Philip Alcabes discusses myths of health, disease and risk.

Media Culture: Beyond Fat and Salt?

Over at Media, Culture & Health, Steven Gorelick notes that a story on salt and the food industry, which appeared on page A1 of the print NY Times on Sunday, would not have made the front page in the past.

What has changed?  How does the story of wrangling over the sodium content of American food merit space in the main news sections of the most influential media — even the front pages of the NY Times or LA Times?

1.  One answer is that health occupies much of the American conversation today.  A visitor from another planet watching our TV news shows or reading the main newspapers would have to be forgiven for thinking that Americans are dying from a multitude of irrepressible disease threats.  We can’t seem to stop talking about how to improve our health.

(In fact, as Michael Haines notes at the Economic History Association website, U.S. life expectancy almost doubled between 1850 and 1960, from 39.5 years to 70.7 years; since then it has increased slowly, and is now estimated to be about 78.2 years.  In other words, health wasn’t a matter of news much during the time when longevity was improving dramatically, in the late 19th century and first half of the 20th.  By the time health became a cultural preoccupation, the majority of Americans were living well past middle age.)

2.  Another answer, perhaps more important is that when we talk about health today we mean personal responsibility.

When I began studying epidemiology, in the late 1970s, public health essentially meant disease control.  Yes, lip service was paid to so-called health promotion — much was made of the World Health Organization’s definition of health, promulgated in 1946:

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

But no metric for complete well-being was widely recognized.  And the usual epidemiologic measures of incidence and mortality rates, life expectancy, and so forth seemed to work just fine as ways of understanding why some groups of people lived longer and more capable lives, while others lived miserably and died young.

Sometime since then, the health sector, including public health, has turned to individual responsibility as the key to well-being.

If each of us is responsible for his or her own health, then it’s our own fault if we get sick.  Naturally, advice abounds:  buckle up, use a condom, eat less fat, know your cholesterol level, wash your hands, use mosquito repellent containing DEET, wear sunblock, eat fresh fruit and vegetables every day, lower your stress.

The advice adds up to this:  know your limits.  Federally sponsored research tells us that self-control is ontagious.

The personal-responsibility view of health says, “control your appetites.”

3.  But let’s think about another change:  more people are concerned about the American diet.  As noted last week, the food movement has given us ways to think about eating that go beyond the tiresome story of obesity and hypertension — Beyond Fat and Salt, you could say.

Of course, the main media outlets still tell the food story in Fat-and-Salt language, as the news articles in the NY Times, LA Times, and others show.  It’s the food industry vs. the foodies, or the food industry vs. public health, or the food industry and public health vs. appetites — anyway, somebody against somebody in the name of health.

The media aren’t quite past obesity and hypertension yet.  But as the culture moves beyond obsessive self-inspection in the name of health, no doubt media will, too.

Tags: , , , , , , , .

This entry was posted on Thursday, June 3rd, 2010 at 10:29 am and is filed under Behavior, Disease, Health Professions, Narratives, News, obesity, public health, Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

2 Responses to “Media Culture: Beyond Fat and Salt?”

What an important idea to keep in the background as we peruse and try to understand messages about health practices or behaviors, i.e., the fact that there is often a latent moral (or not so latent) moral message or agenda undergirding even the most sane, “evidence-based” health behavior. It is so easy to forget, especially when we have so completely internalized these moral frameworks as taken-for-granted reality.

And it’s not that the underlying moral agenda necessarily nullifies the basic behavior being urged. For example, I feel absolutely comfortable and “evidence-based” — and not coerced — when I choose to reduce salt in my diet, avoid the abuse of alcohol, and avoid caffeine use that might lead to sleep disorders.

But you are so right, Phil, about “good vs. bad” moral narratives that are often how culture packages various recommended health behaviors. You are told that need to do something that might reduce your risk for heart disease, not only because that might improve the quality of your life and the people in your social networks, but because that is what moral and decent people do, and because it has the promise of transforming you from a bad overweight person to a good, non-overweight person.

In sociology, we talk a lot about the activities of so-called “moral entrepreneurs” who embed all sorts of recommendations and prohibitions within larger moral narratives that features precisely the theme you describe, Phil — “somebody against somebody in the name of health:”

So often, their narrative conjures an imagined and implied moral chasm between those who are good and wholesome and moral and those who are bad and slothful and immoral.

I suppose the problem is that even the most sane recommended behavior — when cloaked in a scolding, Puritancal narrative — often stimulates resistance from people who sense and reject the mixture of morality and menu. The importance of the behavior can get lost and even marginalized when embedded in an artifically polarized morality tale pitting salt vs. no-salt.

I couldnt agree more that the media and culture needs to move beyond obsessive self-inspection and moral flagellation toward the basic concept of health.

But what a leap that will be for a media and culture that absolutely laps up tales of good vs, evil, regardless of how much nuance and important information those tales obscure.



Philip Alcabes says:

Thanks for joining in, Steve. I agree that when health advice takes the form of a good-vs.-bad narrative, some people are bound to reject it out of distaste for the implicit moralism — even if it’s actually good advice, and even if they might be ready to follow good advice were it offered with a little nuance.

But (this is where your inquiry about media is so important), how does it happen that the story of health risks is so central? Where are the media on Michael Pollan’s account of food reform, for instance, which draws not just on health but on deeper aspects of the human spirit, the thick moral connectedness of family relationships, and a sense of wonder about nature? You point out here that our media prefer tales of good and evil to any nuanced account. How would that change?