Mass media are tools for the transfer of information, concepts, and ideas to both general and specific audiences. They are important tools in advancing public health goals. Communicating about health through mass media is complex, however, and challenges professionals in diverse disciplines. In an article in the Journal of Health Communication, Liana Winett and Lawrence Wallack wrote that "using the mass media to improve public health can be like navigating a vast network of roads without any street signs—if you are not sure where you are going and why, chances are you will not reach your destination" (1996, p. 173).
Using mass media can be counterproductive if the channels used are not audience-appropriate, or if the message being delivered is too emotional, fear arousing, or controversial. Undesirable side effects usually can be avoided through proper formative research, knowledge of the audience, experience in linking media channels to audiences, and message testing.
TYPES AND FUNCTIONS OF MASS MEDIA
Sophisticated societies are dependent on mass media to deliver health information. Marshall McLuhan calls media "extensions of man." G. L. Kreps and B. C. Thornton believe media extend "people's ability to communicate, to speak to others far away, to hear messages, and to see images that would be unavailable without media" (1992, p. 144).
It follows that employment of mass media to disseminate health news (or other matters) has, in effect, reduced the world's size. The value of health news is related to what gets reported and how it gets reported. According to Ray Moynihan and colleagues:
The news media are an important source of information about health and medical therapies, and there is widespread interest in the quality of reporting. Previous studies have identified inaccurate coverage of published scientific papers, overstatement of adverse effects or risks, and evidence of sensationalism. The media can also have a positive public health role, as they did in communicating simple warnings about the connection between Reye's syndrome and the use of aspirin in children (1999, p. 1645).
Despite the potential of news media to perform valuable health-education functions, Moynihan et al. conclude that media stories about medications continue to be incomplete in their coverage of benefits, risks, and costs of drugs, as well as in reporting financial ties between clinical trial investigators and pharmaceutical manufacturers.
The mass media are capable of facilitating short-term, intermediate-term, and long-term effects on audiences. Short-term objectives include exposing audiences to health concepts; creating awareness and knowledge; altering outdated or incorrect knowledge; and enhancing audience recall of particular advertisements or public service announcements (PSAs), promotions, or program names. Intermediate-term objectives include all of the above, as well as changes in attitudes, behaviors, and perceptions of social norms. Finally, long-term objectives incorporate all of the aforementioned tasks, in addition to focused restructuring of perceived social norms, and maintenance of behavior change. Evidence of achieving these three tiers of objectives is useful in evaluating the effectiveness of mass media.
Mass media performs three key functions: educating, shaping public relations, and advocating for a particular policy or point of view. As education tools, media not only impart knowledge, but can be part of larger efforts (e.g., social marketing) to promote actions having social utility. As public relations tools, media assist organizations in achieving credibility and respect among public health opinion leaders, stakeholders, and other gatekeepers. Finally, as advocacy tools, mass media assist leaders in setting a policy agenda, shaping debates about controversial issues, and gaining support for particular viewpoints.
Television. Television is a powerful medium for appealing to mass audiences—it reaches people regardless of age, sex, income, or educational level. In addition, television offers sight and sound, and it makes dramatic and lifelike representations of people and products. Focused TV coverage of public health has been largely limited to crises. However, for audiences of the late 1950s, the 1960s, and the 1970s, television presented or reinforced certain health messages through product marketing. Some of these messages were related to toothpaste, hand soaps, multiple vitamins, fortified breakfast cereals, and other items.
Public health authorities have expressed concern about the indirect influence of television in promoting false norms about acts of violence, drinking, smoking, and sexual behavior. A hypothetical equation for viewers might be: drinking plus smoking equals sex and a good time. Safe sex practices are rarely portrayed on television. An additional public health concern is that TV viewing promotes sedentariness in a population already known for its multiple risk factors for cardiovascular disease and other chronic illnesses.
A more focused coverage of health matters occurred in the 1990s as a result of two events: (1) an expansion of "health segments" on news broadcasts, which included the hiring of "health" reporters, and (2) the expansion and wider distribution of cable television (CATV) and satellite systems. Television coverage of health issues reveals some of the medium's weaknesses as an educator, however. Health segments incorporated into news broadcasts are typically one to three minutes in length—the consumer receives only a brief report or "sound bite," while the broadcaster remains constrained by the fact that viewers expect the medium to be both visual and entertaining. Fortunately, with the advent and maturation of CATV, more selected audience targeting has become possible. The Health Network is dedicated entirely to health matters, while other cable networks (e.g., Discovery Channel) devote significant amounts of broadcast time to health. This narrowcasting allows the medium to reach particular market segments. However, the proliferation of cable channels decreases the volume of viewers for a given channel at any point in time. According to George and Michael Belch, even networks such as CNN, ESPN, and MTV draw only 1 to 2 percent of primetime viewers.
Although TV has the potential to deliver messages about HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome), smoking, cardiovascular disease, cancer, and so on, televised messages have the characteristic of low audience involvement. The main consumer effect of messages occurs through repetition and brand familiarity. Most health messages do not have the exposure level that brands of toothpaste, soap, or antiperspirant receive, for public health groups rarely can sustain the cost of television, thereby limiting their message's penetration.
For all its potential strengths, TV suffers many shortcomings. The cost of placing health messages on TV is high, not only because of the expense of purchasing airtime, but because of production time for PSA creation. Televised messages are fleeting—airing in most instances for only 15 to 30 seconds. Belch and Belch point out that for 13 to 17 minutes of every hour viewers are bombarded with messages, creating a clutter that makes retention difficult.
Radio. Radio also reaches mass and diverse audiences. The specialization of radio stations by listener age, taste, and even gender permits more selectivity in reaching audience segments. Since placement and production costs are less for radio than for TV, radio is able to convey public health messages in greater detail. Thus, radio is sometimes considered to be more efficient.
Radio requires somewhat greater audience involvement than television, creating the need for more mental imagery, or what Belch and Belch call "image transfer." Because of this, radio can reinforce complementary messages portrayed in parallel fashion on TV. However, the large number of radio stations may fragment the audience for health message delivery.
Radio health message campaigns have been effective in developing countries, especially when combined with posters and other mass media. Ronny Adhikarya showed that mass media message targeted at wheat farmers in Bangladesh increased the percentage of those who carried out rat control from 10 percent to 32 percent in 1983. Continuation of the campaign in subsequent years saw rat control efforts rise to 72 percent.
Internet. The advent of the World Wide Web and the massive increase in Internet users offers public health personnel enormous opportunities and challenges. The Internet places users in firmer autonomous control of which messages are accessed and when they are accessed. It is possible to put virtually anything on-line and disseminate it to any location having Internet access, but the user has little control over quality and accuracy. Internet search engines can direct users to tens of thousands of web sites after the user's introduction of one or more keywords. A critical task for public health educators will be to assist people in discriminating among Internet health-information sources. Efforts need to stop short of censorship, thus balancing accuracy, quality, and (in the U.S.) protection of free speech (First Amendment rights).
Unlike TV or radio, which are available in nearly all households, Internet access requires some technical skill, as well as the resources to purchase hardware and Internet subscription services. J. R. Finnegan and K. Viswanath explain that, as with its predecessor technologies, the Internet suffers from a certain "legacy of fear" about its impact on children, youth, and others. As with cinema since the 1940s and TV since the 1950s, the Internet has been accused of promoting mindlessness; exposing people to pornography, violence, and other examples of society's lowest common denominators; and enabling sedentary behavior. The Internet is said to facilitate activities of society's hate groups and to teach children and others how to construct bombs and obtain weapons. Unlike some other mass media, the Internet is presently not universally available across socioeconomic strata due to cost and other barriers. It is possible that this lack of universality has already contributed to existing information gaps between society's "haves" and "have-nots."
The Internet's utility for conveying health information can be illustrated by looking at three sample web sites. Considered by some to be the best source for public health data and information is the web site of the Centers for Disease Control and Prevention (http://www.cdc.gov). From here persons can locate numerous government data sources, obtain facts on chronic and infectious diseases, and gain fingertip access to health updates, including the Morbidity and Mortality Weekly Report (MMWR). Another valuable site is that of the Association for Toxic Substances and Disease Registry (http://www.atsdr.cdc.gov/HEC/primer.html), which includes a primer on health risk communication principles and practice. Through this site, persons learn how to communicate about health risks to a skeptical public, including factors that influence the public's risk perceptions. Finally, Columbia University's health education web site (http://www.goaskalice.columbia.edu) makes it possible to access information on a voluminous array of health topics, with particular relevance to college students. This site also permits individuals to submit questions anonymously, receive responses, and be referred to other Internet links. These items are then archived for use by persons having similar queries.
Speculating about the Internet's future is not easy. However, the Internet offers all of the audio and visual strengths of other electronic media, plus interactivity and frequent updates. The challenge is to increase its availability and augment the skills of Internet users.
Newspapers. Belch and Belch estimate that newspapers are read daily in 70 percent of U.S. households, and in as many as 90 percent of high-income households. Newspapers permit a level of detail in health reporting not feasible with broadcast media. Whereas one can miss a television broadcast about breast cancer, and thus, lose its entire message, one can read the same (and more detailed) message in a newspaper at one's choice of time and venue. Although newspapers permit consumers flexibility concerning what is read, and when, they do have a brief shelf life. In many households, newspapers seldom survive more than one or two days.
Newspapers are available in daily and weekly formats, and local, regional, and national publications exist. In addition, there are numerous special audience newspapers (e.g., various ethnic groups, women and feminist related, gay and lesbian, geography-specific, neighborhood). Consequently, health messages contained in newspapers can reach many people and diverse groups. Newspapers often fall short of their dissemination potential, however. In addition to educating people about public health, deliberate efforts need to be directed at educating other media and politicians (McDermott 2000, p. 269).
Other authorities have illustrated the shortcomings of the newspapers in conveying health information. Few stories call for individual or community policy or action, and even fewer present a local angle.
Magazines. Belch and Belch divide magazines into three varieties: consumer (e.g., Reader's Digest, Newsweek, People ), farm (e.g., Farm Journal, National Hog Farmer, Beef ), and business (professional, industrial, trade, and general business publications). Magazines have several strengths, including audience selectivity, reproduction quality, prestige, and reader loyalty. Furthermore, magazines have a relatively long shelf life—they may be saved for weeks or months, and are frequently reread, and passed on to others. Magazine reading also tends to occur at a less hurried pace than newspaper reading. Health messages, therefore, can receive repeated exposure.
Other Print Media. Pamphlets, brochures, and posters constitute other print media used to disseminate health messages. These devices are readily found in most public health agencies, offices of private practitioners, health care institutions, and voluntary health organizations. They are common and familiar educational tools of the American Cancer Society, the American Heart Association, and the American Lung Association. Though widely used, their actual utility is infrequently evaluated (e.g., units distributed vs. changes in awareness, cost analysis). Until the 1990s, few of these print media were developed with the assistance of target audiences, and few contained varied messages, were culturally tailored, or employed readability and face validity techniques. The extent to which persons read, reread, and keep these devices—or circulate them to other readers—is not well evaluated. Thus, their permanence is unknown.
Outdoor Media. Outdoor media include billboards and signs, placards inside and outside of commercial transportation modes, flying billboards (e.g., signs in tow of airplanes), blimps, and skywriting. Commercial advertisers such as Goodyear, Fuji, Budweiser, Pizza Hut, and Blockbuster all make extensive use of their logo-bearing blimps around sports stadiums. In the United States, none of these outdoor modes are used extensively to convey health messages, although billboards and transit placards are the most likely forms to contain health information. For persons who regularly pass by billboards or use public transportation, these media may provide repeated exposure to messages. Pro-health messages displayed on urban public transportation may suffer, however, from the image problems that afflict urban buses and subways. In addition, the effectiveness of such postings wears out quickly as audiences grow tired of their sameness.
Tobacco and alcohol manufacturers have made extensive use of billboards and other outdoor media. However, the 1998 Master Settlement Agreement between the states and the tobacco industries outlawed billboard advertising of cigarettes. In their 1994 Chicago-based study, Diana Hackbarth and her colleagues revealed how billboards promoting tobacco and alcohol were concentrated in poor neighborhoods. Similar themes were seen in other urban centers (Baltimore, Detroit, St. Louis, New Orleans, Washington, D.C., and San Francisco) where alcohol and tobacco billboards were much more concentrated in African-American neighborhoods than in white neighborhoods. The tobacco industry now pursues the same strategy in developing countries.
Decades of studies on the consequences of mass media exposure demonstrate that effects are varied and reciprocal—the media impact audiences and audiences also impact media by the intensity and frequency of their usage. The results of mass media for promoting social change, especially in developing countries, have become important for public health. J. R. Finnegan Jr. and K. Viswanath (1997) have identified three effects, or functions, of media: (1) the knowledge gap, (2) agenda setting, and (3) cultivation of shared public perceptions.
The Knowledge Gap. Health knowledge is differentially distributed in the population, resulting in knowledge gaps. Unfortunately, mass media are insufficient for distributing information in an egalitarian fashion—changes in social structure and institutions are also necessary for this to occur. Thus, the impact of mass media on audience knowledge gaps is influenced by such factors as the extent to which the content is appealing, the degree to which information channels are accessible and desirable, and the amount of social conflict and diversity there is in a community. Hence, public health media campaigns are more effective when structural factors that impede the distribution of knowledge are addressed.
Agenda Setting. The selective nature of what members of the media choose for public consumption influences how people think about health issues, and what they think about them. When Rudolph Giuliani, the mayor of New York City, publicly disclosed he had prostate cancer prior to the 2000 New York senatorial election, many news media reported the risks of prostate cancer, prompting greater public awareness about the incidence of the disease and the need for screening. A similar episode occurred in the mid-1970s when Betty Ford, wife of President Gerald R. Ford, and Happy Rockefeller, wife of Vice President Nelson Rockefeller, were both diagnosed with breast cancer.
A related theme is the extent to which the media set the public's perception of health risks. According to J. J. Davis, when risks are highlighted in the media, particularly in great detail, the extent of agenda setting is likely to be based on the degree to which a public sense of outrage and threat is provoked. Where mass media can be especially valuable is in the framing of issues. "Framing" means taking a leadership role in the organization of public discourse about an issue. Media, of course, are influenced by pressures to offer balance in coverage, and these pressures may come from persons and groups with particular political action and advocacy positions. According to Finnegan and Viswanath, "groups, institutions, and advocates compete to identify problems, to move them onto the public agenda, and to define the issues symbolically" (1997, p. 324). Thus, persons who desire to access mass media's agenda-setting potential must be aware of the competition.
Cultivation of Perceptions. Cultivation is the extent to which media exposure, over time, shapes audience perceptions. Television is a common experience, especially in the United States, and it serves as what S. W. Littlejohn calls a "homogenizing agent." However, the effect is often based on several conditions, particularly socioeconomic factors. Prolonged exposure to TV or movie violence may affect the extent to which people think community violence is a problem, though that belief is likely moderated by where they live. However, the actual determinants of people's impressions of violence are complex, and consensus in this area is lacking.
THE RELATIONSHIP OF MASS MEDIA TO OTHER FORMS OF COMMUNICATION
The interaction between media messages and interpersonal communication was first described by Elihu Katz and Paul Lazarsfeld in their two-step flow hypothesis. They argued that media effects were moderated principally by interpersonal encounters. Community opinion leaders scan the media for information, then communicate that information to others in interpersonal contexts. It is in this second step, interpersonal interaction, that opinion leaders wield enormous power, influencing others not only by what they choose to reveal but also the slant that they use in conveying the message.
The two-step model has been expanded to include multistep models—most notably information diffusion models. Step models have been limited by their linear assumptions of one-way influence and causation. Media influence is undeniably linked to complex interpersonal dynamics. A shared influence likely results when people are exposed to health messages and then converge together in contexts that influence what they say to one another (and even how they say it), as well as what they selectively think.
George Gerbner describes a three-component framework. The first of these components is semiotics, the study of signs, symbols, and codes. Language comprises one such set of symbols and codes that can be further embellished by sights, sounds, and other visual and aural cues. The second aspect of the framework relates to behaviors and interactions associated with exposure to messages. Psychologists, marketers, and others attempt to predict behavior based on specially designed messages. The third element examines how communication is organized around social systems, and the extent to which history and human experience influence society's institutions.
Designers of health messages need to consider such models and frameworks. Modern views of health behavior change acknowledge eclectic approaches and consider multiple aspects of human experience, from the individual level to the community level. Individual channels of communication (e.g., face-to-face encounters) offer personal support and may invoke trust, but are labor intensive, have limited reach, and may require ancillary materials. Mass media channels transmit information rapidly and to general or specific audiences. Mass media can set agendas, but questions have been raised concerning their impartiality and integrity. Community channels (e.g., coalitions, community action groups, and the like), have less "reach" than mass media, but they reinforce, expand, and localize media messages and offer institutional and social support. Knowledge of the complementary strengths of various channels helps to optimize penetration and effectiveness of health messages.
MASS MEDIA PUBLIC HEALTH CAMPAIGNS—THE RIGHT "MIX"
Because of the inherent properties of various mass media, a U.S. Department of Health and Human Services publication advises that health-message designers consider a series of questions relative to choice of channels:
- Which channels are most appropriate for the health problem/issue and message?
- Which channels are most likely to be credible to and accessible by the target audience?
- Which channels fit the program purpose (e.g., inform, influence attitudes, change behavior)?
- Which and how many channels are feasible, considering your time and budget?
A 1999 article by A. G. Ramirez and colleagues describes a media mix that significantly increased adherence to recommended guidelines concerning cervical cancer screening among women in a predominantly Spanish-speaking Texas border city. The media mix included 82 television segments, 67 newspaper stories, and 48 radio programs, all featuring role models. In a 1998 study by Ramirez and other investigators, programs employing a similar strategy in New York, Florida, and California showed significant change in target behaviors among Hispanic populations.
In Project Northland, Cheryl Perry's team of researchers focused on moderating alcohol use by adolescents, but could not use radio and television spots due to their potential confounding properties (i.e., being heard or viewed by adolescents in a nonintervention comparison group) with respect to evaluation of this school-and community-based intervention. Print media, including posters, brochures, and newsletters, were used in the intervention communities to market health messages and advertise ancillary events, and adolescents and adults were trained in media advocacy to increase media coverage of underage use of alcohol.
The primary health communication tool used by the Centers for Disease Control and Prevention (CDC) is PRIZM, which was developed by Claritas, Inc. PRIZM divides the United States into sixty-two lifestyle clusters, or groups of people with similar "geodemographic characteristics, consumer behaviors, psychosocial beliefs, and media habits" (Parvanta and Freimuth 2000, p. 22). It provides data on 250 sociodemographic census variables and approximately 500 items concerning media preferences, purchasing behaviors, and lifestyle activities.
Following a needs assessment that revealed an abnormally high birth-defect rate in a four-county area of Virginia, mass media were tapped to inform more than 22,000 women of child-bearing age about the health benefits of folic acid supplements and folate-rich foods. The campaign included television and radio PSAs, brochures, posters and display boards, as well as the cooperation of a local grocery store chain that provided other print media (food information cards and special food labels on folate-dense products). In a 1999 evaluation, CDC investigators reported a statistically significant increase in folic acid awareness between 1997 and 1999.
Mass media have been major sources of information about HIV/AIDS and other sexually transmitted infections. In a 2000 study, 96 percent of 1,290 men aged twenty-two to twenty-six reported hearing about these subjects through television advertisements, radio, or magazines. Some authorities have expressed skepticism about the mass media's future motivation to provide positive sex education messages, since portrayal of sex attracts viewers, which in turn, increases revenues.
Other evidence of the media's ability to improve reproductive health and promote population control exists, especially from developing countries. Mass media have made people aware of modern contraception and where to access it, as well as linking family planning to other reproductive health care and to broader roles for women. Communication about family planning and population control creates awareness, increases knowledge, builds approval, and encourages healthful behaviors. In Egypt, where nearly all households have television, population control objectives have been achieved through televised PSAs. Data also support the positive effects of mass media messages on contraception use in Zimbabwe, Ghana, Nigeria, and Kenya. In a 1999 Tanzania-based study, a team of researchers led by Everett M. Rogers showed how the popularity of a radio soap opera promoting family planning increased listeners' self-efficacy with respect to discussing contraception with spouses and peers.
Although mass media are important for disseminating health messages and encouraging an adoption of healthful lifestyles, they currently fall short of their potential. The realization of this potential in the future depends, in part, on increasing the media advocacy skills of public health authorities, improving understanding of competing antihealth media messages, and organizing channels for an optimal media mix.
Robert J. McDermott
Terrance L. Albrecht
(see also: Advertising of Unhealthy Products; Attitudes; Communication for Health; Communication Theory; Health Books; Health Promotion and Education; Impartiality and Advocacy; Internet; Mass Media and Tobacco Control; Media Advocacy; Patient Educational Media; Radio; Social Marketing )
Adhikarya, R. (2001). "The Strategic Extension Campaigns on Rat Control in Bangladesh." In Public Communication Campaigns, 3rd edition, eds. R. E. Rice and C. E. Atkin. Thousand Oaks, CA: Sage Publications.
American Academy of Pediatrics Committee on Communications (1995). "Media Violence." Pediatrics 95:949–951.
Belch, G. E., and Belch, M. A. (1995). Introduction to Advertising & Promotion, 3rd edition. Chicago: Irwin.
Bradner, C. H.; Ku, L.; and Lindberg, L. D. (2000). "Older, but Not Wiser: How Men Get Information About AIDS and Sexually Transmitted Diseases After High School." Family Planning Perspectives 32(1):33–38.
Brown, J. D., and Keller, S. N. (2000). "Can the Mass Media Be Healthy Sex Educators?" Family Planning Perspectives 32(5):255–256.
Centers for Disease Control and Prevention (1999). "Folic Acid Campaign and Evaluation—Southwestern Virginia, 1997–1999." Morbidity and Mortality Weekly Report 48:914–917.
Davis, J. J. (2000). "Riskier Than We Think? The Relationship Between Risk Statement Completeness and Perceptions of Direct to Consumer Advertised Prescription Drugs." Journal of Health Communication 5:349–370.
Finnegan, J. R., Jr., and Viswanath, K. (1997). "Communication Theory and Health Behavior Change: The Media Studies Framework." In Health Behavior and Health Education, 2nd edition, eds. K. Glanz, F. M. Lewis, and B. K. Rimer. San Francisco: Jossey-Bass Publishers.
Gerbner, G. (1983). "Field Definitions: Communication Theory." In 1984–85 U.S. Directory of Graduate Programs, 9th edition. Princeton, NJ: Educational Testing Service.
Hackbarth, D. P.; Silvestri, B.; and Cosper, W. (1994). "Tobacco and Alcohol Billboards in 50 Chicago Neighborhoods: Market Segmentation to Sell Dangerous Products to the Poor." Journal of Public Health Policy 16(2):213–230.
Katz, E., and Lazarsfeld, P. (1955). The Part Played by People in the Flow of Mass Communications. New York: Free Press.
Kreps, G. L., and Thornton, B. C. (1992). Health Communication Theory & Practice. Prospect Heights, IL: Waveland Press.
Littlejohn, S. W. (1989). Theories of Human Communication. Belmont, CA: Wadsworth Publishing Company.
McDermott, R. J. (2000). "Health Education Research: Evolution or Revolution (or Maybe Both)?" Journal of Health Education 33(5):264–271.
Moynihan, R.; Bero, L.; Ross-Degnan, D.; Henry, D.; Lee, K.; Watkins, J.; Mah, C.; and Soumerai, S. B.(1999). "Coverage by the News Media of the Benefits and Risks of Medications." New England Journal of Medicine 342:1645–1650.
Parvanta, C. F., and Freimuth, V. (2000). "Health Communication at the Centers for Disease Control and Prevention." American Journal of Health Behavior 24:18–25.
Pelletier, A. R.; Quinlan, K. P.; Sacks, J. J.; Van Gilder, T. J.; Gilchrist, J.; and Ahluwalia, H. K. (1999). "Firearm Use in G- and PG-rated Movies." Journal of the American Medical Association 282(5):428.
Perry, C. L.; Williams, C. L.; Komro, K. A.; Veblen-Mortenson, S.; Forster, J. L.; Bernstein-Lachter, R.; Pratt, L. K.; Dudovitz, B.; Munson, K. A.; Farbakhsh, K.; Finnegan, J.; and McGovern, P. (2000). "Project Northland High School Interventions: Community Action to Reduce Adolescent Alcohol Use." Health Education & Behavior 27(1):29–49.
Ramirez, A. G.; McAlister, A. L.; Villarreal, R.; Suarez, L.; Talavera, G. A.; Perez-Stable, E. J.; Marti, J.; and Trapido, E. J. (1998). "Prevention and Control in Diverse Hispanic Populations: A National Leading Initiative for Research and Action." Cancer 83:1825–1829.
Ramirez, A. G.; Villarreal, R.; McAlister, A.; Gallion, K. J.; Suarez, L.; and Gomez, P. (1999). "Advancing the Role of Participatory Communication in the Diffusion of Cancer Screening Among Hispanics." Journal of Health Communications 4:31–36.
Robey, B.; Piotrow, P. T.; and Salter, C. (1994). "Family Planning Lessons and Challenges: Making Programs Work." Population Reports 22(2):1–27.
Rogers, E. M.; Vaughan, P. W.; Swalehe, R. M. A.; Rao, N.; Svenkerud, P.; and Sood, S. (1999). "Effects of An Entertainment-Education Radio Soap Opera on Family Planning Behavior in Tanzania." Studies in Family Planning 30(3):193–211.
U.S. Department of Health and Human Services (1989). Making Health Communication Programs Work: A Planner's Guide. Bethesda, MD: National Cancer Institute.
Winett, L. B., and Wallack, L. (1996). "Advancing Public Health Goals through the Mass Media." Journal of Health Communication 1:173–196.
Before the 1960s, the media reported sporadically on the environment—often then referred to as the 'ecology' issue.
But Rachel Carson's 1962 book, Silent Spring, which raised deep concerns about the nation's increasing reliance on synthetic pesticides, sparked the United States' modern environmental movement and, in turn, increased media scrutiny of its issues.
Before Silent Spring, some major pollution events, notably the "killer fog" of Donora, Pennsylvania, and the black afternoon smog of major industrial towns such as Pittsburgh and St. Louis, had largely been the limits of media coverage.
"Throughout most of the Sixties, unless a river was on fire or a major city was in the midst of a weeklong smog alert, pollution was commonly accepted by both the press and the general population as a fact of life," wrote David B. Sachsman in the SEJournal, the quarterly publication of the Society of Environmental Journalists (SEJ).
"Until the late Sixties, conservationists were thought of as eccentric woodsmen and environmentalists were considered unrealistic prophets of doom," continued Sachsman, a communications and public affairs professor at the University of Tennessee at Chattanooga.
With this new environmental interest, pioneers on the environmental beat began to distinguish themselves in the 1960s and 1970s. They included the New York Times' Gladwin Hill and the Houston Post' s Harold Scarlett. More reporters quickly followed.
"The year 1969 was pivotal for this growing media and public interest in the state of our environment," Sachsman concluded. That year, the New York Times, soon followed by other major newspapers, created an environment beat. Time and Saturday Review developed regular environment sections, Look devoted an entire issue to the "ecology crisis." National Geographic offered a nine-thousand-word article on humankind's environmental problems. As the 1970s dawned, Walter Cronkite presented the television feature "Can the World be Saved?" and Paul Ehrlich's book The Population Bomb had also become a best-seller.
About this time, television was coming into its own as a powerful new medium. Its coverage lent fuel to the growing environmental movement. Images of oil-soaked birds on the Santa Barbara beach, the result of the Channel-Union Oil spill in 1969; stories on the "death" of Lake Erie; giant fish kills in the Great Lakes; and the burning Cuyahoga River in Ohio cemented in the nation's mind that an important new political, business, and social issue had awakened.
In turn, an estimated 20 million Americans gathered on April 22, 1970, for the first Earth Day. As a single event related to the environment, it would not be matched for two decades.
Such political action quickly prompted federal legislation, including the Clean Air Act in 1970 and the Clean Water Act in 1972. This legislative attention gave legitimacy to the issue, spawning more media coverage.
During the mid-1970s, the hot environment story was the threat of chemical pollution from the nation's industrial plants and the pollution such operations had left behind. The coverage of Love Canal, New York, in the late 1970s and, in 1983, the evacuation of tiny Times Beach, Missouri, put into headlines and daily conversation such insidious chemical names as "dioxin."
In 1989, the year of the Exxon Valdez oil spill in Alaska, television images again riveted the nation, showing oil-drenched birds struggling to survive on pollution-fouled beaches. Global warming, concern over endangered species, and air and water quality combined to increase coverage in all media. That year, 774 minutes of environmental coverage on the three major broadcast networks' nightly news set a new record, according to the Tyndall Report, an analysis of network news coverage.
In 1991, former New York Times environment reporter Phil Shabecoff, founded the nation's first environmental news service, known then as Greenwire. "The environment isn't a one-shot news story—it's something that needs to covered in-depth, day after day," Shabecoff later told the Columbia Journalism Review.
During the late 1980s, a group of daily reporters covering environmental issues began the SEJ, an organization formed by journalists to help other journalists do a better job on the difficult environment beat. Among the founders were some of the nation's distinguished environment reporters, including Jim Detjen of the Philadelphia Inquirer, Rae Tyson of USA Today, Noel Grove of National Geographic, Shabecoff, and Teya Ryan of Turner Broadcasting. Eighteen reporters attended the group's first organizational meeting.
"We doubt that we will ever become a slick operation," Detjen wrote in 1990. Today, the SEJ boasts more than 1,200 members—journalists, academics, and students, an annual budget of nearly $800,000, and a host of programs for journalists and students, including an annual conference, a quarterly journal, and website updated daily with the latest environmental reports.
In 1990, the twentieth anniversary of Earth Day marked the single largest global demonstration on the environment, winning coverage from Mt. Everest to Kansas. But a backlash against the issue and those who cover it soon developed.
"It is becoming trendy to ask whether environmental laws, not polluters, are the real public enemy," wrote Kevin Carmody, a founding SEJ board member, in the Columbia Journalism Review in 1995. "In newsrooms throughout the country, the hot story is the 'high cost of environmental regulation,' not the people or resources harmed when that regulation fails."
Indeed, journalists caught in the 1990 frenzy to celebrate Earth Day may have forgotten some basic journalistic principles—such as, question everything—opening the door for criticism. John Stossel, an ABC consumer and environment reporter, attracted sixteen million viewers in 1994 with a special report entitled "Are We Scaring Ourselves to Death?" The Los Angeles Times devoted seven full pages to a series by media critic David Shaw, called "Living Scared: Why Do the Media Make Life Seem So Risky?"
By 1993, minutes on the television networks devoted to environmental coverage had dwindled by 60 percent. Even so, environmental stories would reap ten Pulitzer Prizes in the 1990s, compared to just nine in the three previous decades.
When a new Republican president was elected to the White House in 2000—George W. Bush—environment coverage quickly picked up again. From January to May 2001, New York Times reporter Douglas Jehl wrote sixty stories on the environment, many of them displayed on page one.
"I didn't expect this," Jehl told the Columbia Journalism Review. "No matter how you measure it, in terms of volume of copy or prominence of play, there is a lot of environmental coverage today."
The New York Times, the Washington Post, and the Los Angeles Times added environment reporters, anticipating major conflicts thanks to the new Bush Administration. The Tyndall Report found evening news coverage of the issue back up, to nearly six hundred minutes.
"This renewed interest came at a time when the beat was in need of some new twists," said Bud Ward, then executive director of the Environmental Health Center in Washington, D.C. "There was a feeling on the part of some editors that we're talking about the same problems as twenty years earlier," Ward said. "Environmental problems today are more subtle than smog over Pittsburgh."
The September 11, 2001, terrorist attacks, a war in Iraq, and the nation's sputtering economy (which might be used to rally support for decreased environmental protections) will present a new challenge to the coverage and interest in environmental issues. The environmental beat also faces an internal pressure. More newsroom staffs are being pared as the economy contracts and media competition increases.
But the last forty years have shown that each time interest in the topic wanes, enterprising reporters rekindle it. Their future attention or lack of it may play a pivotal role in how much larger the issue becomes in national politics.
"To report news about global warming in 10 inches of copy presents daunting challenges to even the most knowledgeable and skilled environmental reporter and editing team," Ward wrote in a recent issue of Nieman Reports that explored coverage of environmental issues.
Ward continued: "But the ways in which reporters and editors, correspondents and producers confront these challenges—the ones inside and outside the newsroom—will have a large effect in determining how Americans and their government anticipate and respond to continuing environmental pressures."
see also Popular Culture.
Hill, Gladwin. (1973) Madman in a Lifeboat: Issues of the Environmental Crisis. New York: John Day Co.
Keating, Michael. (1993). Covering the Environment: A Handbook on Environmental Journalism. Ottawa, Ontario, Canada: National Round Table on the Environment and the Economy.
Shabecoff, Philip. (2000). Earth Rising: American Environmentalism in the 21st Century. Washington, D.C.: Island Press.
Society of Environmental Journalists Web site. Available from http://www.sej.org.
"The mission of the Society of Environmental Journalists is to advance public understanding of environmental issues by improving the quality, accuracy, and visibility of environmental reporting."
—Gladwin Hill, New York Times, December 30, 1979">
"The enthusiasms of Earth Day 1970 have been institutionalized in legislation, regulation, litigation, political dynamics and new personal values, and woven into the fabric of national life."
—Gladwin Hill, New York Times, December 30, 1979
PULITZER PRIZES AWARDED FOR ENVIRONMENTAL REPORTING
• 1967—PUBLIC SERVICE
• 1971—PUBLIC SERVICE
Winston-Salem (NC) Journal and Sentinel: For coverage of environmental problems, as exemplified by a successful campaign to block strip mining operation that would have caused irreparable damage to the hill country of northwest North Carolina.
• 1979—NATIONAL REPORTING
James Risser of the Des Moines (IA) Register: For a series on farming damage to the environment.
• 1992—PUBLIC SERVICE
Sacramento (CA) Bee: For "The Sierra in Peril," reporting by Tom Knudson that examined environmental threats and damage to the Sierra Nevada mountain range in California.
• 1996—PUBLIC SERVICE
News & Observer, Raleigh, NC: For the work of Melanie Sill, Pat Stith and Joby Warrick on the environmental and health risks of waste-disposal systems used in North Carolina's growing hog industry.
• 1996—EDITORIAL WRITING
Robert B. Semple, Jr. of the New York Times: For his editorials on environmental issues.
• 1998—INVESTIGATIVE REPORTING
Gary Cohn and Will Englund of the Baltimore Sun: For their compelling series on the international ship-breaking industry, that revealed the dangers posed to workers and the environment when discarded ships are dismantled.
MASS MEDIA. The term "mass media" refers to various audiovisual culture industries that send content from a particular source to a wide audience—for example, recorded music and television. The twentieth century in the United States was characterized by the transformation of artisanal, local hobbies and small businesses into highly centralized, rationalized industries working like production lines, and the entertainment and informational media were no different. In the process, pleasure was turned into profit. And when governments occasionally intervened to regulate, or alternative technologies destabilized established forms and interests, ways were found of accommodating threats or capitalizing on others' innovations, resulting in renewed corporate control over each medium. For instance, when newspapers were confronted with radio and then television, they bought into these sectors as quickly as possible, where cross-ownership laws permitted. Even the Internet, initially celebrated as a source of freedom from centralized control, has gradually come under corporate domination.
These tensions are played out in the history of radio and motion pictures. Radio began in the 1920s as a means of two-way communication, a source of agricultural stock-price and weather information, a boon to military technology, and a resource for ethnic cultural maintenance. Then radio became a broadcast medium of networked mass entertainment dominated by corporations in the 1930s that was confronted with wartime censorship and the advent of television as an alternative in the 1940s. It was transformed by popular music and the Top Forty in the 1950s; saw the emergence of college radio and frequency modulation as sites of innovation in the 1960s; and felt the impact of Spanish-language and right-wing talk stations in the increasingly deregulated environment of the 1980s and 1990s.
For its part, the motion picture industry began among textile merchants in New York City, who made films as segments of vaudeville shows. Around the time of World War I (1914–1918), the cinema shifted from depicting actual events and tricks to fictional narratives told in longer forms. This coincided with the rise of trade unions in New York, which, together with climatic considerations, encouraged the industry to shift to California. Filmmaking enterprises emerged and became fully integrated companies, called studios. Each studio owned the labor that made the films, the places where they were shot, the systems by which they were distributed, and the places where they were watched. The federal government intervened after World War II (1939–1945) because this vertical integration was seen to jeopardize competition, and the studios were required to sell off many of their assets. Combined with the advent of television and the suburbanizing movement of population in the late 1940s away from the inner cities (where most theaters were located), this posed a threat to Hollywood. But it managed to reduce costs, sell its product to television, and survive, later becoming linked to other cultural sectors and diverse industries from banking to gin.
Various debates about the mass media have recurred since the beginning of the twentieth century. Most of the U.S. population learned to read with the spread of public schooling. At that point, newspapers divided between those appealing to the middle and ruling classes (today's broadsheets) and the working class (today's tabloids). Ever since, there has been controversy about appeals to popular tastes versus educational ones (that the press will print, and people will prefer rap versus opera and sex crime versus foreign policy). This division is thought to exacerbate distinctions between people who have power and knowledge and other groups. There has also been a debate about concentration of media ownership, which has often generated conflicts of interest and minimized diverse points of view. The most consistent disagreements have been about what are called hypodermic-needle effects on audiences. This concept assumes that what people read, hear, and see has an immediate and cumulative impact on their psyches. Beginning with 1930s panics about movies affecting young people, this perspective became especially powerful with the advent of television. There have been vast numbers of academic studies and public-policy debates on the topic of violence in the media ever since. Such debates reach the headlines whenever an individual embarks on a killing spree—but never when the U.S. military invades another country or engages in covert action and the media accept images and stories provided by the government itself, as per conflicts in Panama and Afghanistan.
Another recurring debate, which began in the 1960s, has been over the extraordinary success of the United States in dominating the media around the world. Accusations have been made of U.S. cultural imperialism, a process whereby the political imperialism of the nineteenth and twentieth centuries has been superseded by the ideological capture of subordinate populations—this time through advertising and popular culture as much as guns and government, with the United States developing into a mass exporter of media products and a prominent owner of overseas media. And when the United States became a more and more indebted nation as a consequence of corporate welfare and military programs favored by successive federal governments, the mass media provided key sources of overseas revenue and capital to offset this crisis.
The twentieth century saw the U.S. mass media multiply in their technological variety but grow ever more concentrated in their ownership and control. The twenty-first century promises more of the same, with an aggressively global strategy to boot.
Herman, Edward S., and Robert W. McChesney. The Global Media: The New Missionaries of Global Capitalism. London: Cassell, 1997.
Hilmes, Michele, and Jason Loviglio, eds. Radio Reader: Essays in the Cultural History of Radio. New York: Routledge, 2002.
Miller, Toby, ed. Television: Critical Concepts, 5 vols. London: Routledge, 2002.
Schiller, Herbert I. Culture Inc.: The Corporate Takeover of Public Expression. New York: Oxford University Press, 1989.
———. Mass Communications and American Empire. 2d ed. Boulder, Colo.: Westview Press, 1992.
Sklar, Robert. Movie-Made America: A Cultural History of American Movies. 2d ed. New York: Vintage Books, 1994.
Earliest advances in mass communications were in the written print technologies, where the printing innovations of Caxton in the 15th cent. developed eventually into the newspaper and magazine industry of the industrial era—first the broadsheet ‘quality’ press and periodicals of the early 19th cent., then the tabloid ‘popular’ press, magazines, and comics of the late 19th cent. New means of reproduction for drawings and photographs created more visual mass communications. When the illusion of movement was created by projecting still images at 16 frames per second in the 1890s, the powerful mass medium of cinema was created.
With the developing electrical technologies of the 19th cent., a realistic reproduction of the human voice was created, first in the gramophone and the telephone, which began to replace telegraphy from the 1870s. Experiments in wire-less telegraphy by Marconi in the 1890s confirmed that messages could be transmitted on sound waves, and with the human voice carried on these waves, the influential medium of radio was developed through the early years of the 20th cent. When a similar means of transmitting visual images was developed, television was launched in the 1930s, and when sound was married to cinema's silent images from the late 1920s, the inter-war range of innovative audio-visual media was complete. The quickening pace of technological change after the Second World War—with microchips, digitization, laser, and fibre optics bringing video, satellite, cable, CD-ROM, and the Internet—has meant that the media can now be used to transmit messages instantly on a world stage to the biggest mass audiences imaginable.
Accompanying each stage of the mass media's development have been struggles and debates over who owns and controls these vital means of communication, who can get access to them, and what messages should or should not be allowed. In Britain, there has been a tradition of strong government regulation, compared with the generally laissez-faire approach of free enterprise USA. Stamp duty and other taxes on the early press were meant to keep potentially seditious literature out of the hands of the masses—though the working classes developed their own means of communication in the underground radical press. Ironically a more efficient way of controlling the masses' reading was developed when the government ‘deregulated’ the system with the abolition of stamp duty in 1855, and a flood of non-political popular papers arrived to divert the energies of the working class.
Television and radio have always been highly regulated—both the official ‘voice of the nation’ the British Broadcasting Corporation, and commercial ‘independent’ TV and radio stations. Where there is no direct government Act or royal charter to set standards, self-regulation has been encouraged, such as the film industry-sponsored British Board of Film Censors (now Classification) set up in 1912; press control bodies like the Press Council (now the Press Complaints Commission); broadcasting control bodies like the Independent Broadcasting Authority (now Independent Television Commission), the Radio Authority, the Broadcasting Complaints Commission, and the Broadcasting Standards Council. The problems of regulating a world-wide medium like satellite TV were major causes of concern to British politicians of the late 20th cent.
The phenomenon of the ‘moral panic’ has regularly followed the development of each new mass medium, with establishment fears that the young, the working class, the outsiders of society will be corrupted by the media products and contribute to the decline of society—whether it be Victorian ‘penny dreadfuls’, early cinema adventures, American comics in the 1950s, the ‘video nasty’ scares of the 1980s, or pornography on the Internet in the 1990s. Fears have also been regularly expressed about the swamping of British culture by brash American media-led values—Hollywood cinema, American comics, rock and roll music, and ‘trashy’ television.
From the left, the main concerns have centred round questions of ownership and control, with power concentrated in the hands of a series of media tycoons, from the early 20th-cent. newspaper magnates like Northcliffe, Rothermere (the Harmsworth brothers), and Beaverbrook to the late 20th-cent. multi-media owners such as Maxwell and Murdoch. Further concerns about the role of the media in transmitting ideology—both obviously in non-fictional news and propaganda, but also more innocuously in the form of apparently ‘value free’ entertainment—will ensure that the mass media remain a constant subject of controversy and debate.
Douglas J. Allen
CBS Suffers Fallout from "60 Minutes" Story on President Bush
On January 5, 2005, an independent investigative panel headed by former U.S. Attorney General Dick Thornburgh and retired Associated Press President and CEO Louis Boccardi handed down its 234-page report to media mogul CBS, in which the panel was critical of the network's "60 Minutes" division for inaccurate and undocumented news reporting. The panel had been convened to investigate the everexpanding fallout from the controversial September 8, 2004 "60 Minutes II" television broadcast in which anchorman Dan Rather presented a story critical of President Bush's Vietnam War-era military service in the Texas National Guard. The story ostensibly relied on documents that the network claimed were written by Bush's then-commander, Lt. Col. Jerry Killian. In them, Killian complained of being pressured to give Bush favorable evaluations, and also complained about other alleged incidents of Bush's conduct, e.g., his failure follow orders; his failure to take a mandatory physical examination; his use of family connections to secure a lofty pilot position within the Guard.
Just hours before CBS released the report's findings, at least four CBS News executives were terminated without incident. (It was later reported that they remained on the payroll and had retained legal counsel.) They included Josh Howard, executive producer of "60 Minutes Wednesday;" Mary Murphy, senior broadcast producer; and senior vice president, Betsy West. The fourth member of the exiting staff was Mary Mapes, the highly visible producer who developed the report, who had worked on the story since 1999 but failed to find any expert who would fully vouch for the documents. Several media articles appearing in such sources as USA Today and the Washington Times reported that Mapes obtained the documents from a highly suspect (i.e., of questionable credibility) source who still had not identified their true origin. In November 2004, several weeks after the September 8 airing of the story, Dan Rather announced his retirement as anchor of the "CBS Evening News." "We deeply regret the disservice this flawed '60 Minutes Wednesday' report did to the American public, which has a right to count on CBS News for fairness and accuracy," CBS President Leslie Moonves publicly stated.
The suspect four documents and story were widely reported by all forms of the media, just weeks and days before the 2004 presidential election. However, almost immediately after the story broke, various Internet sources began to question the credibility of the documents, which used typewriter fonts not even available when they were allegedly written more than 30 years ago by Killian, now deceased. The controversy quickly spread.
CBS later stated that it had received the subject documents/memoranda from "Bill Burkett," a former National Guard officer who said he once observed some of Bush's records in the trash, after the then-Texas governor's aides were allowed to review the military file. Experts hired by CBS admitted they could not verify the authenticity of the documents.
In words that may well become the enduring catch phrase for the scandal, the lengthy investigative report found that the involved CBS employees were guilty of "myopic zeal" to get the story on the air before other networks, without regard for proper authentication and channeled verification. The report also concluded that the network, once faced with the credibility challenge, compounded the error by adhering to a "rigid and blind" defense of its story. Specifically, the report blamed producer Mapes for not being forthcoming with her superiors about the documents. Moreover, the other three terminated staffers failed to ask basic questions that would have revealed the shallow sourcing of the story, the panel concluded. While the panel reported that some actions taken by CBS tended to encourage suspicion about its motives, it did not find the story was motivated by political bias,—a conclusion not universally accepted by other media sources.
Following release of the investigative report, lawyers at the U.S. Justice Department also reviewed the alleged documents for evidence of forgery, but concluded that no federal laws were violated. A department official advised United Press International, "There was just no federal statute that applied."
A revealing article on the scandal appeared in the Washington Times on January 18, 2005. The article alluded to specific flaws in the purported documents (e.g., typographical errors, wrong header and address, signatures, etc.). More impressively, the article, entitled "Exposing CBS," checkmated one document as "fake" by showing that the weekend identified in the document as that when 1st Lt. Bush was ordered to report for his physical, was actually Mother's Day weekend, and the Ellington Air Guard Base, where Bush was allegedly ordered to report, was closed. The author of the article,
William Campenni, served as a pilot in the Texas National Guard in the early 1970s. Concluded Campenni in his article,
While CBS, in its rush to judgment, might have missed this fatal flaw in the Burkett memo, its investigative law firm, Kirkpatrick & Lockhart Nicholson Graham LLP, cannot be excused. Why? Because one of their investigating lawyers was informed of this fact on Nov. 15 and given a list of seven witnesses who worked in the same offices with Jerry Killian every day in 1972. The panel report makes no mention of this, and a canvass of most of the witness list reveals no contact attempt by Kirkpatrick & Lockhart, [who were paid] big bucks for this report.