Entertainment-Education and the Lack of Representation in Media. This article discusses a possible limitation to Entertainment-Education (E-E) that

Transcription

1 Lipinski 1 Entertainment-Education and the Lack of Representation in Media This article discusses a possible limitation to Entertainment-Education (E-E) that stems from the lack of representative characters and storylines of Asian Americans (AAs) in media. E-E has been shown to be effective internationally and domestically, yet its effects may be limited because Asians are underrepresented, preventing viewers from undergoing homophilization. In order to address Asian health concerns, such as hepatitis B, suicide, and heart disease, E-E organizations should encourage Hollywood to adopt practices that represent a myriad of perspectives and ethnic characters. In doing so, E-E interventions will achieve a high degree of homophilization and mediate AA health concerns. Therefore, more Asian representation both on- and off-screen needs to remain a priority among communication scholars and entertainment executives, as there are both health and economic benefits. Key words: diversity, representation, health education, homophilization Entertainment has become an integral part of human life around the world, with more of the global population consuming entertainment each year. The use of health messaging within media channels provides public health professionals with a powerful and far-reaching tool to educate viewers on a myriad of health topics. Rather than acting as a blueprint for health treatment, Entertainment-Education (E-E) aims to disseminate information to spur a dialogue among viewers through the use of health storylines. To accomplish its aims, E-E relies heavily on social cognitive theory and elaboration likelihood model of persuasion (Singhal et al., 2002).

2 Lipinski 2 E-E interventions seek to influence audience behavior change [and increase knowledge] by providing positive and negative role models [television characters] to the audience (Singhal et al., 2002). That is, viewers follow characters intertwined in health storylines and observe an array of health behaviors that grant the viewers higher perceived autonomy over their own health decisions. Since the first recognizable intervention launched on television in 1969 on Simplemente María, the use of E-E has been growing and its successes have spanned the globe, lending support to its use as public health tool. In its sequence focused on gender based violence, Soul City, a South African television series, created a storyline that modeled a community-based solution and provided information about relevant legal assistance (Tufte, 2001). Community members confronting issues of gender-based violence in their own communities, in turn, received content and a viable solution to solve their community s health problems. The series succeeded in sparking community action against gender-based violence as evidenced by cases of communities mimicking the behavior exhibited by the television characters. However, while behavior change may be observed as in the case above, more often E-E causes an increase in knowledge or health-related discussion, understandings that precede the adoption of new behavior ( Slater et al, 2002 ). For example, viewers of Soul City (43%) were more likely than non-viewers (25%) to openly discuss HIV and AIDs (Tufte, 2001). Another study by Chatterjee et al. recorded the benefit of an HIV/AIDS storyline in an Indian television program Jasoos Vijay, finding that viewers engaged in significantly higher levels of interpartner discussion regarding safe-sex practices following the series launch (2009). Similarly, viewers who recalled the messages regarding organ donation on a popular American television drama

3 Lipinski 3 Three Rivers were more likely to engage in positive interpersonal discussion with others (Khalil et al., 2014). One of the most successful E-E interventions in the United States, Ladrón de Corazones, also reported an increase in knowledge and likelihood of calling the hotline broadcasted during the airtime (Wilkin et al., 2007). This knowledge, moreover, encouraged men to engage in discussions with close females about breast cancer screenings (Wilkin et al., 2007). Therefore, E-E has achieved global success in generating not only individual behavior change but, perhaps more importantly, discussion and engagement through an increase in knowledge. Analyses of E-E interventions note best practices in creating and tailoring storylines that elicit significant changes socially and behaviorally. Wilken et al. (2007) conclude that identification with characters leads to talking to others about health topics in shows, calling hotlines, and...increased knowledge (466). This process of identification, referred to as homophilization, occurs when viewers actively envision various features of television narratives as similar to themselves and their own lived experiences (Russell et al., 2013). Viewers who experienced high levels of homophilization were more likely to indicate that they have told others about health topics they saw (Wilkin et al., 2007, 463). In other words, the utilization of characters and storylines with whom audience members identify on the basis of age, sex, race, ethnicity, or life experiences promotes homophilization, which is imperative in determining whether a viewer will engage in or refrain from engaging in health related behaviors. Therefore, in order to create significant health-related change, homophilization needs to remain at the forefront of E-E interventions. Women identified with the protagonist María in Simplemente María, causing a surge in the purchase of Singer typewriters (Singhal et al, 2002). Similarly, viewers of Ladrón de Corazones who had already built relationships with the

4 Lipinski 4 television characters were more likely to engage in behaviors to address the target health issue, breast cancer. Even male viewers who did not identify with the protagonist in terms of gender exhibited changes in behavioral intention and knowledge of breast cancer (Wilkin et al., 2007). Within the United States, lack of representation remains a problem, exported globally with American television programming and cinema. One study finds a preponderance of white, cis-gendered, heterosexual characters in all types of media in 2015; the lack of ethnic and female directors and cast members was significant. With regard to Asian representations, it reports that forty-nine films did not feature even one Asian or Asian-American (AA) speaking or named character (Smith et al., 2016). On a social level, this continuous lack of Asian characters is problematic since, in the absence of personal interactions and experiences, audience members use media and popular images to formulate assumptions of an entire culture (Chin et al., 2007). Adverse health consequences may also result. E-E has been shown to create community efficacy and elicit positive behavior change. Moreover, it is most successful when viewers identify with characters in terms of age, sex, race, or experiences. Since Asian characters remain largely unseen and unheard in American media, however, AAs may not undergo homophilization, an essential component to spur health-related action and discussion. Therefore, the lack of representation in American media may act as an obstruction to E-E s continued success, especially in tailoring and targeting interventions to AA populations. In 2015, 5.6% of persons living in the United Station identified as Asian, an increase from 4.8% in 2010 (U.S. Census Bureau, 2015). While the proportion of Asian people is increasing, their representation in American media has remained stagnant (Smith et al., 2016). The relative absence of Asian characters in popular film and television is disadvantageous to AA

5 Lipinski 5 communities for many reasons, one of which is the missed opportunity for E-E. Given its previous success in addressing health issues specific to Latino, South African, and other populations, E-E could be utilized to address health issues that impact disproportionate number of Asian persons, such as liver, cardiac, and mental health diseases. Hepatitis B, a condition which can lead to cancer or liver failure, remains a primary public health concern among AA populations. About half of all chronic hepatitis B affect AAs and mortality statistics indicate that they are disproportionately dying from the disease (Center for Disease Control and Prevention, 2013). AAs suffer disproportionately from heart disease; in 2013, AAs and Pacific Islanders accounted for 22.2% of deaths caused by heart disease (Heron, 2016). In addition, mental health continues to raise public health concern in AA communities since overall percentage of deaths from suicide is higher for AAs (1.7%) than non-hispanic whites (1.3%) (Heron, 2016). Moreover, Chinese American women have the highest rates of suicide of all ethnic groups. A significant barrier to care stems from the Asian cultural philosophical difference with the Western philosophy, which divides the mind and the body (Kagawa-Singer et al., 2015, 150). These pressing health issues could be addressed via EE s health storylines; however, a crucial first step must be improved representation which would spur higher homophilization. Greater representation may not necessarily facilitate behavior change. According to a study done by Richeson et al. (2002), black students reported higher levels of anxiety when confronted with counter-stereotypical portrayals of black television characters compared with stereotypical portrayals of black television characters. That is, when characters engaged in stereotypical social behavior, black students were less likely to report higher levels of anxiety. These findings could suggest that media can hurt the very population to which it intends to

6 Lipinski 6 provide assistance. More likely, however, these results show that a balance must be achieved between the two extremes (Richeson et al, 2002). Diversification of television roles must be a top priority to promote homophilization and burgeon health-related discussion. With diverse casts, storylines become multi-vocal and viewers can identify with one or more of a variety of characters. Consequently, health messaging may become more nuanced. One character may perceive one solution as optimal while another may seek a second opinion. These types of deviations create a complex health dialogue that spurs discussion and potentially behavior adoption among viewers. Rather than providing audience members with two extremes that limits their ability to relate to one character or the other, television networks and production companies should devote themselves to the casting of racially diverse actors to a multiplicity of roles. There have been many successful instances of E-E; however, no major research studies have shown the effects of E-E on AAs. This paper has recapitulated a few of the most successful E-E initiatives, each with its own specific target audience and health behavior. Each proved successful in their own regard, demonstrating the benefit E-E can provide in diverse populations around the globe. With quantifiable improvements among South Africans through Soul City and among Latinos in the U.S. through Ladrón de Corazones, there is no reason to expect that the outcomes would be different in AA populations. Wilkin et al. (2007) demonstrated that identification can happen on many different levels when their results concluded that men engaged in new, positive health behaviors even though the protagonist of the series was a female. Moreover, further research must be done in order to conclude whether E-E initiatives can be used as a public health tool in AA populations.

7 Lipinski 7 Altering the media landscape requires more than incorporating more ethnically Asian actors. There must also be a focus on the choices made behind the scenes. Of the 886 directors between 2007 and 2015, twenty-five (2.8%) were Asian (Smith et al., 2016). On the other hand, 81% of directors, writers, and producers were male. Storylines dominated by white male influence will continue to reflect specific interests and ignore others. That is, without representatives to assist in the production and direction of a project, the creation and interpretation of Asian characters remains a task of a largely white Hollywood which fails to represent ethnic people and their experiences in true form. This may be especially important considering their potential preference for non-western medicine, which connects the mind and the body (Kagawa-Singer et al., 2015). These intercultural health demands could be addressed through the inclusion of AAs in on- and off-screen roles. Without Asian representation, health storylines will be created by white American men who are accustomed to Western medicine. These stories could potentially assume one solution a Western solution to a health problem. As a result, these storylines would be less likely to spur health-related dialogue since Asian Americans tend to prefer the use of traditional Eastern medicine (Kagawa-Singer et al., 2015) Since it functions best when viewers perceive a high degree of entertainment value, entertainment-education should continue to utilize popular television networks to launch their interventions (Khalil et al., 2014; Wilkin et al., 2007). Recognizing their reliance on profits, Hollywood executives must perceive a benefit to diversifying television both on- and off-screen. Without economic gains, Hollywood executives may continue hiring practices that exclude minorities, consequently limiting the success of E-E interventions to create homophilization among Asian viewers. Empirical evidence shows the profitability of diversity in media. A 2016

8 Lipinski 8 report finds a correlation between profits and diverse casts. Specifically, television programming with representation that reflects the U.S. population receives the higher ratings among viewers (Bunche Center). In other words, media representation reaps economic as well as health benefits. Therefore, Hollywood should adopt practices that represent a myriad of perspectives and ethnic characters, impelling homophilization and mediating mediate health concerns among AA viewers.

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