Download - CISAS | Centro de Información y Servicios de Asesoría ...

INFORME ALTERNATIVO SOBRE LA SALUD EN AMERICA LATINAproviding information needed to attain healthy stateseven people with limited or little access to healthcare.I argue that this linear model of communication inhealth is both empirically wrongheaded and politicallymisguided. Martín-Barbero (1987) suggests that we donot live simply in societies with media but in mediatedsocieties, where our identities and even our conceptof society is shaped by the media. Information abouthealth is thus shaped by mediated concepts from thebeginning, not just when it is reinterpreted by reporters.Science studies scholars demonstrate that scientificknowledge does not exist independently from socialand political life [Latour, 1993]; popular socialconstructions of race, gender, class, and sexuality informepidemiological categories and notions of causation[Haraway, 1997; Harding 1993]. My ongoing researchon health and media in the United Status andVenezuela suggests that public health institutions andsocial movement organizations are increasingly guidedby media logic [Altheide, 1995], such that media specialistsare part of the development of programs fromthe onset, and many officials work closely with mediaprofessionals to develop sound bites and "stay on message."Clinical visits are shaped by the images of doctors,nurses, and patients that each party brings to theencounter, which are shaped by media images, whetherthey appear in the news or soap operas. "The public"that receives media messages actually consists of reallymultiple, competing publics [Calhoun, 1992], and publicdiscourse about health actually helps create publics[Warner 2002].The CDC’s 1983 declaration thathomosexuals, hemophiliacs, heroin-users, and Haitianswere at high risk for AIDS, for example, helped separatethe U.S. population into five publics—these fourand the remaining population, which was presumablynot at high risk [Epstein, 1996, Farmer, 1992].The dominantideology also fails to take into account how individualsrespond to messages and place themselves inrelationship to them—as true believers, skeptics, critics,satirists, etc.—thereby shaping the social impactof health information.At the same time, this ideology reproduces thepower relations that progressive public health scholarsand practitioners are attempting to challenge. Foucault(1973) insisted that power is knowledge, and this hasperhaps never been as true as in "the information age,"in which, some argue, information is the most valuablecommodity [Castells, 1996].To suggest that knowledgeabout health is only produced in sites dominated byhealth professionals (even progressive ones) bolstersthe role of science and medicine in reproducing socialinequality. It also blunts critical understandings ofhealth by making it more difficult to see how scientificfacts are shaped by and shape social and political-economicrelations.This dominant ideology reinforces thenotion that laypersons can only assimilate knowledgeabout health produced by others; when persons withoutspecialized training attempt to position themselvesas producers of knowledge about health, they arebranded as resistant, non-compliant, ignorant, or evendangerous purveyors of misinformation. The linearequation allocates agency to dominant institutions andtheir professional employees, that is, the capacity tocreate ideas, devise courses of action, carry them out,and thereby affect the world. It is, in short, a magicalformula for disempowering communities. Moreover,no one can adequately undertake the role assigned tothe public—reordering their cognitive universes onthe basis of exposure to a few texts, broadcasts, or publicpresentations and then turning this information—point by point—into behavior.The real losers in this linearequation, of course, are the people with least accessto healthcare, education, and other services; evenwhen they assimilate a great deal of biomedical information,they are judged to have failed [Briggs withMantini-Briggs, 2003; Farmer, 1992].Finally, the news and in some countries advertisementscontain more and more health content. This146