The Health and Science Communication SIG held its third annual event “Chronic disease and language” on 29 November 2017 at the Department of Linguistics and English Language, Lancaster University. As chronic diseases become more widespread among populations worldwide, they are also increasingly the target of government initiatives for treatment and prevention and therefore, increasingly the focus of text and talk. The goal of this workshop was to understand how language shapes (and potentially limits) the ways in which individuals and institutions can think, speak and behave with regards to chronic diseases. The event aimed to bring together researchers from different fields to share findings and discuss the challenges and opportunities that representations of chronic diseases pose to treatment and prevention.
The workshop attracted 32 participants from the UK and abroad (including Belgium, Poland and the US) with backgrounds in health policy, psychology, public health epidemiology, sociology and linguistics. The day was organised around: two plenary talks (one discussing the media representations of chronic diseases in general, the other focusing on the case of HIV prevention); four presentation sessions (on media representations, patient narratives, doctor-patient interactions and multimodal artefacts); and a session of poster presentations. Participants also had the opportunity to view a selection of books on health communication provided by Multilingual Matters.
In the first keynote, Shona Hilton (Deputy Director of the MRC/CSO Social and Public Health Sciences Unit at University of Glasgow) used examples from the media coverage of different chronic diseases to demonstrate how media reports tend to focus on problem descriptions, drivers and potential solutions. By emphasising certain drivers and solutions, media articles frame chronic diseases in particular ways. The focus then turned to the industries associated with a range of chronic diseases and how the novel method of “discourse network analysis” can help expose industrial actors engaged in “credibility engineering” (framing issues via the media in ways that ensure products and practices are perceived as credible).
The topic of media framing was continued in the second keynote of the day in which Rusi Jaspal (Chair in Psychology & Sexual Health at De Montfort University, Fellow of the Royal Society of Medicine, the British Psychological Society and the Royal Society of Public Health) focused on the media reporting on HIV prevention. This talk demonstrated how British media has tended to frame pre-exposure prophylaxis (PrEP) as either “a party drug” or “a wonder drug”. “Party drug” representations sustained stereotypes of promiscuity among certain populations. “Wonder drug” representations also emerged as problematic - by recruiting metaphors of war and violence to present PrEP as a “powerful weapon”, potentially unrealistic expectations about PrEP may be encouraged.
The presence of metaphors of war and violence was a finding that ran through most presentations. As Twitter follower @rony_armon remarked, “Looking for updates on language use in health communication? Like, are war metaphors still on? Follow #healthsci17; via @__BAAL”. The use of war and violence metaphors was noted in: media representations of obesity (Tara Coltman-Patel, Nottingham Trent University), ovarian cancer (Neil Cook, University of Central Lancashire) and dementia (Gavin Brookes, University of Nottingham); in multimodal artefacts employed for self-presentation - specifically, tattoos worn by women with breast cancer or endometriosis (Veronika Koller, Lancaster University & Stella Bullo, Manchester Metropolitan University); and in how people with experiences of voice hearing spoke of the relationships they have with their voices (Zsófia Demjén, University College London). These findings remind us just how pervasive metaphor is in talking about health and illness.
In line with the workshop’s aim, much of the discussion focused on the potential implications that chronic disease representations might hold for treatment and prevention. Presenters noted the possible impact of militaristic language which in the case of obesity reporting might discourage help seeking and in the case of dementia is problematic given the absence of a cure (and therefore “a battle to be won”). A further concern was the pervasive negativity of media reporting on ovarian cancer treatments, which might discourage treatment initiation. In the light of reports by women with endometriosis that they have difficulty finding the language to describe their pain, presenters proposed creating “a toolbox for pain descriptions” (for distribution to patients, healthcare professionals and the media) deriving from studies of metaphorical lived-accounts of endometriosis pain.
The closing presentation - a medical case history by Alan Beattie (medical scientist, public health practitioner and community activist) - powerfully reminded us, once again, that there are different ways to experience and talk about chronic disease. Dariusz Galasiński (@d_galasinski) summed this up on Twitter as follows, “What I take from #healthsci17 is that ppl talk/experience illness in many ways. There'll never be right way. ‘We’ mustn’t impose one”.
This summary cannot do justice to the range of issues that were discussed and the reflections that were shared. We at the Department of Linguistics and English Language were delighted to host this event and would like to thank all participants for making it the inspiring event that it was.