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“Protecting the health and
informed consent rights of children since 1982.”
from the NY Times
By SHERYL GAY STOLBERG
WASHINGTON, June 25 - On the eve of Valentine’s
Day 1999, the characters on “Beverly Hills 90210” were in
their usual tizzy.
Donna discovered pictures of Noah and Gina kissing. Dylan,
having sworn off
heroin, cavorted with Gina. After Steve bragged about his
flawless tan, his
girlfriend noticed a strange mole on the back of his neck.
Fearing skin
cancer, he took a megaphone to the beach to shout out the
benefits of
sunscreen. Viewers did not know it, but the sunscreen
reference fit neatly
into a public education campaign being run by the federal
Centers for
Disease Control and Prevention. Agency officials pitched
the skin cancer
story to the staff of “Beverly Hills 90210” as part of a
quiet effort to
persuade Hollywood writers and producers to embed what the
C.D.C. calls
“positive health messages” into television shows. “We
thought ‘90210’ was a
great opportunity to not only reach young adults, but also
the teens who
idolize those young adults,” explained Dr. Cynthia
Jorgensen, who runs
cancer education campaigns for the disease control
centers. When the episode
was broadcast, she said, “We were thrilled.” Call it the
public health
version of product placement. The makers of soft drinks
and automobiles
learned long ago that in an era when viewers are bombarded
with commercial
messages, simple advertising is not enough; sales climb
when a product is
seen in the hands of a star. Now federal health officials,
citing studies
showing that a substantial portion of the public gets its
health news from
TV dramas, are following suit. Whether it is hepatitis C
or childhood
immunizations or antibiotic resistance, television is
grappling with some of
America’s most pressing public health matters, courtesy of
the C.D.C.’s
three-year-old entertainment education program. In
addition to providing
“tips for scripts,” in the C.D.C.’s lexicon, on topics
that include things
like chlamydia and secondhand smoke, the agency is
offering its experts as
unpaid short-term technical advisers to help television
writers get accurate
information. Last week, Dr. Jeffrey P. Koplan, director of
the disease
control centers, visited the Warner Brothers studios to
kick around health
topics with the writers and producers of “E.R.” and “The
West Wing.” The
C.D.C. is not the first government agency to try to
influence the
entertainment media. Under a much-criticized arrangement,
abandoned after it
was disclosed last year, television networks received
financial breaks from
the government in exchange for including anti-drug
messages in scripts. By
contrast, officials at the disease control agency say,
there is no quid pro
quo in this program. Officials do not see scripts in
advance, and the
networks get nothing in return. Still, the effort makes
some people uneasy,
if only because the government’s hand is unseen. “There is
this element of
deception and subterfuge, and that’s where I think people
get a little
ambivalent about it,” said Dr. Deborah Glik, who directs a
health and media
research center at U.C.L.A. “We try to promote media
literacy, which is
knowing where messages come from.” But Dr. Koplan says his
agency deserves
equal time. “If they show Tom Cruise in a movie
chain-smoking, is that
because Philip Morris paid for it?” Dr. Koplan asked. “What
we are trying to
do is have the people putting on these shows consider what
they are
conveying.” Studies show that television can have a strong
impact on health.
A 1999 survey conducted by the marketing firm Porter
Novelli and analyzed by
the C.D.C. found that 48 percent of the people who watched
soap operas at
least twice a week learned something about diseases and
how to prevent them.
The Kaiser Family Foundation, meanwhile, recently
published a study of
regular “E.R.” viewers; it found that one- third got
information from the
show that helped them make choices about their family’s
health care. And
while screenwriters typically bristle at anything that
smacks of government
meddling, they are always in search of good ideas. So they
have been
surprisingly receptive to this effort. “As long as
everybody is upfront
about their agenda, it’s fine,” said Laurie McCarthy,
executive producer of
“Felicity.” Ms. McCarthy wrote the “Beverly Hills 90210”
episode that
included the sunscreen reference, and she has also worked
with the agency on
a story about rape. “The truth is, it was a good story for
this character,”
she said of the skin cancer scare. “And if there is a way,
without being
preachy, to get a message out to the public, hooray! Why
not do it?” Using
television to transmit what academics call pro-social
messages is not new.
In the 1970’s, after introducing America to the bigoted
Archie Bunker, the
producer Norman Lear used the situation comedy “Maude” to
confront the
abortion issue. When the Fonz, played by Henry Winkler,
took out a library
card on “Happy Days,” children across America began
borrowing books. In the
late 1980’s, Dr. Jay Winsten, a public health professor at
Harvard, pressed
television executives to help curb drunken driving by
slipping messages
about designated drivers into their shows. Today, said Dr.
Martin Kaplan,
associate dean of the Annenberg School for Communication
at the University
of Southern California, lobbyists for causes like environmentalism
and gun
control “spend time going from show to show saying, ‘I’ve
got some fabulous
material you might like to use.’ “ The notion that
television could be used
to change health behavior originated overseas, according
to Dr. Phyllis
Tilson Piotrow, an expert in population science at Johns
Hopkins who helps
create health-related soap operas and music videos for
developing countries.
“Many health ministries, with a bit of prodding from
people like us,” she
said, “have come to recognize that if you want to get
health messages to
people on anything from immunization to tuberculosis,
clean water, washing
hands, you need to go via the mass media.” The United
States, of course,
does not run entertainment media, so the international
model does not
translate easily here. But in the early 1990’s, in
response to the AIDS
epidemic, officials at the C.D.C. wondered if they should
try entertainment
education. In 1994, they convened a panel of ethicists and
social scientists
to explore the idea.
“There was overwhelming support,” said Dr. Charles T.
Salmon, a professor of public relations at Michigan State
who was chairman
of the panel. In the face of the AIDS crisis, he said, the
ethicists thought
that the agency had “a virtual obligation” to act. But
they said the agency
should confined itself to “a relatively passive role.” In
1998, Vicki Beck,
a C.D.C. health communications specialist who knew
Hollywood because of a
previous job in public relations for U.C.L.A., began
developing a broader
entertainment education program. She enlisted the help of
Dr. Neal Baer, a
pediatrician and former producer of “E.R.” He urged her to
develop “story
bites” for producers and writers; those tip sheets are now
available on
CD-ROM and at the agency’s Web site. “This whole thing
about how we are only
here to entertain, that drives me nuts,” Dr. Baer said. “We
know that people
see things on TV that are related to health, and they are
going to be
affected by it. And that means you must be accurate.”
Under Ms. Beck’s
direction, the health agency last year established an
award for soap operas
that offer accurate depictions of health issues. The prize
went to “One Life
to Live” for a story about breast cancer. Ms. Beck is soliciting
nominations
for this year. But her primary objective is what she calls a
“strategic
effort” to coordinate television stories with the C.D.C.’s
public
information campaigns. When the agency wanted to teach
Americans about
hepatitis C, Ms. Beck met with writers for three shows,
including “E.R.,”
and all three ran story lines about that disease. So by
the time the
campaign began, many Americans were already familiar with
the disease. Yet
tapping into the creative sensibilities of Hollywood
writers, who value
entertainment above education, is easier said than done,
according to Ms.
Beck and the writers themselves. Dr. Joe Sachs, an
emergency room physician
who writes for “E.R.,” said he had spent years toying with
a story idea on
the overuse of antibiotics, one of the top items on the
C.D.C.’s public
health agenda. The idea languished until earlier this
year, when Dr. Mark
Greene, one of the main characters on the show, had brain
surgery. He
returned to work a changed man, brutally honest. He strode
into the hospital
waiting room and boldly informed patients not to expect
antibiotics for the
flu. Half of them got up and left. “We always start with
the dramatic needs
of the character,” Dr. Sachs said. “If you were to take a
television program
and all it did was to dramatize public health issues, it
would feel like a
documentary. The challenge is to sneak it in.”
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