Research notes: Alcohol brand references in Pop music by United States

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Today I'm going to launch a new feature in health Pop called "research notes".  This feature highlights new revised research that integrates public health and culture pop.

Researchers from the Boston University School of Public Health and the Johns Hopkins Bloomberg School of public health have recently released a study that examined references of alcohol in popular music.  The study is published online in the daily use & abuse of substances:

References of brand of alcohol in the Popular Music of the United States, 2009-2011Michael Siegel, Renee M. Johnson, Keshav Tyagi, Kathryn Power, Mark C. Lohsen, Amanda J. Ayers and David H. JerniganThe study highlights several interesting results: four brands of alcoholic drinks (tequila Patron, Hennessy cognac, Grey Goose vodka and whisky Jack Daniel) accounted for more than half of alcohol brand mentions in songs that mentions alcohol consumption in the most popular Billboard song charts in the year 20092010 2011.Alcohol mentions were more common in urban issues (rap, hip-hop and R & B - 37.7% of alcohol mentioned songs), followed by country (21.8%) and pop (14.9%).Alcohol use was interpreted as overwhelmingly positive, with the negative consequences that is rarely mentioned.Press release of the study, the researchers highlight several practical implications of these findings: "given the heavy exposure of youth to popular music, these results suggest the popular music can serve as an important source for the promotion of the consumption of alcohol among young people," said the study co-author David Jernigan, PhD. "the results set a solid foundation for future research." "A small number of alcoholic beverages and beverage brands seems to make frequent appearances in popular music," said Michael Siegel, MD, MPH, Professor of community health at the Boston University School of Public Health Sciences. "If these exhibitions are found to influence young people drinking behavior, then even more the efforts of public health should focus on youth representations of alcohol exposure on popular music."

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A Pop Health Book Review of "Deadly Outbreaks"

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I was always a fan of "House, MD", a medical TV drama that followed a team of physicians tasked with diagnosing patients with mystery symptoms that stumped every other doctor.  I loved the twists and turns, the hypotheses, the puzzles.

I kept being reminded of House as I read Dr. Alexandra Levitt's new book, "Deadly Outbreaks".  She profiles seven cases where real life medical detectives (aka: field epidemiologists) solve mysteries involving exotic viruses, unexplained deaths, and occupational safety (just to name a few!)

As I thought about the relevance of "Deadly Outbreaks" to Pop Health, I kept coming back to the role of communication between these medical detectives and the public.  This communication is heavily impacted by the media (which can help or hurt an investigation!)  I was fascinated to read about this relationship in the cases presented (from 1976-2007) and think about how it will evolve in the future along with our health communication channels.

Several cases offered particularly striking lessons in health communication:

Lesson 1:  The Role of Communication in Promoting Fear or Stigma
Chapter #4:  Obsession or Inspiration
This case (1976) chronicled the discovery of what would later be named "Legionnaires Disease". With U.S. citizens already worried about a possible influenza epidemic (due to a suspicious death earlier in the year), the medical detectives had to contend with media coverage that fueled public fear:


"The U.S. public, bombarded by daily news stories, was disturbed and frightened by the outbreak in Philadelphia, even though swine flu was quickly ruled out as a possible cause."

"The public was primed and ready to believe that something big and scary was about to arrive, and it had."
Chapter #7: A Normal Spring
This case (1993) followed the trail of a virus affecting people in New Mexico (later discovered to affect people in the four corners (New Mexico, Arizona, Colorado, and Utah). This case was interesting because it presented the challenge of managing the intersection of media coverage and local culture (Navajo people were disproportionately impacted by the condition). "The Navajos were also unhappy at being linked to the disease in Four Corners. The newspapers not only printed the names of dead relatives, but also referred to the disease as the "Navajo flu," stigmatizing an entire people."Lesson 2: The Role of Communication in Promoting Health and Safety
Chapter #5: Deadly Desserts
This case (1994) which involved a Salmonella outbreak, highlighted a successful public awareness campaign! After Salmonella was linked to their products, the Schwan Company conducted a recall and asked customers to discard or return all uneaten products that may be affected. "Schwan's even sent their trucks door-to-door to retrieve ice cream from each household.""Schwan's public awareness campaign- advising its customers not to eat its ice cream -was unprecedented and has been praised and studied as a model of good corporate citizenship."
Lesson 3:  What's In A Name?  The Importance of LanguageChapter #4: Obsession or InspirationThe newspapers called it "Legionnaires Disease" first. This popular name would later become official (and was approved by the American Legion)."It was named Legionella pneumophila ("lung-loving"), in honor of the American Legionnaires.  Although many affected groups do not want the stigma of having an organism or a disease named after them, the leaders of the American Legion decided that the name would honor their fallen colleagues."It is customary to name a newly isolated animal-borne pathogen after a geographic feature around the place it was discovered.  Therefore, names such as the "Four Corners virus", "San Juan virus", and "Muerto Canyon" were proposed. "...the Navajo community was uncomfortable with names that would tie them to the new disease..."In response to this concern, scientists settled on a neutral name for the pathogen: Sin Nombre, the No Name Virus.I highly recommend this book. While I highlighted some of the health communication lessons here, there are lessons for a variety of public health disciplines. It is a great resource for public health students:  Dr. Levitt does a wonderful job of defining key public health terms (e.g., case control study) and providing lots of practical examples. It is a great resource for current public health practitioners who should re-visit lessons from past outbreaks as we tackle the challenges of disease surveillance, domestic/international outbreaks, and the disturbing anti-vaccine movement. This book gives us a good idea of the diverse skill set needed by today's public health workers....and I believe communication skills are at the top of the list. We need scientists who can do the work and also negotiate the media and the challenges of communicating risk to the public. As online news and social media become ubiquitous, I'm curious to see how public health handles the challenges of the 24-hour news cycle where health myths or facts can be spread in the blink of an eye.What Do You Think? Would love to hear from others who have read the book!
Disclaimer: I was invited to review "Deadly Outbreaks" by the Council of State and Territorial Epidemiologists (CSTE) and provided with a copy of the book.

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5 Reasons Why I Hate The New “Brosurance” Ad

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Earlier this week, a “Brosurance” ad was launched as part of the “Got Insurance” Project.  The project is part of the Thanks Obamacare campaign, created by the Colorado Consumer Health Initiative and ProgressNow Colorado Education.  According to their website, the goal is to educate everyone about the benefits of the Affordable Care Act.  I checked out the ad after seeing mixed reviews from colleagues on Twitter.  I immediately hated it.

Here’s why:

1.  It is unoriginal.  “Got Insurance?” is simply a rip-off of the “Got Milk?” campaign tagline.  “Got Milk” has been around since the 1990’s and encourages the American public to consume more cows’ milk.

2.   It promotes unhealthy behaviors.  One unintended consequence of this campaign could be that the ad (featuring cool bros doing keg stands) promotes binge drinking as the norm for this population.  This norm is also promoted through the presence of red “keg cups” which appear in the bros hands, as well as surrounding them on the ground.  Binge drinking is associated with many public health problems from injuries to alcohol poisoning.

3.  It continues to brand the Affordable Care Act (ACA) as “Obamacare”.  The widespread branding of ACA as “Obamacare” has negatively impacted public health’s ability to effectively communicate about the law’s benefits and features.  Aligning the healthcare law solely with the President’s name has created a polarizing effect among the American public along party lines.  As demonstrated earlier this month by Jimmy Kimmel, the use of both names to describe the law has created a lot of confusion.  Many Americans actually think they are two completely separate healthcare policies.

4.  Its success depends on people understanding “Bro”- a term with unclear meaning.  What exactly is a “Bro”?  Does it mean the same thing to all people?  In health communication, it is important that we test out our terminology with the target audience to make sure that we have a clear definition of words and don’t offend anyone with our materials.  Interestingly, NPR used twitter in June 2013 to crowdsource some definitions for “Bro”.  As you might expect, there was wide variation in responses.  In addition to there being racial implications of the word, it can apparently be associated with anyone from a Jock to a Stoner.

5. Its target audience is unclear.  According to multiple articles, the target audience for this campaign is 25 year old healthy males.  Does the image portrayed match that population?  I saw the image and thought it represented young college students at a party.  If I was a part of the target audience, I would be offended by this image.  It makes me wonder if the image and message (“Keg stands are crazy.  Not having health insurance is crazier.  Don’t tap into your beer money to cover those medical bills.”) were ever tested with the target population.  Many 25 year olds have serious responsibilities from careers to academics to families to debt.  This ad makes them all look like a bunch of idiots going on a bender.  But don’t worry!  “Obamacare” (and the American people) will be there to pay for any injuries suffered when these “Bros” inevitably hurt themselves after being dropped from a keg stand.  

What Do You Think?

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3 main trends Pop health in 2013

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Ending 2013 it has given me a great opportunity to reflect on what I've been writing over the past year.  Looking back over 35 posts +, here are the trends that caught my attention:

1. social Media & public health: continues the intersection of these two themes that intrigue us in the field of public health and the implementation of social media is being explored in everything from preparation to education for health.

Favorite pop 2013 health:

Facebook is revolutionizing the search of an organ donor, but is it right? (27 de septiembre, 2013) #RoyalBaby offers the unique opportunity to public health to advocate for Maternal Child Health (July 23, 2013) Instagram is &! Using Instagram to public health (June 26, 2013) how and why should we "Pin" public health? (June 18, 2013)Emergency response to the attacks of the Boston Marathon: looking for social networking information, resources, and connections (16 April 2013) use Twitter to track disease: weighing the benefits and challenges (March 05, 2013) Downton Abbey: a spectator tears mountain leads to a discussion on incredible line on maternal health (29 January 2013)
2. celebrities & public health: this is not a new issue by any means.  For decades, celebrities have been advocates of health or the topic of discussion for a number of public health problems.  However, I like it a tendency to highlight in 2013 for two reasons.  (1) with the help of social media, celebrities are weighing on constantly about health topics and current events in real time. These views can come quickly and casually through Twitter or Facebook... already do not speak exclusively through advertisers and press releases press.  (2) public health is focusing on the evaluation of the impact of celebrities on health issues.  * I hope we see more of this in 2014!

Favorite pop 2013 health:

3. Crowdsourcing & public health: while I have not written anything as much as I'd like, I've been fascinated by the creative use of crowdsourcing in 2013 that has helped advance dialogue for public health.  [For those unfamiliar with the term, "crowdsourcing" is the Act of obtaining ideas, content, etc. for contributions from a large group of people as users of Twitter!]  Specifically, I'd like to recognize the slate for the use of this strategy in the history of #NotDeadYet a link below and, more recently, in its analysis of data from the death of weapon.  I think that in public health we can learn much from strategies of crowdsourcing that Slate has used readers.

Favorite pop 2013 health:

2014: I anticipate that each of these three themes will continue to grow and appear in many Pop health posts in 2014.  I hope that we see more and more evaluation studies of media communication social/celebrity/crowdsourcing and its impact on public health initiatives.  I hope that these studies are widely disseminated and made accessible to many of us — even if we lack broad access to look at magazines reviewed the.  If you see this type of study, pass them along.  I hope to expand my posts "Research notes" in the next year and I would love to highlight such studies on the blog.

What do you think?

What other trends 2013 on health of public social media did you see your job? do trends new/expansion that will be in 2014.?

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Celebrities Aim To Silence The Sounds of Pertussis

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This week I surprised myself when I tweeted:

I happened to catch a portion of last week's episode of Keeping Up With The Kardashians.  While not usually a fan of the content/messages on that show, I was thrilled to see that Pertussis (Whooping Cough) was discussed.  Pertussis is a highly contagious disease that can be fatal when contracted by infants.  Research has shown that the majority of infants who get Pertussis get it from a family member.

Since Kim Kardashian would be staying at the family home with a newborn, her mother Kris brought their family physician in to vaccinate everyone who would come in contact with the baby.  That included the baby's grandparents and aunts/uncles.  What a great preventative health behavior to model on TV!

The show brought me back to a blog post I wrote last year to summarize my reactions to the PBS Frontline special "The Vaccine War".  One question I posed to readers was:

How can public health compete with the media and the internet?

One solution that I proposed:  Let's remember to share the spotlight with celebrities and other spokespeople that have influence over the public.  With anti-vaccine advocates often getting the spotlight (cough...Jenny McCarthy co-hosting The View), we often overlook that there are pro-vaccine celebrities.

This week, a colleague on Twitter shared the link to Jennifer Lopez's PSA for the Sounds of Pertussis campaign.  It was impressive.  First, for the selection of "JLo"- a mother of twins, who is known worldwide for her dancing, singing, and acting.  People are obviously interested in what she has to say- as evidenced by her 25+ million Twitter followers.  Second, her PSA includes the actual sound of a baby with Pertussis.  This is helpful because (1) it educates the public regarding what this cough actually sounds like and (2) without words it portrays the seriousness of the condition.  The baby on the recording is gasping for air.  As Jennifer points out, this sound is hard to hear for 60 seconds on the PSA...let alone coming from your own child.

The Sounds of Pertussis campaign is a joint effort between the March of Dimes and Sanofi Pasteur.  They have recruited other celebrities such as actress Sarah Michelle Geller and NASCAR Champ Jeff Gordon.  The campaign website includes both educational materials (e.g., information on transmission) and action oriented materials (e.g., a Grandparents' Guide to Pertussis that includes a pledge to get vaccinated).  The campaign has also expanded its use of social media to include a Facebook component called "Breathing Room".  This component allows new parents to educate their connections about Pertussis and invite them to take the pledge to get vaccinated.          

What Do You Think?

Can these pro-vaccine celebrities compete with the anti-vaccine messages we often see in the media/internet?  Why or why not?Do you think that the Sounds of Pertussis campaign addresses some of the key barriers to adult vaccination (e.g., low perceived risk to self or baby?)

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Medals and Mental illness: Olympian sparks dialogue

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Today's guest post comes from Julie Maier. Julie holds a Masters degree in social work and is currently a PhD student in the Department of Kinesiology of the University of Maryland (physical approach to cultural studies).  His research interest focuses on the intersection of mental health, gender, sexuality and the body. If you want to contact, you can contact her at jmaier@umd.edu.

Olympic season brings with it a plethora of news focused on some of the best athletes in the world.  In addition to beads made of performances by Olympic athletes, stories of human interest and tabloid gossip are present in the printed media and online.  In fact, there is to bury your head in the snow to avoid hearing about athletes during this time of the year.  While many focused on the Olympic items are seemingly trivial, some stand out as having the potential to create a world socially fairer.  For example, an Olympian left describing their struggles with something that is relegated to doctors offices or classrooms of Psychology: mental illness.  Although the discussion of the mental athletes can be seen as a form of stigmatization to eliminate this problem, the overall impact is dependent on informed reporting that does not perpetuate misconceptions about various forms of suffering.

After winning the gold medal in the event of men's 1,000 meters speed skating in Sochi, news reports that followed not only detailed Olympic victory the Dutch athlete Stefan Groothuis, but disclosure of his battle with depression.  According to Reuters, Groothuis had struggled with depression for years, which prevents not only his training, but their general ability to enjoy life.  Casert, in an Associated Press article, noted that Groothius depression brought it to the point of contemplating suicide.  Opening up about mental illness, Groothius joins a handful of professional athletes who, over the years, have been living with particular forms of distress such as depression, obsessive compulsive disorder, bipolar disorder, and borderline personality disorder.

The importance of such attention to mental health problems cannot be overstated.  Although no doubt progress is being made to reduce the stigmatization of people living with mental illness, there is still a long way to go.  For example, in the 2014 article published in Psychiatry, Dr. Jennifer Stuber and colleagues discovered that negative attitudes towards people with mental illnesses were common among the general public, as well as some mental health providers.  Participants particularly indicated fear of people with schizophrenia due to the erroneous, that such people are inherently dangerous.  In addition, more than two-thirds of the general public and almost half of the professionals of mental health in the study reported not wanting to someone with schizophrenia to marry his family.  Such stereotypes contribute to an environment in which those who suffer from mental health conditions are subject to various forms of abuse, discrimination and marginalization.  Greater openness about mental health can help to educate the public in general about a topic that arises frequently only in the light of the tragedies tabloid as mass executions and then disappears quickly, sending the message that those with illnesses mental are a threat to public safety and mental health is only appropriate to discuss if they have had lives.

The fact that professional athletes are coming out and talking about their experiences with anxiety is of particular importance.  In the field of sport, a male domain traditionally (and still), mental illness is often equated with weakness.  In fact, historian Dr. Roberta Park (2012) pointed out that the sport was used as a way to toughen the men returning from the war suffering from what now could be considered a form of PTSD (PTSD). The idea that mental illness is a form of weakness or an excuse can be seen in many of the responses to the Royce White NBA player coming out such as obsessive compulsive disorder and anxiety disorder (GAD) in 2012, which included death threats.  Such negative reactions, however, only reaffirm the importance of famous athletes expressing their views about mental health.

Although self-disclosure is of course not sufficient in and of itself to drastically change the lives of people with depression, schizophrenia or similar, can have a positive impact on the discourse surrounding mental health.  This depends on the way journalists and other craft and athletes and other public figures, stories of the framework.  For example, one belonging to Groothius headline announced that "Groothuis gold ends years of misery, depression," while another boasted that "Stefan Groothuis overcomes depression and win Olympic gold".  Such a structure can perpetuate the misconception that most mental illnesses can be overcome, to not return, as opposed to an ongoing condition whose severity can decrease and flow throughout life, something that can be handled, although never fully healed.  This is not to discount experience of Groothuis; Perhaps he has done 'surpassed' depression. However, for many suffering from depression--particularly major depressive disorder - never can be enough lucky to be completely free of depression (see widely cited book by psychiatrist Peter Kramer, depression, to know more about this).  With that said, mentioned holders can make people with depression who have fought for years to recover and feel even more marginalized, perhaps by sending the message that mental illness is temporary.

Conversation is desperately needed additional surrounding mental health and stories as the help of Groothius to undermine the profound misunderstanding and stereotypes associated with mental illness.  I hope that one day the athletes coming out with their stories of depression will be a problem, but until then, such disclosures are vital to the health of everyone.

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What can you teach "Chronic resilience" professional public health? An interview with the Danish author Horn

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Last month I had the pleasure of receiving an advanced review copy of "resilience: 10 Sanity-Saving strategies for women to deal with the stress of chronic diseases".  How to read the book, I took note of many issues that are relevant for public health professionals.  Therefore, it is a pleasure to have Danish Horn expand reviews these issues for readers of health Pop.

If you want to connect with Danish, you can visit their website or Twitter.

Leah:  In public health, talk a lot about the "culture" of our society can promote or damage health.  Several places in his book, talks about the connection between our social values and our health.  For example:

Page 33: "our culture is part of the reason that we try to be all things to all people."  You have sat through a business meeting while someone is Sniffling and sneezing and others to its cold exposed to?  At that time they are valuing achievement, money or aspects of their health and that of others in the room. "

How can extend beyond the individual level strategies?  How we can identify and we live our values of health in the neighborhood, the community and the levels of organization?

Danish:  Only takes one person to start a conversation that can become the catalyst for major changes. He begins to talk to the people in your work and in your community to get an idea of what is currently valued. (Written and unwritten) policies in our offices and our fellowship articles will say much about what value collectively. If you find inconsistency or confusion in their conversations, open a dialogue with the leaders of your organization or community to discuss what you want to choose collectively to value. From here you may think together ways to influence change. They can be small changes such as create a block of healthy lifestyle of the party where people share nutritious dishes and exchange good recipes for you or larger changes sick pay (that is not mandatory in all States... yet). Never be afraid to speak. A big issue in chronic resilience are controlling what you can control and talking in their control.

Leah:  In Chapter #6, you write "is up to you to decide how public to make your health."  Several of the women interviewed for his book have blogs that document his journey of health in a very public way.  Researchers in public health Ressler et al (2012) have identified many benefits the patient blogging (e.g., patients report a decrease in feelings of isolation).

Benefits have as a consequence the writing about your health?  What challenges have you found the process of publicly sharing your story?

Danish:  Writing helps me process what is happening from a different perspective. I am all about learning from our challenges, for each post I write is a search for a lesson or a message to me to my diagnosis points. I feel frustration about the progression of the disease and begin to write a rant, but it seems to me that of course ended with a message about my ideals or acceptance. Reformulate my health in this way has been very empowering.

Not met with many challenges with my trip in public health. Commentators have been a great support. That said, I'm picky about what I want to share, and keep some things private. I know other people have faced challenges and someone who should be prepared blogs publicly about their health, they are people that share resources, treatment recommendations, panacea solutions and pleas to have faith in a deity may or may not believe in. While these all come from a memorable place feel intrusive. Also, you may want to give a notice to close relatives and friends before publishing something particularly revealing, emotional or otherwise, which are not shared with them privately first.

There are a number of ways to take advantage of writing about his health. So publicly on a blog can create a sense of community and support, but if it feels very invasive, it can join the support forums anonymously, create a private blog or journal of pen and paper, old-school style.

Leah:  In the chapter #7 ("empower yourself with the investigation"), was happy to see the emphasis on helping patients to assess the validity and safety of medical information on the Internet.  This is a great challenge in public health.  Our messages based on evidence and guidelines often competircon in line with anecdotal evidence and scientific studies.

Why did you decide to devote a portion of his book to this debate?  Why is it so important for patients to discuss what are in line with your medical team?

Danish:  Before I became to discern about what I read on the Internet about my diagnosis, I was completely stressed out. I have read way too too many random supplies to properly resolve what they should believe. I also note that was looking for how it would be worse (side effects, complications and progression of disease) rather than seek how could support my Heath. Fortunately, I realized my stress most came concern created by endless searching the Internet, and decided to take a different approach.

I have found some sources of trust of doctors and nutritionists to study and apply. I decided to concentrate on my personal symptoms, medications and prognosis instead of what other people who even did not personally know that they had experienced. I also started a more open dialogue with doctors about the diet I wanted to try and some of the studies they had read. When we investigate and experiment with our health without informing our doctors have conflicting approaches that can create drug interactions or other harmful complications. The doctors are there to support us. If you are uncomfortable talking to yours, is time to find one that you trust enough to be completely open and honest with. Everyone should have a doctor who will work with us to find treatment solutions with which we are comfortable.

Leah:  A big thank you to Danish to make time for health Pop!  "Chronic resilience" is a great read for those with a personal or professional connection to a chronic disease.  For the doctors of public health, professionals and researchers working in the field of chronic disease: I think that you will get a unique view of firsthand (1) the mental, physical and emotional challenges affecting this population, (2) the incredible resistance showing those with chronic diseases on a daily basis (what can we learn from them??) and (3) specific strategies that can be used to help patients with chronic diseases.  As Danish and I discussed earlier, these strategies have the potential to expand on an individual level to provide support to communities.

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