"健康传播"传播健康 浅谈健康传播学在中国的发展

"健康传播"传播健康浅谈健康传播学在中国的发展

《今传媒》杂志供稿解菲

2009年10月12日20:52 来源：人民网-传媒频道

　　传播是人类社会古老的行为。传播学的开山祖师施拉姆说：传播是最繁忙的交叉口，但许多人只路过而不逗留。20世纪40年代，传播学，特别是大众传播学开始迅速发展。健康传播学就是医学与社会学在路过传播学这个交叉口时“逗留”下的产物。21世纪是健康的世纪。越来越富足的人类，开始关注人本身，健康已经成为大众、政府和学者一致关心的议题。健康传播就是要满足大众对健康信息的渴求，而传媒，在传播健康的过程中发挥着越来越重要的作用。

　　一、健康传播研究的开端

　　美国从20世纪40年代开始，就将健康和医疗当做社会问题并使用相当的手段予以解决，开始了流行病学研究。随着医疗科技的发展，很多疾病可以或者即将被根除，但是社会与环境因素影响着健康和疾病的模式。美国学者开始关注社会变迁对身体的影响、分析健康的社会基础、健康和疾病与社会的关系。

　　在此基础上，出现了早期的在医学中的“治疗性传播”（Therapeutic Communication）概念，随即在1971年，著名的“斯坦福心脏病预防计划”出现，标志着健康传播研究的开端。

　　真正意义上的健康传播学研究在我国进行的时间并不长。我国卫生界、新闻界历史上都有意识地利用报刊等大众传播媒介介绍卫生及健康知识。但长期以来，有关健康知识的“知”“信”“行”基本上局限于“卫生宣传”和“健康教育”的范畴。健康传播概念在大陆的确认、健康传播学的提出，最初并不是源自传播学界，而是始自健康教育学界。

　　1987年，全国首届健康教育理论学习研讨会在北京举行。会上第一次系统介绍了传播学理论，提出了传播学在健康教育中的运用等问题。1989年—1993年，联合国儿童基金会与中国政府第四期卫生合作项目中，增加了健康教育项目，目的是广泛传播妇幼保健知识。健康信息的传播及传播技巧的培训问题得到了强调。由此，健康传播概念在项目执行过程中从完整意义上得到了确认。

　　何谓“健康传播”？一种较为通行的定义是：健康传播是一种将医学研究成果转化为大众的健康知识，并通过态度和行为的改变，以降低疾病的患病率和死亡率，有效提高一个社区或国家生活质量和健康水准为目的的行为。健康传播的研究议题很广泛。它既包括以艾滋病预防为龙头的疾病预防，还包括药物滥用预防、医患关系研究、计划生育、癌症的早期发现与预防、戒烟等内容。所有这些议题的最终目的都是提高大众的健康水平，延长人类的预期寿命。这一定义也反映出研究者明显的社会学研究视野和倾向，关注个人、健康、社会三者之间的交互关系。

　　二、健康传播学在中国的研究现状

　　⒈中国的健康传播研究自开始起就处于“传播者缺席”的状态。

　　多年来，研究健康传播的学术论文多数发表在卫生系统的专业杂志——《中国健康教育》期刊上。这本以公共卫生为背景的期刊开设专栏登载健康传播的研究成果，如“传播健康教育”（1996年）、“健康传播研究”（1999年）等，成为我国大陆率先介绍健康传播研究的期刊。

　　我国的健康传播教育开展时间不长。随着健康传播重要性的日益提升，已经有医学院开始在自己的专业中开设“健康传播学”方向的课程，培养本科学生。但是到目前为止，我国还没有非医学院校开设健康传播专业。大陆对健康传播学的研究依然在美国、欧洲的领跑下进行。

　　近几年来，随着“非典”、禽流感、口蹄疫、三鹿奶粉事件的发生以及近段时间来由墨西哥始爆发的A型流感，我国对重大疾病与健康问题的健康教育与健康促进不断深入，健康传播在内容上正在实现从“提供生物医学知识”到“促进行为改变”的重要转变。在高血压、糖尿病、冠心病等疾病综合防治中，行为与生活方式指导成为健康传播的重要信息内容。但是诸如性病、艾滋病等同样与行为和生活方式有关的疾病由于种种原因，还没能得到健康传播学者的高度重视。

　　⒉研究内容

　　美国健康传播学者Rogers认为凡是人类传播的类型涉及健康的内容就是健康传播。根据关注度的不同，中国学者张自力提出将健康传播研究分为9个方向。包括：（1）大众健康传播媒介与效果研究：涉及大众媒介健康传播的形式，内容和技巧研究以及受众媒介接触行为研究等。（2）组织健康传播研究：主要指企业、社区等组织对个人健康信念的维持，改变和健康行为的促进等。（3）以“医患关系”为核心的人际健康传播研究：从患者角度探讨传播内容，效果的研究日益成为主流，涉及话语权力、知情权等研究课题。（4）健康教育与健康促进研究：解放初期的“吸血虫病防治运动”，上世纪70年代开始的“计划生育运动”、上世纪80年代的“预防脊髓灰质炎”以及上世纪90年代开始的“正确看待艾滋病”的运动都是典型的健康教育和健康促进运动。（5）健康传播的外部环境研究；社会因素和政治因素，尤其是健康政策和健康法制的变化对健康传播有重大影响。（6）健康传播与文化研究：主要解读、建构文化视野下的健康传播；探讨文化因素对健康传播的影响。如不同文化背景下的健康传播比较研究，现代医学与传统医学在健康传播过程中的文化差异等。（7）艾滋病、安乐死、同性恋、器官移植等特殊议题的研究。（8）健康传播史的研究：包括健康传播研究史和健康传播行为史。（9）突发公共卫生事件研究（健康危机的传播研究）。
2003年的非典疫情给国人敲响了警钟，使人们认识到健康传播的重要性。紧接着禽流感风波、巨能钙双氧水事件、流脑疫苗恐慌、苏丹红事件、去年发生的震惊全国的三鹿奶粉事件以及最近由墨西哥始发的A型流感。这些事件都引发了不同程度的社会恐慌。研究这类事件发生的原因、机制以及危机发生后的有效传播和应急预案不仅有很强的学术价值，更有实践指导意义。

　　以上9个方向不仅是目前健康传播领域面临的重要课题，也将是今后一段时间内健康传播研究的主要内容。每一个方向都是多个子领域的集合。这些综合的研究内容汇集在一起，勾勒出一幅“健康传播研究地图”。

　　三、中国的健康传播实践

　　中国目前的健康传播研究，还处于初级阶段。2003年爆发的“非典”疫情，最近一段时间爆发的A型流感，经济全球化的加速也导致疫情传播的迅速化和全球化，这势必引起广大传播学者的关注。从传统媒体到新媒体，都注意到健康传播的重要性，也都开辟了相关栏目或者频道，但整体水平有待提高。⒈新媒体上的健康传播

　　互联网方面，综观各大门户网站可以发现，每家门户网站都有专门的健康频道。内容大同小异，包括饮食养生、减肥健身、两性健康以及健康新闻等。如最近的各大健康频道的头行新闻便是由墨西哥爆发至全球的A型流感，并介绍一些预防流感的措施和症状等等。随着时令节气的变化，健康频道会相应推出适合在各个季节的饮食养身小贴士。但在减肥健身板块方面，内容不免有些鱼目混杂，传播效果不太明显，且容易误导受众。

　　手机媒体方面，初步来看，效果明显。订阅手机报的受众会发现，每天的手机报新闻后面，都会紧跟一些实际有用的健康小知识。手机媒体的特点决定了受众大都为一些年轻时尚人群，接受能力强，所以传播效果极佳。⒉荧屏里的健康传播

　　细数荧屏上的健康传播可以看出，中央电视台走在这个领域的前端。播出近十年的“健康之路”通过央视强大的平台向广大观众普及了很多健康知识。可以说是健康传播中的荧屏之王。其他各大省级卫视也都制作了各个种类的健康养生节目，积极探索健康传播之道。如湖南卫视打造的大型励志健康节目“瘦身魔方”以及“林博士讲健康”，北京卫视的“祝你健康”和“健身节拍”，云南卫视的“健康向前走”，凤凰卫视的“健康新概念”等等，都在不同的方面积极地运用大众传播手段向观众传递健康知识。但其潜在的缺陷是，缺乏实际有用的急救知识等的传播，应当适当开发此类栏目完善健康传播。

　　3．纸质媒体的健康传播

　　曾经有报刊闹出前后矛盾的乌龙事件，此时说生命在于运动，彼时又说生命在于静止。不真实的医学新闻将误导读者，引起人们观念上的混乱。作为传统媒体，报刊健康传播的质量亟待提高。

　　至于健康传播杂志，国内目前为止还没有高质量的专门研究健康传播的杂志，都是偏医学的杂志。

　　健康传播的书籍出版存在严重的偏颇，市面上畅销的都是治病养生类的健康书籍，如曾经火爆京城的洪昭光《登上健康快车》在2002年8月稳居畅销书榜首，更有现在的《不生病的智慧》《求医不如求己》等书，都是健康养生书籍，而健康传播学术研究方面的书籍少之又少。美国健康传播学发展很久，国内相关方面的翻译书籍也还是屈指可数。这都足以引起我们的重视。

　　中国作为世界上人口最多的发展中国家，人民的健康状况在近30年内得到了巨大的改善，卫生事业不断进步。但在农村等边缘地区，老百姓看病难等很多问题还亟待解决，我国的健康传播整体水平与国际上先进水平相比仍有很大的差距。我们也要尽快改变这种“传播学者缺席”的状态，让健康传播研究真正进入传播学的轨道上来。这对我国健康传播学者来说，既是挑战也是机遇，在实践中发展理论，然后在理论指导下发展实践，结合我国国情，走出一条中国特色的健康传播之路。

　　参考文献

　　[1]张自力：《健康传播研究什么》《论健康传播兼及对中国健康传播的展望》《“健康的传播学”和“健康中的传播学”》，《现代传播》，2004年第1期

　　[2]韩纲：《传播学者的缺席：中国大陆健康传播研究十二年》，《新闻与传播研究》，2004年第1期

　　[3]（美）盖斯特-马丁著，《健康传播：个人，文化与政治的综合视角》，北京大学出版社，2006年

　　[4]王迪：《健康传播研究回顾与前瞻》，《国外社会科学》，2006年第5期49页

　　[5]张自力著，《健康传播与社会》，北京大学医学出版社，2008年

　　[6]汤浩：《论健康传播中的传媒角色》，《湖南大众传媒职业技术学院学报》，2008年3月，第2期14页

　　[7]祖光怀：《健康传播过程的传播情境与情境传播》，《安徽预防医学杂志》，2008年第14期第66页

　　（作者系浙江大学传播研究所硕士研究生）

"Health Communication" in spreading health Communication of health development in China

"Media Today" magazine feed Xie Fei

At 20:52 on October 12, 2009 Source: PRC - Media Channel

Communication is an ancient human society behavior. Communication Studies Kaishanzushi Schramm said: Communication is the most busy intersections, but many people just passing through and not stay. The 20th century, 40 years, Communication Studies, especially in mass communication began to develop rapidly. Health Communication is the passing of Medicine and Sociology of Communication at the intersection of time "stay" under the product. The 21st century is the century of health. More and more affluent human beings, began to concern themselves, health has become a public, government and academics concerned with the subject line. Health communication is to satisfy the public thirst for health information, while the media in the dissemination of health played an increasingly important role.

1, the beginning of health communication research

United States 40 years starting from the 20th century, it will be the health and medical care as a social problem and use the considerable means to be resolved, started epidemiological studies. With the development of medical technology, many diseases can be or will soon be eradicated, but the social and environmental factors affect health and disease patterns. American scholars started to pay attention on the health effects of social change, analysis of the social basis of health, health and disease and social relations.

On this basis, there has been early in Medicine "treatment of sexually transmitted" (Therapeutic Communication) concept, then in 1971, the famous "Stanford Heart Disease Prevention Program" appears, marking the beginning of health communication research.

The true sense of the health communication studies carried out in our time is not long. China's health sector, the media have a sense of the history of the use of newspapers and other mass media about the health and health knowledge. For a long time, health-related knowledge, "knowledge" and "Trust" "OK" is basically limited to "health promotion" and "health education" category. Health communication concept in mainland China confirmed that the proposed health communication studies, was not originally from the spread of academia, but rather originated from the health education sector.

In 1987, the first national study of theory of health education seminar held in Beijing. Was the first systematic description of communication theory, put forward the dissemination of science in health education in the use of other issues. 1989, -1,993, UNICEF health cooperation with the Chinese government Phase IV project, increasing the health education project aimed at wide dissemination of knowledge in maternal and child health. Health information dissemination and communication skills training was highlighted. As a result, the concept of health communication in the project implementation process from the full sense has been confirmed.

What is "health communication"? A more pass is defined as: Health Communication is a way to medical research results into public health knowledge, and through changes in attitudes and behavior in order to reduce disease morbidity and mortality, effectively improve the life of a community or country the quality and standard of health for the purpose of behavior. Health communication research topic is very wide. It includes HIV prevention as the leading disease prevention, including drug abuse prevention, physician-patient relationship research, family planning, cancer, early detection and prevention, smoking cessation and so on. All of these topics ultimate goal is to improve the public health, prolong human life expectancy. This definition also reflects the researcher a clear vision and sociological research orientation, awareness of personal, health, social interactions between the three.

2, Health Communication Research in China

⒈ China's health communication research since the beginning middle of the "communicator absent" state.

Over the years, the majority of health dissemination of academic papers published in professional journals in the health system - "Chinese Health Education," Journal. In the context of this public health columns published in the journal Health Communication of research results, such as "the dissemination of health education" (1996), "Health Communication Research" (1999), etc., and has become the first mainland China introduced the journal Health Communication Research .

China's health communication education has been conducted is not long. With the rising importance of health communication, there are already medical profession started to open his own "health communication study" the direction of the curriculum to cultivate undergraduate students. But so far, China has not yet set up for non-medical institutions, health communication professionals. China Communication on health research is still in the U.S., Europe, carried out under the lead.

In recent years, as the "SARS", avian flu, foot and mouth disease, Sanlu milk powder incident, and came in. Recently in Mexico before the outbreak of type A influenza, China's major diseases and health problems, health education and health promotion continue to depth, health communication is being achieved in the content from the "provides biomedical knowledge" to "the promotion of behavior change" major changes. In hypertension, diabetes, coronary heart disease and other diseases in a comprehensive prevention and treatment, behavioral health communication and lifestyle guidance to become an important information content. However, such as sexually transmitted diseases, AIDS is also related to behavior and lifestyle-related diseases due to various reasons, not to get health communication scholars attach great importance.

⒉ research content

U.S. Rogers health communication scholars think that any type of human communication is the content related to health, health communication. According to the different degree of concern, the Chinese scholar Zhang Zili proposed to health communication research is divided into nine directions. Include: (1) The effect of media and public health research: the mass media health communication related to the form, content and techniques of contact to research and media audience research. (2) To organize health communication research: mainly referring to businesses, community organizations such as the maintenance of personal health beliefs, behavior change and health promotion. (3) to "physician-patient relationship" as the core of interpersonal health communication research: communication content from the patient's perspective, the effect of becoming mainstream, involving the power of discourse, the right to know such study. (4) health education and health promotion research: the liberation of the early "blood-sucking insects Disease Prevention" campaign began last century 70's "family planning movement," the 80s "against polio," and the 90s of last century The "correct view of AIDS" campaign has been typical of health education and health promotion campaigns. (5) the external environment for health communication research; social factors and political factors, especially health policy and health changes in the rule of law have a significant impact on health communication. (6) Health Communication and Cultural Studies: The main interpretation, and build a cultural heritage under the Health Communication; of cultural factors on health communication impact. Such as the different cultures in the context of health communication comparative study of modern medicine and traditional medicine in health communication in the process of differences in culture. (7), AIDS, euthanasia, homosexuality, organ transplants and other special topics studies. (8) history of health communication research: dissemination of research include health history and the history of health communication behavior. (9) public health emergencies of research (health crisis communication research).
SARS epidemic in 2003, sounded the alarm to the nation, to create awareness of the importance of health communication. Followed by the avian flu crisis, giant can of calcium hydrogen peroxide events, epidemic cerebrospinal meningitis vaccine panic, Sudan incident occurred last year, Sanlu milk powder incident that shocked the nation and, most recently by the Mexican origin of the A-type influenza. These incidents have led to varying degrees of social panic. Research the causes of such incidents, mechanisms and effective post-crisis communication and contingency plans not only have strong academic values, more practice-oriented.

The direction of more than 9 is not only the field of health communication is an important question facing and it will be some time to come the main elements of health communication research. Each direction is a collection of multiple sub-areas. These bring together a comprehensive research content, and sketched out a "health communication research map."

Third, China's health communication practices

China's current health communication research, is still in its infancy. 2003 outbreak of "SARS" epidemic, the most recent outbreak of influenza A, the acceleration of economic globalization has also led to the rapid spread of the epidemic and globalization, this is bound to spread aroused the attention of scholars. From traditional media to new media, have noted the importance of health communication, have also opened up the relevant columns, or channels, but the overall level to be improved. ⒈ new media on the health communication

The Internet, we look at the major portals can be found, each portal has a dedicated Health Channel. Similar content, including dietary health, diet fitness, health, gender and health news. The major channels such as the recent first-line health information is from Mexico to the global outbreak of influenza A, and introduce a number of preventive measures and symptoms of influenza and so on. With the seasonal changes in solar terms, health channel will launch corresponding suitable for all seasons, diet of self-cultivation tips. However, weight loss fitness section, the content can not help but mix some of the fish head, communication was not as effective, and easy to mislead the audience.

Mobile media, the initial point of view, an evident result. Subscribe to the mobile phone newspaper audience will find the daily news report behind the mobile phone will keep some actual useful knowledge of the health of the small. Determine the characteristics of mobile media audience, mostly for a number of the young and trendy crowd, receiving ability, so communication with excellent results. ⒉ screen inside the Health Communication

Health communication breakdown on the screen can be seen that China Central Television to go in this area the front end. Broadcast nearly a decade of "healthy way" by CCTV powerful platform for universal access to a broad audience a lot of health knowledge. Health communication can be said to the king of the screen. Other produce major provincial-level TV also various types of health, health programs, and actively explore health communication way. Such as Hunan Satellite TV to build a large-scale inspirational health program "downsizing Rubik's cube" and "Dr Lam stresses health", the Beijing TV's "wish you health" and "health beat", Yunnan TV's "Healthy move forward," Phoenix " the new concept of health, "and so on, are active in different aspects of the use of means of mass communication to pass health information to the audience. However, its potential drawback is the lack of practical and useful first aid knowledge dissemination, the development of such sections should be properly improved health communication.

3. Paper-based media, health communication

Press sudden, there was inconsistency amusing incident at this time that life is movement, said that life is still wound up. Unreal Medical News will mislead the reader, causing confusion in people's attitudes. As a traditional media, newspapers need to raise the quality of health communication.

As for the Journal of Health Communication, domestic so far no high-quality magazine specializing in health communication are partial medical journal.

Health Communication in book publishing there is a serious bias on the market are the best-selling books on health, healing health class if they have the capital Jau-hot light "boarded the Health Express" in August 2002 Wenju top-selling books, more now, the "wisdom of non-sick" "has been better to seek medical treatment" and other books, are a healthy health books, and health communication research books on very little. American Health Communication development of a long time, domestic-related aspects of books in translation are still very few. It is enough to arouse our attention.

As the world's most populous developing country, the people's health status in the past 30 years has been tremendous improvement in health progress. However, in rural and other marginal areas, people see a doctor is difficult, and many other issues that urgently need to solve our country's overall level of health communication with the international advanced level there is still a wide gap. We would also like to change this as soon as possible, "media scholar absent" state, so that health communication research into the spread of real science track. Of this on our health communication scholars, is both a challenge and an opportunity to develop the theory in practice, and then in theory under the guidance of development practice, combined with China's national conditions, out of a Chinese characteristics, health communication path.

References

[1] Zhang Zili: "Health Communication Research what" "On the health communication and health communication and Prospects for China" "" Healthy Communication "and" health of the Communication "", "modern communication", 2004 1

[2] Han Gang: "the absence of communication scholars: China Health Communication Research twelve", "Journalism and Communication Research," 2004 No. 1

[3] (U.S.) Geist - Martin, the "health communication: personal, cultural and political integrated perspective", Beijing University Press, 2006

[4] Wang Di: "Health Communication Research Review and Outlook", "foreign social science", 2006 No. 5, page 49

[5] Zhang Zili forward, "Health Communication and Society", Peking University Medical Press, 2008

[6] Hao Tang: "On the role of health communication in the media", "Hunan Mass Media Vocational Technical College," in March 2008, No. 2, page 14

[7] Zu-Guang Ying Huai: "the process of dissemination of health communication and the situational context communication", "Anhui Preventive Medicine", 2008 No. 14, p. 66

(The author is the Department of Zhejiang University, Postgraduate Institute of Communication)