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An Introduction to Public
Health Communication
Dr. Crystal Jiang
Dept of Media and Communication
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Learning Objectives

n Define
health in terms of different concepts and
perspectives

n Describe determinants of health

n Understand what health communication is

n Describe
the general steps in public health
communication
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Health

Public Communication
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Poll

What do you think health is?

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What do you think health is?

n No disease = Health?

n Availability of health services = Health?

n 陰陽調和 (TCM) ＝ Health?

n Fitness = Health?
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Health

n The
word “health” is widely used in public
communication, and yet its meaning sounds vague

n Lay Point of view:

Persons are healthy when they are doing their

activities with no apparent symptoms of disease in
them. The New oxford Dictionary of English
describes health as ‘the state of being free from
illness or injury’.
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Health

n The
word health is widely used in public
communication, and yet its meaning sounds vague

n Professional points of view:

“a measure of the state of the physical bodily organs,

and the ability of the body as a whole to function”. It
refers to freedom from medically defined diseases.
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Health

n The
word health is widely used in public
communication, and yet its meaning sounds vague

n WHO definition in1948:

“a state of complete physical, mental, and social

well-being and not merely the absence of disease or
infirmity”. It’s a state of health that enables a person
to lead a socially and economically productive life.
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Health

n The WHO definition of health is not an operational

definition

n But it specifies:
n Physical - anatomical integrity and physiological
functioning of the body
n Mental - the ability to learn and think clearly and
coherently
n Social - the ability to make and maintain acceptable interaction
with other people
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Health Defined on Different Levels

n Individual health

n Population health: the health outcome of a group of individuals, including the

distribution of such outcomes within the group (Kindig & Stoddart, 2003)
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How can health be measured?

n In practices, multiple indicators are used for measuring

health.
n Morbidity indicators
n Mortality indicators
n Disability indicators
n Nutrition indicators
n Healthcare delivery indicators
n Healthcare utilization indicators
n Social and mental health indicators
n Socioeconomic indicators
n Environmental indicators
n Quality of life indicators
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Poll

What are the major causes of death you can think of?
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https://www.who.int/gho/mortality_burden_disease/causes_death/top_10/en/
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WHO (2009). Global health risks: mortality and burden of disease attributable to selected major risks
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Determinants of Health

n The Health Field Concept (Lalonde, 1974)

n Human Biology
n Environment
n Lifestyle
n Health Care Organization

n4 health fields are interdependently responsible

for individual health
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Determinants of Health

n The Health Field Concept (Lalonde, 1974)

n Human Biology

All aspects of health, physical and mental,

developed within the human body as a result of
organic make-up
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Determinants of Health

n The Health Field Concept (Lalonde, 1974)

n Human Biology
n Environment

All matters related to health external to the human

body and over which the individual has little or no
control; includes the physical and social
environment
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Environmental Factors

a. Life support, food, water, air etc

b. Physical factors, climate, rain fall

c. Biological factors: microorganisms, toxins,

biological waste
d. Psycho-social and economic e.g. crowding,
income level

e. Chemical factors: industrial wastes, agricultural

wastes, air pollution, etc
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Determinants of Health

n The Health Field Concept (Lalonde, 1974)

n Human Biology
n Environment
n Lifestyle

The aggregation of personal decisions, over which the

individual has control; self-imposed risks created by
unhealthy lifestyle choices can contribute to, or cause,
illness or death
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WHO (2009). Global health risks: mortality and burden of disease attributable to selected major risks
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Determinants of Health

n The Health Field Concept (Lalonde, 1974)

n Human Biology
n Environment
n Lifestyle
n Health Care Organization

The quantity, quality, arrangement, nature and relationships

of people and resources in the provision of health care
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Alternative Theories of
Health Determinants

Dahlgren & Whitehead (1991):

Social Ecological Model of Health
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Globalization and Health

n Trade and mobility contribute to

epidemics
n Measles & smallpox (Asia to
Europe)
n Black Death (Mongolia to
Europe)

n 1973 – 1999: severe outbreaks of

20 known and 29 new infectious
diseases

n HK as transportation hub: disease

can reach HK within 24 hours
McNeill (1977). Plagues and Peoples
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+ Population size fluctuations of TB
(tuberculosis)
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Globalization and Health

n Infectious Diseases
n South to North
n Developing to developed

n Non-communicable diseases
n North to South
n Developed to developing
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Globalization and Health
n 1.5 million babies die every year because they were not
breastfed particularly in less economically developed countries
(WHO & UNICEF)

n Preparing formula exposes babies to much bacteria & diseases

(unsafe water, no boiled water, low literacy, use less formula for
saving money, etc.)

n Formula companies, Nestlé in particular, aggressively market

formula (e.g., provide free formula for hospitals)
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Conclusion

n Ecological view:
health is profoundly affected by the social, environmental,
and behavioral factors with which people live
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Reality
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Conclusion

n Ecological view:
health is profoundly affected by the social, environmental,
and behavioral factors with which people live
n Thisconcern gives birth to the new discipline of
public health – to prevent disease, prolong life and
promote health through the organized efforts and
informed choices of society, organizations,
communities and individuals
n Strategic
communication provides a useful approach
to promote public health.
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Health

Public Communication
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Poll

n Rimal & Lapinski 2009

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Communication as a Discipline

“Communication Studies is a field of research on

the production and uses of symbols (both linguistic
and non-verbal, whether face to face or mediated)
in concrete social and cultural contexts to enable
the dynamics of systems, society, and culture”
(Baxter & Babbie, 2004, p. 11)
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Communication as a Discipline

“Communication Studies is a field of research on

the production and uses of symbols (both linguistic
and non-verbal, whether face to face or mediated)
in concrete social and cultural contexts to enable
the dynamics of systems, society, and culture”
(Baxter & Babbie, 2004, p. 11)
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Function of Communication

Carey (1989):

• Instrumental role (information and

knowledge transmission)

• Ritualistic function (connecting humans as

members of a social community)
+ Transmissional

Ritualistic
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Definitions

n Health Communication
The study and use of communication
strategies to inform and influence individual
and community decisions that enhance health
(NCI/CDC, 2010).

n Applied
n Strategic
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Definitions

n Public Health Communication

“the scientific development, strategic
dissemination, and critical evaluation of
relevant, accurate, accessible, and
understandable health information
communicated to and from intended audiences
to advance the health of the public”
(Bernhardt, 2004)
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History
Informatics Marketing

Psycholo Medicine
gy

Communi Health Infodemiology

cation Comm

• Stanford launched the benchmark Heart Disease Prevention Program in 1972

• ICA established the Health Comm division in 1972
• NCA formed the Commission for Health Communication in 1985
• Earliest books: Kreps & Thornton (1984), Sharf (1984), Northouse & Northouse (1985)
• Refereed journals: Health Communication, Journal of Health Communication
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Foci of Health Communication
(Kreps, 2020)
n Provider-patient communication

n Health campaigns and other types pf health promotions

n Health information in the media

n eHealth and mHealth

n Health risk communication

n Communicative processes within health organizations

n Everyday health communication

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What Can Health Communication
Accomplish?
n Population behavior change

n Change language to alter perceptions of problems &

solutions

n Identify & support people in need

n Diffuse /translate successful programs

n Policy change

n Professional training & improved patient-provider

encounters

n Organize stakeholders (boards, coalitions)

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Communication

Health
Transmission Ritualization

Public
 Public Health Communication

n Emphasizes on combining theory and practice in

understanding communication processes and changing
human behaviors

n Has relevance for virtually every aspect of health and

well-being
Media
campaigns at
Media population
advocacy at level
Social policy level
marketing at
Targeting at community
group level level
Tailoring at
individual
level
 Public Health Communication

Assumes…
n Ecological Perspective

n Change Orientation

n Audience-Centered Philosophy

(Bernhardt, 2004)
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Next Week

n NCI’s Theory at a Glance (P2; pp. 10-33)