The Role of Media in Public Health

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The Role of Media in Public Health

• Professor SH Lee
• Emeritus Professor of Community Medicine
• The Chinese University of Hong Kong

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What is Public Health?
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Definition of Public Health

• The science and art of promoting health,
  preventing disease, and prolonging life through
  the organized efforts of society.
• (Acheson Report, London, 1988)

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The New Public Health Movement
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Up-stream Approach
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Determinants of Health
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Determinants of Health

• Personal health practices and coping skills
• Biological and genetic endowment
• Environmental risk factors
• Social and economic factors
• Health Services

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Personal health practices and coping skills

• Smoking
• Diet
• Obesity
• Lack of exercise
• Stress
• Alcohol abuse
• Drug misuse
• Sexual practices

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Tobacco
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Smoking
1994

• Source HKCOSH

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Substance Abuse
1990 - 1999
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Substance Abuse
1992 - 1999
Population
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Obesity Student Survey
95/96 - 98/99
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Biological and genetic endowment

• Gender differences
• Physiological, anatomical and mental capacities

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Environmental risk factors

• Physical environment
• Radiation exposure
• Workplace hazards
• Infectious agents
• Home hazards
• Traffic
• Product design

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Social and Economic factors

• Income and social status
• Social support networks
• Education
• Employment and working conditions
• Social disintegration
• Overpopulation
• Geography and Transportation

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Health Services

• Accessible preventive and primary care services
• Healthy child development services
• Personal health services e.g.
• Student health
• Women health
• Elderly health

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Genetic Influences
Health and Medical Services
Lifestyle
HEALTH
Social, Economic Cultural Environmental
Conditions
The Health Field Concept
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The Ottawa Charter for Health Promotion and the
Jakarta Declaration
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Definition of Health Promotion
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U.S. Department of Health
Education and Welfare (1979)
A combination of health education and related
organizational, political and economic
programmes designed to support changes in
behaviour and in the environment that will
improve health.
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Nutbeam (1985)
The process of enabling people to Increase
control over the Determinants of health and
Thereby improve their health.
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WHO (1984) (1986')
The process of enabling people to increase
control over their health. and thereby to
improve their health.
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Health Promotion

• Targets towards whole population
• Basically healthy
• Involvement of community and individual measures
• Promotion of healthy lifestyle
• Goal to enhance state of well being

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Disease Prevention

• Activity in the medical field
• Dealing with a disease or environmental threat
• Protects individuals or groups of population at
  risk
• Aims to conserve health

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Disease Prevention
Primary Prevention
Prevention of disorders before they occur e.g.
vaccination, healthy lifestyles
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Disease Prevention
Secondary Prevention
Early diagnosis and treatment e.g. screening
programmes
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Disease Prevention
Tertiary Prevention
Reducing burden of disability to individual and
society e.g. treatment and rehabilitation
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Five Priority Actions Of Ottawa Charter for
Health Promotion

• Build Healthy Public Policy
• Create supportive environment for health
• Strengthen community actions for health
• Develop personal skills
• Re-orient health services

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Ottawa Charter for Health Promotion
An International Conference on Health
Promotion The move towards a new public
health November 17-21, 1986, Ottawa, Ontario,
Canada
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The Jakarta Declaration on Leading Health
Promotion into the 21st Century (1997) Five
priorities for action

• Promote social responsibility for health
• Increase investments for health development
• Expand partnerships for health promotion
• Increase community capacity and empower the
  individual
• Secure an infrastructure for health promotion

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Mass Media and Public Health
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The meaning of Mass Media

• Two key features
• Mass audience
• Message is mediated

Source Health Promotion effectiveness,
efficiency and equity, Keith Tones and Sylvia
Telford
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Mass Media in Health Promotion

• The difference between health marketing and
  commercial marketing
• Health promotion, ethical and professional goals
• Difference in size of budgets
• Health education programmes set standard often
  too high

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Mass Media in Health Promotion

• The nature of the product in offer is different
• The health education product frequently
  intangible and gratification seen only at distant
  future
• Deep seated attitudes not easy to change

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Mass Media in Health Promotion

• Ten key marketing concepts in health promotion
• Market philosophy
• The four Ps of marketing product, price,
  place, promotion
• Hierarchy of communication effects
• Audience segmentation

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Mass Media in Health Promotion

• Understand all the relevant markets
• Feedback
• Interpersonal and mass communication interactions
• Commercial resources
• Competition
• Expectations

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Mass Media and Public Health Advocacy
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Public health advocacy

• Sometimes called public health lobbying
• Process of over coming major structural barriers
  to public health goals
• Such barriers could be political, economic or
  cultural

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What are the components of an effective public
health advocacy campaign?

• Information
• Health Professionals
• Skilled Professionals
• Partnerships or Coalitions
• Champions or Leaders

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Skills required in effective public health
advocacy

• Competency and understanding of subjects and
  roles
• Political science, sociology of mass
  communication
• Structuring of media
• Health issues
• Networking techniques

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Skills required in effective public health
advocacy

• Community educators and organizers
• Journalists
• Lawyers and political analysts / advisers
• Research
• Evaluation

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Does it work?

• Governments (and organizations) tend to adopt
  policies only in activities of public headiness,
  using the principles that Governments
  (organization) should not move far from what is
  perceived to be public opinion

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What are the conditions for success in public
health advocacy?

• A recognized constituency
• Building community agreement that an issue is a
  priority for action and that the proposed
  solutions are acceptable

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What are the conditions for success in public
health advocacy?

• Empowered communities
• A feasible solution (a feasible solution is not
  necessarily based only on, for example,
  epidemiological evidence. Many different types of
  evidence can be used by politicians, and
  managers when mainly policy decisions)

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Mass Media

• The mass media, by definition, reach mass
  audiences, including key political and
  bureaucratic decision makers. If well informed
  about the process of news reporting, public
  health advocates may be in the position of
  influencing journalist to report issues in ways
  more consonant with public health objections.

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Case Studies in Public Health Advocacy in Health
Education and Health Promotion
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Case Study 1

• Smokeless
• Tobacco

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Case Study 2

• Tobacco advertising in printed media and outdoor
  advertising

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Case Study 3

• Prohibition of smoking in restaurants and other
• public indoor premises

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The Asia Pacific Association for the Control of
Tobacco (APACT)
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The Hong Kong Declaration APACT 2001

• The Asia Pacific Association for the Control of
  Tobacco (APACT) recognizes that tobacco use is a
  major cause of death in the Asia-Pacific region
• The current pandemic of tobacco-related diseases
  is causing tremendous harm and an excessive
  burden on the economy.
• Everyone, especially children, has the right to
  live in a tobacco-smoke free environment.

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The Hong Kong Declaration APACT 2001

• Of all the children alive today in Asia, a
  conservative estimate is that at least 150
  million will eventually be killed by tobacco.
• There is a need for an urgent effort to contain
  this pandemic of tobacco-related diseases as well
  as its terrible effects on the environment and
  the economy. If it is to effectively prevent
  young people from smoking, it must be a
  comprehensive programme directed at the entire
  community.

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The Hong Kong Declaration APACT 2001

• A comprehensive regional tobacco control policy
• An end to all tobacco advertising
• Increase in taxes
• Protection of youth
• Regulation and control of tobacco products

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The Hong Kong Declaration APACT 2001

• A comprehensive regional tobacco control policy
• Cessation programmes
• Strong public education programmes
• Support WHO FCTC
• Holding tobacco companies accountable

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The Hong Kong Declaration APACT 2001

• In addition, the 432 participants from 34
  countries to this 6th APACT Conference on Tobacco
  or Health give full support to Hong Kongs
  current legislative proposals, particularly the
  recommendations for 100 smoke-free workplaces
  and restaurants.

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Case Study 4

• Promotion
• of Healthy Cities

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How do we get a Healthy City ?

1. Invite expert to introduce and explain the
   concept of Healthy Cities and talk about
   experience on implementation
2. Seek government and community support and
   participation
3. Establish a Steering Committee to plan and
   co-ordinate Healthy City programme
4. Identify priority health issues (through
   community diagnosis)
5. Develop an action plan
6. Secure potential community and funding support
7. Monitor and evaluation of the project

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Healthy Cities

• Eight Healthy Cities in Hong Kong
• Tseung Kwan O
• Wan Chai
• Central Western
• Kwai Tsing
• Tsuen Wan
• Sham Shui Po
• Wong Tai Sin
• Tai Po

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Case Study 5

• Health Promoting Schools
• and Healthy Schools
• Award Scheme

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School-Based Approach

• Involve Kay Personnel
• School Principals
• School Teachers
• School-based Health Coordinators
• Pupils
• Parents

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School-Based Approach

• Supportive environment and policy making
• Community Partnership
• Participation of Parents
• Networking

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Hong Kong Healthy Schools Award Scheme Opening
Ceremony 20 May 2001
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Case Study 6

• Healthy Workplace

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Healthy Workplace
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Healthy Workplace
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Case Study 7

• Why Canada has been successful in
• Tobacco Control?

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Tobacco industrys survival strategy Nine Ds

• Deny the health consequences of smoking.
• Deceive consumers about the true nature of
  cigarettes through marketing and PR.
• Damage the credibility of industry opponents.
• Direct advertising to women and youth, in
  addition to men, to maximize sales volume.

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Tobacco industrys survival strategy Nine Ds

• Defeat attempts to regulate the industry or
  control smoking.
• Delay legislation if it cant be defeated.
• Destroy legislation once it passes, either by
  trying to overturn the law in court, by
  disobeying the law, or by exploiting loopholes.
• Defend lawsuits filed against the industry.
• Develop new markets around the world.

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Factors for success on Tobacco Control

• Political will
• Bureaucratic support and experience
• Effective advocacy outside government

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Political Will

• To introduce, implement and enforce tobacco
  control measures
• Political support from
• Minister of Health
• Minister of Labour
• Minister of Finance
• Departments support

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Advocacy (lobbying)

• Anti-smoking and health groups
• Tobacco-control campaign
• Collaboration between government and NG sectors

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Use of effective advocacy techniques

• Factors for success
• Health Groups offer the government solutions, not
  just problems
• Unity is strength advocating coalitions

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Use of effective advocacy techniques

• Factors for success
• Coalitions include
• Public support
• Health organization
• Provisional councils
• Consumers
• Religious groups
• Womens organizations
• Volunteers

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Use of effective advocacy techniques

• Factors for success
• Adequate financial resources and staff
• Health groups able to respond quickly
• Use a wide array of tools
• E.g. letters, phone calls, newspaper
  advertisements, meetings with government
  officials

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Case Study 8

• Atypical Pneumonia Epidemic, Hong Kong
• Impact of Community, NGOs, Professionals
  Involvement

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Conclusion
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Conclusion

• Advocacy is a powerful strategy for promoting
  health
• Possible to use political processes to bring
  about positive changes to health
• Media sector has a very important role to play in
  health communication

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Conclusion

• There should be close working partnership between
  health and media professionals in promoting
  health
• Joint education and training programmes for both
  the health and media sectors in health
  communication would greatly enhance the
  cooperation and communication between the two
  sectors

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Conclusion

• More workshops, seminars on various subjects of
  health should be organized and better methods of
  communication should be developed to enable the
  media sector to have easy access to health
  information and a good understanding of the
  various issues affecting health

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Conclusion

• The World Health Organization should be requested
  to organize more international workshops and
  seminars for the media in order to acquaint them
  the major global public health problems which can
  only be dealt with effectively by joint forces of
  all countries on a regional and global basis

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THANK YOU