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Yates, B. L.  (1999).  Media literacy: A health education perspective.  Journal of Health Education, 30 (3), 183-187.

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An earlier version of this paper was presented to the Health Communication Division of the National Communication Association in Chicago in November 1997.  Click here to view this version.

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University of Florida, College of Journalism and Communications, Graduate Division, 2000 Weimer Hall, PO Box 118400, Gainesville, FL 32611-8400.

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Media Literacy: A Health Education Perspective

Keywords: media literacy, health messages, health education



This paper argues for an increase in media literacy training to help students combat the mixed health messages found in the media. Media literacy is defined as the ability to access, analyze, evaluate, and produce media messages. Much of the paper deals with laying out specific exercises school health educators and other teachers can use to incorporate media literacy into health education. The paper suggests that through media literacy students can learn to evaluate critically the health messages in various media outlets. Once students realize how the media package messages, they will be more aware of what to look for and how to interpret what they see and hear.


Media Literacy: A Health Education Perspective

The pervasiveness of the mass media creates a seemingly endless flow of information. Contained in the flow are various forms of health information. Consumers of the media are at the mercy of the respective media outlets to provide them with the most current and accurate information possible. Although the health community recognizes the power of the mass media to disseminate information about health risks and prevention measures, unfortunately, the purposes of the two entities are not the same. As a result, the public is not always informed of possible health risks or preventative measures; not all health messages are easily understood, and some messages contain misleading or false information (Signorielli, 1993; U.S. Department of Health and Human Services, 1988).

The recognition of the mass media’s dissemination power as well as the potential dangers of sending inaccurate information or omitting vital information spawned an effort by the Office of Disease Prevention and Health Promotion, the National Cancer Institute, and the Office for Substance Abuse Prevention to examine how the mass media and health community could work together more effectively (U.S. Department of Health and Human Services, 1988).

The subsequent report, Mass Media and Health: Opportunities for Improving the Nation’s Health (U.S. Department of Health and Human Services, 1988), revealed a number of areas that needed attention. These included using all facets of the media to develop health messages, improving the communication skills of those in public health, and teaching individuals how to interpret health information in the media.

While all of the recommendations are vital to the effective dissemination of health information, the final recommendation--to educate the public about how to interpret health messages in the media--is more closely associated with the focus of this paper. After reading the recommendations of the investigators, it is apparent that their concerns can be addressed through the concept of media literacy.

Media literacy is concerned with helping students develop an informed and critical understanding of the nature of the mass media, the techniques used by them, and the impact of these techniques. More specifically, it is education that aims to increase students’ understanding and enjoyment of how the media work, how they produce meaning, how they are organized, and how they construct reality. Media literacy also aims to provide students with the ability to create media products (Ontario Ministry of Education, 1989, p. 6-7).

This definition of media literacy focuses primarily on children/students, which is in accord with the recommendations outlined in the governmental report. It is vital to teach younger consumers of the media because they are the most vulnerable to media messages; although, it is important for adults, too.

This paper will review the relevant literature dealing with media literacy and health messages and explore the relationship between media literacy and health information. Much of the paper will deal with laying out specific exercises school health educators and other teachers can use to incorporate media literacy into health education related to the most important health risks facing children and adolescents. The ultimate goal of the paper is to add another dimension to the media literacy concept and provide evidence for a method of education that will satisfy the recommendations made in the governmental report, Mass Media and Health: Opportunities for Improving the Nation’s Health.



According to Media Literacy (1989), a textbook published by the Ministry of Education in Ontario, what we know about the world beyond our immediate surroundings comes to us via the media. Unfortunately, the media does not present its messages in a neutral and value-free way; it shapes and distorts reality (Considine, 1990; Melamed, 1989). This poses a problem for society. Individuals, especially students, are unable to distinguish between genuine and questionable messages sent by the media. For example, NBC’s "ER" has encouraged responsible sexual behavior by showing Dr. Doug Ross giving condoms to a teenage girl who was living on the street, but it also depicted irresponsible sexual behavior when it was revealed that Dr. Peter Benton got his girlfriend pregnant. In order to handle these mixed messages young people must be taught to be responsible consumers of the media. But who is going to do the teaching? The logical choice is America's educators.

Several researchers have called for the inclusion of media education within existing school curricula (Considine, 1990; Duncan, 1989; Kahn & Master, 1992; Melamed, 1989; Wulfemeyer, Sneed, Van Ommeren, & Riffe, 1990). They argue that media education makes students critically aware of what they see, hear, and read. Television/video/film viewing and magazine reading are no longer ways to pass the time. They are learning opportunities. Students analyze and critique messages and determine how they could be said better or differently. Media education also gives groups of students the opportunity to work together toward a common goal. In the process they learn about responsibility, cooperation, and problem solving. No matter what they do in life, they will always encounter situations that require these skills. In addition, students identify their strengths and weaknesses, develop varied interests, and accept new challenges.



Much of the early media literacy literature focused on the call for including media literacy within the existing school curricula. Attention was given to defining media literacy skills and garnering support for the movement (Duncan, 1989; Considine, 1990; Wulfemeyer, et al., 1990). In the years since the movement began, leaders within the movement have been able to agree on a basic, more comprehensive definition of media literacy as well as identify fundamental objectives (Aufderheide, 1993). According to the Aspen Institute’s Report of the National Leadership Conference on Media Literacy,

a media literate person--and everyone should have the opportunity to become one--can decode, evaluate, analyze and produce both print and electronic media. The fundamental objective of media literacy is critical autonomy in relationship to all media. Emphases in media literacy training range widely, including informed citizenship, aesthetic appreciation and expression, social advocacy, self-esteem, and consumer competence (Aufderheide, 1993, p. 1).

As the media literacy movement continues to grow, its range of emphases is expanding (Aufderheide, 1993). Traditionally, the literature rarely has separated health issues from the more common areas of focus like advertising and violence. However, more recent literature has given health education and health crises their due (Considine, 1994; Considine, 1995).


Impact of Mass Media on Adolescent Health

Given the focus of this paper it is important to establish the relationship between the mass media and the health of young adolescents. Many would agree that the media are the biggest educators in today’s society (Strategies, 1992). "By age 18 a young person will have seen 350,000 commercials and spent more time being entertained by the media than any other activity except sleeping" (Davies, 1993, p. S-28).

Such media-saturation is cause for concern, especially in the area of health. Davies (1993) discussed the impact of the media on adolescents in terms of nutrition, sexual information, alcohol and tobacco, violence, and stress. A brief review of each topic will offer some insight into the influence of mass media on the health of America's youth. More importantly, the discussion will address how the concept of media literacy can be used to reduce the negative influences mass media are believed to have on young people's health-related attitudes and behaviors.



Proper nutrition is especially important for adolescents because of their accelerated body growth. In addition, their early dietary decisions can have lifelong health implications, e.g., obesity, poor nutrition, inadequate female reproductive development (Davies, 1993). Unfortunately, adolescents are susceptible to poor nutritional habits. They often eat with peers, rather than family. Because they are growing physically they snack a lot, but the snacks are usually high in fat and calories. Adolescents also are very busy, and they argue they do not have the time to eat properly (Davies, 1993).

The media perpetuate poor diet decisions. One study estimated that early adolescents between two and 12 contributed $82.4 billion in food and beverage purchases in 1990 (McNeal, 1992). This figure is alarming when studies show most of the advertised foods contain little nutritional content (Dwyer, 1982; Gerbner, Gross, Morgan, & Signorielli, 1982). Even more alarming is the issue of body image. Young adolescents are led to believe that the media-created image of the ideal body is how their bodies should look (Davies, 1993). This leads to females trying to look like Cindy Crawford and Kate Moss. In their attempt to have the perfect body, females often end up adopting fad diets that may lead to more serious eating disorders (Davies, 1993). Davies (1993) also points out that boys are susceptible to media body images because they want to build muscles like many actors and sports heroes. This desire to "bulk up" often leads to poor diet and possibly the use of steroids.

Considine and Haley (1992) offer a number of assignments that can be used to educate children and adolescents about nutritional messages in the media. One such assignment is useful for elementary and middle school students. Students select one episode from their favorite television program and record what each character eats and drinks. Videotaping the show will ensure the accuracy of their record. Student records are then summarized to create a chart that graphically depicts the food and drink consumption of popular television characters. Using the chart to guide the discussion, teachers can ask students about the nutritional value of the food and drink consumed by the characters, how often the characters snack, if the characters eat on the run, and where the characters frequently eat. Other topics might explore the relationship between the type of foods eaten and a character’s lifestyle, size, and weight. For example, do the lifeguards on "Baywatch" have a diet that will help or hinder their ability to save lives (Considine & Haley, 1992)?

Another assignment might focus on the issues of body image and stereotypes. The assignment would be to create a commercial using a male spokes-model and a female spokes-model. Students could study existing advertisements and determine how males and females are typically portrayed. They could make it a point not to depict either gender in a stereotypical way. Through such an assignment students learn much more than how to get a message across about a product. They learn about the inherent meaning of body image, body language, and stereotypes.


Sexual Information

Mass media also provide formal and informal messages about sexuality. The greatest concern about the sexual information disseminated by the mass media is that it is value-laden (Davies, 1993). Glasser (1990/91) points out that all television shows answer the question, "What is ethical behavior?" Adolescents are adopting norms for their behavior based on what they see and hear in the media. The norm of having multiple sexual partners is a constant theme on NBC’s "Friends." The character "Joey" is known for his sexual conquests. One of the female characters, "Monica," is often the target of jokes about her inactive sex life. The underlying message is that it is okay to have sex with lots of people; otherwise, you may be the punch line of someone’s joke. Liebert and Sprafkin (1988) concluded that adolescents who watch a lot of sexual content on TV are less satisfied with their sexuality and develop misconceptions, which are similar to the "Friends" example, about sex.

Although sexuality is a difficult topic to discuss with youngsters, teachers need to create media literate students who can evaluate the sexual information provided by the mass media. An assignment for middle and high school-aged students involves identifying advertisements that use sex appeal and sexual images to market various products. Teachers can guide students’ analysis by asking questions like: What does sex have to do with the product? What creates the sex appeal: the people, the props, the camera angles, the music, the sound effects, or the set? Students can also compare the interactions of the characters in the commercials with real life behaviors (Considine & Haley, 1992). It should become evident to students that putting on cologne or perfume each morning will not result in an instant sexual experience. Through these exercises students will be more aware of how sex is used to sell a product, even though it has little to do with the actual product.

Teachers can help students deal with their own struggles about sex by studying teenage television characters. After the television teens have been identified, students should discuss how realistically each character’s sexuality is depicted. For example, Becky and Darlene in "Roseanne" talked about their menstrual cycles and French kissing. Is it normal for teenage girls to discuss these subjects? In "The Wonder Years," Kevin and Winnie were overwhelmed with anxiety when they were forced to "make out" at a party. They elected to go to their respective homes and wait until they were mature enough to handle "making out." Are Kevin’s and Winnie’s feelings natural (Considine & Haley, 1992)? Teachers can use such depictions to help students understand it is normal to feel anxious about sex and that they should talk about their feelings. The discussions produced by this exercise should reduce students’ anxiety about sex and help them feel more comfortable with their emotions and physical changes.


Alcohol & Tobacco

Sex is often associated with alcohol in the media. Gorgeous, sexy female models are a constant in beer and wine advertisements that target males. Television shows often portray alcohol as a means to sex. In addition, alcohol is associated with success, excitement, and good times. For younger media consumers, media depictions of alcohol are tantalizing and alluring. A 1991 report, Youth and Alcohol: A National Survey, said that 35 percent of all wine coolers in the United States are consumed by high school juniors and seniors. The report also revealed that these upperclassmen drink 1.1 billion cans of beer and half of the 20.7 million seventh through twelfth graders drink (U.S. Department of Health and Human Services, 1991).

Although alcohol is heavily advertised in this country, there is one product that tops it: cigarettes. Like alcohol, cigarettes are marketed to young people, although both the alcohol and tobacco industries challenge such a claim. The high volume of alcohol and tobacco advertisements makes media literacy training a must for young people. Teachers have several options to help arm students with the weapons to battle the marketing specialists. One assignment begins with taking a survey to determine how many students smoke. Data collection should include the students’ gender, when they started smoking, the brand they smoke, how often they smoke, why they smoke, and if other members of their family smoke. The survey can be done anonymously or within a class discussion. Most students will not suggest that advertising influenced their decision to smoke because most people are unaware of their motivations for purchasing and using various products (Considine & Haley, 1992). Teachers should create and share a profile of the smoking behaviors of the class.

The profile can be used to carry out several other lessons. For example, teachers can collect magazine ads for the cigarettes commonly smoked by the class. Students should study the words and images in the ads, paying attention to the activities depicted, the moods created, and the settings. In addition, comparisons of locations, sex, age, jobs depicted, and social status can be made among the ads. Students can be asked to consider differences between ads for cigarettes preferred by female class members versus cigarettes preferred by male class members (Considine & Haley, 1992).

Some of the same exercises described above can be used for lessons on alcohol, but a number of other activities also are useful. One such exercise gets students involved in the creation of media messages. Students can develop a design for a poster or series of posters to warn about the dangers of alcohol or make others aware of how advertisers target adolescents. The posters can be used in the school, library, or community. Such an exercise helps students understand the process of creating media messages and makes them more aware of how advertisers target young audiences (Considine & Haley, 1992). This exercise also can be adapted for television.



The impact of the mass media on early adolescents has been studied extensively. One of the most intensive areas of research has been violence in the media. Although there was a battle for a number of years over whether or not televised violence leads to subsequent aggressive behaviors, most researchers contend there is a connection (Murray, Rubinstein, & Comstock; 1972; Pearl, Bouthilet, & Lazar, 1982). Because adolescents watch about 20 hours of television a week (Nielsen Media Research, 1990) there is serious concern about the impact violent portrayals have on their behavior. Media executives, parents, teachers, and communities cannot dismiss violent programming as pure entertainment because the media have the power to model attitudes and behavior (Considine & Haley, 1992). With more and more adolescents becoming victims of crime as well as committing the crimes (Davies, 1993), the aforementioned groups need to reexamine how they can help combat this growing trend.

Several activities can be used with elementary, middle, and high school students to make them aware of the impact of violence in the media. For younger children, defining violence is important. Teachers should ask students to describe the violence they typically witness on television and talk about the type of characters who commit violent acts. Teachers should note whether the characters are criminals, police officers, superheroes, or a combination of characters and consider how realistic students’ perceptions are. Since children’s programming contains more violence than most prime time shows, children may have an inaccurate impression of violence. Teachers need to identify these impressions and help children understand that not all people behave like the characters in their favorite shows (Considine & Haley, 1992).

Middle and high school students can consider the functions of visual violence by discussing some of the concepts related to viewing violent programming. Some research suggests that viewing violent content results in subsequent aggressive behavior (Murray, Rubinstein, & Comstock; 1972; Pearl, Bouthilet, & Lazar, 1982); other research claims that viewing violence relieves tension and reduces the likelihood of violent behavior (Feschbach, 1961). Students can examine these and other notions about the impact of violent programming to better understand the potential effects of visual violence.



Another area of concern is the amount of stress indirectly caused by the mass media (Davies, 1993). Because early adolescence is a stressful period in life (Hamburg, 1974; Elkind, 1986), younger media consumers are more susceptible to additional stress created by the media. Educator Neil Postman (1982) argues that television exposes young viewers to adult knowledge before they are prepared to handle it; television essentially blurs the boundaries between childhood and adulthood. Kids who try to imitate behaviors they see on television, e.g., sexual situations, often experience confusion and dejection because they are unable to reproduce the behaviors in the same manner (Chlubna, 1991). In essence, the media messages children receive are pushing them to be adults before it is time (Elkind, 1981). This pressure to act like an adult causes undue stress, which can lead to unnecessary health problems or cause adolescents to cope with stress in ways similar to those portrayed in the media, e.g., drinking, smoking (Davies, 1993).

Most of the previously discussed media literacy activities can be used to discuss how the media produce unnecessary stress on adolescents. Teachers simply need to add questions that directly address stress-related issues into each exercise. For example, assignments dealing with diet and body image are ideal for talking about how the media put pressure on teens to have the perfect body, while tempting them with advertisements for junk food. Advertisements for alcohol and tobacco, which often are targeted to younger audiences, perpetuate the notion that if you use these products you will be more like an adult, thus creating additional pressure to be "grown up." In addition, television portrayals of people in crisis who turn to alcohol provide students with inappropriate models for dealing with stress in their lives.

A possible assignment for students to better understand how much stress the media create for them involves role-playing. Students can analyze a television program that depicts an adolescent trying to decide if he is ready for his first sexual experience. Teachers can guide the discussion to help students determine the options available to the character. Groups of students can act out these options and discuss why the character made the decision he did. By acting out these situations, students may react more responsibly if they are ever in a similar situation.



Health education involves issues ranging from "self-image, diet, school violence, alcohol, and tobacco, [to] pregnancy, [and] sex" (Considine, 1994, p. 27). All of these topics require an understanding of media messages by children as well as health educators (Considine, 1994). Considine (1994) argues that health educators should be able to do more than just identify media messages about health; he insists that educators provide students with frameworks and strategies to help them understand how advertising and other media messages influence their health beliefs and behaviors. Davies (1993) also recommends media literacy as a regular course of study for those interested in the education profession. "It is incumbent upon our educational system to prepare its students with the skills necessary to be able to approach the media critically, particularly advertising. In addition, the middle school years are an ideal time to teach media literacy" (Davies, 1993, p. S-33).

The media literacy movement must give more attention to health issues immediately because American adolescent health is in a state of crisis (Hechinger, 1992). According to the Carnegie Council on Adolescent Development, by age 15 nearly a quarter of adolescents practice harmful or dangerous behaviors (Hechinger, 1992). The Carnegie Council recognized the need to respond to health problems among adolescents by examining the cultural context in which youngsters make their decisions (Hechinger, 1992). Teenage smoking among females will not be reduced until researchers identify the motivations behind smoking. Is it really the cigarette advertisements that keep them smoking, or is it the belief that smoking substitutes for eating (Considine, 1995)?

Teen sexuality is also of concern in the health community because the media influence teenagers’ attitudes and beliefs about their sexuality. The most alarming aspect of this issue is the finding that much of what teens learn about sex from the media does not address the potential consequences of these behaviors or the necessity of sexual responsibility (Brown & Walsh-Childers, 1994).

The Carnegie Council made recommendations similar to the governmental report, Mass Media and Health: Opportunities for Improving the Nation’s Health, which called for teaching children and adolescents to become critical viewers of the mass media. In a media-dominated society, it is imperative to evaluate critically the barrage of messages sent by the media on a daily basis. Yet for many students, the ability to think critically is underdeveloped (Sneed, Wulfemeyer, Van Ommeren, & Riffe, 1989), and, until recently, most schools were not taking advantage of the opportunity to develop students' critical thinking skills through media education. Schools must realize that the living room has become a learning room. They must open up to media education and properly train teachers how to use the media as an instructional tool, or students will continue to be vulnerable to the messages and values communicated by the media (Considine, 1990).

Through media literacy students can learn to evaluate critically the health messages that are contained in various media outlets. Once students realize how the media package messages, they will be more aware of what to look for and how to interpret what they see and hear. Any health-related messages will be scrutinized and judged with a critical eye. Such scrutiny should make students more aware of their health and encourage them to avoid unhealthy behavior.



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B.L. Yates 2000