Chapter 2
Media Consumption as a Public Health Issue

A range of attitudes and beliefs are evident in public discourse about the effects of media exposure. Parents are especially concerned with how media exposure and content may influence the healthy development of their children. Yet efforts to restrict the content of media influences have raised important questions about the types of features or interactions that warrant attention, the extent to which media choices should be restricted for certain age groups, and the need for policy interventions as well as parental and professional guidance. Early proposals for parental warning labels on CDs with explicit lyrics, for example, have been part of an extensive and frequently spirited public debate about puritanism, censorship, and the First Amendment to the U.S. Constitution. At present, only limited and frequently conflicting data are available to examine the effects of music lyrics on health and development or the role that they play in the formation of youth identity, social networks, and parent-child relationships. Claims and counterclaims about possible benefits and detrimental effects of different kinds of media exposure appear regularly in the popular press, but often without strong grounding in peer-reviewed research.

Survey data from the Kaiser Family Foundation indicate that many parents are concerned about the amount of sex and violence that their children see on television. But many parents do not understand the available ratings systems for TV and other media, and only 6 percent of parents of young children are aware that the American Academy of Pediatrics has recommended that children under age 2 not watch television or videos at all (Kaiser Family Foundation, 2004). The amount of television to which young people are exposed suggests that, despite their concern, parents are not effectively limiting their consumption.

Recent data provide a general overview of children’s current media consumption (see Box 1); sources and methods for collecting these data are addressed in detail in Chapters 3 and 4.

With these data as a backdrop, the workshop began with a conversation about why research on media exposure is important, led by Ellen Wartella and Dan Anderson. Both called attention first to the growing proliferation of media experiences. The ubiquitousness of televisions in homes and public spaces and the large number of daily activities that adults now conduct online are only part of the story. The advent of digital technology in particular has expanded the possibilities for the use of different media technologies simultaneously (the multitasking phenomenon) and in new settings. Computers now allow kids (and adults) to move rapidly between the Internet and a word processing program, frequently with music in the background, as well as detours to play an electronic game or to engage with e-mail or instant messaging functions. All this can be done with earphones on, or with music or television (or both) on in the background, interspersed with cell phone calls, and so forth. Cell phones can be used to transmit digital photographs, and new MP3 players allow users to download video clips, movies,



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Studying Media Effects on Children and Youth: Improving Methods and Measures - Workshop Summary Chapter 2 Media Consumption as a Public Health Issue A range of attitudes and beliefs are evident in public discourse about the effects of media exposure. Parents are especially concerned with how media exposure and content may influence the healthy development of their children. Yet efforts to restrict the content of media influences have raised important questions about the types of features or interactions that warrant attention, the extent to which media choices should be restricted for certain age groups, and the need for policy interventions as well as parental and professional guidance. Early proposals for parental warning labels on CDs with explicit lyrics, for example, have been part of an extensive and frequently spirited public debate about puritanism, censorship, and the First Amendment to the U.S. Constitution. At present, only limited and frequently conflicting data are available to examine the effects of music lyrics on health and development or the role that they play in the formation of youth identity, social networks, and parent-child relationships. Claims and counterclaims about possible benefits and detrimental effects of different kinds of media exposure appear regularly in the popular press, but often without strong grounding in peer-reviewed research. Survey data from the Kaiser Family Foundation indicate that many parents are concerned about the amount of sex and violence that their children see on television. But many parents do not understand the available ratings systems for TV and other media, and only 6 percent of parents of young children are aware that the American Academy of Pediatrics has recommended that children under age 2 not watch television or videos at all (Kaiser Family Foundation, 2004). The amount of television to which young people are exposed suggests that, despite their concern, parents are not effectively limiting their consumption. Recent data provide a general overview of children’s current media consumption (see Box 1); sources and methods for collecting these data are addressed in detail in Chapters 3 and 4. With these data as a backdrop, the workshop began with a conversation about why research on media exposure is important, led by Ellen Wartella and Dan Anderson. Both called attention first to the growing proliferation of media experiences. The ubiquitousness of televisions in homes and public spaces and the large number of daily activities that adults now conduct online are only part of the story. The advent of digital technology in particular has expanded the possibilities for the use of different media technologies simultaneously (the multitasking phenomenon) and in new settings. Computers now allow kids (and adults) to move rapidly between the Internet and a word processing program, frequently with music in the background, as well as detours to play an electronic game or to engage with e-mail or instant messaging functions. All this can be done with earphones on, or with music or television (or both) on in the background, interspersed with cell phone calls, and so forth. Cell phones can be used to transmit digital photographs, and new MP3 players allow users to download video clips, movies,

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Studying Media Effects on Children and Youth: Improving Methods and Measures - Workshop Summary and television shows to be watched anywhere, any time. Many media experiences, such as giant screens with surround sound, for example, are far more intense than ever before. And software for babies—even devices alleged to promote the development of fetuses in the womb—are bringing new forms of sensory intensity to young nervous systems that are highly malleable and vulnerable to significant developmental changes. What impact might all this have on people and their behavior? Anderson noted that multiple claims are made of negative effects on social behavior, health, education, and cognition (e.g., increases in aggression and obesity, interference with reading, increase in problems with attention), as well as positive effects and opportunities in the same areas (e.g., teaching or modeling prosocial behavior, providing a vehicle for public health messages that reduce obesity, teaching reading and other skills, enhancing attention skills). Some, he explained, view media in general as a toxin, exposure to which should be controlled in the same way that environmental pollutants are permitted in small doses. The problem with this approach is that it does not address the significant variation in media content and the context in which exposure takes place, nor does it account for variations in the findings about the effects of exposure. A more promising approach may be to consider the components of a media diet in terms of the different types, amounts, and effects of media influences, Anderson suggested. In this analysis, certain media influences could be viewed as desserts or stimulants rather than toxic agents. As with food, the overall quantity ingested is important, but equally important are quality and balance. Thus, for example, children may benefit from information, educational programming—and, most likely, entertainment, as well—although the research base for developing precise guidelines as to the recommended levels or proportions of each is insufficient. While the harmful effects of media influences such as violent programming are well established, the basis for making concrete recommendations related to the degree or nature of the violence, maximum safe exposure, and so forth, is similarly absent. The alternative concept of a media diet accommodates recommendations that address such qualitative aspects as the nature, content, and context of media exposure, as well as the quantity, allowing for flexibility in the face of almost overwhelming pressure to consume media. An extensive research literature is now available that examines the health effects of media use, especially in the areas of violent and sexual behavior and, increasingly, in dietary choices and eating behaviors. The workshop participants focused on these initial areas to review how research studies currently measure important dimensions of media interactions with children and youth. EFFECTS OF VIOLENT OR SEXUAL PROGRAMMING Regardless of which metaphor is most useful for public health recommendations, a strong research base is available for some important conclusions about media exposure. Perhaps strongest is the case for the effects of violent programming, which some researchers have suggested is at least as strong as the evidence base regarding links between exposure to tobacco smoke and lung cancer (Oakes, 2006; Anderson et al., 2003). A meta-analysis of the varied research base on this issue has shown that exposure to media violence has demonstrable long- and short-term effects on the likelihood of

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Studying Media Effects on Children and Youth: Improving Methods and Measures - Workshop Summary aggressive or violent behavior.1 Exposure can have the effect of glamorizing violence; trivializing its effects, consequences, and moral significance; and desensitizing the viewer or participant to its impact. The short-term effects include changes in behavior (such as reductions in helping behavior or increased willingness to inflict punishment in an experimental setting), thoughts, and emotions; the long-term effects include increased likelihood of engaging in physical assaults or spousal abuse. These casual relationships are disputed by others, however, primarily on the basis of imprecise measurement and confounding variables. Questions remain as to the potential influences of several variables on the outcome of exposure to media violence. The characteristics of viewers, the precise content of the programming, and mediation by parents or others may all either intensify or mitigate the effects. Moreover, the psychological processes through which these effects occur are not yet fully understood. Nevertheless, the evidence suggests that the effects are pervasive and significant from a public health perspective. An association has also been demonstrated between media consumption and sexual activity among teenagers (L’Engle, Brown, and Kenneavy, 2006). One recent study has shown that adolescents whose media diet includes more sexual content—and content that presents sexuality in a risk-free light—are also likely to engage in more sexual activity and report a greater degree of openness to sexual activity. Media that portray sexual content together with violence can have a particularly strong effect— specifically in increasing the likelihood that male viewers will behave aggressively or physically assault females who have provoked them (Anderson et al., 2003). Findings such as these clearly indicate the importance of considering the media diet as part of any effort to address adolescent sexuality. EFFECTS ON OBESITY The possible links between obesity and food marketing on television are another public health concern that has been investigated, and the results illustrate well some of the difficulties researchers have in tracing media effects, Wartella pointed out. A previous study reviewed 122 studies, covering four decades, of television advertising and children’s diets (Institute of Medicine and National Research Council, 2006). The results established a causal connection between advertising and both food preferences and food choices, but they could not confirm a link to adiposity (i.e., fatness). In her remarks, Wartella speculated that a possible explanation for this lack of strong relationship in the obesity studies may reside in the methodological limitations of earlier studies—and that other research designs might yet uncover a causal relationship. 1 Although the majority of research has addressed violence in television programming, movies, and music videos, some similar findings have been produced with regard to violence in computer and video games.

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Studying Media Effects on Children and Youth: Improving Methods and Measures - Workshop Summary Box 1 Growing up in a Media Saturated Environment The average American home contains: 3.5 Television (82 percent of families have cable access or satellite TV) 1.9 VCRs/DVD players 1.5 Computers (74 percent of families have internet access; 60 percent have instant messaging software) Children use electronic media from 2 to 5 hours daily, spending more time with television than in any other activity except sleep. 75 percent of children ages 8–18 have a television in their bedroom; 36 percent of children ages 0–6 do. 44 percent of children ages 8–18 use a computer every day, and 39 percent play video games every day. Source: Vandewater and Lee (2006)