E. Michele Ramsey
Given the impact of gender on health, healthcare decisions, and treatments for illness, as well as the increased inequities encountered by non-white men and women, messages about health and health risks are affected by purposeful assumptions about gender identity. While the term sex denotes the biological sex of an individual, gender identity is about the psychological, cultural, and social assumptions about a person associated with that person because of his or her sex. Gender and health are intimately connected in a number of ways, and such connections can differ based on race, ethnicity, age, class, religion, region, country, and even continent. Thus, understanding the myriad ways that notions of gender affect the health of females and males is fundamental to understanding how communicating about risks and prevention may be tailored to each group.
Gender role expectations and assumptions have serious impacts on men’s health and life expectancy rates, including self-destructive behaviors associated with mental health and tobacco use, self-neglecting behaviors linked to the reluctance of men to seek treatment for ailments, reluctance to follow a physician’s instructions after finally seeking help, and risk-taking behaviors linked to drug and alcohol use, fast driving, guns, physical aggression, and other dangerous endeavors. Because gender role expectations tend to disfavor females, it is not surprising that gender generally has an even greater impact on women’s health than on men’s. Even though biological factors allow women, on average, to live longer than men worldwide, various gendered practices (social, legal, criminal, and unethical) have serious impacts on the lives and health of women. From sex discrimination in research and treatment regarding issues linked to reproductive health, depression, sexual abuse, alcohol and drug abuse, the sex trade, and normalized violence against women (such as rape, female genital mutilation, forced prostitution/trafficking, and domestic violence), women’s lives across the globe are severely affected by gender role expectations that privilege males over females.
While some general consistencies in the relationships between gender, women, and health are experienced worldwide, intersections of race, ethnicity, class, age, country, region, and religion can make for very different experiences of women globally, and even within the same country.
The recent years have seen an increasing call to reconsider the binary means by which we have defined sex and gender. Advances in our understandings of lesbian, gay, bisexual, intersex, and transgendered individuals have challenged traditional notions and definitions of sex and gender in important and complex ways. Such an important shift warrants a stand-alone discussion, as well as the recognition that sexual orientation should not be automatically linked to discussions of sex and gender, given that such categorization reifies the problematic sex/gender binaries that ground sexist and homophobic attitudes in the first place.
William A. Donohue
Understanding intergroup communication in the context of genocide and mass killing begins with an exploration of how this kind of communication can devolve into such heinous human tragedies. How does communication set the stage that enables groups to pursue this path? The literature suggests that genocide is preceded by a period of intense communication that seeks to exacerbate racial divides while also providing social sanctions for killing as a solution to this intergroup strengthening activity. As individuals use language in their intergroup exchanges that seeks to build their own identity through the derogation of an outgroup, they become trapped in a conflict paradox that can then lead to violence or genocide. Strategies for detecting language associated with forming an identity trap and then dealing with it are also discussed.
Mohan Jyoti Dutta
Amid the large scale inequalities in health outcomes witnessed globally, communication plays a key role in reifying and in offering transformative spaces for challenging these inequities. Communicative processes are integral to the globalization of capital, constituting the economic conditions globally that fundamentally threaten human health and wellbeing. The dominant approach to global health communication, situated within the global capitalist logics of privatization and profiteering, deploys a culturally targeted and culturally sensitive framework for addressing individual behavior. The privatization of health as a commodity creates new market opportunities for global capital. The extraction of raw materials, exploitation of labor, and the reproduction of commoditization emerge on the global arena as the sites for reproducing and circulating health vulnerabilities. By contrast, the culture-centered approach to global health foregrounds the co-creative work of building communicative infrastructures that emerge as sites for resisting the neoliberal transformation of health care. Through processes of grassroots democratic participation and ownership over communicative resources, culture-centered interventions create anchors for community-level interventions that seek to transform unhealthy structures. A wide array of social movements, activist interventions, and advocacy projects emerging from the global margins re-interpret the fundamental meanings of health to create alternative structures for imagining health.
Hans J. Ladegaard
Although there is no exact definition of globalization, and relatively little empirical evidence on how it affects people’s lives, most scholars argue that it reflects an increasingly mobile and interconnected world. People travel for pleasure or work, or they migrate to other parts of the world. They also communicate with linguistic and cultural others, either face-to-face or via modern communication technologies, which requires them to use a global lingua franca (English). This leads to greater interdependence and a sense of sharedness, but also to more intergroup conflicts. Thus, the world has become more interconnected, but also more fragmented, and social and economic inequality both within and across nation-states has become more visible.
The importance of culture as an analytical concept in (intercultural) communication research is another pertinent topic in the literature. Some scholars have argued that culture has lost its potency as a meaningful analytical concept and therefore should no longer take center stage in communication research. Others claim that culture will always be salient and influence behavior. How and to what extent globalization changes culture has also been discussed extensively in recent years. Some scholars argue that globalization leads to sameness and uniformity, and ultimately to the end of the nation-state. Others disagree and posit that globalization leads to a strengthening of the nation-state and of the cultural values we associate with it.
A meaningful way to test theoretical assumptions about globalization and culture is to analyze communication and work practices in global organizations. Research from these contexts suggests that globalization has not led to cultural assimilation and uniformity. Employees in the global workplace and student sojourners use national stereotypes as a frame of reference when they communicate with cultural others, and they demonstrate high awareness of cultural differences and how they impact their communication, study, and work practices.
Recent research on cultural change and globalization has included a critical dimension that questions a world order where the increase in power and cultural and economic wealth in developed countries happens at the expense of poor people with no voice and little visibility living in developing countries. Critical (intercultural) communication research considers these imbalances and also provides a critique of Anglocentric research paradigms, which do not include the cultural and linguistic experiences of non-Western cultural others.
Diana Isabel Bowen
Gloria Anzaldúa was a Chicana feminist, queer, cultural critic, author, and artist who is well-known for her concept of the borderlands, physically referring to the U.S.–Mexico border, but also incorporating psychological aspects to describe the spiritual, sexual, or other boundaries that, although arbitrary and painful, guide one’s identity. Using her experiences as a means to create art and social thought, Anzaldúa calls the process of using struggles resulting from sexism, racism, and homophobia a starting point; she explained how theories of the flesh were born out of this necessity. Often, this process involves creating art or writing poetry, fiction, and theoretical essays that require adopting or crafting new terms and categories to more fully explain the lived experiences of people of color. In her writing, she used autohistorias—a term that describes using biographical stories interspersed across genres of writing—and often switched between English, Spanish, and Náhuatl languages. Noticing that scholars tended to use her theory of the borderlands almost exclusively to discuss the geographic tensions between the United States and Mexico, for example, she adopted the Náhuatl term nepantla to more succinctly describe the spiritual dimensions of experience.
Scholars interested in Anzaldúa’s work have observed the importance of acknowledging intersectionality and standpoint theories as central to exploring Chicana feminist thought. While her work connects her to the Chicana/o movement and to the women’s movement, Anzaldúa also discusses how the Chicana/o movement excluded women and the women’s movement excluded voices of women of color. Centering experiences of women of color and bringing marginalized voices to the center highlights Anzaldúa’s strategy for gaining awareness of one’s marginal status, reclaiming one’s identity through this knowledge, making use of everyday and structural acts of resistance, and creating theories of social change. These spaces of in-between are uncomfortable but also provide opportunities for social transformation.
Kevin Real and Andy Pilny
Effective communication in health care teams is central to the delivery of high-quality, safe, dependable, and efficient patient care. Understanding how health care team communication operates within healthcare systems is important. Viewing health care teams in hospital settings as creators and channels for diffusions of health and risk messages is an important contribution to health communication scholarship. Health care teams are essential elements of healthcare systems. In many instances, they are components of multiteam systems embedded within larger network ecosystems. These teams are not identical, thus, considering how team type (e.g., unidisciplinary, multidisciplinary, interdisciplinary) shapes distinct communication processes offers a better understanding of how these teams facilitate health and risk message diffusion. TeamSTEPPS is an important framework for essential teamwork behaviors that facilitate team processes in healthcare systems. Significantly, we develop specific communication competencies drawn from observation work that facilitate health care team effectiveness. Ideas developed by Kurt Lewin are utilized to consider how different types of multiteam systems can be effective as channels and facilitators of health and risk messages. We end the chapter with examples from field research. A set of hospital nursing unidisciplinary teams comprise a network of teams that form a heterarchical structure with important messages flowing between teams. An innovative form of hospital interdisciplinary rounds relies on specific communication practices to create and exchange health and risk messages to patients, families, health care team members, and other healthcare stakeholders.
Michael Mackert, Sara Champlin, and Jisoo Ahn
Health literacy—defined as the ability of an individual to obtain, process, understand, and communicate about health information—contributes significantly to health outcomes and costs to the U.S. health-care system. Approximately one-quarter to one-half of U.S. adults struggle with health information, which includes understanding patient education materials, reading medication labels, and communicating with health-care providers. Low health literacy is more common among the elderly, those who speak English as a second language, and those of lower socioeconomic status. In addition to conceptualizing health literacy as an individual-level skill, it can also be considered an organizational or community-level ability.
Increased attention to the field of health literacy has resulted in debates about the definition and the best ways to assess health literacy; there is also a strong and growing movement within the field of health literacy research and practice to frame health literacy less as a deficit to overcome and more as an approach to empowering patients and improving outcomes. As health-care providers have recognized the importance of health literacy, workshops, and training programs have been developed and evaluated to improve the care of low-health-literate patients. Similarly, health promotion professionals have developed best practices for reaching low-health-literate audiences with traditional and new digital media, which can also increase access for patients with hearing or visual impairments. Additionally, recent policy changes in the United States, including those related to the Affordable Care Act, contribute to a greater focus and regulation of factors that impact health literacy. Researchers and practitioners together are advancing understanding of health literacy, its relationship to health outcomes and health-care costs, and improved strategies for improving the health of lower health literate patients. Development and review of health literacy pieces can aid in shared decision making and provide insights for patients on various health-care services.
Dennis Myers, Terry A. Wolfer, and Maria L. Hogan
A complex web of attitudinal, cultural, economic, and structural variables condition the decision to respond to communications promoting healthy behavior and participation in risk reduction initiatives. A wide array of governmental, corporate, and voluntary sector health-related organizations focus on effective messaging and health care options, increasing the likelihood of choices that generate and sustain wellness. Researchers also recognize the significant and multifaceted ways that religious congregations contribute to awareness and adoption of health-promoting behaviors. These religiously based organizations are credible disseminators of health education information and accessible providers of venues that facilitate wellness among congregants and community members. The religious beliefs, spirituality, and faith practices at the core of congregational cultural life explain the trustworthiness of their messaging, the health of their adherents, and the intention of their care provision.
Considerable inquiry into the impact of religion and spirituality on health reveals substantive correlations with positive psychological factors known to sustain physical and psychological health—optimism, meaning and purpose, hope, well-being, self-esteem, gratefulness, social support, and marital stability. However, the beliefs and practices that create receptivity to health-related communications, care practices, and service provision can also be a deterrent to message impact and participation in healthy behaviors. When a productive relationship between spirituality and health exists, congregational membership offers rituals (e.g., worship, education, mission) and relationships that promote spiritual well-being. Research demonstrates increased life satisfaction and meaning in life, with health risk reduction associated with a sense of belonging, enriched social interactions, and shared experiences.
Congregations communicate their commitment to wellness of congregants and community members alike through offering a variety of congregationally based and collaborative wellness and risk reduction programs. These expressions of investment in individual and community health range across all age, gender, and ethnic demographics and address most of the prominent diagnostic categories. These programs are ordered along three dimensions: primary prevention (health care messaging and education), secondary prevention (risk education), and tertiary prevention (treatment). Applying the dimensions of sponsorship, goal/mission, focus, services, staffing, and intended outcome highlights the similarities and differences among them. Several unique facets of congregational life energize the effectiveness of these programs. Inherent trust and credibility empower adherence, and participation decisions and financial investment provide service availability. These assets serve as attractive contributions in collaborations among congregations and between private and public health care providers.
Current research has not yet documented the best practices associated with program viability. However, practice wisdom in the planning, implementation, and evaluation of congregationally based and collaborative health-related programs suggests guidelines for future investigation. Congregational leaders and health care professionals emphasize well-designed needs assessment. Effective congregational health promotion and risk reduction may be linked to the availability and expertise of professionals and volunteers enacting the roles of planner/program developer, facilitator, convener/mediator, care manager/advocate, health educator, and direct health care service provider.
Lily A. Arasaratnam
The phrase “intercultural competence” typically describes one’s effective and appropriate engagement with cultural differences. Intercultural competence has been studied as residing within a person (i.e., encompassing cognitive, affective, and behavioral capabilities of a person) and as a product of a context (i.e., co-created by the people and contextual factors involved in a particular situation). Definitions of intercultural competence are as varied. There is, however, sufficient consensus amongst these variations to conclude that there is at least some collective understanding of what intercultural competence is. In “Conceptualizing Intercultural Competence,” Spitzberg and Chagnon define intercultural competence as, “the appropriate and effective management of interaction between people who, to some degree or another, represent different or divergent affective, cognitive, and behavioral orientations to the world” (p. 7). In the discipline of communication, intercultural communication competence (ICC) has been a subject of study for more than five decades. Over this time, many have identified a number of variables that contribute to ICC, theoretical models of ICC, and quantitative instruments to measure ICC. While research in the discipline of communication has made a significant contribution to our understanding of ICC, a well-rounded discussion of intercultural competence cannot ignore the contribution of other disciplines to this subject. Our present understanding of intercultural competence comes from a number of disciplines, such as communication, cross-cultural psychology, social psychology, linguistics, anthropology, and education, to name a few.
Conflict, as part of interpersonal interactions, occurs in specific cultural settings. Viewing conflict as cultural behavior helps explain why disputes over seemingly similar issues can be handled so dissimilarly in different cultures. There have been numerous cross-cultural comparison studies of different conflict management strategies, most of them utilizing a “national culture” approach. The findings reported in the cross-cultural conflict literature point to a picture that collectivists value harmonious interpersonal relationships with others, preferring indirect or avoiding styles of dealing with conflict and showing concern for face-saving. Understanding the range of behavior choices and strategies available to manage conflict as well as differences in preferred styles adds considerably to people’s skills as effective communicators.
Following the devastation of World War II, policymakers and scholars worked to advance international partnerships and mutual understanding. In the 1940s and 1950s, international student exchange programs were launched to foster international good will; training programs for diplomats were created that focused on intercultural communication competence; and researchers turned their attention on how to optimize intergroup relations. Most prominently, Gordon Allport outlined principles of effective intergroup contact in the contact hypothesis. Scholarship based on the contact hypothesis later determined that the potential for friendship is not only a facilitating but also an essential factor for prejudice reduction and optimal intergroup contact. Focusing largely on the friendship experiences of international students studying abroad, research also identified numerous other benefits of intercultural-friendship formation, including stronger language skills, greater life satisfaction, lower levels of stress, and enhanced perceptions of the host country. Despite these benefits, the lack of friendship between sojourners and host nationals is a common finding in intercultural-friendship research and a concern for the many educational institutions worldwide that are attempting to internationalize, in part by attracting international students. Current research, therefore, often focuses on factors that influence intercultural-friendship formation and, increasingly, on measures for promoting intercultural friendship.
First among the factors affecting the development of intercultural friendships is cultural difference. Cultural similarity provides attributional confidence and reduces uncertainty; that is, interactants can more easily predict and explain behaviors in people who are similar to them. Highly dissimilar cultures often exhibit differences in communication patterns, value dimensions, and friendship styles that can impede relationship development, especially in the orientation and exploratory stages of social penetration, during which cultural complexities are most critical. Another prominent factor is the interactants’ motivation to form relationships across cultural lines. In one of the prime arenas for intercultural contact, international student exchange, for example, sojourners seeking cultural knowledge and personal growth generally have more interest in interaction and friendships with host nationals than students who are task oriented and focus on education for better career prospects after returning home. Similarly, host environment factors, such as host receptivity (ranging from welcoming attitudes to discrimination) influence the likelihood with which intercultural friendships are formed. Other factors affecting intercultural-friendship formation include communicative competence, intercultural sensitivity, and aspects of identity and personality (e.g., cultural versus personal identification, empathy, and open-mindedness). Among measures for promoting intercultural-friendship formation are infrastructures that facilitate proximity and frequency of contact, provide foreign language training, support experience abroad, and offer intercultural education and training to further intercultural competence and the appreciation of difference.
Malgorzata Lahti and Maarit Valo
The workplace is a highly meaningful context for intercultural communication where persons who come from different countries, identify with different ethnic groups or speak different languages get to collaborate and develop relationships with one another. Needless to say, interpersonal communication in the workplace has always been a primary area of interest for intercultural communication research.
Early scholarship focused on the preparation of U.S. military personnel, diplomats, business people, and missionaries for overseas assignments. However, the increasing pluralization of the social landscape has bolstered research endeavors. These days, the scope of intercultural workplace communication inquiry comprises everyday face-to-face and technology-mediated interactions in encounters, relationships, groups, and teams in a variety of working arrangements, and across a range of public and private sector organizations worldwide. The scholarship also draws on the organizational approaches of antidiscrimination and diversity management that emerged in the United States and have subsequently been exported to and reinterpreted in workplaces around the world.
Researchers have looked into such workplace communication processes and phenomena as social categorization, stereotyping, prejudice and discrimination, conflict and its management, organizational satisfaction and identification, socialization, supportive communication, interpersonal relationship development and informal interaction, negotiation of shared workplace culture, knowledge sharing, decision-making, learning and innovation, or leadership and management. In recent years, there has been a growing interest in the ways languages are used in interactions at work.
Federica Pieragostini, Bruno Gabriel Salvador Casara, and Caterina Suitner
Globalization is making interethnic communication an increasingly widespread issue. The reduction of actual and psychological distances due to migratory flows and media communication increases contact opportunities between individuals from different ethnic groups. Communication between members belonging to different ethnic groups can also be considered a challenge as it brings in more general intergroup controversies. Ethnicity affects both verbal and nonverbal communication at different intensity levels. For example, using verbal communication, interethnic conflict may emerge through the use of hate speech, and—at a lower intensity level—may also emerge by the subtle use of pronouns (e.g., avoiding the use of “we” to exclude members of other groups). Similarly, in nonverbal communication, interethnic conflicts may strongly be evident in explicit exclusion behaviors, but also in subtler cues such as by enhancing spatial distance from persons belonging to other groups. Ethnic identities and their implications are also evident in and influenced by mass media narratives, which mirror, establish, and perpetuate inequalities and discrimination. Interethnic communication is therefore a challenge and an opportunity to understand and to improve relationships between ethnic groups.
The focus of intergroup communication research in the Baltic countries is on interethnic relations. All three countries have Russian-speaking urban minorities whose process of integration with Estonian, Latvian, and Lithuanian majorities has been extensively studied. During the Soviet era when the Russian-speaking communities in the Baltic countries were formed, they enjoyed majority status and privileges. After the collapse of the Soviet Union, there was a status reversal as Russian speakers become minorities in the newly emerged national states. The integration of once monolingual Russian-speaking communities has been the major social challenge for the Baltic states, particularly for Estonia and Latvia where they constitute about 30% of the population. Besides the Russian-speaking minorities, each of the Baltic countries has also one other significant minority. In Estonia it is Võro, a linguistically closely related group to Estonians; in Latvia it is Latgalians, closely related to Latvians; and in Lithuania, it is the Polish minority. Unlike the Russian-speaking urban minorities of fairly recent origin, the other minorities are largely rural and native in their territories.
The intergroup communication between the majorities and Russian-speaking minorities in the Baltic countries has often analyzed by a triadic nexus consisting of the minority, the nationalizing state, and the external homeland (Russia). In recent analyses, the European Union (through its institutions) has often been added as an additional player. The intergroup communication between the majorities and the Russian-speaking communities is strongly affected by conflicting collective memories over 20th-century history. While the titular nations see the Soviet time as occupation, the Russian speakers prefer to see the positive role of the Soviet Union in defeating Hitler and reconstructing the countries’ economy. These differences have resulted in some symbolic violence such as relocation of the Bronze Soldier monument in Estonia and the riots that it provoked. Recent annexation of Crimea by the Russian Federation and the role of the Ukrainian Russian speakers in the secessionist war in the Eastern Ukraine have raised fears that Russia is trying to use its influence over its compatriots in the Baltic countries for similar ends. At the same time, the native minorities of Võro and Latgalians are going through emancipation and have demanded more recognition. This movement is seen by some among the Estonian and Latvian majorities as attempts to weaken the national communities that are already in trouble with integrating the Russian speakers. In Lithuania, some historical disagreements exist also between the Lithuanians and Polish, since the area of their settlement around capital Vilnius used to be part of Poland before World War II. The Baltic setting is particularly interesting for intergroup communication purposes, since the three countries have several historical parallels: the Russian-speaking communities have fairly similar origin, but different size and prominence, as do the titular groups. These differences in the power balance between the majority and minority have been one of the major factors that have motivated different rhetoric by the nationalizing states, which has resulted in noticeably different outcomes in each setting.
Culture is a broad term that is often used in a wide variety of contexts. Its meanings can be anything from very narrow conceptualizations such as the notion of high culture to a much broader view of culture being all-encompassing. In addition, scholars identify different types of cultures, such as regional, national, or even global cultures, as well as sub-cultures or cultures of shared social practices. At the social systems level, culture is often defined as relating to shared social practices, meanings, beliefs, symbols and norms. The relationship between journalism, culture, and society is a symbiotic one. Journalism influences culture, but it is also influenced by it. In fact, as some argue, journalism is culture.
While journalism’s influence on culture has found extensive attention in the cultural studies literature, cultural and societal influences on journalism have been far less researched. When studies examine broader media system influences on journalism, the focus tends to be on political and economic determinants. However, cultural influences also provide substantial explanatory potential when trying to understand why journalism is practiced differently across the globe. Culture as the broader system of beliefs and practices in a given society, as in the case of cultural values, has an established research tradition in cross-cultural psychology. Three key works on cultural values provide guidance for examining cultural influences on journalism, and involving these in research improves understanding of journalism cultures on a variety of levels. Both normative calls for the preferred role of culture in journalism, as well as empirical studies of the influence of cultural values on journalism demonstrate the value such approaches bring to journalism studies.
For the past two decades, the Korean Wave has been recognized in many parts of the world, and has articulated dynamic junctures of globalization, regionalization, and localization in the realms of media and popular culture. Due to online media platforms such as streaming services, television content has been diversifying and increasing its transnational circulation. More recently, the outbound scope of K-drama and K-pop has further reached dispersed global audiences, most of whom are not Korean media consumers or fans, thanks to active use of social media, such as YouTube, in transnational media consumption. The Korean Wave can be a meaningful contra-flow in transnational pop culture. Moreover, the Korean Wave is an evolutionary cultural flow, as traced in the history of its growth. The Wave has been experiencing continuities and discontinuities in its stream for years, along with its popularity cycle, and interestingly disjuncture has shaped it differently. A set of studies of the Korean Wave should map out the presence of the Wave in the big picture of cultural globalization, beyond the pre-existing geocultural divisions. The very recent Korean Wave drives not only the flow of various kinds of content and formats but also reciprocal interchanges of diverse levels of human, financial, technological, and cultural elements; this reconstructs implied meanings of the Korean Wave and its globalizing phenomena.
Ee Lin Lee
Language is an arbitrary and conventional symbolic resource situated within a cultural system. While it marks speakers’ different assumptions and worldviews, it also creates much tension in communication. Therefore, scholars have long sought to understand the role of language in human communication. Communication researchers, as well as those from other disciplines (e.g., linguistics, anthropology, psychology, and sociology), draw on each other’s works to study language and culture. The interdisciplinary nature of the works results in the use of various research methods and theoretical frameworks. Therefore, the main goal of this essay is to sketch the history and evolution of the study of language and culture in the communication discipline in the United States.
Due to space constraints only select works, particularly those that are considered landmarks in the field, are highlighted here. The fundamentals of language and the development of the Sapir–Whorf hypothesis in leading to the formation of the language and social interaction (LSI) discipline are briefly described. The main areas of LSI study—namely language pragmatics, conversation analysis, discourse analysis, and the ethnography of communication—are summarized. Particular attention is paid to several influential theories and analytical frameworks: the speech act theory, Grice’s maxims of implicatures, politeness theory, discursive psychology, critical discourse analysis, the ethnography of speaking, speech codes theory, and cultural discourse analysis. Criticisms and debates about the trends and directions of the scholarship are also examined.
Jon F. Nussbaum and Amber K. Worthington
Health and risk message design theories do not currently incorporate a lifespan view of communication. The lifespan communication perspective can therefore advance theorizing in this area by considering how the fundamental developmental differences that exist within and around individuals of different ages impact the effectiveness of persuasive message strategies. Designing health messages for older adults therefore requires an examination of how theoretical frameworks used in health and risk message design can be adapted to be age sensitive and to effectively target older adults. Additionally, older adults often make health decisions in conjunction with informal caregivers, including their adult children or spouses, and/or formal caregivers. Message design scholars should thus also consider this interdependent influence on health behaviors in older adults. Strategic messages targeting these caregivers can appeal to, for example, a caregiver’s perception of responsibility to care for the older adult. These messages can also be designed to not only promote the older adults’ health but also to alleviate caregiver stress and burden. Importantly, there is an unfounded stereotype that all older adults are alike, and message designers should consider the most beneficial segments of the older adult audience to target.
Lifestyle journalism is a significant and very substantial field of journalism. Unlike other fields of journalism, however, it has not been the focus of much scholarly debate. Providing audiences as it does with “news you can use,” it is often considered a supplement to breaking news, political news, and news on social and cultural conflicts. Lifestyle journalism has frequently been defined in opposition to the normative ideal of journalism and therefore in terms of what it is not. This means that it has often been defined from within other journalistic fields, or as a fusion of journalistic elements such as soft news, service journalism, consumer journalism, popular journalism, or even cultural journalism. Lifestyle journalism has also been an umbrella term for more specialized beats of journalism such as travel journalism, fashion journalism, or food journalism. But while lifestyle journalism is partly defined by the topics addressed, it is also characterized by specific genres or modes of addressing the audience (as consumers, for example). Common to a lot of characterizations is a strong connection with advertising and public relations, which means that lifestyle journalists often have been accused of running the errands of the market. For this reason the journalistic role and the self-perceptions of journalists in this field have been a special point of interest in the scholarly debate. In addition to being challenged from within journalism, the legitimacy is also challenged by the many new voices that participate in the field of lifestyle issues in a digital media landscape, a participation that increasingly blurs the boundaries between professionals and non-professionals.
The field of lifestyle journalism is, however, itself characterized by blurred boundaries, both between the various subfields and between soft and hard news. Genres traditionally used in hard news, for example, have been adapted to soft news, and topics such as health can in one context be presented as “soft news” (e.g., “how to improve your health”) but in others as “hard news” (e.g., “smoking causes economic expenses”). The relatively new practice of constructive journalism can serve as a case of how approaches associated with lifestyle and service journalism have migrated to more traditional hard news fields.
Maricel G. Santos, Holly E. Jacobson, and Suzanne Manneh
For many decades, the field of risk messaging design, situated within a broader sphere of public health communication efforts, has endeavored to improve its response to the needs of U.S. immigrant and refugee populations who are not proficient speakers of English, often referred to as limited English proficient (LEP) populations. Research and intervention work in this area has sought to align risk messaging design models and strategies with the needs of linguistically diverse patient populations, in an effort to improve patient comprehension of health messages, promote informed decision-making, and ensure patient safety. As the public health field has shifted from person-centered approaches to systems-centered thinking in public health outreach and communication, the focus in risk messaging design, in turn, has moved from a focus on the effects of individual patient misunderstanding and individual patient error on health outcomes, to structural and institutional barriers that contribute to breakdown in communication between patients and healthcare providers.
While the impact of limited proficiency in English has been widely documented in multiple spheres of risk messaging communication research, the processes by which members of immigrant and refugee communities actually come to understand sources of risk and act on risk messaging information remain poorly researched and understood. Advances in risk messaging efforts are constrained by outdated views of language and communication in healthcare contexts: well-established lines of thinking in sociolinguistics and language education provide the basis for critical reflection on enduring biases in public health about languages other than English and the people who speak them. By drawing on important findings about language ideologies and language learning, an alternative approach would be to cultivate a deeper appreciation for the linguistic diversity already shaping our everyday lives and the competing views on this diversity that constrain our risk messaging efforts.
The discourse surrounding the relationship between LEP and risk messaging often omits a critical examination of the deficit-based narrative that tends to infuse many risk messaging design efforts in the United States. Sociolinguists and language education specialists have documented the enduring struggle against a monolingual bias in U.S. education and healthcare policy that often privileges proficiency in English, and systematically impedes and discriminates against emerging bilingualism and multilingualism. The English-only bias tends to preclude the possibility that risk messaging comprehension for many immigrant and refugee communities may represent a multilingual capacity, as patients make use of multiple linguistic and cultural resources to make sense of healthcare messages. Research in sociolinguistics and immigration studies have established that movement across languages and cultures—a translingual, transcultural competence—is a normative component of the immigrant acculturation process, but these research findings have yet to be fully integrated into risk messaging theory and design efforts. Ultimately, critical examination of the role of language and linguistic identity (not merely a focus on proficiency in English) in risk messaging design should provide a richer, more nuanced picture of the ways that patients engage with health promotion initiatives, at diverse levels of English competence.