You love your car mechanic – he’s a genius who never fails to fix the flibberty gibbet on the frammus. You love your computer wonk – she’s a genius who never fails to retrieve your lost data and stop your email from crashing. But would you turn to either to help you resolve a health issue?
Decidedly not. So why do so many people treat celebrities, people they don’t even know, as credible sources of health information?
That question was at the heart of a recent article in BMJ (British Medical Journal) and a Los Angeles Times commentary by Julia Belluz and Steven J. Hoffman about Hoffman’s research for the BMJ report.
Belluz is a health journalist and Knight Science Journalism Fellow at MIT, and Hoffman teaches clinical epidemiology and biostatistics at McMaster University in Ontario, Canada, and is a visiting professor at the Harvard School of Public Health.
Hoffman’s mom, it turned out, had received an email that said 200 people had died from the HPV vaccine, an event that fed right into his area of inquiry. The HPV vaccine immunizes against a common form of cervical cancer in women, and penile and anal cancer in men. It’s recommended to be given to youngsters before they become sexually active. (See our blog, “HPV Vaccine Is a Clear Success.”)
The source of the alarming email wasn’t the Centers for Disease Control and Prevention (CDC), the FDA or a medical center or research study; it was the result of a recent episode of Katie Couric’s ABC talk show. Most of its anti-HPV claims have since been debunked. But Mom, like so many people, the writers said, “remains a victim of celebrity medicine: She heard a warning from someone famous, believed it and spread the misinformation.”
“Celebrities have crept into our medicine cabinets and kitchens, influencing what pills we pop, tests we order and foods we fear,” wrote Belluz and Hoffman in “Katie Couric and the Celebrity Medicine Syndrome.”
“More often than not, their advice and products are dubious.”
Hoffman’s research shows why people don’t seem to care. He reviewed studies from a range of disciplines and concluded that human brains and societies seem to be hardwired to trust famous people, even about things in which they have no expertise.
“Economics tells us that we use celebrity endorsements as signals or shortcuts for judging qualities such as validity or relevance,” they said in The Times. “So when Bill Clinton recommends veganism, his approval elevates animal-free eating even though his expertise lies more with foreign policy than nutrition.”
The “halo theory” from marketing studies is that a well-known person’s success in one area encourages people to believe that person is competent in unrelated areas – a good actor is a good medical advisor. “This influences how we interpret their health messages no matter how nonsensical,” said Belluz and Hoffman, “and may explain why Gwyneth Paltrow has become a credible advisor on vitamin D deficiency, even though she didn’t go to medical school nor is she a health expert.”
We are conditioned to associate unrelated things and feelings – if you warmed to Michael Jordan’s basketball wizardry, you warm to Hanes underwear when he’s selling it on TV. That’s why companies pay so much for celebrity endorsements – it’s not about the reality, it’s about the feelings.
And they are visible in brain scans. Images of celebrities, the writers explained, increase activity in the medial orbitofrontal cortices. That’s the area of the brain responsible for forming positive associations. So if you like Michael Jordan, his image stimulates this part of the brain, making you more likely to think more positive thoughts about whatever he’s talking about.
Underwear is one thing; medical diagnoses and treatment are quite another. Make a poor underwear choice and you might get chafed skin. Make a poor vaccination choice and you could contract a dread disease.
“But, as the science shows, celebrity influence is not rational.”
“The first step to addressing celebrity medicine,” The Times writers suggested, “is recognizing that it is a human vulnerability and a serious public health challenge. Doing that can empower us to think twice before we take advice from the stars.”
They also said medical professionals who rely on evidence-based information to make treatment decisions could learn something from the Jenny McCarthys of the world selling their whacked-out ideas. They can learn to see patient encounters not only as opportunities to introduce sources of health information and their trustworthiness, but to use counter-marketing, maybe even partnering with celebrities, to discredit bogus medical advice while promoting evidence-based practices.
That is, associate science and the practice of weighing risks against benefits with attractive, successful people. Bring the fad into the reality.