culture, meaning, and health literacy. These new measures should function to improve the validity of current approaches and provide new knowledge about the impact of health literacy on health outcomes in diverse populations.

MASS CULTURE

Mass culture refers to the institutions, organizations, and individuals that produce and disseminate health messages to Americans. The quantity, quality, and lack of quality control over these messages have exploded in the past 10 years. Hundreds of health organizations across the country from hospitals to advocacy groups to major government agencies like HHS, the Centers for Disease Control and Prevention (CDC), the National Library of Medicine, and the National Institutes of Health (NIH), have created elaborate “user-friendly” information sources. These are often electronically accessible 24 hours a day to provide Americans with up-to-date health information on the care and prevention of disease. But the information sources available to Americans do not stop there. Major advocacy groups such as AARP and The American Cancer Society, plus many others, also offer detailed information on health care and disease prevention. These approaches to providing and accessing information are in their infancy, and must be evaluated and then modified for maximum effectiveness. When consumer needs are at the core of information provision, whether via print, digital media, or intrapersonal communication, the information can be more accessible. With appropriate attention to the information needs of health-care consumers, new technologies can offer all segments of society greater access to health information.

In the private sector, the marketing of pharmaceutical drugs—both over-the-counter and prescription—is now a part of every American’s television viewing. The cost of pharmaceuticals promotions rose to $19.1 billion in 2001 (Medvantx, 2003). The industry drug packaging and consumer education programs are another powerful source of health information. Radio programs provide regular advice on both modern and herbal medicines. Products of all kinds make health claims as part of their marketing programs. Indeed, health has become a major consumer motivator along with sex and price promotions in American marketing.

The news media has also taken health information seriously. Dozens of major news outlets have health reporters who are increasingly skilled in interpreting health studies. The Journal of the American Medical Association is widely quoted and referenced in news articles in both print and broadcast media. Finally, the Internet has provided an opportunity for any individual to make health claims about any product or procedure with little or no scientific basis. In sum, the American public is now faced with a



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