Words Matter in Public Health Issues Like Flu

Giving people a sense of being in control is an important element in health messages, according to researchers at Nottingham and De Montfort universities. The research, which was funded by the Economic and Social Research Council, looked at how language used in policy messages and media coverage affects the public perception of health threats. The report warns that lyrical and over-emotional language may be counter-productive when issuing warnings and advice about pandemics and hospital infections.

"During the SARS and bird flu scare scientists and health organizations used disaster metaphors, such as tsunami, perfect storm and bio-terrorism to mobilize the media, governments and individuals to prepare for a pandemic in waiting. Such terms can make people sit up and listen, but they can also lead to panic or cynicism," says professor Brigitte Nerlich, who led the research. “Recent advice on swine flu has centered on basic hygiene, which makes people feel they can do something practical, instead of being mere victims of so-called superbugs or killer viruses. But obviously this is easier to do when a disease is relatively benign.”

Nerlich points out that easier internet access might also help people to feel in control, an issue that emerged from a previous ESRC project on foot and mouth disease carried out in Nottingham, England. "Nowadays, and especially in the context of swine flu, e-mail, Twitter, and public health sites all give information and advice which can be useful to worried individuals and may dampen down panic," she says. "But more research needs to be done in this area."

This research focused on MRSA along with avian flu and was conducted by a multidisciplinary team with expertise in nursing, the social study of health and illness, environmental studies and linguistics. It compared the language of biosecurity, hygiene and cleanliness used in policy documents and media coverage with the language used by hospital matrons and poultry farmers dealing with the realities of MRSA and avian flu.

“We found that the way people communicate about a threat largely determines how they understand it and behave towards it,” says Nerlich.

Additional findings established that media coverage of hygiene and cleanliness in hospitals tended to portray doctors and nurses engaged in a heroic battle"against intelligent superbugs. This was personified by the modern matron wielding the weapon of cleanliness. Interviews with hospital matrons revealed a gap between the media portrayal and the reality on the wards. Matrons said that the limitations in their authority over contractors, and time constraints made it impossible for them to spend even half their time as a visible presence on the wards.

“This was another example of the control issue,” says Nerlich. “Modern matrons have limited powers to limit the spread of infection or improve hygiene. For instance, they can't hire extra nursing staff for barrier nursing or deal with problems with cleaning contractors. Our findings highlight the need for policy messages to be translated more accurately into practice.”