Jennifer A. Malkowski, J. Blake Scott, and Lisa Keränen
Rhetoric, commonly understood as the art, practice, and analysis of persuasion, has longstanding connections to medicine and health. Rhetorical scholars, or rhetoricians, have increasingly applied rhetorical theories, concepts, and methods to the texts, contexts, discourses, practices, materials, and digital and visual artifacts related to health and medicine. As an emerging interdisciplinary subfield, the rhetoric of health and medicine seeks to uncover how symbolic patterns shape thought and action in health and medical texts, discourses, settings, and materials.
In practice, rhetoricians who study health and medicine draw from the standard modes of rhetorical analysis, such as rhetorical criticism and rhetorical historiography, as well as from social science methods—including participant observation, interviewing, content analysis, and visual mapping—in order to deepen understanding of how language functions across health and medical objects, issues, and discussions. The objects of analysis for rhetorical studies of health and medicine span medical research, education, and clinical practice from laboratory notes to provider–patient interaction; health policymaking and practice from draft policies through standards of care; public health texts and artifacts; consumer health practices and patient advocacy on- and offline; public discourses about disease, death, bodies, illness, wellness, and health; online and digital health information; popular entertainments and medical dramas; and alternative and complementary medicine. Despite its methodological breadth, rhetorical approaches to science and medicine consistently involve the systematic examination and production of symbolic exchanges occurring across interactional, institutional, and public contexts to determine how individuals and groups create knowledge, meanings, identities, understandings, and courses of action about health and illness.
Style is in the traditional canon of rhetoric and means the manipulation of language for rhetorical effect. Historically, eras that emphasized style in rhetoric also tended to regard rhetoric as of secondary importance in public discourse, as the window dressing for logic and more substantive modes of invention.
When we think of style more broadly as the use of gesture, clothing, decoration, objects, grooming—in short, of style in the more colloquial sense of “he’s got style”—then we see a wider and more important role for style as a major form of rhetoric. Today, the need of global capitalism to sustain artificially high levels of consumption is largely achieved through a rhetoric of style. The public must be persuaded to churn its clothing, decoration, grooming styles, and so forth constantly to keep consumption up, and the most effective way to achieve that end is through creating in people a preoccupation with style. Once that happens, then style becomes the major way in which we think about presenting ourselves to others. Style becomes the way in which people say who they are, who they want to be, and who they feel opposed to. Style becomes a major expression of political commitment.
In short, style has become a major if not the major rhetorical system at work in the world today. We understand what others mean, and we influence others, through style much more than we do through carefully planned discursive discourses, argument, and expository presentations. Because global capitalism is the engine behind this preoccupation with style, style is a system of communication likely to increase in dominance and importance.
John D. H. Downing
Social movements are the matrix of many forms and formats (technologies, genres) of media that contest dominant power. Such media are in many ways the lifeblood of such movements. Media activism denotes collective communication practices that challenge the status quo, including established media. Frequently, such media are underfunded or unfunded and have a much shorter life cycle than capitalist, state, or religiously funded media. They are a “tribe” within a much larger continent of nanomedia (also called alternative media and citizens’ media). Their functions may spill over at times within the operation of established media, especially in times of social turbulence and crisis.
The “dominant power” in question may be quite variously perceived. Extreme-right populist movements, as in several European countries, may define the political establishment as having betrayed the supposed racial purity of the nation, or in the case of India’s Islamophobic Hindutva movement, as having traduced the nation’s religious purity. Labor movements may attack capital, feminist movements, or patriarchal and sexist structures. Sometimes these movements may be local, or regional; other times, they are transnational.
The impact of these media is still a matter of considerable debate. Often, the debate begins from a false premise—namely, the frequently small size and/or duration of many social movement media projects. Yet women’s right to vote and the abolition of slavery in the Americas were not won overnight, and neither was the dismantling of South Africa’s racist apartheid system. The Hindutva movement goes back over a century. We should not hold social movement media to a higher standard of impact, any more than we should ascribe instantaneous power to established media.
Social movements wax and wane, and so do their media projects. But the persistence of some such media activism between the peaks of movement activism is generally essential to the regeneration of social movements.
M. Jeffrey Farrar, Yao Guan, and Kaitlyn Erhardt
Humans live not only in a physical world but also in a mental world. Theory of mind reflects the understanding that the mind is comprised of different mental states, such as intentions, desires, and beliefs. This conception of the mind is a critical achievement in human development because it directly impacts effective communication and social interaction. It allows for the understanding of others’ behaviors by inferring their mental states. The formation of a theory of mind has been a central topic in psychology, neuroscience, cognitive science, and philosophy. It impacts related processes, such as communication skills, perspective-taking ability, and social cognition.
Across the life span, the understanding of the mind becomes increasingly complex. Early in development, infants and toddlers can discern the intentions of others. Later, more sophisticated reasoning about the mental states of others becomes possible. For instance, the ability to follow and understand the recursive thought that “Sam believes, that Mary said, that Jose wanted . . .” develops. Additionally, within distinctive developmental time periods, people differ in their ability to take into account mental states. Once people’s beliefs, including their misconceptions, are identified, it is possible to generate effective communication strategies designed to teach, learn, and even reduce risk-taking behaviors.
Sarah C. Vos and Elisia Cohen
Using pictures (also called images) in health and risk messages increases attention to messages and facilitates increased retention of message content, especially in low-literate populations. In risk communication, researchers have found that pictorial warnings stimulate communication and that images without text can communicate risk information as effectively (or, in some cases, more effectively) than text. However, little empirically based guidance exists for designing images for health and risk messages because most studies use an absence-presence model and compare visual communication to textual communication, rather than compare different types of visual communication. In addition, visual communication theories focus on describing the “how” aspect of communication instead of offering proscriptive guidance for message design. Further complicating the design of visual messages is that the number of possibilities for a visual message is, like text-based messages, almost infinite. Choices include colors, shapes, arrangement, and the inclusion of text, logos, icons, and so on. As a result, best practices on visual messages often draw on design recommendations. Before the widespread advent of Internet use and the adoption of social networking sites like Facebook and Twitter, using images—especially color images—could be cost prohibitive. However, these online platforms facilitate the distribution of visual content, and many public health organizations use these platforms to distribute visual messages. The need for guidance and research on using pictures effectively is growing. Although there has been increasing focus on images in health messages, many questions still exist about how visual messages should be composed and what their effect is. The existing evidence suggests that visual information can improve persuasive and, on social networking sites, diffusion outcomes. However, visual information may be prone to misinterpretation. Researchers should also evaluate ethical considerations when choosing pictures. Message testing is highly recommended.
A communication style is the way people communicate with others, verbally and nonverbally. It combines both language and nonverbal cues and is the meta-message that dictates how listeners receive and interpret verbal messages. Of the theoretical perspectives proposed to understand cultural variations in communication styles, the most widely cited one is the differentiation between high-context and low-context communication by Edward Hall, in 1976. Low-context communication is used predominantly in individualistic cultures and reflects an analytical thinking style, where most of the attention is given to specific, focal objects independent of the surrounding environment; high-context communication is used predominantly in collectivistic cultures and reflects a holistic thinking style, where the larger context is taken into consideration when evaluating an action or event. In low-context communication, most of the meaning is conveyed in the explicit verbal code, whereas in high-context communication, most of the information is either in the physical context or internalized in the person, with very little information given in the coded, explicit, transmitted part of the message. The difference can be further explicated through differences between communication styles that are direct and indirect (whether messages reveal or camouflage the speaker’s true intentions), self-enhancing and self-effacing (whether messages promote or deemphasize positive aspects of the self), and elaborate and understated (whether rich expressions or extensive use of silence, pauses, and understatements characterize the communication). These stylistic differences can be attributed to the different language structures and compositional styles in different cultures, as many studies supporting the Sapir-Whorf hypothesis have shown. These stylistic differences can become, in turn, a major source of misunderstanding, distrust, and conflict in intercultural communication. A case in point is how the interethnic clash between Israeli Jews and Palestinian Arabs can be exacerbated by the two diametrically opposite communication patterns they each have, dugri (straight talk) and musayra (to accommodate or “to go along with”). Understanding differences in communication styles and where these differences come from allows us to revise the interpretive frameworks we tend to use to evaluate culturally different others and is a crucial step toward gaining a greater understanding of ourselves and others.
Marla L. Moon
A visual impairment can affect cognitive, emotional, neurological, and physical development. Visual impairment impairs reading speed and comprehension, and is often mistaken for a learning disability. Learning is accomplished through complex and interrelated processes, one of which is vision. As a result, visual impairments limit the range of experiences and kinds of information to which one is exposed. A reliance on visual cues in health and risk messages intensifies these effects with regard to health information. The millions of children and adults who are affected by visual impairments worldwide thus require specific consideration regarding how best to make health information accessible for them. The reliance on caretakers to address the health information needs of those living with visual impairments violates their privacy and threatens their emotional well-being. Technological and modality advances that rely on touchscreens that lack tactile or auditory cues marginalize a broad segment of society that is in need of gateways to overcome barriers to accommodating visual impairment. In designing strategic health and risk messages, consideration should be given to this scope of possible limitation and its implications for access to and processing of health and risk information. Health and risk message designers should understand both the realities of challenges to accessing information for the visually impaired and strategies for addressing these realities and the scope of the issue worldwide and across the lifespan.