February/March 2022: Well-Being and Health Messaging

“Because researchers are bounded by either the discipline of their study or the nature of communication practice, attention to what drives illness and health and subsequent interventions to promote health and well-being have focused generally on one level.” In their recently published chapter in The Routledge Handbook of Health Communication, Center Co-Director Dr. Vish Viswanath and colleagues examine health communications from an ecological perspective, accounting for the ways in which individuals interact with larger social, structural, and cultural forces as they encounter health messaging.

With co-authors Dr. Mesfin Bekalu and Dr. Rachel McCloud – both Research Scientists at the Center – Dr. Viswanath outlines various considerations for researchers and policymakers aimed at improving population well-being through effective health messaging. The team’s recent Routledge chapter discusses the complex relationships between communication, health, and equity, describing the communication factors that contribute to disparate outcomes across and within populations. The authors propose a pathway through which multilevel factors may interact with communication inequalities, leading to inequalities in health.

The chapter illustrates the ways in which upstream societal forces – such as culture, policy, and concentration of poverty at the community level –  operate alongside the influences of social networks and individual factors. This system of ecological factors influences who is able to access, engage with, process, and benefit from health information. “Understanding the influence of communication across multiple levels is critical, as it is a potent force in addressing divides in population health,” the authors write. “The influence of communication on health disparities may be studied through communication inequalities along the dimensions of engagement with health information and platforms and channels that provide health information, how information is processed, and communication effects.”

According to the authors, a person’s ability to perform a healthy behavior promoted by a communications campaign may be restricted by lack of community resources, pressures exerted by social norms, or the stress of competing priorities. “Culture matters. Policies matter,” Dr. Viswanath said. “How people access [health messaging] and engage with it can influence whether inequalities in health and well-being increase or decrease.” The authors point to examples in which harmful messages, including tobacco ads, have had a disproportionate impact on vulnerable groups, as well as the field’s historical focus on individual factors rather than social and environmental factors.

“If you pay attention to a message, you’re most likely to engage with it.” Dr. Viswanath said. Yet stressors like scarcity can profoundly affect an individual’s ability to process and implement health information. “If the mind is focused on one thing, such as hunger or poverty, other abilities and skills, including attention, often suffer,” the authors write. “As such, although the impact may differ depending on the type and magnitude of scarcity one experiences, scarcity fundamentally reduces cognitive resources that one is able to allocate to process and decipher a given piece of information.” This framework provides insight into how stressors such as racism or poverty may negatively influence a person’s attendance to a health-related message.

While the authors recognize communication inequalities as “one of the more addressable social determinants,” they also draw attention to several challenges, including the need to understand well-being on a broader level. “Work so far has focused on mental illness and poor physical health. There is a need to transition to positive health,” Dr. Viswanath said. “One application of a positive health lens comes from understanding the potential benefits of social media use – work that has been of particular interest to scholars at the Center. While much of the attention in research on social media has focused on harmful effects of social media, some of our work is showing that social media may also be beneficial by fostering social connections and improving perceptions of social cohesion. How this relates to inequalities in well-being is one of the foci of our research.”

The authors argue that there is an urgency for communication scholars to address the inequalities through theory, policy, and practice. “The advantage of using an ecological framework for communication with the primacy on social, structural, and cultural communication drivers lies in illuminating the factors that lead to disparities and the potential for addressing them,” they write.