28 FEB 2025
The Intersection of Health & Journalism
Author: Dr Dipannita Kaushik, Public Health Expert, Co-Founder DIBHA Foundation
Intersection of Health & Journalism is crucial
Introduction
Media has a very strong potential to influence health behaviour of people. It is expected to provide with accurate, unbiased and complete health information. However, the media we consume, especially in India is often flooded with conflicting information from different sources. There is minimal specialised trainings available for media personals who interpret and report complicated health statistics and jargons. Very little has been done to assist journalists in interpreting scientific developments for the public. Mutual efforts of health‐care professionals, researchers and journalists using a variety of approaches is required to address these constraints. However, the contact between journalists and physicians is often a meeting between two diverse cultures with many possibilities for misunderstanding.
History
In the world history, media is clearly known to have withhold the reporting of multiple diseases and health conditions suffered by world leaders and country Presidents for the purpose of keeping it a secret. On the contrary, there are instances from the past where media has been useful in health reporting and awareness generation; for example, pamphlets and personal appeals were used to promote immunization during a smallpox epidemic in Boston in 1972. Another example of a public health campaign was after the discovery that M. tuberculosis causes TB which was communicable but preventable. An ordinance was issued that prohibited spitting in public places and media helped the public health department to drive this behaviour change intervention to prevent the spread of TB. Awareness about the HIV-AIDS epidemic and political attention to it was also increased by media reporting. Very recently, the role of media during the COVID19 pandemic was also a significant one.
Media and Health
Countries like UK and Australia have now come up with their Science Media Centres to enable efficient science communication. In 2004, Australia launched the Media Doctor website with an aim to provide an objective analysis of the strengths and weaknesses of the health stories appearing in the Australian mainstream media. It also aimed to increase the completeness of health stories and, subsequently, health literacy among journalists and media consumers. The Indian Institute of Science Education and Research, Pune has now developed its own Science Media Centre. It also conducts workshops to train personnel in print and electronic media to encourage science communication.
However, the responsibility for accurate health reporting is not solely the jurisdiction of the media. Researchers and medical journal editors need to provide balanced and accurate media releases on published studies, designed to inform journalists, and through them the public, rather than generate a high media profile for the journal.
A report in the New England journal of Medicine presented the results from a national poll of 2256 adults commissioned by the National Health Council. 75 percent of those surveyed said they pay 25-50%(moderate to high level) of attention to medical and health news reported by the media. Primary sources of health news listed by these respondents were television (40%), doctors (36%), magazines /journals (35%), newspapers (16%) and internet(2%). 58% reported some kind of behaviour change/action after reading, seeing or hearing a health news story and 42% reported seeking further information. 53% said that when they have mentioned a media report to their doctor, he/she has been "happy" to talk about it, and 7% reported that their doctor did not take their question seriously. 45% percent said that these encounters have improved their relationship with their doctor. A vast majority (80 %) reported that they have never read, seen, or heard a media medical report or health news story that led them to question their doctor's advice. In the US, public pays attention to health in the media. 50% of U.S. adults report that they follow health news closely.
During the swine flu epidemic, it was crucial for public health to use media to influence health practices while hitting the correct pitch. The publication about relative risks of medication in general media can result in significant numbers of people stopping their medicines, with potentially harmful impact of it. Press coverage of dramatic medical stories, such as organ transplants, often raise unrealistic expectations and may promote new technologies that have not been adequately evaluated.
Although the impact of health‐care reporting is difficult to measure, the mass media can influence individual health behaviour, health‐care utilization, health‐care practices, health policy and the stock market. In many countries people have a right to make informed decisions about their own health. But only with exposure to correct information this right can be executed effectively. Even policy makers and healthcare professionals get medical information from the mass media and this can affect their work.
Obstacles
It has been repeatedly pointed out that many journalists have difficulty distinguishing between relative and absolute measures of change. There is evidence that many journalists feel they lack the medical knowledge to question the authority of experts. Lack of time, space and knowledge are the most common obstacles. The importance of different obstacles varied with the type of media and experience. It is often difficult for health reporters to find independent experts willing to assist them, and also editors need more education for critical appraisal of medical news. Although most journalists will agree that the informative value of their reporting is important. Nearly everyone wanted access to short, reliable and up‐to‐date background information on various topics available on the Internet. A study found four problem areas: sensationalism, biases and conflicts of interest, lack of follow-up, and stories that are not covered. There are many other barriers to increasing quality of health and medical reporting. These include: lack of technical training for journalists, the time constraints of news production, and the commercial imperatives that drive story selection and headlines. The daily schedule and strict deadlines dominated the days of all the journalists. Most journalists had only a concentrated time window to assemble their story and also broadcast was very brief and could not cover the entire story. Commercialism was also perceived to be an obstacle.
A recent study (Voss, 2002) highlights reporters' self-perceptions about their own ability to report health news. In response to questions about reporting ability, 49.7 per cent of respondents reported it was sometimes easy and sometimes difficult to understand key health issues, and 31 per cent found it often or nearly always (2.7 per cent) difficult to do. Also, 51.3 per cent of respondents reported that it was sometimes easy or sometimes difficult to interpret statistical data, whereas 27.4 percent found it often or nearly always (6.2 per cent) difficult. More than 83 per cent reported that they had no training at all.
Recommendations
Several authors have discussed problems with the dissemination of health information to the general public through the mass media and recommend better education for journalists. Physicians and scientists who are concerned about coverage of medicine in media can come up with specific strategies to help resolve the problem.
Peer review could be a potential solution. A study found four characteristics of reviewers that predicted better-quality reviews: younger age, affiliation with a top academic institution, familiarity with the journal's editor, and masking of the name and institutional affiliation of the author of the study.
The Ingelfinger rule by Dr. Ingelfinger said that the Journal will not publish an article whose substance has been reported previously. His motivation for this policy was driven by both concern about quality (the need to allow time for peer review before the information is disseminated to the public) and economic issues (the desire to prevent other publications from scooping the Journal ). Today, majority of medical scientists and practicing physicians support this policy. But it is despised by many members of the medical journalism fraternity, because they feel it smothers the free exchange between scientists and journalists until the time of publication. Embargo policy allows reporters some lead time to investigate and prepare reports and make them more accurate and understandable.
General News vs Medical News Reporting
General news consists of relatively confined events that can be reported according to the traditional checklist of journalists — the famous who, what, where, when, and why. In contrast, medical news does not usually happen at an isolated point in time that can be summarized by those descriptions. Medical information is part of an ongoing stream of experimentation and data production that typically grows out of past experiments and will undoubtedly change, often very quickly, with future experiments. In contrast to general news, which is based on facts, sources and opinions, medical information is traditionally based on data, probabilities and conclusions. Unlike the reporting of standard news, which requires general journalistic skills and familiarity with the subject matter, good medical-news reporting requires additional and very specific skills in the understanding of biostatistics and epidemiology. Given that most medical news stems from scientific studies, I think it is virtually impossible to do a good job of analysing and reporting such information without a basic grounding in knowledge of such matters as the strengths and weaknesses of descriptive studies, analytical studies, the evaluation of association, possible contribution of chance, bias, and confounding variables, potential causation effect and the critical difference between relative and absolute risk in real-life interpretation of results.
The need for such knowledge leads directly to the controversial and complicated question of whether or not those who report medical news should have any special training or credentials. A study found that in one case, the author himself realized that his training as a physician was inadequate to practice medical journalism and that's why he went to Harvard School of Public Health to get a basic understanding of biostatistics and epidemiology. This doesn't mean that all medical journalists must take such a formal approach to their training. But the fraternity of medical journalists should develop some kind of system to ensure that those who wish to become medical journalists have a basic knowledge of the subject and some way of certifying them that would be recognized by employers and consumers. The fact is that we automatically expect our sources on the medical side of the medicine–media equation to have some kind of credentials but we do not expect it on the media side.
A good medical journalist today must take the time and trouble to study the kinds of skills mentioned above and then pass some sort of reasonable examination to prove one's knowledge. Obviously, the question of who should develop and administer such an examination is extremely difficult. But as has been demonstrated in many other areas, it is possible. Such training would also enable to solve certain stylistic tensions that exist between scientists and reporters. Readability in the eyes of a journalist may be over-simplification to a scientist. Arguments over words, such as "breakthrough" and "best" and "epidemic" and "dangerous," and difference of opinion over the use of a human-interest story to illustrate the report is presently inevitable. For the scientist, such a story is just one piece of information in a large pool of data. But for the journalist, the story can create an ineradicable imprint on the viewer that will supersede any discussion on its qualification; if the story is true or if it is helpful or misleading.
Conclusion
Scientists blame this problem on the press, claiming that reporters are careless about how they present medical research. Reporters, in turn, accuse the medical community of obstructing, misguiding, or failing to alert the press. Media critics suggest that the difficulty lies with the audience. People must be more attentive and more sceptical when they interpret health news. Journalists and scientists share combined responsibility for accurate health communication to the public. Journalists working in the medical field are often accused of being sensational, speculative and paying too much attention to circumstantial findings. Reporters, on the other hand, find scientists unable to describe their research in comprehensible terms, or interested in using mass media to promote their own interests.
Some efforts undertaken as a part of the solution to the problems in media reporting of health include the Kaiser Media Fellowships in Health that provide print or broadcast journalists and editors interested in health issues with an annual stipend that allows them to pursue individual projects on a wide range of health and social policy issues. There is also the Kaiser Media Internships in Urban Health and the Kaiser Media Mini-Fellowships to provide travel and research grants to journalists to research and report on health policy and public health issues. The Association of Health Care Journalists (AHCJ) is an independent, not-for-profit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy, and visibility of health care reporting, writing, and editing. It offers workshops and training resources on current and emerging issues in health care and reporting skills.
