Viewpoint:
Medical research and the popular media

By Ian J Deary, Martha C. Whiteman, F.G.R. Fowkes
Copyright 1998 The Lancet
June 6, 1998


On Aug 23, 1997, we published a study in The Lancet which reported that men and women with more submissiveness were less likely to have a myocardial infarction.1 When demographic and medical factors were controlled for, the association between personality and heart disease remained significant beyond the 5% level for women, but not for men. Before publication we met as a research team to discuss handling the likely press interest. We had five areas of concern.

First, we knew that "submissiveness" had popular as well as scientific meanings. Therefore, we planned to explain that people with higher submissiveness opted to let others take the lead. We decided that the work "meek" might be a suitable popular synonym. Second, journalists always ask about the applications of a study. Therefore, we decided to emphasise that any effect of submissiveness on heart disease was small, that our study required replication, and that the association was for only one disease. Third, we rehearsed that the effect was found in men and women, but that in men it was linked with typical risk factors. Fourth, we should use the publicity to explain that typical risk factors for heart disease were important. And last, we should mention the institutions involved in funding and conducting the research.

The financial sponsors of the research, the British Heart Foundation, faxed a press release to us for checking. It described the study accurately and in a popular style, with some quotes from us and the British Heart Foundation staff about the implications of the study. We were happy overall with its content but were concerned about the mention, on the first line of the text, of the effect in women.  

The media response

The story was under embargo until midnight on Thursday, Aug 21. However, unwittingly, the Daily Telegraph ran the story on the Thursday morning under the headline, "Put down that rolling pin darling, it's bad for your heart . . .". Despite this headline the Daily Telegraph's story was excellent; written by their health correspondent David Fletcher, it summarised our study clearly, mentioned typical risk factors, had a health promotion message from the British Heart Foundation, and mentioned other relevant studies. What a pity about the sub-editor's down-market headline.

The interest from newspapers and radio stations that followed was a bombardment. Accurate stories--very similar to that in the Daily Telegraph--appeared the following day in the Times, Express, and Herald (formerly Glasgow Herald). These stories were largely based on the British Heart Foundation's press release.

Many of the interviews with the media were straightforward, and we were able to put across the points that we had discussed previously. However, one of us (IJD) fielded a telephone call from a news-agency journalist. The conversation began something like this: "So these feminists are all barking up the wrong tree? Should they all be getting back to the kitchen sink?" Attempts were made to disabuse the journalist that there was a "back-to-the-kitchen-sink" message in the results. The news agency conjured the following quote attributed to IJD: "One interpretation could be that it's better to be an obedient housewife but I like to think there are many ways to view the results". The Daily Star and the (Scottish) Daily Record carried it the following day. A journalist from the Daily Record telephoned us, having seen the news agency release. It was explained that the quotes were fiction. The Daily Record stated "last night Prof Deary said 'I would never say it is better to be an obedient housewife. I have got more sense!'". A nod to truth, but one that enlivens the story by making the boffin appear to have the thought while being too coy to state it. No small print quote could outdo the headline that the Daily Record ran, "Do what hubby says and you'll live longer. Professor's shock advice to women". The association that many newspapers made between submissiveness and housewifery is bewildering (see panel). The Daily Telegraph (in its headline), the Daily Express (in its editorial on the story), the Daily Star, and the Daily Record all equated submissiveness with housewifery at some point, and interpreted the story to mean that women were safer as housewives.

Newspaper headlines following the press release on the Edinburgh Artery Study's article on submissiveness and coronary heart disease.1
Daily Star Do as you're told girls . . . and live to be
  old
Express Stay home and you'll live longer
Daily Record (Scotland) Do what hubby says and you'll live longer.
  Professor's shock advice to women
Daily Telegraph Put down that rolling pin darling, it's
  bad for your heart . . .
Daily Mail Meekness is good for woman's heart.
  Quieter types healthier than feisty
  females says report
Independent For a healthier heart, turn into a shrinking
  violet
Herald For "healthy" read "timid"
Guardian Meekness may help the heart
Times The meek shall inherit more life

Most of the radio interviews, arranged for the Friday morning (Aug 22), took place in the BBC Scotland studios in Edinburgh. The interviews were straightforward, and granted us the opportunity to correct the inaccuracies we had seen in print. The live format was reassuring, since we heard the entire broadcast, were in complete control of our replies to the questions, and were at liberty to clarify or add information where necessary. Prerecorded interviews were used for news releases on national BBC stations on the Friday. Mostly, we were able to explain the design of the study and the nuances of the findings. On the down side, the radio interest dominated our work schedule during the Thursday and Friday. Our desire to reshape the distortion created by the newspapers made it difficult to remain unmoved by producers' urgency to fill programme space. Nonetheless, these interviews did give us back some sense of control that we had lost in the first media frenzy.  

What price publicity?

This intense and transient media interest caused us to reflect on the costs and benefits to the research community of mass publicity of their findings. For the funding body there is publicity leading to the donation of more funds. For the scientific journal there is greater attention, leading to higher circulation, increased advertising, greater profits, and a better impact factor. For the news media there is a "sexy" medical story or the opportunity to deride the findings, as in the Express editorial, "Science proves that granny was right all along--part 1,678,939". For we three media-shy researchers, the benefits were to provide our funding body with increased public exposure, and to provide our employer, the university, with what we hoped would be welcome publicity. The costs were watching data from thousands of patients collected over several years trivialised, distorted, and used in some outlets to support a set of misogynistic attitudes. There was a positive side too. A generally good press release--as produced by the British Heart Foundation--was often used with little alteration as a newspaper "story".  

Self-criticism, problems, and remedies

Could we have handled things better? We should have been less obliging in allowing the sex differences to be mentioned so prominently in the press release. We should have been more formal with tabloid and news agency journalists. We suggest that quotes should be limited to a formal press release; "quotes" arising from conversations with them may be nothing of the kind. We held back from writing to the papers to correct the distortions. In the present case this proved correct, because the story died quickly. However, the fallacious women-safer-as-housewives angle kindled its own follow-on media interest and this was killed only by refusing to comment further. We could have been more active in helping journalists to frame a popular version of the story; but the original press release seems as far as we could go without trivialising the research. We could have compiled a list of statements about what the study did not imply, but none of us foresaw the housewife angle.

There are genuine problems in disseminating scientific findings via popular media. The news media have deadlines that are foreign to researchers. Scientists may experience loss of control when their story is exposed outside the scientific press: caveats and considered responses are unwelcome. Scientific stories are picked up arbitrarily by the media, and are given a titbit approach. Thus, stories often have no wider context and no public knowledge base. At worst, this can make scientific research seem like a disconnected and contradictory stream of faddish ideas: issues of diet and food safety have suffered especially badly in this regard. Moreover, different parts of the media want scientists to retell their story in a way that will fit in with their own agendas. If only one could tell it once and tell it well.

Despite these problems we should communicate scientific findings via the popular news media. The public has a right to know what we are up to. It is not too pious to hope that scientists could educate the media about the nature of scientific discovery. Most studies are not breakthroughs; neither are they the fancies of other-worldly scientists. The media are quite prepared to report political stories incrementally, week after week, as new events occur. Reporting science should be similar: it emits a genuinely interesting series of stories-in-evolution, whose understanding requires background knowledge and frequent and accurate (and well-told) updating.  

Reference

1 Whiteman MC, Deary IJ, Lee AJ, Fowkes FGR. Submissiveness and protection from coronary heart disease in the general population: Edinburgh Artery Study. Lancet 1997; 350: 541-45.

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