Using the Power of Media to Influence Health Policy and Politics
Using the Power of Media to Influence Health Policy and Politics
Beth Gharrity Gardner, Barbara Glickstein, Diana J. Mason
“Power relations … as well as the processes challenging institutionalized power relations are increasingly shaped and decided in the communication field.”
Manual Castells
In the 2008 Presidential campaign, social media did for the Obama campaign what the then new media of television did for John F. Kennedy in 1960. From the onset of his campaign, then U.S. Senator Barack Obama (D-IL) enlisted the support of Chris Hughes, a founder of Facebook, and David Axelrod, a former partner in the public relations firm ASK Public Strategies. Hughes and Axelrod built a team that marshaled every tool in the social media and marketing toolbox to create and sustain the Obama campaign. The campaign was ahead of competitors in using social media to connect with a growing audience of followers on Facebook, Twitter, and blogs. In the general election, then Senator Obama had 118,107 followers on Twitter, outpacing his opponent John McCain’s 2865 followers by a factor of 40 to 1 (Lardinois, 2008). He used social media to build a grassroots movement that resulted in his historic victory (Talbot, 2008). Using the Power of Media to Influence Health Policy and Politics
By the 2012 Presidential elections, the majority of social media users expected candidates to have a social media presence and stated that social media provided information that influenced their voting decisions (Steele, 2012). These trends among voters, and young voters in particular, were not lost on the Romney and Obama campaigns. By the eve of the 2012 conventions, both campaigns were regularly updating blogs on their websites and posting to Twitter, Facebook, and YouTube. As in 2008, Obama drastically outpaced all of his competitors in the volume of messages sent, the number of followers or fans, and in social media response (e.g., shares, views, and comments) (Pew Research Center’s Journalism Project Staff, 2012; Shaughnessy, 2012). Voters also played a larger role in communicating campaign messages. In 2012, the top five trending political topics on Facebook were “Barak Obama,” “Mitt Romney,” “voted,” “four more years,” and “Paul Ryan” (Groshek & Al-Rawi, 2013). Social media is now fully integrated into political campaigning and engagement (see Chapter 48). Using the Power of Media to Influence Health Policy and Politics
The use of social media has not been limited to political campaigning. Launched immediately after Obama’s 2008 win, Change.gov provided a website for people to share their ideas for improving legislation before it was signed into law. This sent the message that Obama had no intention of being limited by a traditional media operation as President. Rather, he was going to continue to engage people in supporting his agenda for the nation through multiple channels. When health care reform was teetering from a growing army of dissenters blocking its passage, he continued using social media to mobilize supporters to pressure Congress to act before the April 2010 recess. President Obama also took to the road and held town meetings in key communities because he knew that these meetings would garner reports on primetime television and radio and take a front-page position in newspapers. He could count on the primetime news including a sound bite and visual image of him speaking before a crowd of enthusiastic Ohioans. The personal appearances were a way to get his message to those who were not yet social media enthusiasts and to reinforce it with those who were already his followers on Twitter and 121Facebook. In 2014, when the open enrollment window for signing up for health insurance drew to a close, Obama appeared on the show “Between Two Ferns,” an online parody of celebrity interviews hosted by comedian Zach Galifianakis, to urge young adults to go to Healthcare.gov to sign up for health insurance. This unlikely appearance garnered coverage across traditional and social media platforms.
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New digital information and communication technologies have dramatically changed how and what we think about communicating with others, whether connecting with family or building a grassroots political movement to push policymakers to pass new laws. Even traditional media outlets are now augmenting their work with all sorts of social media to extend their reach, impact, and, in some cases, survival. Legislators are routinely launching blogs, using Facebook, and tweeting to make their voices heard and to connect with their constituents. This chapter looks at the integration of traditional and social media as powerful tools for nurses to harness in shaping health policy and politics. Throughout, we draw insights from contemporary and past cases to highlight the role of media in influencing health policy and politics. Using the Power of Media to Influence Health Policy and Politics
Seismic Shift in Media: One-to-Many and Many-to-Many
In the 21st century there has been a seismic shift in the way media is created and distributed. For many years, the dominant paradigm in media was a model in which one broadcaster sent a message out to a mass audience. This broadcast model is referred to as the one-to-many model. This model has been challenged by the Internet and user-generated content in which many people create media and distribute it to their individualized networks. This new model is sometimes referred to as the many-to-many model because it provides opportunities for feedback and interaction, features that have led to the ubiquitous use of the term “social media.”
We now have convergence media, or the interweaving of traditional and social media. Rather than these platforms remaining separate, traditional and networked media are working side by side. For instance, even though the New York Times in print or even as an app is mostly a one-to-many broadcasting media model, the newspaper’s blogs, videos, and comment sections reflect the digital side of the newspaper as a networked media platform. News organizations exclusive to the online environment have been created and some veteran print publications have moved entirely or mostly online, but the degree of convergence is unclear (Hindman, 2009). Using the Power of Media to Influence Health Policy and Politics
Mass Media: the One-to-Many Model
Traditional media in radio, television, film, and newspapers was based on the idea that one broadcaster would try to reach as many audience members as possible. However, for those interested in influencing health policy and politics through the media there were many advantages and some significant disadvantages to the one-to-many model of broadcast media (Abramson, 2003).
Radio, film, and television have all been used to communicate messages about health to consumers and policymakers alike. What all these media share is the ability to broadcast a message to a mass audience, sometimes in the millions or tens of millions. When there were few media outlets it was possible to repeatedly broadcast a consistent message to a wide audience. The use of mass media has been a major tool in health promotion campaigns because it reaches a large audience and is capable of promoting healthy social change (Institute of Medicine, 2002; Wakefield, Loken & Hornik, 2010). Using the Power of Media to Influence Health Policy and Politics
There are also disadvantages to mass media communications. Large corporations own media outlets and control what goes out through their channels and the expense of buying time or space in major media outlets can be prohibitive, especially for nonprofit organizations. Mass media campaigns, by definition, are intended to reach a wide audience but are not as effective at reaching target populations. For example, a mass media campaign about HIV prevention may reach a wide audience but fail to reach the specific population that is most vulnerable to infection. However, political operatives have developed increasingly sophisticated approaches to segmenting and targeting specific electoral districts with mass media when they want 122to pressure a policymaker who may hold a deciding vote on an important bill. Such organizations buy commercial time on the dominant television station in that policymaker’s district. However, what no form of mass media does very well is allow users to create and distribute their own content with the messages they find most important Using the Power of Media to Influence Health Policy and Politics
