IMPACT OF MEDIA ON HEALTH AND BEHAVIOR OF CHILDREN

Starting from when we are very young, we get the majority of our information from media, which includes television, movies, music, magazines, the Internet, video games, books, videos and all forms of advertising.  While media offers us, including children, many opportunities to learn and to be entertained, how people interpret media images and media messages also can be a contributing factor to a variety of public health concerns.  Among children and adolescents, research shows that key areas of concern are: 

• Aggressive behavior and violence; desensitization to violence, both public and personal

• Substance abuse and use

• Nutrition, obesity and dieting

• Sexuality, body image and self-concept

• Advertising, marketing and consumerism 

As a result of this research, the AAP and its members have been working on many fronts to help parents and children glean the best from unending media exposure.  The AAP launched its Media Matters campaign (www.aap.org/advocacy/mediamatters.htm) five years ago to help pediatricians, other health professionals, parents and children become more knowledgeable about the impact that media messages can have on children's health behaviors.  Public education brochures on the media have been developed and distributed, including one that explains how the various ratings systems work.  In addition, the Academy established a Media Resource Team (www.aap.org/mrt) in 1994 to work with the entertainment industry in providing the latest and most accurate information relating to the health and well being of infants, children, adolescents and young adults. 

Parents alone cannot stem the tidal wave of images their children are exposed to throughout a given day.  They need help, particularly from the entertainment industry and retailers. 

Impact of Music Lyrics and Music Videos

Pediatricians' concern about the impact of music lyrics and music videos on children and youth compelled the American Academy of Pediatrics to issue a policy statement on the subject 13 years ago, with revised, updated versions developed and published multiple times since then.  Policy statements communicate the official position of the Academy concerning health care issues, and help guide pediatricians in their assessment and treatment of patients. 

As a pediatrician who specializes in adolescent medicine, I am keenly aware of how crucial music is to a teen's identity and how it helps them define important social and interpersonal behaviors.  In fact, one study showed that 24% of high school students ranked popular music as one of their top 3 sources for guidance on social interaction.  We often use music to define our beliefs and convictions.  We are attracted to music that will confirm and support these beliefs and convictions.  Music can truly affirm and confirm a teenager's struggles, joys, sorrows, fears, and fantasies. 

During the past four decades, rock music lyrics have become increasingly explicit -- particularly with reference to drugs, sex, violence and sexual violence.  Heavy metal and rap lyrics have elicited the greatest concern, as they compound the environment in which some adolescents increasingly are confronted with risk-taking, substance use, pregnancy, HIV/AIDS and other sexually transmitted diseases, homicide and suicide.  

Despite stories in the popular press relating suicides, ritualistic killings and school shootings to popular music influence, to date, no scientific studies have proved a cause-and-effect relationship between violent or sexually explicit lyrics and adverse behavioral effects.  Causality is exceedingly difficult to prove, as we have all witnessed in the debate about whether tobacco smoking causes lung cancer, heart disease, and stroke.  However all of us, pediatricians, parents, and responsible members of society, must pay attention to the associations that have been observed between music content and health outcomes. There is some music that communicates potentially harmful health messages, especially when it reaches a vulnerable and impressionable audience. Teenagers become absorbed in songs they believe help better define them during this rocky transition into adulthood.  The words and images evoked by popular music are powerful influences on how they are socialized.  Youth who feel rejected and alienated are especially responsive to lyrics that glorify hostility and violence. Numerous studies indicate that a preference for heavy metal music may be a significant marker for alienation, substance abuse, psychiatric disorders, suicide risk, sex-role stereotyping, or risk-taking behaviors during adolescence.  With the advent of MTV and VH-1, not only do we have to listen to violent lyrics, but we also get to see violent narratives graphically portrayed.  Research studies indicate that music videos may have a significant behavioral impact by increasing violent attitudes and behaviors in viewers, desensitizing male college students to violence against women, disproportionately reinforcing racial and gender stereotypes, and by making teenagers more likely to accept and engage in unsafe sex. 

The world can be a threatening and scary place, especially for young people who feel powerless, disenfranchised, or disrespected due to economics, race, or beliefs.  Artists should have the right to reflect that reality and address any issue in any way that they choose.  However, we must recognize that the content that we choose to listen to inevitably affects us and we must choose accordingly.  Changes in young people's attitudes and behaviors toward each other hurt all young people, regardless of their race, gender, religious or ethnic backgrounds.  Parents and pediatricians believe that it is important to know the contents of the food we feed our children's bodies.  To protect their physical and mental health, we should be equally aware of what, to paraphrase Jefferson Airplane, we feed their heads. 

AAP Recommendations

Although there is no one solution, awareness of and sensitivity to the potential impact of music lyrics and videos by consumers, the entertainment and music industry is one important piece of the puzzle.  It is in children's and teenagers' best interest to listen to lyrics or to watch videos that are not violent, sexist, drug-oriented, or antisocial. As a result, the Academy has, in our November 2001 policy statement on media violence, suggested that "music lyrics should be made easily available to parents so that they can read before deciding whether to purchase the recording."  To date, this has not occurred.  Many recordings are broadcasted in sanitized radio versions, which are difficult, if not impossible, to buy retail.  The current system of parental advisory labels applied by the producers themselves provides inadequate information for parents to make appropriate choices for their children.  To disclose the content of their product is not a violation of rights, but truth in advertising. 

The Academy strongly opposes censorship.  We advocate for more child-positive media.  As a society, we have to acknowledge the responsibility that parents, the music industry and others have in helping to foster the nation's children.  The entertainment industry should extend personal concern for the well being of children to their business of creating and selling music, movies, television programming and video games.

 Although the evidence is incomplete, based on our knowledge of child and adolescent development, the AAP believes that the public, including the recording industry and parents, should be aware of pediatricians' concerns about the possible negative impact of music lyrics and videos. The Academy recommends that:

• The music industry should develop and apply a system of specific content labeling of music regarding violence, sex, drugs, or offensive lyrics. We label the food we eat--- why not label the music?  Let the consumer, including parents and youth, know what the music contains and let the educated consumer make the decision.  For those concerned about the "forbidden fruit" syndrome, one study has examined the impact of parental advisory labels, and it found that teens were not more likely to be attracted simply because of the labeling. 

• Music lyrics should be made easily available to parents so that they can read before deciding whether to purchase the recording. 

• Broadcasters and the music industry should be encouraged to demonstrate sensitivity and self-restraint in decisions regarding what is produced, marketed and broadcast. 

• Performers should be encouraged to serve as positive role models for children and teenagers. 

• Research should be developed concerning the impact music lyrics have on the behavior of adolescents and preadolescents. 

• Parents should take an active role in monitoring music that their children are exposed to and which they can purchase, as well as the videos they watch.  Ultimately, it is the parent's responsibility to monitor what their children listen to and view.  Pediatricians should encourage parents to do so. 

• Pediatricians should counsel parents to become educated about the media.  In order to help this process, the Academy has launched Media Matters, a national media education campaign targeted to physicians, parents and youth.  The primary goal of the Media Matters campaign is to help parents and children understand and protect themselves against the sometimes negative effects of images and messages in the media, including music lyrics and videos. 

Media education includes developing critical thinking and viewing skills, and offering creative alternatives to media consumption.  The Academy is particularly concerned about entertainment media images and messages, and the resulting impact on the health of vulnerable young people, in areas including violence, safety, sexuality, use of alcohol, tobacco, and illicit drugs, nutrition, and self-concept and identity. 

For example, if a music video shows violence against women to any degree, a viewer, including young girls, could be led to believe such action is acceptable.  If they were educated about the media, the premise in the video would be questioned and hopefully rejected.

 Parents should also be reminded that if we, as consumers, do not buy or use entertainment media that are harmful to children, these media would no longer be produced.  Media are not the only cause of violence, sexism, racism, or health risk behaviors, but they are a powerful influence on these behaviors over which we have some control. 

There must be a collective solution to this social problem.  Parents, pediatricians, the music industry and others have critical roles in discussing and addressing the increasing amount of violence in society, particularly when it comes to children and adolescents. If we can make our lives and our future safer by paying attention to these issues and intervening where necessary, then we owe it to our children, ourselves, and our society to do so. 

Thank you for your time today, and I am willing to answer any questions you may have.