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A quantitative analysis of the quality and content of the health advice in popular Australian magazines

Authors:

Abstract

Objective: To examine how health advice is provided in popular magazines and the quality of that advice. Methods: A prospective quantitative analysis of the quality of health advice provided in Australian magazines between July and December 2011 was conducted. A rating instrument was adapted from the Media Doctor Australia rating tool used to assess quality of health news reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence; advice clear and easily applied; benefits presented meaningfully; potential harms mentioned; evidence of disease mongering; availability and cost of treatments; obvious advertising; vested interest, and anecdotal evidence. Results: 163 health advice articles were rated showing a wide variation in the quality of advice presented between magazines. Magazines with 'health' in the title, rated most poorly with only 36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving advice based on reliable evidence. Conclusions: Australian magazines, especially those with health in the title, generally presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest quality advice. Implications: Consumers need to be aware of this when making health choices.
2017 vol. 41 no. 3 Australian and New Zealand Journal of Public Health 256
© 2016 Public Health Association of Australia
The media play a central role in the
dissemination of information on health
and medical issues. More people obtain
information about new developments through
the media than from health professionals in
Australia and elsewhere.1,2 Media coverage
of health news has been shown to inuence
how people perceive medical issues and to
aect health behaviours in both positive and
negative ways.3,4
Health advice has been provided by
magazines for many decades and while
publication sales in all areas of the media
are falling, magazines remain a popular
way to seek health information.5 Magazine
proprietors widely promote their publications
as having a substantial impact on readers.
There is evidence that shows media coverage
can aect health behaviour, such as the rise in
the number of mammogram appointments
after Kylie Minogue was diagnosed with
breast cancer3. It is reasonable to assume
that lifestyle magazines, especially those with
the word ‘health’ in their title, would have an
impact on health literacy and behaviour.
Lifestyle magazines target specic age and
gender readerships and are very popular in
Australia. The top six magazines in Australia
have a combined annual circulation of over
1.7 million with a readership of nearly ve
times that gure (Table 1). Around 60% of
Australians over 15 years of age read at least
one magazine every week and in the year
to June 2013, Australians spent $789 million
buying 150 million magazines.6,7
The impact of the media on health literacy
along with evidence of poor quality health
reporting presents a strong rationale
for implementing measures to improve
media coverage.2,8 Most Australian lifestyle
magazines dedicate signicant space to
health advice including ‘question and answer’
sections, columns, stories, product promotion
and short ‘break-outs’ on health information.
Advice includes prevention and/or treatment,
and is written by medical doctors, dietitians,
herbalists, psychologists or lay journalists.
There is strong evidence around the poor
quality of health reporting in the media.8-10
However, while one study comparing health
information presented in two magazines
found less than optimal reporting, there has
been no quantitative evaluation of the quality
of this health advice.11
This study aimed to examine the way health
advice is provided in popular magazines and
assess the quality of that advice. This is an
area of the health media with a substantial
ongoing audience and the potential to
negatively aect health behaviour. Our
ndings provide insight into the quality
of this medium and an initial step towards
raising this quality and awareness around it.
Methods
The study was a prospective quantitative
analysis of the quality of health advice
provided in Australian lifestyle magazines.
Magazine articles specically providing
health advice, as opposed to health news
or information, were collected from lifestyle
magazines over the six months July to
December 2011. Hard copies of each
magazine were purchased at the time of
publication (via subscriptions) and manually
A quantitative analysis of the quality and content of
the health advice in popular Australian magazines
Amanda Wilson,1 David Smith,1 Roseanne Peel,1 Jane Robertson,2 Kypros Kypri1
1. School of Medicine and Public Health, University of Newcastle, New South Wales
2. Clinical Pharmacology, University of Newcastle, New South Wales
Correspondence to: Dr Amanda Wilson, University of Newcastle - Medicine and Health, University Drive, Callaghan, New South Wales 2308;
e-mail: Amanda.wilson@newcastle.edu.au
Submitted: March 2016; Revision requested: June 2016; Accepted: August 2016
The authors have stated they have no conict of interest.
Aust NZ J Public Health. 2017; 41:256-8; doi: 10.1111/1753-6405.12617
Abstract
Objective: To examine how health advice is provided in popular magazines and the quality of
that advice.
Methods: A prospective quantitative analysis of the quality of health advice provided in
Australian magazines between July and December 2011 was conducted. A rating instrument
was adapted from the Media Doctor Australia rating tool used to assess quality of health news
reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence;
advice clear and easily applied; benets presented meaningfully; potential harms mentioned;
evidence of disease mongering; availability and cost of treatments; obvious advertising; vested
interest, and anecdotal evidence.
Results: 163 health advice articles were rated showing a wide variation in the quality of advice
presented between magazines. Magazines with ‘health’ in the title, rated most poorly with only
36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving
advice based on reliable evidence.
Conclusions: Australian magazines, especially those with health in the title, generally
presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest
quality advice.
Implications: Consumers need to be aware of this when making health choices.
Key words: life expectancy, eciency, data envelopment analysis, Māori, New Zealand
HEALTH PROMOTION
257 Australian and New Zealand Journal of Public Health 2017 vol. 41 no. 3
© 2016 Public Health Association of Australia
searched-for articles. Articles were eligible
for inclusion if they explicitly recommended
interventions to treat, manage or prevent
diseases or health issues and were not
obviously advertisements. The articles
included dedicated health advice columns,
long articles on specic problems and short
break-out articles on how to improve health
or deal with health issues. Ten Australian
magazines were included in the study (Table
1). The magazines were selected on the
basis of their popularity (circulation rates)
and target readership (gender, interest and
age range). Every issue of each magazine
published from 1 July to 31 December 2011
was included in the study.
The rating instrument used in this study was
adapted from the Media Doctor Australia
rating instrument used to assess the quality
of health reporting in the Australian news
media.12 The 10 criteria are shown in Box 1.
For each article, a search was conducted to
locate any relevant journal articles, author
qualications or other supporting literature
that might assist the reviewers in making their
assessments of the quality of the information
reported. A coding manual was developed
to guide the assessments and interpretation
of the criteria. For each article, the 10criteria
were assessed as ‘satisfactory’, ‘not satisfactory’
or ‘not applicable’. Agreement was achieved
between raters as to how the evaluation
criteria would be interpreted. All dierences
between raters in the scores assigned for
individual criteria were resolved by consensus
during regular face-to-face meetings. Ethics
approval was not sought given that the data
are in the public domain.
A total of 163 articles providing health advice
were collected over the six months by an
experienced researcher (RP). Two of three
experienced Media Doctor Australia raters (AW,
DS, RP) independently assessed each article.
A descriptive analysis was conducted and
consensus scores calculated on each of the
10 rating criteria. The results are presented as
the number and percentage of items within
each magazine that were considered to be
satisfactory for each criterion and across all
criteria. Only one article was included from
the magazine Girlfriend and while it rated
satisfactory on all items, it has not been
included in the overall results.
Results
The range of dierent health topics covered
by the articles reviewed is presented in Table
2. The most frequently discussed topics
related to gynaecological and urinary tract
matters (22.6%) and the use of vitamin and
mineral supplements (14%). Of the 984
criteria assessed from 163 articles, only 570
(58%) were assessed ‘satisfactory’. However,
there was a wide range of quality between
publications (see Table 3) with Dolly at 100%,
and Women’s Health at 26%.
The magazine Dolly scored well on all items.
Most of the articles from Dolly took the form
of reader questions with answers provided
by a practising medical doctor. The topics
covered were typically those important to
adolescents, such as skin problems, body
image and emerging sexuality, however,
concerns including depression, severe anxiety
and suicidal tendencies were also raised.
From a clinical perspective of quality of
content, the two most important rating
criteria were advice is based on accepted
medical practice or reliable evidence and
benets of advice are presented in a meaningful
way. There were 160 articles where both of
these criteria could be assessed (Table 4).
These results demonstrate a wide variation
in the quality of advice presented between
magazines. Magazines with the word ‘health’
in the title, rated most poorly with only 36%
(26/73) of these articles presenting advice
that was clear and meaningful and 52%
(38/73) of the articles presenting advice
based on reliable evidence or reected
current practice.
Conclusions
The ndings from this study show that overall,
the quality of advice presented in magazines
was low, although there was a wide variation
between magazines. Magazines with the
word ‘health’ in the title, such as Women’s
Health, presented the lowest quality advice,
while the teen magazine Dolly rated as the
highest quality.
The media shape the public’s perceptions
of both health and disease and inuence
health behaviour and use of health care
interventions.1,2 The Press Council of
Australia’s Advisory Guidelines states:
“The Press Council views with concern
inadequately researched reports on health
and medical matters appearing in the press
and in the media as whole. The dangers of
exciting unreasonable fears or hopes are far
too great for anything but the most careful
treatment”.13 This study shows that popular
Table 1: Magazine readership and target audience.
Title Circulation Readership
(% female)
Target Audience
(% of readership)
Frequency
Women’s Weekly 470,221 2,348,000 (80) Female 25-54 years (87) Monthly
Woman’s Day 365,266 1,802,000 (84) Female 25-54 years (85) Weekly
New Idea 303,264 1,192,000 (83) Female all ages (NA) Weekly
Cosmopolitan 125,548 529,000 (85) Female 18-34 years (63) Monthly
Cleo 105,157 378,000 (89) Female 18-30 years (59) Monthly
Women’s Health 92,323 417,000 (87) Female 25-44 years (57) Monthly
Dolly 90,318 318,000 (91) Female 14-17 years (47) Monthly
Girlfriend 80,014 318,000 (89) Female 14-17 years (51) Monthly
Men’s Health 73,086 392,000 (20) Male 25-44 years (56) Monthly
Good Health 66,294 299,000 (81) Female 25-54 years (89) Monthly
Box 1: Rating criteria.
Articles were assessed for the extent to which they
complied to the following 10 criteria:
1. Recommends seeing a doctor, if applicable
2. Advice is based on accepted medical practice or reliable
evidence
3. Advice is clear and easily applied
4. Benets of advice are presented in a meaningful way
5. Potential harms of recommended treatments are
mentioned
6. There is no evidence of “disease mongering” (12)
7. The availability and costs of treatments are mentioned
8. The author has no apparent vested interests
9. There is obvious advertising
10. Anecdotal evidence is used appropriately
Table 2: The number of topics covered in the health
advice articles.
Topic Number of
articles (%)
Gynaecological and female urinary tract
disorders, sexually transmitted infections,
contraception/fertility/pregnancy
37 (23%)
Vitamin and mineral supplements 22 (14%)
Cardiovascular disease/blood pressure 12 (8%)
Cancer 12 (8%)
Brain/memory disorders 7 (4%)
Gastrointestinal disorders 7 (4%)
Respiratory disorders 6 (4%)
Pain 5 (3%)
Diabetes 3 (2%)
All other topics 52 (31%)
Health Promotion Quality of health advice in Australian magazines
2017 vol. 41 no. 3 Australian and New Zealand Journal of Public Health 258
© 2016 Public Health Association of Australia
Australian lifestyle magazines, especially
those with the word health in their title, are
not meeting these standards. The ndings
presented in this study only represent a
relatively brief snapshot of a specic and
diminishing section of the media landscape.
However, magazine readers should be
informed that the health advice provided by
these magazines is often poorly presented
and unreliable.
Specically titled health magazines
rated poorly on all measures. However,
the magazines marketed to adolescent
girls performed well overall. In Dolly, all
reader questions were responded to in
an accessible, non-judgmental manner
with encouragement to seek help from
appropriate health professionals. This
magazine provided excellent examples of
ethical ways to deliver health advice and also
highlighted the need for this type of advice to
be provided for this particular age group.
The overall range of health advice topics
was very limited and did not include any
important contemporary health issues such
as smoking, obesity and immunization. The
two most commonly discussed topics were
genitourinary issues and the use of vitamins
and minerals. While not presented in this
paper, we collected data on advertisements
in close proximity to the advice rated, and
the most common advertisements were
for female genitourinary products and
vitamins and minerals, suggesting a possible
nancial conict of interest. Advertising is
by its nature, manipulative and strategic.14 A
strong correlation between advertisement
placement and article content is an eective
marketing strategy that has been shown to
exist even in medical journals.15
Implications
The ndings from this study raise questions
around the social responsibility of the
media. Most journalists and public health
providers believe that health is a special
commodity that gives rise to particular social
responsibilities.16,13 If the public has a right
to know it also has a right to be provided
with information that is accurate and
complete17. Many studies have looked at the
inuence and quality of health news stories,
but few, if any, have looked at the quality
of health advice given in magazines. The
ndings present here are important because
magazines are not generally subjected to
the same rigours of news journalism and
the content is likely to be inuenced by
companies advertising ‘health’ products and
interventions. This type of soft journalism
appears in many dierent forms on the
internet where health advice is presented as
evidence based and current. We have shown
that the quality of health advice provided in
magazines is generally poor. This message
is important in order to raise the awareness
and promote critical thinking among health
consumers.
References
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public learns about screening and diagnostic tests
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Simbra M, et al. What are the roles and responsibilities
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Studdert DM. Use of breast cancer screening and
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Table 3: Criteria assessed as satisfactory.
Magazine Articles
n
Criteria Assessed
n
Criteria assessed satisfactory
n (%)
Good Health 38 259 126 (49)
New Idea 26 164 68 (41)
Women’s Weekly 19 116 78 (67)
Women’s Health 18 104 27 (26)
Men’s Health 17 102 70 (69)
Dolly 16 84 84 (100)
Cosmopolitan 13 85 69 (81)
Cleo 9 46 32 (70)
Woman’s Day 3 20 12 (60)
Table 4: Number of articles assessed as satisfactory on two specic criteria.
Magazine n Advice presented clearly and
meaningfully n (%)
Advice based on reliable evidence
or medical opinion n (%)
Good Health 38 21 (55%) 14 (37%)
New Idea 26 12 (46%) 14 (54%)
Women’s Weekly 19 15 (79%) 14 (74%)
Women’s Health 18 4 (22%) 3 (17%)
Men’s Health 17 13 (76%) 9 (53%)
Dolly 16 16 (100%) 16 (100%)
Cosmopolitan 13 12 (92%) 11 (85%)
Cleo 9 7 (77%) 7 (77%)
Woman’s Day 3 2 (67%) 1 (33%)
Wilson et al. Article
... Aber auch bei wissenschaftlichen Auseinandersetzungen mit Zeitschriften stand nicht der funktionale Leistungsbeitrag dieser Mediengattung für moderne differenzierte Gesellschaften im Vordergrund: Vor allem galt das Erkenntnisinteresse entweder der ökonomischen Leistungsfähigkeit von Zeitschriften im Rahmen von Marktanalysen (Heinrich, 2002; Medien Journal 3/2019 • Das Konzept Mediensystem in Zeiten von Konvergenz und Digitalisierupg 47 Nowak, 2009;Seufert, 2004;Tschörtner & Schenk, 2009;Vogel 2010;Vogel 2014) oder den spezifischen Inhalten (bspw. dem Frauenbild in Zeitschriften : Beetham 1996; Davalos, D.B" Davalos, R.A. & Layton, 2016;Hermes, 2010;Sakamoto, 1999;Schlenker, Caron & Haltemann, 1998;Stephenson, 2007; Ytre-Arne, 2011, oder Gesundheitsinformationen: Aubrey & Hahn, 2016;Bazzini, Pepper, Swofford & Cochran, 2015;Hinnant, 2009;Mathews, Laditka, S.B" Laditka, J.N. & Friedman, 2009;Ringelmann, 1991;Wilson, Smith, Peel, Robertson & Kypri, 2017). Zudem herrschen Fallstudien vor (Cauers, 2009;Fiedler, 2003;Sehmolke, 2002;Rössler & Ott, 2002;Röttger, 2002). ...
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Claims made in current advertising for medical products is not necessarily scientifically proven, yet at the same time clinicians are required to adopt evidence-based practices and undergo periodic certifications. This is a clear contradiction. It is crucial to begin to reflect on the need to regulate information presented in the media and to place greater emphasis on patient well-being and safety instead of on third-party interests. The medical community must demand stricter regulations and evidence-based advertising policies.
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A lot of money can be made from healthy people who believe they are sick. Pharmaceutical companies sponsor diseases and promote them to prescribers and consumers. Ray Moynihan, Iona Heath, and David Henry give examples of "disease mongering" and suggest how to prevent the growth of this practice.
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This study's purpose was to investigate the types and quality of health information reported in Glamour and Men's Health magazines. While neither magazine was completely accurate when reporting results of medical journal articles, there were statistically significant differences with respect to accuracy between the two magazines. These findings suggest that health experts, PIOs, and journalists need to work more closely together in order to provide the public with accurate and clear health information.
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