**8. Conclusion**

Mass media health campaigns clearly can be an effective tool for health promotion whether the effort is on a national or local scale. We should stop arguing whether they are more or less effective than other strategies or whether one channel is better than another. Instead we should carefully formulate our conceptual model of how we expect an intervention to work and then evaluate it accordingly. Health promotion interventions are not like pills – they are much more complex and indirect in the way they work. Therefore our evaluation designs may be very different allowing us to track a social influence process and document its effects on social and political institutions as well as on individuals.

#### **8.1 When to use the media**

It is apparent from the evidence that the media can be an effective tool in health promotion, given the appropriate circumstances and conditions. Some of the situations in which media have been found to be most appropriate are as follows.


A report published by the National Health Services in UK (2004) on anti-smoking






Mass media health campaigns clearly can be an effective tool for health promotion whether the effort is on a national or local scale. We should stop arguing whether they are more or less effective than other strategies or whether one channel is better than another. Instead we should carefully formulate our conceptual model of how we expect an intervention to work and then evaluate it accordingly. Health promotion interventions are not like pills – they are much more complex and indirect in the way they work. Therefore our evaluation designs may be very different allowing us to track a social influence process and document its

It is apparent from the evidence that the media can be an effective tool in health promotion, given the appropriate circumstances and conditions. Some of the situations in which media

1. When wide exposure is desired. Mass media offer the widest possible exposure, although this may be at some cost. Cost–benefit considerations are at the core of media

2. When the timeframe is urgent. Mass media offer the best opportunity for reaching either large numbers of people or specific target groups within a short timeframe. 3. When public discussion is likely to facilitate the educational process. Media messages can be emotional and thought provoking. Because of the possible breadth of coverage, they can be targeted at many different levels, stimulating discussion and thereby

4. When awareness is a main goal. By their very nature, the media are awareness-creating tools. Where awareness of a health issue is important to its resolution, the mass media

5. When media authorities are 'on-side'. Where journalists, editors and programmers are on-side with a particular health issue, this often guarantees greater support in terms of

campaigns in the 1990s high-lighted lessons, some of which may be of general value:

**7. Lessons about implementing mass media campaigns** 

needed to engage the emotions of the target audience


messages if the context is encouraging and supportive.

effects on social and political institutions as well as on individuals.

have been found to be most appropriate are as follows.

can increase awareness quickly and effectively.

expanding the impact of a message.

space and editorial content.


are available – they need reminding of the benefits of not smoking

of delivery can complement each other


supportive messages

**8.1 When to use the media** 

selection.

**8. Conclusion** 


#### **8.2 Further research questions**


#### **9. References**

Brown, J. & Campbell, E. (1991). Risk communication: Some underlying principles. *Journal of Environmental Studies*, Vol. 38, 1991, 297-303.

**22** 

*Argentina* 

**The Unresolved Issue** 

*Hospital Privado de Comunidad de Mar del Plata,* 

Sergio Eduardo Gonorazky

**of the "Terminal Disease" Concept**

 *"I have already told you with what care they look after their sick, so that nothing is left undone that can contribute either to their case or health; and for those who are taken with fixed and incurable diseases, they use all possible ways to cherish them and to make their lives as comfortable as possible. They visit them often and take great pains to make their time pass off easily; but when any is taken with a torturing and lingering pain, so that there is no hope either of recovery or ease, the priests and magistrates come and exhort them, that, since they are now unable to go on with the business of life, are become a burden to themselves and to all about them, and they have really out-lived themselves, they should no longer nourish such a rooted distemper, but choose rather to die since they cannot live but in much misery; being assured that if they thus deliver themselves from torture, or are willing that others should do it, they shall be happy after death: since, by their acting thus, they lose none of the pleasures, but only the troubles of life, they think they behave not only reasonably but in a manner consistent with religion and piety; because they follow the advice given them by their priests, who are the expounders of the will of God. Such as are wrought on by these persuasions either starve themselves of their own accord, or take opium, and by that means die without pain. But no man is forced on this way of ending his life; and if they cannot be persuaded to it, this does not induce them to fail in their attendance and care of them: but as they believe that a voluntary death, when it is chosen upon such an authority, is very honourable, so if any man takes away his own life without the approbation of the priests and the senate, they give him none of the honours* 

In 1977, Leon Eisenberg suggested a distinction should be made between the terms "disease" and "illness" (Eisenberg, 1977): *"The dysfunctional consequences of the Cartesian dichotomy have been enhanced by the power of biomedical technology. Technical virtuosity reifies the mechanical model and widens the gap between what patients seek and doctors provide. Patients suffer ''illnesses''; doctors diagnose and treat ''disease''. Illnesses are experiences of discontinuities in states of being and perceived role performances. Diseases, in the scientific paradigm of modern medicine, are abnormalities in the function and/or structure of body organs and systems. Traditional healers also redefine illness as disease: because they share symbols and metaphors consonant with lay beliefs, their healing rituals are more responsive to the psychosocial context of illness…When physicians dismiss illness because ascertainable ''disease'' is absent, they fail to meet their socially assigned responsibility. It is essential to reintegrate ''scientific" and ''social'' concepts of disease and illness as a basis for a functional system of medical* 

*of a decent funeral, but throw his body into a ditch."*1 Sir Thomas More (1516)

**1. Introduction** 

*research and care.".* 

1 Direct quotations appear in italics.

**1.1 Prefatory emarks** 

