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What Is the Image of Illness in the Media? Does It Matter?

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Have you noticed that most sick characters on TV shows look pretty good and are coherent – often feisty – even when they are in the hospital?

Have you caught the number of ads for drugs and health plans showing happy, vigorous people that dominate the major consumer health websites and are common on TV?

Have you noted that websites of disease voluntary organizations (lung, cancer, Crohn's disease, arthritis) tend to show healthy people participating in "fun runs" or other fundraising activities, in addition to robust, active people going about their daily lives?

Now, I know I don't look great when I'm feeling sick. I generally don't appear happy or vigorous either. But I rarely see anyone who actually looks sick online, in print or on TV. The appearance of illness and suffering is slightly more common in images of older people, but as a group they are vastly underrepresented in entertainment, news and advertising.

There is a big, diverse herd of us out here who are ill and who don't see our experience realistically portrayed by the media. So what?

The inaccuracy of health information as it appears electronically and in print has long been a concern of advocates for specific groups and diseases, public health and some journalists. They are concerned that erroneous and imprecise information and commercial messages affect consumer behavior. Such messages decrease the urgency with which we act to prevent and detect disease and increase our appetite for unproven and/or expensive technologies and drugs.

While it is difficult to draw a clear causal link between inaccurate health information and advertising claims in the media and specific behavior of individuals, there is ample evidence that many of us have only a faint grasp of risk statistics and that we don't cast a highly critical eye on news and advertising. Further, we are documented under-achievers at following preventive and clinical guidelines and our doctors' recommendations. Surely, confusing and false media messages contribute somehow.

But what about the images that accompany health information and advertisements? Do these misleading pictures and the dearth of those that portray suffering or discomfort make a difference to us as individuals and as a population? Does the misrepresentation of our reality when we are sick influence our willingness to engage in our health and health care? Does it subtly encourage us to favor pharmaceutical and technological fixes as opposed to, say, making the effort to work out a better plan for managing multiple medications, go to physical therapy or get up and move around a little more?

Though I haven't found any studies that have asked these questions, it's worth considering some possible unintended consequences of this distortion of our experience:

  • Might the not-so-hidden message communicated by those uber-healthy images in the media – i.e., that illness affects neither our mind nor body – subtly undermine our confidence that we are doing the best we can? Findings from studies of Facebook show that heavy users are less happy than non-users. The unhappiness is attributed to the upward social comparisons people make with their friends. So what happens when we compare the way we feel and look to the media images of people who are supposed to be sick? Do we likewise add to our discomfort? Are we failing if we can't feel – or at least look – like those happy people?
     
  • On the other hand, might these positive images fuel our optimism and willingness to act on our own behalf? In the collective picture portrayed by the media, the full continuum of health and illness is represented only by pictures of people just getting on with it, illustrating a sort of "pull yourself up by your bootstraps" American ideal. By implication, such images "present health as a permanent condition in which the body and mind should be, if one applies the right doctors, techniques and products, optimal. Cancer, broken bones, obesity, aging, a large nose, small breasts, everything can be fixed," writes Ferdinand Protzman in his essay The Picture of Health. The media shows us a picture of a desired result, not a series of processes with a reliable failure rate. Protzman notes that it is critical for marketers (and advocates) to represent good health as attainable, since if it is not attainable, it is also not obtainable through purchasing the right drugs, consulting the right doctor, taking the experimental medicine or expending the effort to lose weight or stop smoking.
     
  • Might the absence of realistic images of illness and disability lead the public to underestimate the size of the population that is ill and the impact of poor health on people's abilities to work, for example? While I could find no studies documenting the effects of the positive depiction of illness by the media, there is no shortage of research and commentary on the effect of the inaccuracy of images of women, minorities and older people. In each case, the authors speculate that this inaccuracy allows the public to overlook both the contributions and the needs of these groups and adds to negative stereotypes and stigma.

    Does the dearth of accurate images of ill people encourage us to limit our concern only to our own experiences and of those we hold dear and to disregard illness's impact on those in other neighborhoods and states? Does it contribute to a sense among the general public that people who are ill are fundamentally different or that we sick people simply aren't trying hard enough to be healthy and that therefore we deserve our suffering?

At a time when highly politicized views on who should have access to what health care through what means are discussed at high volume, I find myself puzzling about how, as a nation, we are able to advocate diverse policies based on such radically different views of how we become ill and whether we need health care when we are. Perhaps the invisibility of our experience of illness in the media plays a role.

More Blog Posts by Jessie Gruman

author bio

Jessie C. Gruman, PhD, was founder and president of the Center for Advancing Health from 1992 until her death in July 2014. Her experiences as a patient — having been diagnosed with five life-threatening illnesses — informed her perspective as an author, advocate and lead contributor to the Prepared Patient Blog. Her book, AfterShock, helps patients and caregivers navigate their way through the health care system following a serious or life-threatening diagnosis. The free app, AfterShock: Facing a Serious Diagnosis, offers a pocket guide based on the book. | More about Jessie Gruman


Tags for this article:
Inside Healthcare   Health Information Technology   Seek Knowledge about your Health   Mental Health  


Comments on this post
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Marilynn Larkin says
September 25, 2013 at 9:27 PM

When I handled the migraine "verticals" for Reuters Health a number of years ago, researchers used the term "Hollywood headache" to refer to the way actors bounced back from falls, beatings, auto accidents, etc. no worse for wear--except maybe for a headache. So--I agree we don't have realistic media portrayals of illness. But more importantly, we also don't have realistic portrayals of health. Why must we continue to focus on illness rather than health? I'm not denying that many people have chronic illnesses--but does their whole demeanor and mindset have to be defined by their illness? I've said for many years that if you google "health" or "mental health," very few results are about health; the vast majority are about diseases. I think we would do well, at every age but especially at "certain" ages when things like medications and screenings are supposed to kick in big time, to focus on how we really are doing, as individuals, and not succumb to the numbers game. I know these comments are somewhat off topic, but for me, part of being a prepared patient is understanding that you don't have to be a patient. When we get that right, we might get more realistic images of health as well as illness.

Zal Press says
September 26, 2013 at 4:30 PM

This is an important topic. I've long felt insulted by the glossy imagery of happy "sick" people. I don't know if its just the laziness of the graphic designers that they choose the same stock imagery but I've seen the same guy playing patient and doctor in hundreds of reports, websites, brochures etc.
I'm not saying you need to have such realistic portrayals of the illness experience that they're more like horror movies and the insides of lungs on cigarette packages. Rather, there are many more ways to creatively illustrate the illness experience that is more representational. On our site patientcommando.com we have portrayals in art, photo and even graphic novel, that aren't air brushed and teflon coated. They're sensitive, real, respectful and insightful. And these are coming from patients, the people who are suffering, who are in pain and anguish, sometimes every day 24/7.
There's nothing wrong with illness - its part of the life experience. We do a disservice to our capacity to understand, cope and manage illness by using imagery designed to keep us ignorant.

Maggie.danhakl@healthline.com says
November 4, 2013 at 8:37 PM

Hi,

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Healthline provides a very comprehensive overview of Rheumatoid Arthritis as a critical starting point for individuals and/or their loved ones.

Why you should include Healthline as a resource:

-Video overview of RA by Dr. Paul Auerbach of Stanford Medicine
-A free interactive educational tool on RA: http://www.healthline.com/rheumatoid-arthritis/anatomy-animations#1/what-is-rheumatoid-arthritis?
-Breaking news (ex. http://www.healthline.com/health-news/arthritis-gum-disease-bacteria-worsens-rheumatoid-arthritis-091713) and in-depth, doctor-reviewed content

For more information about our rigorous editorial process, to view our board of directors and more visit the Healthline about page: http://www.healthline.com/health/about-healthline.

Please let me know if you are open to adding Healthline’s RA center as a resource. Thank you in advance for your consideration, and I look forward to hearing back from you.

Warm Regards,
Maggie Danhakl- Assistant Marketing Manager
p: 415-281-3124 f: 415-281-3199

Healthline Networks, Inc. • Connect to Better Health
660 Third Street, San Francisco, CA 94107 www.healthline.com

Maggie.danhakl@healthline.com says
November 23, 2013 at 10:46 AM

Hi,

I hope this finds you well. I represent Healthline Networks, and we were wondering if you could include Healthline’s Rheumatoid Arthritis Center (http://www.healthline.com/health/rheumatoid-arthritis) as a resource on your page: http://blog.preparedpatientforum.org/blog/2013/what-is-the-image-of-illness-in-the-media-does-it-matter#.UpByctKBkYY

Healthline provides a very comprehensive overview of Rheumatoid Arthritis as a critical starting point for individuals and/or their loved ones.

Why you should include Healthline as a resource:

-Video overview of RA by Dr. Paul Auerbach of Stanford Medicine
-A free interactive educational tool on RA: http://www.healthline.com/rheumatoid-arthritis/anatomy-animations#1/what-is-rheumatoid-arthritis?
-Breaking news (ex. http://www.healthline.com/health-news/arthritis-gum-disease-bacteria-worsens-rheumatoid-arthritis-091713) and in-depth, doctor-reviewed content

For more information about our rigorous editorial process, to view our board of directors and more visit the Healthline about page: http://www.healthline.com/health/about-healthline.

Please let me know if you are open to adding Healthline’s RA center as a resource. Thank you in advance for your consideration, and I look forward to hearing back from you.

Warm Regards,
Maggie Danhakl- Assistant Marketing Manager
p: 415-281-3124 f: 415-281-3199

Healthline Networks, Inc. • Connect to Better Health
660 Third Street, San Francisco, CA 94107 www.healthline.com

jen.brousseau@healthline.com says
January 5, 2014 at 8:13 PM

Hi,

I hope this finds you well. I represent Healthline, a medical website dedicated to providing trustworthy health news and advice.

We just launched a new product with our partner TrialReach that allows you to search for clinical trials in an area for a specific medical condition.

I thought you would be interested in our Rheumatoid Arthritis clinical trial results: http://www.healthline.com/health/trial-reach-rheumatoid-arthritis-clinical-trials

I am writing to ask if you can help spread the word about this great new tool by including it as a resource on your page: http://blog.preparedpatientforum.org/blog/2013/what-is-the-image-of-illness-in-the-media-does-it-matter#.UpByctKBkYY

Please let me know if this would be possible. I’m happy to answer any other questions as well.

All the best,
Jennifer Brousseau • Marketing Assistant
p: 415-281-3100 | f: 415-281-3199

Healthline • The Power of Intelligent Health
660 Third Street, San Francisco, CA 94107
www.healthline.com | @Healthline | @HealthlineCorp

About Us: corp.healthline.com | Media Kit: mediakit.healthline.com

jen.brousseau@healthline.com says
January 10, 2014 at 5:51 PM

Hi,

I hope this finds you well. I represent Healthline, a medical website dedicated to providing trustworthy health news and advice.

We just launched a new product with our partner TrialReach that allows you to search for clinical trials in an area for a specific medical condition.

I thought you would be interested in our Rheumatoid Arthritis clinical trial results: http://www.healthline.com/health/trial-reach-rheumatoid-arthritis-clinical-trials

I am writing to ask if you can help spread the word about this great new tool by including it as a resource on your page: http://www.cfah.org/blog/2013/what-is-the-image-of-illness-in-the-media-does-it-matter#.Unf3AHCBnn4

Please let me know if this would be possible. I’m happy to answer any other questions as well.

All the best,
Jennifer Brousseau • Marketing Assistant
p: 415-281-3100 | f: 415-281-3199

Healthline • The Power of Intelligent Health
660 Third Street, San Francisco, CA 94107
www.healthline.com | @Healthline | @HealthlineCorp

About Us: corp.healthline.com | Media Kit: mediakit.healthline.com