Celebrities’ hidden role in public health

NCS
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When celebrities converse, it appears, the world listens – even in relation to private and public health.

Just have a look at what occurred after Charlie Sheen’s HIV disclosure two years in the past, mentioned John Ayers, a analysis professor at San Diego State University.

Sales of in-home HIV testing kits reached document highs across the similar time the actor announced that he had been identified as HIV-positive in 2015, in response to a examine printed in the journal Prevention Science on Thursday. Ayers was a co-author of the examine.

About the identical time, “in record numbers, people were going online, seeking out information on what the signs of HIV are, on how to find and appropriately prevent HIV with devices such as condoms and also how to get tested,’” Ayers mentioned. “We’ve seen this … many times over.”

For the brand new examine, Ayers and his co-authors monitored weekly gross sales of OraQuick, the one FDA-approved at-home oral HIV testing kit out there in the United States, from 2014 to 2016.

The researchers discovered that there have been 8,225 extra gross sales than they anticipated the week of Sheen’s HIV standing announcement. Elevated gross sales continued for 4 weeks after Sheen’s disclosure.

The findings present a correlation, not a direct causation. Yet in a earlier examine, Ayers and his colleagues additionally discovered that Google searches for HIV testing and associated matters additionally spiked after Sheen’s announcement.

“The most common reaction is, ‘So what? What does a search really mean?’ Our new study shows not only did Sheen’s disclosure lead people to seek information about HIV prevention, it also corresponded with record levels of at-home rapid HIV testing sales,” Ayers mentioned.

Though they aren’t medical doctors, many celebrities have had each constructive and unfavourable ties to public health in current years.

“The positive example I often point to is when Magic Johnson talked about being HIV-positive, which provided a moment to bust stigma around HIV,” mentioned Steven Hoffman, scientific director of the Institute of Population and Public Health in Canada and director of the University of Ottawa’s Global Strategy Lab.

In 1991, when most individuals didn’t have a lot details about the virus and the Internet was not generally used, the American basketball star introduced that he had examined constructive for HIV and retired from the NBA.

“Here was a very prominent athlete who is publicly disclosing being HIV-positive and opening up conversation around it for people,” mentioned Hoffman, who was not concerned in the most recent examine. “I think that’s an example highlighting the positive role that celebrity can play in informing health decisions.”

Yet whereas Johnson’s HIV disclosure spurred questions and conversations, because the virus was nonetheless unfamiliar, Sheen’s disclosure was linked to motion, Ayers mentioned.

After Sheen’s announcement, about 1.25 million individuals in the United States searched on-line for matters instantly associated to condoms, HIV signs or HIV testing, in response to Ayers’ earlier examine, printed in the journal JAMA Internal Medicine final yr.

That examine concerned analyzing Google Trends and search time period information from 2004 by November 2015, which included when Sheen disclosed his HIV standing on November 17, 2015.

The researchers discovered that Sheen’s announcement corresponded with the best variety of HIV-related Google searchers ever recorded in the US. But Sheen didn’t make a right away name to motion for the public to get examined or use condoms, and public health teams didn’t use him as a face to lift HIV consciousness.

Therefore, Sheen’s disclosure was an instance of how – with out the superstar or public health leaders calling for motion – the public appeared to nonetheless reply based mostly on health info that was extensively identified, Ayers mentioned.

“When Magic Johnson made his disclosure, there wasn’t a similar reaction. There couldn’t be, because people didn’t know what to do,” Ayers mentioned.

“Remember, people (were) asking, ‘Can he play basketball?’ ‘Can I shake his hand?’ There wasn’t this trove of information about HIV, HIV prevention and HIV testing. When Sheen disclosed, there was this trove of information,” he mentioned. “We saw people seeking out information on the signs of HIV, HIV testing and how to prevent HIV by using condoms. We saw this trilogy of reaction that is fairly consistent with what public health has been promoting for 20-plus years.”

Kami Kosenko, an affiliate professor of health communication at North Carolina State University, mentioned that she believes actress Angelina Jolie’s 2013 announcement of a double mastectomy to stop breast most cancers additionally had a constructive affect on public health, regardless of probably influencing an uptick in pointless genetic testing.

Jolie mentioned she made her determination as a result of she has a mutation in her BRCA1 gene. Specific inherited mutations in BRCA1 enhance the chance of breast and ovarian cancers, and Jolie’s mom died of ovarian cancer. Jolie determined to even have her ovaries and fallopian tubes removed in 2015.

Kosenko led a examine in which 229 girls had been surveyed instantly after Jolie’s announcement to bear a double mastectomy. Researchers checked out whether or not Jolie influenced the ladies’s genetic testing intentions.

The examine, printed in the Journal of Health Communication final yr, confirmed that 30% of the ladies supposed to get examined to see whether or not they carried the BRCA1 gene, 23% mentioned they might most likely get examined, and seven% mentioned they might positively get examined. The others reported that they might not get examined.

Kosenko mentioned that separate studies demonstrated elevated genetic testing requests and Internet searches associated to BRCA1 after Jolie’s announcement.

“We rely heavily on friends and family for health information, and we tend to see certain celebrities as friends. Unfortunately, we do not share the same resources as these famous ‘friends,’ which impacts our ability to follow celebrity health advice,” she mentioned. “For example, at the time of Jolie’s announcement, the genetic tests she underwent were prohibitively expensive for the average American.”

There are examples of celebrities having a probably dangerous affect on public health too, mentioned Hoffman, director of the University of Ottawa’s Global Strategy Lab.

“The most prominent example of harm would be, in my mind, Jenny McCarthy,” Hoffman mentioned.

The American actress has been a vocal autism activist, spreading issues that autism could be related to childhood vaccines.

McCarthy was unavailable for remark, however her consultant mentioned she addressed her stance on vaccines in an op-ed printed in the Chicago Sun-Times in 2014, headlined “The gray area on vaccines.”

Her son, Evan, was diagnosed with autism. She believes that medical doctors ought to change some kids’s vaccine schedules, reminiscent of permitting for one shot per physician’s go to as a substitute of a number of photographs, she wrote in the op-ed.

“I am not ‘anti-vaccine.’ This is not a change in my stance nor is it a new position that I have recently adopted. For years, I have repeatedly stated that I am, in fact, ‘pro-vaccine’ and for years I have been wrongly branded as ‘anti-vaccine,’ ” McCarthy wrote.

“My beautiful son, Evan, inspired this mother to question the ‘one size fits all’ philosophy of the recommended vaccine schedule,” she wrote. “I embarked on this quest not only for myself and my family, but for countless parents who shared my desire for knowledge that could lead to options and alternate schedules, but never to eliminate the vaccines.”

Research exhibits that side effects from vaccines are rare, and the Centers for Disease Control and Prevention has repeatedly said that there isn’t a hyperlink between vaccines and autism.

“She is actually recommending practices that are unhealthful and potentially dangerous,” Hoffman mentioned about McCarthy’s stance on altering vaccine schedules.

“Recommending to people not to vaccinate their children means not only are the children being subjected to unnecessary harm, but many others around those children who might not be able to get vaccinated for legitimate reasons are put at an additional risk ask well,” he mentioned. “It’s not only unfair to the children who aren’t being vaccinated, but also to the many people who can’t be vaccinated, who interact with those children.”

Even although they’re weak to sickness, some individuals could not be capable of get sure vaccines based mostly on age, an allergy or pre-existing health situation, or different elements, according to the CDC.

Public health consultants even have accused actress Gwyneth Paltrow of spreading some questionable health ideas by her way of life weblog, goop.

In a written assertion, goop spokeswoman Noora Raj Brown described the web site as pushing “new ideas into the conversation” in health and wellness.

“We have a disclaimer on the bottom of every article that states the purpose is to highlight alternative studies and induce conversation. It’s not a substitute for professional medical advice, diagnosis, or treatment. The views of the experts profiled don’t necessarily represent the views of goop,” the assertion mentioned.

One blog post on goop really helpful inserting a rock, referred to as a jade egg, into your vagina to enhance your intercourse life and orgasms, amongst different advantages.

Some consultants have mentioned that not totally cleansing or sterilizing the jade egg could lead to infection, or that it may get caught.

“In many cases, there are opposing opinions on issues – like the jade eggs for example – and our role is to service the conversation,” Brown mentioned.

A listing of spas and wellness centers on goop mentions “v-steam,” or vaginal steaming, and means that the follow “balances female hormone levels,” which some experts have refuted.

“Gwyneth Paltrow’s messages, it’s mostly that she’s recommending practices that don’t work,” Hoffman mentioned. “The biggest harm is the loss or waste of money and the misplaced attention away from practices that actually work.”

A jade egg on goop prices about $66. Hoffman mentioned that the cash could possibly be higher spent on shopping for nutritious meals or a gymnasium membership.

“Do celebrities have an impact on health outcomes? We know they do. … There’s so many studies out there that have demonstrated that when celebrities either give helpful or harmful advice to people, it’s routinely followed,” Hoffman mentioned.

“I do blame celebrities, because they need to recognize the impact they can have and the potential harm that can result from it,” he mentioned. “I definitely blame those who are spreading misinformation.”

Hoffman and his colleagues printed a review paper in the British Medical Journal to research the affect celebrities have on individuals’s health choices by the elements of economics, advertising and marketing, psychology and sociology.

“In marketing literature, they talk about a halo effect around celebrities, whereby people have a very positive view of celebrities, and when celebrities endorse a product or recommend a particular health practice, it transfers their golden glow from the celebrity to the products or practice,” Hoffman mentioned.

“In economics literature, there’s recognition of something called signaling, which is whereby in a marketplace filled with competing ideas, people are constantly looking for a shortcut in order to identify which products or practices they should be following, and so a celebrity endorsing a product provides a cognitive shortcut to an otherwise very complicated decision,” he mentioned. “There is increasing recognition of the role of social networks, and there’s few people who have bigger social networks than celebrities. Just think of the number of Twitter followers some celebrities have cultivated.”

However, Ayers, creator of the most recent examine, mentioned it may not be that difficult.

“It’s not so much about a celebrity effect,” he mentioned, including that when celebrities converse out about health-related points, it could resonate as a result of they’re talking as people with simply as a lot vulnerability to health impacts as anybody else.

“Typically, public health uses top-down strategies. The most effective messages are believed to come from the experts, ‘from the top.’ The people who know the most about the subject, the people who are paid to sit around and think about the subject,” Ayers mentioned.

“It turns out, though, that if you look at the Sheen effect and if you look at these other examples of organic media events … that’s not the case. These messages, they come from the bottom; they come from ordinary people. People who aren’t health experts. Sheen might be a celebrity, but he’s not a health expert. Angelina Jolie is not a health expert,” he mentioned.

All in all, Hoffman mentioned, public health officers may work with celebrities to harness their fame to unfold evidence-based health info and mitigate the unfold of misinformation.

He cited supermodel Christy Turlington Burns as a constructive instance of a celeb working with public health authorities to advertise constructive health practices. She served as a spokeswoman in CDC promotional ads elevating consciousness about smoking cessation and the health dangers of smoking.

Ayers mentioned he noticed public health officers make the most of the ability of Sheen’s superstar in actual time, not throughout however after his HIV announcement.

“It turns out that actually because of our study, we got to see those things happen. When we published our study, a few weeks later, Charlie Sheen began speaking out about HIV prevention, particularly condoms, and he cited our study as one of the reasons for doing that,” Ayers mentioned of the examine on Google searches. “We also saw several leading organizations in HIV prevention begin to use Charlie Sheen’s disclosure as a way to promote HIV prevention.”

Hoffman mentioned it could be helpful to see extra examples of celebrities and public health leaders working collectively in the longer term.

“I think there probably are a lot of celebrities who want to do good and would be open to the idea of working with public health officials to do good,” he mentioned. “We just need to still figure out the best way of doing that, in terms of what would be most effective.”

For now, to make knowledgeable health choices, Dr. Georges Benjamin, govt director of the American Public Health Association, provided some steerage in an e mail.

“Get a second opinion,” he wrote. “Trust but verify celebrity statements from trusted health sources like the American Cancer Society, the Center for Disease Control and Prevention, APHA, American Academy of Pediatrics” and others.