The NMJI

Media and Health. Clive Seale. Sage Publications, London, 2002. 244 pp, £18.99. ISBN 0–7619–4730–2.

At a time when SARS, mysterious fevers in Andhra Pradesh, marathon surgeries attempting to separate conjoined twins and, of course, headlines screaming about the ‘AIDS pandemic’ hit the front pages with predictable regularity, Clive Seale’s timely book is essential reading for health educators, healthcare providers as well as media professionals.
Seale, Professor of Sociology at Goldsmiths College, University of London, attempts to bring together the field of media studies with that of the sociology of health and illness. A stupendous task, considering the barrage of media images in daily life that profoundly impact policy-making as well as people’s responses to illness and healthcare.

‘ Edutainment’ initiatives that represent a compromise with the ‘pleasure principle’ which drives the relationship between most mass media and their audience, as well as ‘social marketing’, which conceives of health promotion as an attempt to ‘sell’ a product, are reflective of the packaging of good health as something that consumers aspire to. Seale attributes this shift to a dissatisfaction with what he calls the ‘information–delivery’ model, which conceives of health messages as ‘hypodermic needle’ injections of information into a largely passive audience. Pointing out that analyses of mass media health messages often involve little more than routine condemnation of biased media representations and lack a thorough analysis of the complex relationship of mainstream media products with the everyday life experience of people in contemporary society, Seale goes about attempting to provide this analysis.

In the study on the ‘production of unreality’, through an analysis of the depiction of death, illness experience and healthcare, the author provides thought-provoking evidence for inaccuracy in media representation. For instance, sensational events such as botulism, flood, homicide, accident or cancer were overestimated to be causes of death as compared with non-dramatic, quiet killers such as asthma, diabetes or tuberculosis. These beliefs also affected the assessment of risks, as well as policy decisions about health. Analyses of both television and print media show that diseases resulting in death were more likely to be reported than non-fatal diseases, while the mortality rates in popular television soap operas was rather high. Interestingly, rather than reach the more expected conclusions about the direct negative impact of distorted media representations, Seale argues that viewers/readers may regard such media stories with a healthy skepticism, and may well understand that media realities and everyday realities are different. More audience studies exploring the consequences of inaccuracy are needed, he feels.

Seale’s analysis of ‘media scares’ and the resultant arousal of fear is particularly relevant. He rightly observes that consciousness regarding safety issues has reached a ‘chronic’ level, with the media creating panic about almost every item of food, the environment and commonplace activities—from sitting in the sun to driving a car or using a phone. Studies have shown that such negative news coverage can be correlated with high levels of anxiety and stress in viewers/readers. The author looks at alarmist headlines about ‘killer viruses’, exaggerated or distorted news reports about exposure to electromagnetic fields, for instance, and other pseudo-scientific ‘reports’ and their impact on the public. The analogy of war with the experience of cancer—invasion, attack, battle with treatment and conquest—is particularly noteworthy.

Media coverage of AIDS has provided an opportunity for media imagery that could replace syphilis as the disease to represent a moral warning about the dangers of free sexuality. In fact, the contours of media coverage, Seale points out, were themselves subjected to a fierce critique, which gained considerable media publicity. The construction of ‘villains and freaks’—in the coverage of mental illness, disability and old age—represent the urge to project ‘the other’ in opposition to a supposedly ‘normal’ self. The role of the media in the construction of stereotypes and stigmas is particularly revealing. However, the highlighting of gender stereotypes in the book is limited to women as ‘victims’—of breast cancer, AIDS, mental illness or eating disorders. Media depiction of the gender element in the medical profession, as well as the patriarchal constructs of ‘modern’ medicine, are left unexplored. Moreover, Seale falls into the usual trap of viewing women’s health as restricted only to reproductive health.

The projection of children as ‘innocent victims’, prey to evils such as cancer, their misery exacerbated by villains such as the unresponsive bureaucracy, medical system or society at large, is juxtaposed with the presentation of doctors as ‘professional heroes’ battling all odds. The analysis of medical soap operas on television, portraying heroic doctors wielding magical powers should be of interest, given the spurt in serials with doctors as the main protagonists.

The lack of an ongoing critique of medical practice, technological innovations and the introduction of new drugs and treatments is apparent. While the media picks up sensational stories of bungling by certain professionals, or ‘scare stories’, a reasoned, well-articulated critique is lacking, as Seale points out. This is accompanied by a valorization of alternative ‘holistic’ approaches to medical therapy that assist in the task of breaking up the authority of orthodox medical expertise.

The argument that the citadel of medical prestige, based on possession of technological resources for patient care, is under assault from a media-orchestrated consumerism is backed by compelling evidence. The examples of ‘ordinary heroes’—notably there are no heroines—tell about the courageous endeavours of ordinary people who suffer and, in some cases, overcome illness. This, argues Seale, goes hand-in-hand with a questioning of traditional forms of authority—a phenomenon India is currently witnessing more than ever before.

Well printed and excellently proofread, the publication is handy and easy on the eye. The style, though uncomplicated for the most part, could be smoothened further if complicated formulations were avoided. Words such as ‘extrematisation’, ‘inter-actionist’ and ‘mythologizing’, among many others, tend to obscure an otherwise conversational style understandable even to those not schooled in academic jargon. This apart, this extremely relevant book, with its well-presented case studies, is valuable reading for those wishing to make connections between media representations and health.