key: cord-0860249-e3jttmab authors: Sharma, D.C.; Pathak, Dr Abhishek; Nath Chaurasia, Dr Rameshwar; Joshi, Dr Deepika; Kumar Singh, Dr Rajesh; Nath Mishra, Dr Vijay title: Fighting infodemic: Need for robust health journalism in India date: 2020-07-25 journal: Diabetes Metab Syndr DOI: 10.1016/j.dsx.2020.07.039 sha: f84c43723b2e1f0dc4fed4318df781e00a17bb18 doc_id: 860249 cord_uid: e3jttmab BACKGROUND AND AIMS: Communication plays an important role in advancing public health goals as well as in greater appreciation of underlying science and public policies. It is critical at all times, be it promoting health benefits of immunisation, importance of hand hygiene or taking personal measures for prevention of non-communicable diseases. Communication assumes even greater importance in the time of emergencies like the ongoing Covid-19 pandemic. A primary vehicle for health communication is mass media like television channels, newspapers and radio channels. METHODS: An analysis of current trends shows that the messages emerging from mass media are getting further amplified and dispersed through digital outlets and social media platforms which have become immensely popular. This has also given rise to a new phenomenon called infodemic or over-abundance of information – both genuine and fake. RESULTS: The article examines role of mass media in health communication in times of pandemic and the context of infodemic. CONCLUSIONS: The analysis points to the need for improvement in health journalism to improve its quality, credibility as well as relevance in a country like India where mass media consumption is high and health literacy is low. Mass media refers to tools and technologies deployed to communicate information and entertainment to the masses. Media scholar Wilbur Schramm defined a mass medium as "essentially a working group organised around some device for circulating the same message, at about the same time, to large numbers of people." 1 This implies mass media is mediated through a device or a medium which could be a newspaper, radio set, television screen or mobile phone or any other digital screen. The rise of social media platforms has added new dimension to the media landscape though social media can't be clubbed with media like newspapers and television because not all news, information and entertainment in the social media is created by journalists and there are no gatekeepers like editors. Yet there are a lot of synergies between social media and mainstream or legacy media. The role of mass media is to inform and educate citizens about new developments in political, social, economic, scientific, health, and cultural spheres of the society. Issues, subjects and themes that figure prominently in media become prominent in the public mind too. Therefore, the coverage of health in mass media and its quality is very critical. Mass media is a key source of health-related information for the general public. A survey done by the Pew Research Center for the People and the Press showed that attention to health news is ranked sixth in popularity among news topics. It is outranked only by news about weather, crime, community, the environment, and politics. 2 Besides being a source of health news and a medium to shape general understanding about health, experts have argued, mass media also help in promoting public health. 3, 4, 5 Media, according to Wallack, "can be a delivery mechanism for getting the right information to the right people in the right way at the right time to promote personal change." 6 That's why all health communication and disease prevention strategies emphasise on health messaging through mass media. Studies have cautioned that "inadequate, misleading or incomplete news reporting constitutes a public health threat. Such reporting can lead people to make misguided choices that may put their health at risk or influence policymakers to adopt inadequate or harmful laws, regulations, or policies." 7 If media ignores a health issue, it may affect implementation of related public policies designed to have a positive impact on public health. A Statement of Principles published by the Association of Health Care Journalists states that "journalists have a special responsibility in covering health and medical news. Association members know that readers and viewers may make important health care decisions based on the information provided in our stories." 8 Larger objective of all health communication is not just to inform but to motivate people to make informed choices and decisions about their health and overall quality of life. Much of public understanding of health and health policy occurs not from their direct experience but through what they read and watch in media. 9 Health news informs people about disease and prevention, motivates them to change their behaviours and promotes understanding of health policy as well as public health. Health journalists, thus, act as mediators between public and doctors, scientists and drug companies. In effect, health writers help in translating or transferring scientific knowledge about diseases and health to the society at large. Therefore, both quantity and quality of health news appearing in mass medianewspapers, radio, television and internet -is important as it plays a critical role in health communication, which has a direct bearing on disease prevention, health promotion and quality of life. 10 The quality of media coverage of health, in particular, has emerged as an area of concern in recent years in India. For instance, a study of obesity-related news stories in six Indian newspapers by the National Institute of Nutrition, Hyderabad, found most obesity-related coverage to be sensational. 11 Some of the articles on obesity were identified as selfcontradictory. In several reports, the source of information was not mentioned, while in nearly all stories journalists "ignored methodology of the research and rarely discussed design flaws." A study of coverage of H1N1 outbreak in Times of India showed that the newspaper framed H1N1 as a deadly disease and its coverage presented death in such a manner as to produce fear and panic. 12 By choosing not to provide contextual informationpercentage of dead or recovery cases, the newspaper framed H1N1 virus into a 'deadly disease' and created an exaggerated sense of uncertainty, anxiety and fear. In contrast, a study in the UK found that newspaper coverage of the swine flu epidemic in 2009-2010 was "largely measured" unlike the trend of overhyping the flu pandemic in media elsewhere in the world. 13 While overload of information is a dominating feature of the information age, the Covod-19 pandemic has given rise to a new phenomenon called infodemic. The World Health Organisation (WHO) has described it as "second disease" accompanying the pandemic. The world body has defined 'infodemic' as 'an over-abundance of information -some accurate and some not -that makes it hard for people to find trustworthy sources and reliable guidance when they need it.' 14 False information in circulation can be classified as both disinformation (designed with malicious intentions) and misinformation (lies spread with or without bad intentions). In the both the cases, it is harmful to its consumers as the information in question relates to human health. WHO has also launched an international programme on infodemiology, just like epidemiology of any other disease. It feels that infodemic -its causes, spread, risk factors, prevalence-need attention and focus similar to diseases if solutions or treatment for it has to be found. Another UN agency, UNSECO, in its policy briefs on infodemic has observed that "the volume and velocity of false information within the 'infodemic' points to the existence of a toxic disinfodemic of disinformation and misinformation." It says "while information empowers, the disinfodemic disempowers. It endangers lives and leads to confusion and discord.' 15 In addition to the existing challenges of increasing space for health in media and enhancing its quality, the emergence of infodemic poses new challenges for health journalism practice in India. Studies have shown that a bulk of the information that forms part of infodemic messages circulating on social media are coming from 'unreliable sources' and which are not originating from verified sources such as newspapers. Data scientists are applying machine learning techniques to analyse infodemic messages. An analysis of 112 million messages relating to the pandemic in 64 languages, conducted by Bruno Kessler Foundation, showed that 40 percent of these messages came from unreliable sources. Another study by the COVID-19 Infodemic Observatory found that 42% tweets related to the pandemic were produced by bots and 40% of them were unreliable. 16 As the volume and velocity of misinformation and disinformation message grows during a health crisis such as the current pandemic, the onus of clearing the air falls on the mainstream media. In addition to giving authentic news, mainstream media has to bust fake news which has risen sharply during the pandemic. The pandemic and the rise of infodemic have reinforced the role of professional health journalism. The need for verified and authentic information is the need of the hour, and this need can be fulfilled by health journalists through mainstream media. Free and independent media can be an effective counter or antidote to toxicity of the infodemic. Besides providing facts and verified news to people, independent media also holds governments and public authorities accountable. That's why trust of people in independent media like newspapers may be growing, despite difficulties being faced in circulation of physical copies. A study by the Reuters Institute found that 60% of respondents in six countries (Argentina, Germany, South Korea, Spain, the UK, and the US) said it was the news media that had helped them make sense of the pandemic. Trust in news media was rated significantly higher than information received on social media. 17 An online and offline survey done in India has revealed a majority of people have rejected myths and conspiracy theories floating around in social media, and have relied on scientific information. 18 In order to strengthen Indian media to play effectively its role of providing authentic and verified health news and information, the following measures are proposed: -Employing professionally trained, fulltime reporters and subeditors to write and edit health stories. While health news is covered widely in Indian media, much is left to be desired in its quality and relevance. This is because of lack of appropriately trained health journalists in Indian newsrooms. For this to happen, there is a need for greater focus on health and science journalism in training schools, and also onthe-job training through workshops, fellowships etc. -Newspapers and television channels will also have to undertake fact-checking functions, particularly to debunk fake news, misinformation and disinformation on health subjects. This needs to be done by professionally trained fact checkers equipped with skills in dealing with new digital platforms as well as editorial insights. Many media houses in India have started doing this, but they need to focus more on health and science domains. There are independent fact checking organisations as well, and media houses can collaborate with them. -Greater communication between media and health experts, researchers and policy makers is essential for improving quality of health news in Indian media. For this, academic institutions, health bodies, and organisations engaged in scientific and medical research need to improve their communication with media keeping in view the need to explain research findings, policies and trends to media persons. Experts from these bodies should also be available to offer expert comment to debunk fake news and misinformation. Proactive measures are required from both media and health community. -One of tenets of good health journalism is to present evidence-based news along with benefits and risks of new therapies and research developments. Findings of medical research come with a lot of caveats and disclaimers. Research findings, therefore, have to be reported in media with proper perspective, and without giving rise to sensationalism or alarm. Fear mongering should be avoided at all the times. Health journalism training should lay special emphasis on this aspect. -It is also the responsibility of media to engage with people and communities, empowering them with 'news and information literacy.' This will help people to combat infodemic on their own, and reinforce faith of the people in media. Such engagement with people is also critical to stimulate new solutions as well as their participation in health-related decisions and policies that affect them. As one of the four pillars of a democratic society, media has the responsibility to inform and educate people. Newspapers, television channels and radio can play a pivotal role in shaping opinions of people and policy makers on key issues facing the society. The coverage of health in the press and its quality is very critical as this is a key source of health-related information for the general public. Health news has the potential to promote public health, particularly when India is facing the triple challenge of communicable, non-communicable diseases and trauma. In the time of a health emergency like the Covid-19 pandemic when a new phenomenon called infodemic has emerged, it is critical that health news delivered by newspapers is authentic, accurate and free from vested interests. Therefore, it is important to take steps to improve the quantity and quality of health news in Indian media. How Communication works: In. W. Schramm: Process and Effects of Mass Communication Key news audiences now blend online and traditional sources The effectiveness of mass communication to change public behavior Mass Communication and Public Health: Complexities and Conflicts The SAGE handbook of media processes and effects The role of mass media in creating social capital: A new direction for public health Checking the pulse: Midwestern reporters' opinions on their ability to report health care news What are the roles and responsibilities of the media in disseminating health information? Health communication and mass media: An integrated approach to policy and practice Why health communication is important in public health A matter of looks: The framing of obesity in popular Indian daily newspapers Construction of death in H1N1 news in The Times of India UK newspapers' representations of the 2009-10 outbreak of swine flu: one health scare not over-hyped by the media? New UNESCO Policy Briefs launched assessing the COVID-19 'Disinfodemic Navigating the 'infodemic': How people in six countries access and rate news and information about coronavirus. Reuters Institute Scientific Knowledge, Perception and Attitudinal Changes during Corona Pandemic Need for improving quality, credibility as well as relevance of health journalism in India Capacity building of media persons, emphasis on fact checking can help boost quality The authors declare no conflict of interest associated with this paper.