Words matter in public health

Friday 7 August 2009

Giving people a sense of being in control is an important element in health messages, according to researchers at Nottingham and De Montfort universities. The research, which was funded by the Economic and Social Research Council (ESRC), looked at how language used in policy messages and media coverage affects the public perception of health threats. The report warns that lyrical and over-emotional language may be counter-productive when issuing warnings and advice about pandemics and hospital infections.

'During the SARS and bird flu scare scientists and health organisations used disaster metaphors, such as "tsunami," "perfect storm" and "bio-terrorism" to mobilise the media, governments, and individuals to prepare for a pandemic in waiting. Such terms can make people sit up and listen, but they can also lead to panic or cynicism,' says Professor Brigitte Nerlich, who led the research. 'Recent advice on swine flu has centred on basic hygiene, which makes people feel they can do something practical, instead of being mere victims of so-called "superbugs" or "killer viruses". But obviously this is easier to do when a disease is relatively benign.'

Professor Nerlich points out that easier internet access might also help people to feel in control, an issue that emerged from a previous ESRC project on foot and mouth disease carried out in Nottingham. Nowadays, and especially in the context of swine flu, 'email, Twitter, and public health sites all give information and advice which can be useful to worried individuals and may dampen down panic,' she says. 'But more research needs to be done in this area.'

This research focused on MRSA along with avian flu and was conducted by a multidisciplinary team with expertise in nursing, the social study of health and illness, environmental studies and linguistics. It compared the language of biosecurity, hygiene and cleanliness used in policy documents and media coverage with the language used by hospital matrons and poultry farmers dealing with the realities of MRSA and avian flu. 'We found that the way people communicate about a threat largely determines how they understand it and behave towards it,' says Professor Nerlich.

Additional findings established that media coverage of hygiene and cleanliness in hospitals tended to portray doctors and nurses engaged in a heroic "battle" against "intelligent super bugs. This was personified by the modern matron wielding the weapon of "cleanliness." Interviews with hospital matrons revealed a gap between the media portrayal and the reality on the wards. Matrons said that the limitations in their authority over contractors, and time constraints made it impossible for them to spend even half their time as a "visible presence" on the wards.

'This was another example of the control issue,' says Brigitte Nerlich. 'Modern matrons have limited powers to limit the spread of infection or improve hygiene. For instance, they can't hire extra nursing staff for barrier nursing or deal with problems with cleaning contractors. Our findings highlight the need for policy messages to be translated more accurately into practice.'

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Notes for editors

  1. This release is based on 'Talking cleanliness in health and agriculture', a study funded by ESRC. The research was conducted by Professor Brigitte Nerlich, Professor Paul Crawford, Professor Ronald Carter, Dr Brian Brown, Dr Nelya Koteyko and Dr Nick Wright.
  2. The findings are based on analysis of media and policy coverage of avian flu and MRSA and data from interviews with practitioners in agriculture and nursing.
  3. The Economic and Social Research Council (ESRC) is the UK's largest organisation for funding research on economic and social issues. It supports independent, high quality research which has an impact on business, the public sector and the third sector. The ESRC's planned total expenditure in 2009/10 is £204 million. At any one time the ESRC supports over 4,000 researchers and postgraduate students in academic institutions and independent research institutes.
  4. ESRC Society Today offers free access to a broad range of social science research and presents it in a way that makes it easy to navigate and saves users valuable time. As well as bringing together all ESRC-funded research (formerly accessible via the Regard website) and key online resources such as the Social Science Information Gateway and the UK Data Archive, non-ESRC resources are included, for example the Office for National Statistics. The portal provides access to early findings and research summaries, as well as full texts and original datasets through integrated search facilities.
  5. The ESRC confirms the quality of its funded research by evaluating research projects through a process of peers review. This research has been graded as outstanding.