Public Health Media Advocacy
Lori Dorfman, Michael Bakal, Priscilla Gonzalez
  • LAST REVIEWED: 23 August 2017
  • LAST MODIFIED: 23 August 2017
  • DOI: 10.1093/obo/9780199756797-0111


The history of public health is clear: social conditions and the physical environment are important determinants of health. To improve social conditions and physical environments in lasting and meaningful ways, public health practitioners must be involved in policy development and policy advocacy, since policy defines the structures and sets the rules for society. News portrayals of health issues are significant for how they influence policymakers and the public regarding who has responsibility for preventing and treating health problems. Issues are not considered by the public and policymakers unless they are visible, and they are not visible unless the news or other media have brought them to light. Media advocacy is an approach to health communications that helps people understand the importance and reach of news coverage, the need to participate actively in shaping such coverage, and the methods to do so effectively. While media advocates do reach beyond news media to advertising and entertainment as well as social media, news remains a priority because of its influence on policy. Media advocacy differs significantly from traditional mass communications approaches because it focuses on changing conditions and environments rather than changing personal health behavior. Media advocacy emphasizes institutional accountability, which typically receives less attention from the news than individually oriented solutions. The practice was developed by tobacco and alcohol control advocates who applied political campaign tactics in the context of scientific approaches to prevention. Public health practitioners continue to use media advocacy in tobacco and alcohol control and have expanded its application to policy advocacy on childhood lead poisoning, violence and injury control, early care and education, nutrition, physical activity, health inequities, and affordable housing, among other issues.

General Overviews

Media advocacy is the strategic use of the mass media to support community organizing to advance a social or public policy initiative. Essential steps include strategy development, setting the agenda, shaping the debate, and advancing policy. Media advocacy may be confused with other health communications strategies such as social marketing or public information campaigns because, at the tactical level, they all strive to garner news attention, sometimes called “earned media.” Media advocacy differs from other health communications in its target audience. Most health communications treat audiences as consumers, targeting the population with the health problem with information so they can reduce their risk for illness or injury. Rather than targeting the people with a particular health problem with information, media advocates target policymakers and those who can be mobilized to influence them. Media advocacy treats audiences as citizens in a democratic process designed to change policies that shape environments. Institute of Medicine 2003, and Wallack and Dorfman 1996 describe the basics of media advocacy with examples from violence, affordable housing, and nutrition, among other topics. Cutting and Themba-Nixon 2003 examines the special case of media advocacy applied to racial justice, which is relevant for public health practitioners working to rectify health inequities. Dorfman and Wallack 1993 explores the application of media advocacy to paid advertising in contrast to public service announcements (PSAs), a common health communications tactic.

  • Cutting, Hunter, and Makani Themba-Nixon. 2003. Talking the walk: A communications guide for racial justice. Oakland, CA: AK Press.

    Written for activists who want to challenge racist stereotypes in the news, this guide provides a comprehensive overview on how to use media advocacy to reframe the debate and work with journalists more effectively to promote racial justice.

  • Dorfman, Lori, and Lawrence Wallack. 1993. Advertising health: The case for counter-ads. Public Health Reports 108.6: 716–726.

    Defines counter-ads as a strategy to frame public health problems in sociopolitical contexts and promote policy, as opposed to public service announcements (PSAs), which tend to focus on uncontroversial notions of behavior change. Uses the first comprehensive tobacco media campaign from California to illustrate the continuum from PSAs to counter-ads.

  • Institute of Medicine. 2003. Media. In The future of the public’s health in the 21st century. Edited by the Committee on Assuring the Health of the Public in the 21st Century, 307–357. Washington, DC: National Academies Press.

    Describes the media’s critical role in generating national attention and action on public health issues. Discusses health communication strategies, distinguishes between social marketing and media advocacy. Concludes with a summary of behavior change and media impact theories, and a discussion of evaluation and research.

  • Wallack, Lawrence, and Lori Dorfman. 1996. Media advocacy: A strategy for advancing policy and promoting health. Health Education Quarterly 23.3: 293–317.

    DOI: 10.1177/109019819602300303

    Authors describe a case study of violence prevention in California and one on public housing in Chicago to illustrate how the essential elements of media advocacy—developing strategy, setting the agenda, and shaping debate—can be used to address public health problems.

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