Getting on the Public’s Agenda
One of the most important roles that media plays is getting issues on the agendas of the public and policymakers. What the mainstream media do or do not cover is equally powerful in determining what issues are considered by policymakers.
The news media are instrumental in getting issues onto the agenda of policymakers, but non-news entertainment television programs can mobilize public constituencies around an issue. Television continues to be the dominant form of media in most people’s lives, despite the rise of new forms of media online. The television is on more than 8 hours a day in the average American household (Nielsen Reports, 2007). Teenagers still spend more time watching TV than they do online (Generation M2, 2010). The Internet may be where people go to find out about a health issue, but they often first become aware of the issue through television.
Turow (1996) points out that non-news television entertainment is particularly loaded with rhetoric that often stereotypes power relationships and may be more successful than the news in shaping people’s images of the world. Highly viewed TV presentations of health care hold political significance that should be assessed alongside news. Medical and nursing dramas on broadcast and cable television, such as Grey’s Anatomy, ER, and Nurse Jackie, are often important sources of information about health and health policy for a wide audience. Researchers Turow and Gans (2002) systematically evaluated one television season of four hour-long medical dramas and found that health care policy issues appeared regularly in the programs. Evidence from a national telephone survey indicates that the percentage of regular viewers of the show ER who were aware that HPV is a sexually transmitted disease was higher (28%) one week after viewing an episode of the show about HPV than before seeing the show (9%). Even 6 weeks after viewing the episode, 16% had retained this knowledge. This capacity to quickly get a message out to millions of people through an hour-long drama is part of the reason that many health advocates work to get their particular issue included in a storyline of a major network drama. For many working in public health, storyline placement is considered the “gold standard” for achieving advocacy goals.
Perhaps not surprisingly then, when National Institutes of Health (NIH) wanted to get out a message that “drug addiction is a brain disease,” they turned to HBO. In a landmark collaboration between HBO, the NIH, and the Robert Wood Johnson Foundation, the cable network launched The Addiction Series (2007), an award-winning collection of documentary films about substance use, each by a leading director. Of course, The Addiction Series also included a website with more information about treatment options and a lively discussion board (Bauder, 2007).
Documentary films, in conjunction with online campaigns, are influencing health policy and politics, while achieving mainstream commercial success. For example, Morgan Spurlock’s Super Size Me (2004) explored the health impact of fast food on childhood obesity, fueling changes in local school and community policies requiring posting of calories in fast food stores, changing the foods and beverages available in schools, and ramping up exercise options in schools. Michael Moore’s documentary SiCKO (2005) examined health care policy in the U.S., helping to raise the public’s awareness of how bad the U.S. health care system had become at a time when health care reform was on the nation’s agenda. Many of those who were uncertain about whether or not health care reform was needed became converts after watching SiCKO.
For some media activists concerned with health policy, Internet technologies have transformed documentary films into just one element in a multimodal social action campaign. Perhaps the archetypal example of how media is converging across multiple platforms and creating change in awareness about health and galvanizing movement for policy change around an important health issue is the development of Food, Inc. (2008). In 2001, journalist and filmmaker Robert Kenner read Fast Food Nation, a book by Eric Schlosser about the rise of agribusiness, and Kenner was appalled. He wanted to do something about the industrialization of the food supply, so he started work on the documentary that would eventually become Food, Inc. Kenner collaborated with Schlosser on the film (Schlosser is listed as co-producer). The online presence for Food, Inc. (www.foodincthemovie.com) is a vast repository of further information about the issues surrounding the industrialization of food. It includes opportunities to participate in activism, such as signing the online petition to reauthorize the Child Nutrition Act, which would support healthy food choices in schools. The film also inspired another book (Food, Inc.), an e-version that can be downloaded at the website, or a hard copy can be ordered from online booksellers. The social action campaign around Food, Inc. started with a heavily researched book and became a documentary film, a website, another book, and links for people to take action. This exemplifies how people are converging media to shape health and health policy.