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Editorial: RevolutionizingHealth: Communication CanMake a DifferenceScott C. RatzanPublished online: 29 Oct 2010.

To cite this article: Scott C. Ratzan (1999) Editorial: Revolutionizing Health:Communication Can Make a Difference, Journal of Health Communication:International Perspectives, 4:4, 255-257, DOI: 10.1080/108107399126805

To link to this article: http://dx.doi.org/10.1080/108107399126805

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Editorial : Revolutionizing Health : Communication CanMake a Di%erence

SCOTT C. RATZAN

At the cusp of a new millennium, the digital revolution is changing society muchlike the printing press did centuries ago. Like the Gutenberg invention, informationtechnology and the world wide web will rede�ne the world with the potential toadvance knowledge beyond our wildest imagination. However, we know that trans±

mission of information or mere data does not equal eŒective communication. Nordoes the ability of global transmission inherently carry with it ethical responsibilityof the source’s message being transmitted. We must beware of the existing barrier todeveloping knowledge.

At the same time, we also have a great amount of data on measuring morbidityand mortality, descriptions of chemicals and risk factors, and a vast nomenclaturefor disease, syndromes, signs and symptoms. Nonetheless, ‘‘health’’ remains difficultto quantify and attain equally throughout the world.

While this new communication age can recon�gure our understanding of whowe are, as well as aspirations for our communities and the world, it also has thepotential to drive a health revolution. A revolution that does not focus on the eco±

nomic ‘‘system’’ of payments, reimbursements and professionalism, but rather a rev±

olution that provides each of us the tools and knowledge for ideal health decisions.The challenge for such a revolution to focus on health was perhaps presaged by

Thomas JeŒerson in his day. JeŒerson challenged 18th Century leaders : ‘‘With yourtalents and industry, with science, and that steadfast honesty which eternallypursues right, regardless of consequences, you may promise yourself every thing±

but health, without which there is no happiness. An attention to health then shouldtake place of every other object.’’1 Clearly, while much has happened since JeŒer±

son’s day, health is still not at the top of everyone’s agenda.

What might this 21st century revolution look like?

First, our call to arms to should be the development of an individual ethic is usingtechnology to promote quality health worldwide. While a minority of the world’spopulation has direct access today, in the 21st Century the Internet will beubiquitous ± accessed from television, land± linked and cellular phones, satellites,radio, kiosks, watches and other new venues. The wearable web or ‘‘e± device’’ will bea multi± way device with the potential to monitor physiologic components and tocommunicate with providers for instant feedback/advice and recommendations.Eventually, it also will overcome the reliance on English and the 20th Centuryforms of written language.

Of course, there is a great role for scienti�c discovery in advancing health. Butscience will not have all of the answers. The translation of the incremental nature of

Scott C. Ratzan, MD, M PA, is executive director, health communication technology and educa ±

tional innovation, at the Academy of Educational Development, Washington, DC. He also is editor± in ±

chief of the Journal of Health Communication and holds faculty appointments at Tufts University Schoolof Medicine and George Washington University.

T he papers of Thomas Je� erson, ed. Julian P. Boyd, vol. 11, 9, 558 (1955).

Journal of Health Communication, Volume 4, pp. 255­ 257, 1999Copyright 1999 Taylor & FrancisÓ

1081 ± 0730/99 $12.00 1 .00 255

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256 Editorial

scienti�c progress to the public is limited. In the 21st Century, we must not onlystrive for new medical discovery, but also to translate such knowledge into usabledata for a healthier society. Communicating health accurately will require commu±

nication of the context± what this will ‘‘mean’’ for the health of the individual.

Our current window to the world is the computer or television set—the media

The paradox is that a concentration of leadership in media conglomerates hasemerged which could bene�t the transmission of valid and valuable information.Instead, the erosion of traditional journalistic norms that have contributed toserving the public good have been threatened with corporate stakeholders’ �nancialinterests. Such for± pro�t motives threaten to dictate news decisions and choices ofentertainment programming.

Simply put, where do the six billion individuals who share the earth as theirhome now turn for a valid assessment of the world± as well as a legitimate call toaction on research, health and quality of life issues ? The result of such corporatere± structuring is a crisis in± if not absence of± ethical leadership committed toserving the overall global public good.

Furthermore, the escalation of medical knowledge and technology is taxing theability of governments and news media to monitor new developments or to assesstheir implications, so we have an information glut with media clutter and confusion.The challenges are for the health consumer to navigate a ‘‘system.’’ But it is difficultfor many to answer the following questions.

1. Who is to be believed ?2. Who decides and using what criteria, if an advancement actually promotes the

general health ?3. Which so called advancements undermine social/cultural ethics and should be

controlled ?

The answers do not reside solely with individual or global governments and organ±

izations. Today’s economic windfall has only widened the gulf between rich andpoor countries. The unbridled prosperity has not trickled down to many parts of theworld. Harvard professor JeŒrey Sachs suggests that the 42 so± called HighlyIndebted Poor Countries face ‘‘a combination of extreme poverty and �nancialinsolvency that mark them for a special kind of despair and economic isolation.’’According to Sachs, such countries ‘‘escape our notice± almost entirely± unless waror exotic disease breaks out.’’ One sel�sh motive for including such coverage isclear± the sensational appeal and expected increase in market share in the ‘‘infotain±

ment’’ format that now permeates much of the commercial media programming.Clearly, as we embark upon a new millennium with 6 billion people, the global

health and resource are strained. Yet, we have the ability unlike other generations toprogress and increase our ability to navigate amongst an environment and globalmarketplace unparalleled in history. The answer to the question : ‘‘Can the world behealthy ?’’ on the current course is unknown. If we marshaled all of our resources toovercome poverty, we would still have infectious and non± communicable disease,albeit at a lower level. All health requires a commitment and investment to applyour scienti�c know how to the idea of creating ‘‘ideal health.’’ If we commit tointegrating health into all sectors of society and generate the same level of enthu±

siasm as we have for economic growth, we will be revolutionizing health.

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Editorial 257

The future will challenge us to use our wisdom to prevent disease, build asociety with healthy economic and environmental development, and oŒer scienti�cprogress to support our behavioral commitment to quality of life and health. Withsuch wisdom the emphasis will shift when ethical decision± making and leadershipcan advance us into an age we can all be proud of± the health age.

A major caveat: We must beware of best health. It is the enemy of good health

What is the diŒerence between good health and best health ? If we strive toward aworld with attainment of basic needs± adequate food, shelter and clothing± we willbe making great strides in health. The world does not need a proliferation ofmodern day technologies. Health is not measured by the number of MRI’s, thehuman genome, or the availability of a super medical facility.

We should focus on ideal health± ideal to the community, ideal given economicconditions, ideal as based on the individual that we often discuss as a statistic. Idealhealth to most deals with quality issues of individual salience, rather than absence ofdisease. Health for all should guarantee a basic set of values and services ; it shouldnot be confused with ‘‘free’’ health for all or ‘‘longest life’’ for all.

Much of the success of the last century is largely due to the early work anddiscoveries of Louis Pasteur, Robert Koch and others who identi�ed germs as wellas Joseph Lister introduction of antiseptic practices. Average life expectancy grewfrom between 45 to 50 years in Europe at the turn of the century to now over 80years in some countries. The next great leaps will be with new ideas. We can heedthe advice of history and work to alleviate such inequalities through the modern±

day knowledge to diŒuse personal health, hygienic practice, and enact policies toenhance public health to strive for ideal health and to meet the goal of good health.The western world can continue to set the scienti�c agenda for ideal health, but atthe same time powerful agencies (pharmaceutical companies, governmental fundedstudies, universities etc.) have an ethical responsibility also to insure basic needs aremet during this health revolution.

Earlier this year, my son Alexander was born. It is my hope the health progresscan oŒer him the opportunity to witness the entire health revolution �rst hand as itdevelops in the 21st Century. I also hope we extend the economic prosperity totranslate into health status so that other children born in Africa, Asia, LatinAmerica and throughout the world who share the discoveries of vaccines, anti±biotics, medical interventions and nutrition and who avoid the lifestyle diseases oftobacco, sedentary lifestyle and other such vulnerabilities .

Of course, I am urging each of us, as readers of the Journal of Health Communi±cation, to take an active role± as credible, trustworthy sources in communicatinghealth issues to particular targeted audiences. We can all be healthy : it begins athome, at work, at school, in government and in our environment. But most impor±

tantly, health begins in our mindset.

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