Communication for Health Health Article

COMMUNICATION FOR HEALTH

Communication has long been an important tool in health promotion, and during the closing decades of the twentieth century it became an essential part of public health programs. Although its roots date back hundreds of years (to Cotton Mather's smallpox vaccination campaign during Colonial American times), if not thousands of years (to Aristotle's theories of persuasion), the field of public health communication is very much an outgrowth of contemporary social conditions.

Demographic, social, and technological trends that developed over the second half of the twentieth century fostered conditions in which the value of good health information, and thus the value of effective health communication, became increasingly clear. Throughout the twenty-first century, public health communication is likely to become increasingly integrated with the core public health disciplines, especially health education and health promotion. Other public health disciplines, including epidemiology, health policy, occupational health, environmental health, international health, and health services research, are coming to appreciate both the fundamental importance of communication processes and the potential of effective communication to improve the public's health.

COMMUNICATION RESEARCH, THEORIES, AND INTERVENTIONS

Public health communication includes a continuum of activities that span from research to interventions. Communication theory can and should be used to inform the research and intervention activities along this spectrum.

The purpose of health-communication research is to understand the processes of communication, how communication can help to improve health, and the effects of communication itself on health outcomes. Research questions that have attracted considerable interest include: Does violence in the media cause violent behavior? Is the increasing rate of childhood obesity the result of an increase in electronic media use? Does bias in news media coverage lead the public to worry excessively about rare health risks while ignoring more prevalent health risks? Do people process health information in systematically biased ways that contribute to "irrational" decision making? Does the news media tend to "frame" public health issues in a manner that obscures the true nature of the problem (and thereby obscuring the most promising solutions)?

Answers to these and other research questions are used to develop communication interventions that effectively improve health outcomes. For example, the National Institutes of Health (in partnership with health professional associations, voluntary health agencies, and pharmaceutical companies) has conducted a communication campaign that has contributed to more than a 60 percent reduction in the death rate from stroke. Sudden infant death syndrome (SIDS) campaigns conducted around the globe during the 1990s led to rapid and dramatic (50–80%) reductions in death rates from SIDS. In 1998 and 1999, the state of Florida conducted a mass media and grassroots youth antismoking campaign (the "Truth" campaign) which reduced rates of smoking among middle school students by 40 percent and among high school students by 18 percent. The "Truth" campaign was funded through Florida's financial settlement with the tobacco industry. Florida's settlement, and the settlement signed by most other states was in large measure the result of successful public health communication efforts to reframe the tobacco issue. Previously, the media tended to frame smoking as an issue of individual choice. Communication efforts of the Campaign for Tobacco-Free Kids and other organizations during the mid-1990s succeeded in reframing the issue in terms of the tobacco industry's persistent unethical business practices and attempts to entice children to become addicted smokers.

Communication theory (which draws from a broad range of other social science and behavioral science disciplines) is the interface between health communication research and health communication interventions. Communication research is used to develop and test theories of communication, information processing, and human behavior. These theories attempt to explain how and why people process health information, the impact of communication and information on behavior, and how factors in the social and physical environment mediate the relationship between communication and behavior. Theories that have been shown to have useful predictive and prescriptive power (such as social cognitive theory, the theory of reasoned action, stages of change theory, theories of risk perception, and framing theory) are a powerful asset in planning successful public health communication interventions.