I have been intending to write about this for some time, and with the US Senate about to open up debate on the appropriations bill for the Department of Health and Human Services this week, the time must be now.

Back in July, when the House of Representatives was voting on the HHS Appropriations bill, Congressman Ryan of Wisconsin successfully passed an amendment on a voice vote that took out the line item for the CDC's entertainment education project (currently housed at USC as Hollywood, Health and Society). This is a well-known, successful program that works with television writers and other entertainment industry professionals to ensure that health issues are depicted accurately and to work towards inclusion of health content into shows to promote healthy behaviors on the part of the audience. I have written about the effectiveness of the entertainment education approach many times before.

Congressman Ryan lumped this program in with other instances of what he considers wasteful spending by the CDC and tarred it with a very broad brush. Here's an excerpt from the transcript of his remarks:

Mr. Chairman, there is a recent troubling report entitled "CDC Off Center,'' which was produced under the direction of Senator Coburn with a report in the Senate Government Affairs Committee. Instead of using its resources to fight life-threatening diseases like HIV/AIDS and cancer, the CDC has instead spent money on needless luxury items and nongovernment functions.

For example, the CDC's Office of Health and Safety recently provided its employees with a new, extravagant fitness center that includes such items as rotating pastel "mood'' lights, zero-gravity chairs, and $30,000 dry-heat saunas. The CDC has also spent over $1.7 million on a "Hollywood liaison'' to advise TV shows like "E.R.'' and "House'' on medical information included in their programming, clearly an expense that should have been covered by the successful for-profit television shows, not by our hard-earned tax dollars. They also further squandered taxpayer dollars in an office intended to help improve employee morale...

In a time when we are facing increasing risk of bioterrorism and disease, these are hardly the best use of taxpayer dollars. My amendment simply would ensure that the CDC would not be able to spend any more Federal funding on these three boondoggles described above. And it is my hope that we can get the CDC focused on doing its job, which is very important and they do a good job on that, and not on these kinds of boondoggles.

With that one sentence about the “Hollywood liaison,” boom, out went that program. I'm not going to comment on the rest of the CDC "boondoggles" because I don't know enough about them. I do know that entertainment education is not a boondoggle, but a very effective public health activity.

Congressman Ryan's chief objection seems to be that those rich Hollywood types should pay for their own darn consultants if they want to be medically accurate. The fact is, TV writers and producers are in the business of telling stories and entertaining people. There aren't many producers out there like Neal Baer who put a premium on incorporating health education while telling a good story. Many need to be convinced, and then handed the information on a silver platter. If programs like Hollywood Health and Society (HHS) and others like it weren't doing constant outreach to the entertainment industry, much more inaccurate information would be getting out to the public, which might then be erroneously acted upon.

And that doesn't take into account that this type of outreach is much more cost-effective than producing television ads and purchasing time to run them. Some examples of the cost savings can be found by looking at the shows HHS has consulted on (thank you to my anonymous well-placed contacts who provided me with this information):

• Show: ER
  Topic: adolescent obesity and related topics
  Length: approx. 7 minutes
  Audience: 24.8 million
  If purchased time using ad rate: $4,818,324
  Evaluation results:
  • Viewers reported more healthy behaviors after seeing the storyline, i.e. exercising and eating healthy (AOR 1.65, p<.01).
  • Viewers had more knowledge of 5 A Day compared with non-viewers (AOR 1.05, p<.05).
  • Men had the greatest and most significant gains in knowledge (AOR 1.25, p<.01).
  

• Show: 24
  Topic: Bioterrorism/major disease outbreak
  Length: approx. 20 minutes
  Audience: 11.4 million
  Cost if purchased time using ad rate: $12,360,000
  Evaluation results:
  • Viewers who saw one or more of the 5 storyline episodes had increased knowledge about susceptibility to a bioterrorism attack, how infection spreads, public health response, and steps to take in a bioterrorism emergency.
  • Viewers were also significantly influenced in their intention to follow directions from authorities.
  

Over the past five years, the total time that television shows aired public health information concerning CDC topics was approximately 545 min., reaching 586 million viewers. The total cost if they had purchased ad time on those shows would have been $72,442,644. For the number of people they reached, and the effectiveness of the content, I'd say the program was a bargain at $1.7 million.

If you agree that the CDC should continue to promote public health through the very effective entertainment education approach, please contact your Senators to express your support for retaining this funding. You can find your Senators' email and fax numbers here. You can adapt this sample letter:

Date

Senator _______
U.S. Senate
Washington, D.C. 20510

Dear Senator _______:

I am writing to share my support for the CDC’s Entertainment Education Program, an important public health tool which utilizes the power of popular mass media to educate Americans about healthy behaviors. I urge you to oppose any attempts to eliminate funding for the program when the Senate considers the Labor-HHS Appropriations bill for fiscal year 2008.

The CDC’s Entertainment Education Program fosters the use of factual health information in television shows and promotes the incorporation of important and timely public health messages into television programming. Funding for this program allows the CDC to reach out to television writers with written materials and experts on a wide range of public health issues, to respond to requests from television writers, producers, and researchers, and to ultimately connect them with experts who can provide factual information. Rather than serving in lieu of paid consultants to the shows, the program ensures accurate depictions of health issues even when no such effort would have been made otherwise on the part of the entertainment professionals.

During House consideration of the Labor-HHS bill, Rep. Paul Ryan (R-WI) successfully offered an amendment to eliminate funding for the program. I urge you to oppose any similar effort in the Senate.

According to the 2005 HealthStyles (Porter Novelli) study, nearly six out of 10 (58%) regular television viewers report learning something about a disease or how to prevent it from a daytime or primetime drama. More importantly, nearly three out of 10 (28%) regular viewers took one or more actions as a result of a television health storyline, such as telling someone about the health topic, calling a hotline or visiting a clinic.

Under the guidance of the CDC’s Entertainment Education Program:
• More than 400 television episodes contained public health information, including more than 82 major storylines
• 11 shows ran some combination of informational PSAs, info spots, and toll free numbers
• 28 storylines were evaluated for effect on viewing audiences
• More than 200 links to public health information were provided to show websites for their viewers

The entertainment education approach works. Up to 20 million viewers may watch a single T.V. show, and they act on the health information they receive. It would be a public health tragedy for this highly successful program to lose its funding.

Sincerely,

Please pass this information along to other entertainment education professionals and social marketers you know so that the entire field is not dismissed offhandedly as a "boondoggle." The House wasn't paying attention. Let's make sure that the Senate is.


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