INTRODUCTION

Volume 1, Number 1
January-March 1996

Vol. 1, Num 1: Contents | Introduction | Up Front | Abstracts

Introduction
SCOTT C. RATZAN

This new Journal of Health Communication is dedicated to offering practical and heuristic insights into the reciprocally beneficial relationship between optimal health and effective communication. My overarching goal as editor, working closely with the talented researchers and practitioners on the editorial board, is to present a meaningful dialogue on the multidisciplinary approaches required to preserve our most fundamental and natural resource-the health of our global polity. Suffice it to say that this perspective on health is far-reaching than that embodied in the age-old traditional medical goal of "absence of disease." Yet central tenets of the contemporary mission of researchers and practitioners should be traditional ones: prevention and ethical decision making.

I was initially attracted to the health professions by the powerful idea of "helping people" and of becoming one of the 600,000 people in the United States engaged in the meritorious task of being a physician. As I continued along the traditional educational path toward becoming a medical doctor, I grew more and more disturbed by the realization that the root of so many diseases and illnesses lies within our inability to communicate effectively and influence lifestyle decisions. I also realized that, despite this inability, the traditional role and expectations of the physician have become more specialized and narrow in scope.

Today's medicalization of disease-objectifying the people and standardizing the approach-is a rigid practice that is hard to change. The result is that the etymological definition of doctor- as "teacher" (from docere) has been supplanted. Currently, the physician frequently acts more as a business person or as an employee in a health care enterprise. Witnessing this change in medicine firsthand, from the perspective of a physician and a son of a physician, I acquired an intense interest in health communication. and the opportunities the discipline has to meet the health challenges of today and the next century.

Health communication is concerned with the use of ethical, persuasive means to craft and deliver campaigns and implement strategies that promote good health and prevent disease. It is practiced by people from a number of disciplinary backgrounds who plan, influence, and evaluate health care policy and who make health decisions that will enhance the quality of life for individuals and communities across the globe. It is multifaceted and multidisciplinary. This is why the editorial board of the Journal of Health Communication is composed of experts trained in a myriad of fields, including communication, medicine, psychology, public health, sociology, government, and marketing, among others.

Today's technological tool chest, the almost daily miraculous medical breakthroughs, and ever-expanding venues of instantaneous global communication-all of these enrich the potential of discovering Ponce de Leon's fountain of youth. Nonetheless, duration and quality-of-life advancements are dwarfed by dangers similar in magnitude to the biblical plagues and pestilences of centuries past. Deleterious human behavior, environmental conditions, and microbial disease outstrip modern medicine's machinery and humankind's ingenuity. Witness the latest pandemic of AIDS, recent outbreaks of Ebola, tuberculosis resurgence, cholera epidemics, and other viral threats. These recent nemeses to our global health are aggravated by the overriding deadly impact and dastardly toll of preventable diseases. According to the U.S. Centers for Disease Control and Prevention (CDC), six chronic diseases-heart disease, cancer, stroke, diabetes, chronic obstructive pulmonary disease, and chronic liver disease-account for 71.5% of all deaths in the United States. In such diseases, effective health communication can command a central role in designing and practicing the optimal Course of action-prevention.

An important objective of the Journal of Health Communication, in keeping with its ambitious agenda, is to expand the realm of health communication to include that which traditionally has been associated with advocacy, marketing, media, persuasion, and global communication. Given the technological capabilities and crucial role of the mass media in packaging information and disseminating it to various publics, it is paramount that health communication be viewed not only as concerned with the health of individual members of society, but also with prudent policy making and the ultimate well-being of the community, nation, and humankind. Inherent within this expanded approach to scholarship and efficacious practice is the formulation, development, and implementation of healthy public policy.

Effective health communication is emblematized in the elements of an acronym signifying balance-POISE, for Physical, Occupational, Intellectual, Social, and Emotional well-being. At the core of this conceptualization is ethics, and the responsibility we all have in establishing trusting relationships. A central focus of this Journal, therefore, is that effective health communication depends on a shared understanding of community ideals, With this common understanding, we can begin to eliminate the current bureaucratic maze, simplify medical and behavioral jargon, and nurture supportive personal, family, work, and community environments.

Reflecting this outlook, the "Up Front" section of the Journal, which opens each issue, is designed to provide readers with noteworthy, practical material in a user-friendly fashion. A "Vital Data" segment of this section contains key findings from the field, announcements, preliminary results, and material gleaned from a variety of academic and professional sources. The "Prescriptions" segment that follows includes key action steps from current contributions to the Journal. The objective here is to provide information in an easy-to-read format, complete with distilled ideas and action statements for immediate interest and application. Distributed electronically on the World-Wide Web, this section should spawn interest in the original research in subsequent sections. Health communication specialist Mary Jo Deering, of the Office of Health Promotion and Disease Prevention of tile U.S. Department of Health and Human Services, will serve as associate editor for this important component of the Journal.

The second section of the Journal features the traditional, scholarly, peer-reviewed articles on a variety of subjects related to the theory and practice of health communication. The final section, "Forum," includes essays, commentary, book reviews, and other salient observations. It is our intent to offer a variety of pertinent viewpoints, thereby advancing the dialogue beyond the confines of the traditional academic journal.

Among the full-length contributions to this issue, Everett M. Rogers' lead article, "The Field of Health Communication Today," highlights the growth in importance of communication within the health field over the last quarter century. Rogers' pioneering work in diffusion has served as a cornerstone for the development of health communication as a field of research. His latest endeavor is developing a doctoral program in health communication at the University of New Mexico.

The next article, co-authored by J. Gregory Payne and Carol Bishop with me, delineates "The Status and Scope of Health Communication." Through a review of tile pertinent health communication literature and a survey of health communication scholars, this article provides the reader with an overview of tile field. It concludes with a definition of health communication and its practice.

Michael A. Chamberlain's article outlines the globalization and technological innovations in communication. As a new media technologies specialist working in the United Kingdom, Chamberlain outlines the application of U.S. innovations worldwide and their potential impact on health communication. Chamberlain also challenges the fundamental assumption that mass communication is THE vehicle for change. According to him, demassification and interactivity have the power to change communication "as we know it. "

Health professionals and communication experts concur that the power of communication lies in its ability to change behavior, which frequently translates into life over death. Given the increase of AIDS as a sexually transmitted disease (STD), effectively communicating salient messages about STDs is of great importance to targeted audiences. Such is the focus of William DeJong and his colleagues, who assessed the STD prevention messages in clinics in cities throughout the United States in their article "The Status of Clinic-Based STD Patient Education: The Need for a Commitment to Innovation in Health Communication." With the subjects studied having the highest prevalence of such diseases-and the highest incidence of HIV/AIDS in particular-the article outlines prevention strategies currently employed in various cities. Although critical of the lack of innovation demonstrated in the subject clinics, the study recommends efficacious communication strategies, rather than over reliance on one-on-one counseling, which is commonly used today as the mechanism for prevention.

Terrance L. Albrecht and Carol Bryant, in "Advances in Segmentation Modeling for Health Communication and Social Marketing Campaigns," outline a methodology for effective health communication campaign delivery. Following a thorough description of a variety of techniques for audience segmentation, the authors explore the potential use of the chi-squared automatic interaction detection (CHAID) model, in particular its application in the Texas Women, Infants, and Children (WIC) program.

The "Forum" section highlights two different areas in health communication. In "Health Legacies from Franklin Roosevelt to Robert Dole, or How Medical and Health Care Issues Took Over the Nation's News," former newspaper reporter Stephen G. Bloom, now of the University of Iowa, chronicles a transformation in 20th century journalism, from the avoidance of personal aspects of the lives of individuals in the public eye to their matter-of-fact requirement in public discourse. The domain he addresses is weighty because it concerns governance. Acknowledging the public's right to know issues that affect performance in office, Bloom suggests that presidential candidates disclose their medical records.

In "Communicating to Promote Justice in the Modern Health Care System," Gary L. Kreps, who has published a number of books and articles in health communication, reminds readers of the disparities in health care and misallocation of resources in the United States. He also offers ideas for the strategic use of health communication to benefit disadvantaged populations.

Additionally, the Journal features book reviews. In this issue, Kerr L. White reviews The Medical Interview, by Mack Lipkin, Jr. White, who coined the term primary care, urges us to regard the book as a new standard reference.

We hope you'll find this premier issue stimulating and informative. More importantly, we hope you'll participate actively in out- mission-to present timely research into and evaluations of the use of communication to prevent disease and promote good health. We encourage you to send any responses, ideas, or submissions to our editorial offices!