In early 2008, the public health community was involved in a bit of TV drama. A new ABC law series, “Eli Stone,” was about to premiere featuring a plotline that real-life health officials have spent years trying to diffuse: the misbelief that vaccines cause autism.
While the show featured science-based statements disputing the link, the episode’s conclusion spoke otherwise, with a jury believing the autism-vaccine link and awarding a fictional mother millions of dollars in compensation. The episode and its potential reach into millions of households had health advocates calling for its cancellation, with groups such as the American Academy of Pediatrics going so far as to say that “if parents watch this program and choose to deny their children immunizations, ABC will share in the responsibility for the suffering and deaths that occur as a result.” With television shows influencing people’s beliefs and behaviors at rates that most health advocates could only dream of, the “Eli Stone” episode was a situation that the University of Southern California’s Hollywood, Health & Society program was made for.
The brainchild of the Centers for Disease Control and Prevention, the program is one of a handful occupying the gap where reality and entertainment come together, helping Hollywood writers weave accurate health information — and sometimes pointed health messages — into today’s most popular prime-time TV shows and blockbuster movies. With medical and health issues at the heart of television storylines every day on popular TV series — such as “ER,” “Grey’s Anatomy” and “House” — the opportunity to improve viewers’ health knowledge seems unlimited. In fact, according to a 2005 Porter Novelli Health Styles survey, more than half of regular prime-time drama and comedy viewers reported that they learned something about a disease or how to prevent it from a TV show, and about one-third of regular viewers said they took some action after watching about a health issue during a TV show.
Actors Forest Whitaker, second from left, and Goran Visnijc, third from left, are filmed for an episode of the TV show 'ER.' Public health experts have worked with show writers in hopes that health information is conveyed accurately to viewers.
Photo by Mitch Haddad, courtey NBCU Photo Bank
“We don’t pitch storylines, but we do present real case studies,” said Sandra de Castro Buffington, MPH, director of Hollywood, Health & Society. “We respect writers as artists. They’re master storytellers…They’re always looking for ideas and so some of (our) material gives them real-life situations that can trigger the creative process for them.”
Having consulted on more than 700 different health topics since its official launch in 2002, the program’s origins are rooted in CDC’s HIV/AIDS education and outreach to the public. Many years ago, CDC asked a team evaluating the HIV work to look toward Hollywood as a possible industry partner, Buffington said, and the team responded with a “resounding yes.” CDC began its Hollywood outreach from its headquarters in Atlanta, but officials soon realized they needed a physical presence in California as well as guidance from those already entrenched in the entertainment industry. The University of Southern California’s bid won CDC’s eventual request for proposals and, as they say, a star was born. The resulting Hollywood, Health & Society program is now a partnership between CDC, the National Cancer Institute and the university’s Annenberg Norman Lear Center. The program offers direct access to thousands of health and medical experts across the world, and has built strong relationships with the top 20 Nielsen-rated scripted TV shows for general, black and Hispanic audiences.
Actor Hugh Laurie, who plays Dr. Greg House on the TV show 'House,' attends to the bandages of a patient with a brain problem, played by actress Felicia Day.
Photo by Greg Gayne, courtey NBCU Photo Bank
“In traditional public health campaigns, we have control from beginning to end and design them around key messages,” Buffington told The Nation’s Health. “This is the opposite: We serve as a resource to writers and have no control over the end product. Our model is one of outreach to writers.”
While acknowledging writers’ top priority is getting viewers glued to their seats, Hollywood, Health & Society’s pro-accuracy message has gained a foothold in the Hollywood hills. For example, the program recently received funding from the Bill and Melinda Gates Foundation to focus on global health topics, which prompted Buffington and colleagues to organize a briefing between Harvard educator Atul Gawande, MD, MPH, MA, and the writers of “ER” to discuss the World Health Organization’s recently released surgical safety checklist, which was co-authored by Gawande. To begin, according to Buffington, Gawande was asked: “If you could reach 20 million people in an hour with three messages on your topic, what would they be?” The result was a tip sheet created for writers, who wove the surgical checklist into “ER’s” March 12 episode featuring a kidney transplant patient whose life was saved because of the checklist. The storyline garnered such a positive response that doctors at Maimonides Medical Center in Brooklyn, N.Y., used the “ER” episode to kick off a discussion about the surgical checklist among their own staff, Buffington said.
The sheer power of TV was also illustrated a few years ago when Hollywood, Health & Society worked with the soap opera “The Bold and the Beautiful.” The collaboration centered around the storyline of an HIV-positive character, with one of the episodes featuring a public service announcement referring viewers to a CDC HIV/AIDS hotline. It was that Aug. 13, 2001, episode — in which the character Tony revealed his HIV status to his fiancé — that had tipped off the CDC hotline’s highest volume of calls to date, Buffington reported.
“(Writers) want to tell a compelling story, and it can become even more compelling if it’s accurate,” she said. “But we have to remember that writers are not health educators, that’s not their motive…What we do is simply serve as a resource and support for them.”
What Hollywood, Health & Society is doing for public health, the National Academy of Sciences hopes to do for the broader scientific field. Officially launched late last year after a successful two-year pilot, NAS’ Science and Entertainment Exchange aims to connect entertainment industry professionals with top scientists and engineers, and boasts advisory board members from HBO to the Discovery Channel to actor Dustin Hoffman. According to exchange director Jennifer Ouellette, the service is “sort of like match.com,” bringing TV, movie and video game developers together with leaders in the scientific fields. The exchange receives requests on a broad range of topics, Ouellette said, from epidemiology and quantum physics to viral disease outbreaks and the science of studying earthquakes. Ouellette noted that the exchange usually gets involved early on in a project before misconceptions get too deeply embedded in a plot structure.
“(Hollywood) wants to tell a good story and wants enough input to make a plot more plausible,” Ouellette told The Nation’s Health. “We really can’t control too much, but we can improve accuracy over time. It’s a win-win.”
Among the exchange’s recent activities was organizing a science think tank for the sequel to the science fiction cult classic “Tron,” meeting with writers for the Fox TV show “Fringe,” and finding a physicist to consult on the superhero movie “Watchmen” — luckily finding a physicist who was also a lover of comic books, Ouellette said. Like Buffington, Ouellette described the exchange’s role as a supporting one. Science isn’t necessarily the star, she said, but it lays a good foundation.
“Week after week, millions of viewers are getting our messages and while they’re subtle, they’re important, and that’s how you get long-term shifts in perception among the audience,” Ouellette said. “It’s not the job of entertainment to educate the masses, but they can certainly inspire.”
Among some writers, however, the science came with the writing. For Neal Bear, MD, now executive producer of “Law & Order: SVU,” “accuracy is paramount — Why not be accurate if people can learn from it?” And Baer should know. Involved with Hollywood, Health & Society since its inception and currently co-chair of its board, Baer earned his medical degree while he was a writer on “ER” — the first TV show to hire real doctors as writers, he said. During his time with “ER,” Baer said he found himself calling on CDC for accurate information quite often. And while Baer agreed that TV shows exist to tell compelling stories, he said it doesn’t absolve them from spreading misinformation. TV shows go to great efforts to look real — the sets look real, the characters seem real, the storylines reflect realistic situations — “and if you’re going to go to that effort, it behooves one to think hard about the responsibility one has” to present accurate information to viewers, Baer said.
“I don’t set out to educate,” Baer told The Nation’s Health. “I set out to tell great stories — great stories that have conflict and different points of view and that ultimately can educate.”
For more behind-the-scenes information on public health, science and Hollywood, visit the Norman Lear Center at www.learcenter.org/html/projects/?cm=hhs or the NAS program at www.scienceandentertainmentexchange.org.
- Copyright The Nation’s Health, American Public Health Association
In this issue
