society at large may identify with
"celebrity branding" of health issues perpetuated by the media. When
magazine articles mention celebrities in conjunction with health
topics, about one third of the time these articles will probably be a
run-of-the mill features or brief articles regarding personal health
issues of celebrities or their families. About two-thirds of the
time, however, articles using celebrities and health topics in
conjunction with one another may contain some element of advocacy,
endorsement, or advice. These results, however, do not indicate any
patterns of relationships between advocacy, endorsement, and advice.
In other words, because one is an advocate does not necessarily mean
that he or she will be providing advice, and vice versa.
This brings up several ethical considerations. First of all,
celebrities should recognize the abundance of media coverage and the
potential impact of their roles as health advocates or advisors.
Celebrities should be encouraged to examine how they communicate
health ideas either while working in partnership with organizations
who promote health in our community or as a personal advocate for a
cause. Celebrities should recognize their ability to gain media
attention and influence their audiences. This requires a sensitive
approach to endorsement and advice-giving.
Secondly, media professionals and public relations practitioners also
have a great ethical responsibility. Results of this study indicate
an extreme lack of additional reporting of professionally-backed
health information within the context of celebrity advocacy or
advice. While there may be nothing unethical about celebrities
promoting public health discourse in the media, the challenge may be
to create a public relations forum that unites health advocacy or
advice from celebrities with credible information from the medical or
public health community. Media professionals should seek to inform
the public as best they can by supplementing coverage with accurate
and sound medical information. Popular stories about celebrities may
be unforeseen opportunities for hard facts about health and disease
prevention to be presented.
The implications for medical professionals are also important. an K.
Smith's column in Time magazine illustrates how those with medical
credentials can use celebrities as examples to grab reader attention.
Medical professionals and educators may have a role in communicating
more health information directly to publics, or should actively seek
ongoing and strong communicative relationships with celebrity advocates.
Limitations
Conducting content analysis of popular magazines does not come
without its limitations—the first being accessibility. Hard copies of
archived magazines were used as the primary choice for this research.
While many hard copies were available for review, it was noted that
these archives are not always complete—issues were found to be
missing, and occasionally the issues reviewed were incomplete, with
pages having been removed (torn out) from the bound copy. Online
archives may be unreliable and are not always complete; issues of
Prevention archived online did not contain every page of the
magazine. In addition, online archives of popular magazines do not
always contain pdf images of the articles. While html full text
articles were usually available, this format makes it impossible to
view corresponding images, page numbers, and the layout of text.
This study also contained a relatively small sample. Magazine content
from other magazine genres should be analyzed to improve the
generalizability of the study. This study also fails to indicate the
prevalence or significance of the usage of celebrity figures when
discussing health topics into the overall picture of current health
communication trends. This research did not report on health topic
coverage when celebrities are not mentioned, and therefore the nature
of "celebrity branding" within the larger health communication
context cannot be addressed by these initial findings.
Future Research
Katie Couric's message in a 2001 advertisement for the National
Colorectal Cancer Research Alliance implies that early testing for
colorectal cancer would have been beneficial for her husband, who
died at the age of 42 . Studies similar to the one reported in this
paper should be replicated to explore a variety of media
campaigns—from health communication campaigns instigated by
nonprofits, to drug advertising, to campaigns for research
fundraising. Additional research designed to measure the impact of
celebrity health advocacy and advice on consumer and patient behavior
will clarify the overall implications for future public health
discourse and policy.
References
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