CDC Helps Millions Get Accurate Health Information from TV

WASHINGTON — Cassie Newman's father sang to her when she died. Her mother held her hand.

Cassie's skull had been fractured in a terrible car crash, and as her 15-year-old heart stopped beating, all her family members were there to tell her goodbye.

So were approximately 5 million grief-stricken soap opera viewers who were glued to their screens during the death of one of the most popular characters on America's most popular afternoon soap opera, "The Young and the Restless."

But what the soap opera fans did not see was how federal health agencies had a role in shaping the television drama.

The writers had considered having Cassie's organs harvested for donation. This plot twist was abandoned when experts advised that organ donations don't happen in cases such as Cassie's.

"We were told that in order to make that work, we would need to alter the story line, and we did not want to do that," said screenwriter Kay Alden, who was a story consultant for the CBS afternoon show in May 2005, when Cassie died.

The advice came through the Centers for Disease Control and Prevention under a program in which the CDC, the National Cancer Institute, the Agency for Healthcare Research and Quality and the transplantation division of the Health Resources Services Administration provide free consultations for writers of television dramas.

In the past five years, the four agencies have spoken with script writers on several hundred occasions to make sure entertainment dealing with health matters is accurate.

Under a CDC grant, Hollywood Health & Society, a program at the University of Southern California, hooks the writers up with experts to iron out kinks and errors.

The shows that have availed themselves of the free assistance include prime-time dramas as well afternoon soaps.

"If I haven't said so, you guys are great," said a producer from "House," the Fox Broadcasting Co.'s hospital drama. " 'House' is a tough show to write, and without lots of input from doctors, we'd be lost."

Similar comments have poured in to Hollywood Health & Society from writers and producers on "CSI: Miami" (CBS), "Grey's Anatomy" (ABC), "Law & Order" (NBC) and many others.

While free medical advice from a reputable government source is always welcome, medical shows don't depend exclusively on the CDC. They have their own highly paid consultants and access to an array of real-life medical cases.

Dr. David Foster, a Harvard-trained internist and Harvard Medical School instructor, is on the writing staff of "House." He devises scenarios based on his own knowledge and hospital experience. "House" also has an internist from UCLA's medical school on staff who mines case studies from the New England School of Medicine for stories.

NBC's "ER," which set the standard for medical realism, has four medical supervisors and technical advisers on staff at any given time. All of CBS's "CSI" dramas employ forensic scientists, and even a relatively lightweight medical drama such as "Grey's Anatomy" has a team of medical advisers on call.

So what do the taxpayers get for the approximately $560,000 the federal program spends each year making television writers so grateful? Not much, says Rep. Paul Ryan, R-Wis.

Ryan in July got the House to agree by a voice vote to eliminate the program from CDC's 2008 budget. He declared that the cost of making sure the medical information used on entertainment television is accurate is "clearly an expense that should have been covered by the successful, for-profit television shows, not by our hard-earned tax dollars."

Supporters of the initiative say critics like Ryan are missing the point.

They say the money is being invested in "entertainment education," a powerful tool for communicating health information, one of the CDC's mandates.

In response to the House action, CDC spokesman Tom Skinner said agency officials "thoroughly understand and recognize that we live in a time of competition for resources."

"All we can really do is speak to the success of this program, which has been pretty amazing when you look at the amount of information about health protection that we're getting it to millions of people," he added.

The power of TV to affect what people think and do has been demonstrated in nearly countless ways since the 1973 evening when Johnny Carson made a joke about a fictitious national shortage of toilet paper, leading to a run on grocery shelves the following day.

But entertainment education has an even more compelling argument, they say, because it appears to reach people who don't get information anywhere else.

A 1999 survey showed that people most in need of reliable health information are more apt to form opinions on the basis of daytime television dramas than from newspapers, broadcast news or any other source.

A study by Georgia State University health communications specialist Holley Wilkin found a Spanish-language program led to an immediate "spike" in health awareness.

The story, "Ladron de Corazones," which aired on the network Telemundo, explored a woman's anguish over whether she should become pregnant after discovering a lump in her breast.

In research being reported in the Journal of Health Communication, Wilkin said before-and-after surveys found knowledge of key breast cancer facts had increased significantly among persons who watched the show. Male viewers were significantly more likely to encourage women in their lives to get breast cancer screenings.

Vicki Beck, a former CDC employee who now directs the Hollywood Health & Society program, said that by facilitating access to the screenwriter community, the program can reach people who don't get crucial health information from traditional sources.

"The people we are trying to reach are people who are going to be watching a lot of TV shows and are not necessarily reading the paper or listening to the news, or even going to the doctor," she said. "It's a hard-to-reach audience."

Alden, the television writer who consulted on the death of Cassie on "The Young and the Restless," is now writing for "The Bold and the Beautiful," another CBS soap.

That story is in the middle of a mystery over the origin of fertilized eggs that were implanted when Taylor, a main character, underwent in vitro fertilization.

There was some mix-up at the fertility clinic, and soap opera chat rooms are embroiled in debate over whose eggs are in Taylor's womb.

The outcome is being developed with guidance of experts contacted through the Hollywood Health & Society program, Alden said.

"I feel a tremendous responsibility as a daytime television writer," she said. "When you're doing a medical story, I think you have to keep it in the realm of possibility."

Diane Holloway of the Austin American-Statesman contributed to this article.

On the Web:

Education entertainment at CDC: www.cdc.gov/communication/entertainment_education.htm

Hollywood Health & Society: www.learcenter.org/html/projects/?cm=hhs