Select Working Papers
Particularly important papers by Dr. Viswanath and colleagues aimed
at understanding health communication, as a growing field of inquiry,
with a particular focus on underserved populations.
Social Capital and Health Communications (2008) (PDF file)
Communication has been identified as playing a vital role in integrating people into their communities by helping to support and maintain their community ties and in promoting interpersonal trust (Cappella, Southwell and Lee, 1997; Janowitz, 1952). Accordingly, the role of social capital, at both mass and interpersonal levels, has attracted enormous attention from scholars for the purported reason that communication may lead to both an increase or in some cases a decrease in social capital, which in turn may affect public health. The relationship between communication and social capital, however, is not always direct and its association may often be with antecedents of social capital. A clearer delineation of the relationship between health communication and social capital would not only be of academic interest but could be fruitful in the practice of social change in public health.
Health Disparities, Communication Inequalities and eHealth: A Commentary (2007) (PDF file)
Advances in communication and computer technologies have revolutionized the way that health information is gathered, disseminated and used by healthcare providers, patients, citizens, and mass media, leading to the emergence of a new field and new language captured in the term “eHealth.” As exciting as these technologic changes are, they have led to sometimes overly optimistic prognostications about what eHealth can do to improve the health of patients and the public and the quality of care available from providers. While conceding the significant advantages bestowed by the technologic developments and their adoption into the healthcare system, we contend that without careful and systematic research and policy, eHealth may work primarily to the advantage of individuals and communities with greater resources and the healthcare systems to serve them. This could have the effect of deepening disparities in health status among population subgroups.
Perceptions of Environmental Health Risks and Communication Barriers among Low-SEP and Racial/Ethnic Minority Communities (2007) (PDF file)
Despite a disproportionate burden of environmental hazards in lower socioeconomic positions (SEP) and racial/ethnic minority communities, research suggests that such communities may have concerns about environmental risks different from those of their higher SEP and White counterparts. These groups also face disproportionate barriers to accessing and utilizing public health information. Little work has focused on the environmental risk communication barriers that low-SEP minorities face. This paper reports on the results of seven focus groups conducted in three low-SEP Massachusetts communities, with an over-sample of racial/ethnic minorities. We explored (1) definitions of the environment, (2) perceptions of environmental health effects, (3) information-seeking behaviors around these issues, and (4) challenges to accessing and utilizing information. The local environment shapes these communities' perceptions of environmental risks; they face considerable barriers to accessing, understanding, and utilizing other sources of information about environmental health risks. We discuss the implications for future targeted campaigns to reduce negative impacts of environmental health risks.
Public communications and its role in reducing and eliminating health disparities (2006) (PDF file)
This chapter in the NIH report entitled, "Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business," explores the role of public information and community outreach as strategies to reduce health disparities The recent explosion in health information poses two fundamental challenges. One is a need to translate scientific information in a usable format and language that can be understood and used by different audiences through appropriate channels. Such a translation would require attention to the dissemination of evidence-based and timely information to different publics. This challenge is compounded by the large number of channels and actors, which make it difficult to control the interpretation of biomedical information as it cascades through different segments of society. A second and equally, if not more, important challenge is that we need to ensure that the information is available to all of those who need it, regardless of their social class, cultural, geographic, and individual backgrounds. This latter need is a particular challenge, given the profound information inequalities that characterize our society. While the number of channels through which information, particularly through subscription telecommunication services, increases, it also comes at a price that requires recurring expenditures and investment to obtain those services.
Cancer Knowledge and Disparities in the Information Age (2006) (PDF file)
Increasing information flow often leads to widening gaps in knowledge between different socioeconomic status (SES) groups as higher SES groups are more likely to acquire this new information at a faster rate than low SES groups. These gaps in knowledge may offer a partial but robust explanation for differential risk behaviors and health disparities between different social groups. Drawing on the Health Information National Trends Survey (HINTS 2003), a national survey of communication behaviors conducted by the National Cancer Institute (NCI), we examine the relationship between publicity and knowledge gaps on two cancer topics that received different levels of publicity: knowledge about tobacco and sun exposure and their respective links to cancer. Analyses of the HINTS 2003 data suggest that differential knowledge levels of causes of cancer between SES groups are one potential explanation of cancer disparities that have been extensively reported in the literature. It is evident that high income and high education are associated with awareness of causes of major cancers such as lung and skin, and may allow people to protect themselves and minimize their risks. The data also show that heavier media attention could attenuate the knowledge gaps though moderate publicity or lack of news coverage may actually widen them. Last, the findings in this article suggest that it is necessary to take into account the SES variation within different racial and ethnic groups rather than mask them by treating the groups as one.
Message Effects and Social Determinants of Health: Its Application to Cancer Disparities (2006) (PDF file)
Recent work on message effects theories offers a fruitful way to systematically explore how features, formats, structures of messages may attract audience attention and influence the audience and is of great relevance to public health communications. Much of this work, however, has been pursued primarily at the individual level of analysis. It is our contention that message effects on health outcomes could potentially be moderated and mediated by social contextual factors in public health such as social class, social organizations and neighborhoods, among others, leading to differential effects among different audience sub-groups. This essay, through a selective review of literatures in communication and social epidemiology, will explore how major message effects may moderate and mediate the role of social determinants of health on cancer control, specifically cancer-related health disparities.
