HEALTH PRODUCT ADVERTISING THROUGH NEWS IN
LIFESTYLE MAGAZINES
OGLAŠEVANJE ZDRAVSTVENIH IZDELKOV V OBLIKI NOVINARSKIH PRISPEVKOV V REVIJAH ZA ŽIVLJENJSKI SLOG
Karmen Erjavec1, Katarina Štular1, Melita Poler Kovačič1 Prispelo: 10. 7. 2010 - Sprejeto: 26. 8. 2010
Original scientific article UDC 659.1:613
Abstract
Background: In addition to doctors, the mass media are the key source of information about health issues. It is therefore veiy important what kind of messages they produce and convey. Some media researchers called attention to pa'id-for health-related texts, published as editorial content without being labelled as advertisements (now commonly referred to as advertorials). There is a lack of studies investigating the practice of such messages production. Methods: The aim of the study is to fill the gap in this research field by identifying characteristics of unlabelled health-related advertorials and thus give the readers the mechanisms they need to recognise them. Textual analysis of unlabelled health-related advertorials published by three Slovenian lifestyle magazines was combined with an ethnographic study.
Results: Textual analysis indicated that readers can recognise advertorials by the partial and positive-only presentation of health-related products/services, which are described and promoted by using synonyms of effectiveness. Observation and in-depth interviews showed that the key actors in the production process are advertisers and newspaper marketing agents. Advertisers want to have control over texts presenting their products/ services. Marketing agents stress poor financial situation of their magazines. News producers claim that they carry out orders given by advertisers and marketing agents.
Conclusion: By publishing unlabelled advertorials, lifestyle magazines privilege a pharmaceutical-commercial attitude to health. They promote the pharmaceutical industry by presenting it one-sidedly and in a simplified way, and by ascribing to it the capacity to solve health problems of people in a non-problematic way. A more complex social view of health issues, however, is neglected.
Keywords: health, news articles, life-style magazines, advertising, promotion
Izvirni znanstveni članek UDK 659.1:613
Izvleček
Izhodišča: Poleg zdravnikov so množični mediji glavni vir obveščanja ljudi o zdravstvenih temah, zato je pomembno, kakšna so sporočila, kijih ustvarjajo in posredujejo občinstvu. Nekateri raziskovalci medijev so opozorili na pogosto pojavljanje hibridnih prispevkov, ki so med novinarstvom in oglaševanjem zdravstvenih tem. Značilno zanje je, da so jih naročniki plačali, vendar pa so bili objavljeni kot novinarski prispevki in brez oznake, da gre za oglasno sporočilo. Ra^^isk^a^v, ki bii omenjano pr^obl^matik^o natančneje f^reučile, je za^enk^rat pr^emalo. Metode: Z r^azis^a^o smo želeli zapolniti omenjeno r^azis^o^alno vr^el in r^azkr^iti značilnosti neoznačenih hibr^idnih besedil o zdravju. Na ta način želimo br^alcem pr^edstaviti mehanizme, pr^k kater^ih bi lah^o ts^kšne prispevk^e tudi pr^epoznali. V razisk^avi smo v treh slovenskih r^evijah za življenjski slog analizir^ali vsebiino neoznačenih hibr^idnih prispevkov, ki obravnavajo zdravstveno problematiko. Ugotovitve smo primerjali in obravnavali skupaj z opravljeno etnografsko študijo.
Rezultati: Analiziranje obravnavanih besedil je pokazalo, da bralci lahko prepoznajo hibridna besedila na podlagi pristranskih, zgolj pozitivnih lastnosti z zdr^avjem povezanega pr^oizvoda oz. stor^itv^, ozir^oma na podlagi opisom,
1University of Ljubljana, Faculty of Social Sciences, Kardeljeva pl. 5, 1000 Ljubljana, Slovenia Correspondence to: e-mail: karmen.erjavec@fdv.uni-lj.si
ki izrazito in pogosto omenjajo izraze, povezane z učinkovitostjo. Z opazovanjem in s poglobljenimi intervjuji smo ugotovili, da so glasni akterji produkcijskega procesa oglaš^ve^lci in tr^žni a^genti v časopisnih hišah. Oglaševalci želijo nadzor nad vsebinami, ki obr^avna^ajo njihove pr^oiz^ode oz. stor^it^e. Tr^žni a^genti izpostavljajo šibek finančni položaj svojega medija.. Novinarji pa zatrjujejo, da zgolj izpolnjujejo u^aze oglašev^alcev in tr^žnih s^gentov. Zak^ljuče^k: Rev^ije za življenjsh^i slog ustvarjajo hibr^idna besedila, s l^ater^imi pr^omovir^ajo fa^i^ma^cev^sk^o-^om^rcia^lni pogled na zdravje. Oglašujejo pomembnost farmacevtske industrije, ki jo predstavljajo enostransko, poenostavljeno in k^ot tisto, k^i nepr^oblematično t^ešuje zdr^avst^ene pr^ot^leme ljudi. Bolj celovit drvžt^eni pogled na zdr^avstveno problematiko pa pri tem ostaja prezrt.
Ključne besede: zdravje, novinarski prispevki, revije za življenjski slog, oglaševanje, promocija
1 Introduction
Timely and accurate health information is the life blood of health care (1). Several studies revealed that, in addition to doctors, the mass media are key sources of information about health issues (2, 3, 4, 5). Therefore, it is very important what kind of messages the media produce and communicate. Health news production is flourishing in media outlets also to feed the appetite of media consumers (6), and because it sells the advertising time well (4). The number of health-related messages in the news increases and they are often accompanied by advertisements (7, 4). Even more, some media and journalism researchers in Slovenia (8, 9) and in other Eastern European countries (10, 11) called attention to health-related commercial messages published as news and not labelled as ads. This practice violates journalistic ethical standards (12), advertising ethics (13), as well as the media legislation (14).
Studies of a hybrid between advertisement and editor/al, referred to as "advertorial", are mainly based on the premise that readers can recognise such texts as commercial by at least one of their external characteristics, i.e., a label (15, 16, 17). The objective of our analysis of paid-for and unlabelled health-related messages published as news was to fill up a gap in this area of research. We used a combination of an ethnographic study and textual analysis of unlabelled health-related advertorials published by three Slovenian life-style magazines covering health-related issues. The main aim of this study was to identify the characteristics of unlabelled health-related advertorials and thus provide the readers with the mechanisms for recognising these hybrid messages.
2 Methods
Hitherto research on health-related issues in the media has focused on four main areas: media coverage of
specific health issues; media portrayals of public health crises; the framing of health news stories related to public policy; and media portrayal of health behaviours (18). Health journalism studies of the framing of public policy issues mostly dealt with specific topics, such as tobacco and care/health reforms (2, 19, 20, 21). Research in electronic media revealed that texts on health did not provide the pertinent information needed to teach the media audiences how to identify, prevent, or deal with health problems (22, 23, 24). This paper focuses on the practice of publishing unlabelled advertorials, a topic mostly neglected in health journalism research. Researchers have analysed advertisements in health-related magazines, but paid little attention to health-related advertorials (25, 26). Cameron and Ju-Pak synthesized the conceptual definitions of other authors in defining advertorials as blocks of paid-for, commercial messages, featuring any object or objects that simulate the editorial content of a publication in terms of design/structure, visual/ verbal content, and/or context in which it appears (27). Advertorials gained more attention and were rated more positively as the medium was perceived as a (co-)sender of the advertised message (17). As a result consumers activate their advertising schemas to a lesser extent and evaluate the message more favourably (28). A lack of studies on the practice of producing paid-for and unlabelled health messages published as news incited us to seek answers to the following research questions:
RQ1: What is the production process of unlabelled health-r^^lated adv^rior^ials li^e? Advertorial products are designed to blend in with the media overall content in order to increase their effectiveness as marketing vehicles. With advertorials, not only do advertisers get an advertisement that mimics a credible news story, but often an advertiser gets the opportunity to control the entire environment within which the message is embedded (16). Because hitherto studies have dealt with labelled advertorials only, presenting the reasons for their production in a
simplified way and focusing mostly on advertisers, the second research question posed was as follows: RQ2: What are the main reasons for the production of unlabelled health-related advertorials? In Slovenia, publishing commercial texts without identifying their advertiser is a violation of journalistic ethical standards (12), advertising ethics (13), and the Mass Media Law(14). As it is of key importance for the readers to recognize unethical/illegal messages if these are to be sanctioned, the third research question was worded as follows:
RQ3: Which are the textual characteristics of unlabelled health-related advertorials?
Because previous studies based on the framework of critical discourse analysis (29, 30) were only text-based, we combined textual analysis with an ethnographic study, i.e., in-depth interviews and observation in order to analyse the process of unlabelled health-related advertorials production, and reveal the main actors' interpretations.
During observation, a researcher joins in with the group he/she studies to observe it and to examine its structure, working process, problems and behaviour (31). In 2009, we spent over 250 hours in the editorial and advertising departments of L&Z, Lepa in Zdrava (Beautiful and Healthy), and Zdravje (Health), three most popular monthly lifestyle magazines covering health-related topics (32). Lifestyle magazines were chosen because they play an important role in the maintenance of cultural values, thereby forming an "ideal" reader, who is at the same time formed and "imprisoned" by the texts published. Health-related topics are the predominant and recurring theme in lifestyle magazines; advice articles seek to instruct women in appropriate lifestyles (33).
One of the researchers had worked with the chosen magazines before. She had established contacts with the key actors in these magazines, which enabled us to enter the field of research. Another approach was to make contacts during the production process. The way of entering the field had impact on the respondents' reactions to our observation and information seeking: the respondents approached on the basis of previous contacts expressed more trust and openness than those approached on the basis of newly established contacts. The latter were more distrustful and reluctant to reveal information, as if the practice observed were illegal. In-depth interviews enable researchers to go deeper, and to open novel problem dimensions and get an accurate opinion based on personal experience (31). We conducted in-depth interviews with all the main participants actively involved in the production
of unlabelled health-related advertorials, i.e., with an editor, an assistant editor, five reporters, four magazine marketing agents, and three marketing agents in advertising companies (hereafter referred to as advertisers, to distinguish them from magazine marketing agents) with the purpose to identify the reasons for production. The interviews were semi-structured; the key question being: What are the reasons for your participation in the production of unlabelled health-related advertorials? The interviews were conducted individually and lasted approximately one hour each. They were tape recorded and transcribed verbatim. Each interview was analyzed by all three researchers. The interviewees were 25 to 47 years of age; all of them except for one advertiser and two magazine marketing agents were women. They agreed to be interviewed on condition that full anonymity was guaranteed. For this purpose they were labelled with letters, and any words that were likely to reveal their identities were omitted and replaced by ellipses. The sample for textual analysis consisted of 179 unlabelled health-related advertorials, which were published between January and September 2009 in three monthly life-style magazines covering mostly health-related topics, i.e., L&Z, Lepa in Zdrava, and Zdravje. We analysed all the unlabelled advertorials, which during the production process were identified as paid-for advertising messages, broadcast as news and in no way labelled as ads.
3 Results
3.1 Textual analysis
3.1.1 Topics
Topics or themes are an important aspect of news, as they represent what news producers construe to be the most important pieces of information. Analysis of unlabelled health-related advertorials showed that the following topics prevailed: healthy food and drinks (61 items); production of new drugs (52 items); new or improved health-related products/services (26 items) new or improved wellness products/services (16 items) reports on successful medical treatments (11 items) reports on events of several pharmaceutical companies (10 items); reports on service/business success of pharmaceutical companies (3 items). As demonstrated by the advertorial presented in Table 1, advertorials did not cover social events in a way typical of news items (31), but rather dealt with positive characteristics of products and services, which is a
feature of promotional texts. They most often included information about healthy food and drinks or about the pharmaceutical industry, presenting medicaments, services and business success. The texts did not address more complex social themes, such as problems concerning reduction of health insurance rights or side-effects of drugs. Thus, unlabelled advertorials were found to offer a simplified and commercialized way of addressing health issues, acting primarily in the interest of the pharmaceutical industry.
items did not differ from that of other news items published in a magazine, as the reporter answered all basic journalistic questions.
Typical elements of promotional discourse included in advertorials can only be recognised by a discourse analysis. The analysed news items used the schematic structure of a situation (34) to introduce the health problem, i.e., diarrhoea during carefree holiday. This structure was preceded by a b^ck^gr^ound describing the conte^xt of the problem, i.e., change of environment, diet and hygiene during holidays which can cause diarrhoea.
Table 1. A typical unlabelled advertor^ial in a lifestyle magazine. Tabela 1. Tipični neoznačeni advertorial v življenjskostilni reviji.
TEXT/BESEDILO	SCHEMATIC STRUCTURE/ SHEMATSKA STRUKTURA
Text of the photograph/Besedilo fotografije	
[name of the drug]/[ime zdravila] Probiotic to treat diarrhoea and fiatulence/Probiotik proti driski in napenjanju 14 capsules/14 kapsul [name of the pharmaceutical company]/[ime farmacevtskega podjetja]	Headline + Lead/ Naslov + vodilo
Main text/Jedro besedila	
Besides relaxation, holidays may bring us problems. The change of environment is followed by changes in dietary and hygiene habits./Počitnice nam lahko poleg sprostitve prinesejo tudi neprijetnosti. Spremembi okolja sledi sprememba prehrane in higienskih navad.	Background (context)/ Ozadje (kontekst)
Thus diarrhoea may strike during carefree holidays./ Torej lahko driska udari med brezskrbnimi počitnicami.	Situation: presenting a problem/ Situacija: predstavitev problema
You can quickly and effectively stop diarrhoea with capsules [name of the drug]./ S kapsulami [ime zdravila] lahko hitro in učinkovito ustavite drisko.	Situation: offering a solution/ Situacija: ponudba rešitve
Therefore they are indispensable in your holiday pharmacy kit. They are also appropriate for children./Zato so neizogibne v vaši počitniški lekarni. Primerne so tudi za otroke.	Comment (evaluation): praising the solution (the drug)/ Komentar (ocena): hvaljenje rešitve (zdravila)
Label/Označba	
Editorial choice/Uredniška izbira	Editorial authorization/Uredniška avtorizacija.
3.1.2 Genre
A schematic concept of genre is most common in the academic literature (30, 34). At first glance, the generic structure of unlabelled health-related advertorials was the same as in other news items. The format of analysed
Next, a solution was offered, i.e., the drug identified by its name. The last schematic structure was the comment', the drug was praised as being indispensable in a holiday medical kit and also appropriate for children. Thus, the drug was presented not only as a medication
for people with disease symptoms, but also as a useful item in a medical kit of everyone wishing to enjoy a relaxing holiday. As a result the number of potential users (buyers) of the drug increased. In the case study item, the schematic structure hee^dline + lead was replaced by a colour photograph of the drug, providing the main information, i.e., the name of the drug, medical indications, and the name of the manufacturer. The photograph was published in the upper left corner of the item, with the name of the drug on the top, printed in bigger and bolder-type letters than other parts of the text, either on the photograph or in the rest of the item. Thus the name of the drug stood out as a title, indications for its use (and thus the drug's usefulness) served as a lead, and together they summarized key information about the item. The item was labelled "editorial choice", which suggested that the text was not of promotional nature, but adhered to the editorial standards of the magazine as a journalistic product with journalistic functions. However, as demonstrated by our analysis, the item first presented the problem, then offered the solution and finally praised the solution, which is a schematic structure typical of promotional texts.
3.1.3	Perspective
An important feature of unlabelled health-related advertorials is the perspective from which events and actions are described (30). One of the main characteristics of the advertorials analysed was their partiality: a topic was addressed from one point of view only. Advertorials never pointed up the controversial or negative aspects of a product/service, an approach characteristic of promotional texts. A typical advertorial described positive characteristics of a drug and provided no critical/negative information, such as its side effects or high price.
3.1.4	Over-lexicalisation
The unlabelled health-related advertorials used a promotional vocabulary. The key characteristics were the use of positive words which presented the subject in question in a favourable light (35), and especially the use of a lexical device called over-lexicalisation. The analysed unlabelled health-related advertorials provided several synonymous or near-synonymous terms for communicating a specialised area of expertise (36). The use of synonymous adjectives and other direct references to good, such as excellent, best, agreeable, effective, efficient, quality, unique, extraordinarily helpful, natural, distinguished, original, powerful,
indispensable, contributed to the co-referentiality of the effectiveness of products/services. In our typical case, drug action was described as quick and effective, i.e. with words that promoted the item in question. Moreover, the drug was referred to as indispensa^ble for everybody going on holiday.
3.1.5 Direct address of the reader(s)
A common feature of all analysed texts was that their meaning and structure were organised in such a way that they addressed their readers in direct terms, commonly by the use of the second person pronoun "you". This approach stimulates interpersonal communication, in which "I" or "we" (writer(s)) speak directly to "you" (reader). In our typical case item, the reader was addressed directly through the schematic structure of situation ("You can quickly and effectively stop diarrhoea") and the comment ("They are indispensable in your holiday kit"). Direct address simulates a conversational and therefore relatively personal, friendly, and informal relationship. Thereby, it fills a discursive gap between a magazine and its readership, creating an illusion of reciprocity with an imagined reader and implying a shared subjective reality that is taken for granted (37). Thus, it creates and simulates the atmosphere which makes promoting health products/services easier and more effective.
3.2 Ethnographic study 3.2.1 Production process
Our observations showed that during the observation period Zdravje published approximately three advertorials, L&Z 12 advertorials, and Lepa in Zdrava 15 advertorials per issue. Advertisers usually bought one-quarter or one-third-page in a magazine for advertorials from marketing agents. Knowing that publishing advertorials was illegal, they registered them in contracts and invoices as regular advertisements, for the same price as advertisements. It was a common practice for the advertisers to buy formally space for ten advertisements and fill it with eight advertisements and two advertorials, or to buy ten advertisements and get three or four advertorials for free. The price for unlabelled health-related advertorials ranged from 800 to 2000 Euros per page, depending on the magazine. Another way to buy space in magazines for health-related advertorials was through free advertorials that marketing agents offered gratis to the leading advertisers. At meetings they made verbal arrangements specifying the production and number of advertorials,
but the details, such as the length of an advertorial and its confirmation, were arranged by e-mail. Marketing agents then summoned a reporter to cover a promotional event organised by advertisers, usually in a form of a press conference or presentation of health-related product(s) and service(s). The selection of events and facts was entirely in the hands of advertisers. The marketing sector sent a reporter on an assignment to write a health advertorial or to cover a press conference, which would not have taken place if the reporters or marketing agents, who were sent there, had not been present. These findings have led to the conclusion that marketing agents are key actors in the production of advertorials. Moreover, they had the power to choose a reporter who will write an advertorial. Marketing agents always discussed the advertorial with the reporter assigned to write it. Reporters usually accepted the work "because in most cases it is a fairly easy job, for which they normally get paid the same as for the work done on their own. A reporter assigned to write a short news item receives all source material and the advertiser's wishes via email" (Marketing Agent D). Our observations showed that advertisers did not interfere with the writing of unlabelled health-related advertorials intended to appear as short news items. Advertisers had a decisive role in editing too; they demanded that advertorials be published on certain pages or on pages with certain content. We found that unlabelled health-related advertorials were given precedence over regular news. Marketing agents gave the editor detailed instructions on when and how to write an advertorial. The advertorials were usually published instead of some longer and more complex articles about health-related topics. During the period studied, the magazines published no negative news about the advertisers who had paid for unlabelled health-related advertorials.
3.2.2 Reasons for the production
All the interviewed advertisers agreed that it was their right to have an insight into the journalistic content referring to the topics which made part of their advertisements. They were convinced that advertorials enabled them to impact their target audiences and to be more effective. All of them also argued their point that advertorials had more credibility than ordinary advertisements, because their readers recognised them as editorial content. "Readers are fed up with the classic advertising, so they only rarely notice it. Advertising in the form of advertorials never goes unnoticed. And readers put more trust in such items." (Advertiser C).
To justify the production of advertorials, advertisers referred to their work as helping the readers. Marketing agents pointed out that advertorials were produced because of economical weakness of their magazine. During the period of economic recession, the amount of advertising was radically reduced and marketing agents tried to keep their old advertisers. Having advertorials published was offered as a bonus for frequent advertisers. "Usually short news items are offered without hesitation to good clients who advertise in our magazine on a monthly basis" (Marketing Agent C). Further, marketing agents claimed that they produced advertorials to attract new advertisers or those who had not advertised in their magazine for a longer time: "We offer them these texts to get their attention and trust, and to convince them of the importance of advertising in our magazine." (Marketing Agent B) Reporters and editors explained that they produced advertorials because of marketing agents' demands, so that they would contribute to financial liquidity of their magazine. Sometimes they agreed to produce advertorials because they had received a gift from an advertiser.
4 Discussion and Conclusion
Our observations revealed that in the process of unlabelled health-related advertorials production the key role is played by advertisers, who pursue their commercial interests by paying for the publishing of advertorials that promote their products/services. The role of editors and reporters is to fulfil orders from advertisers and marketing agents by disguising promotional texts as regular content. In-depth interviews with the main actors revealed the following reasons for the advertorial production: advertisers wanted to have control over the content, form and timing of publication; marketing agents emphasised weak financial position of their magazines, and news producers claimed they just carried out marketing agents' orders. The textual analysis indicated that readers can recognise unlabelled health-related advertorials through the partial, positive-only evaluation of health-related products/services, which are visually presented and described by using the synonyms of effectiveness aimed at their promotion. These items introduce the problem, then offer a solution, and finally, praise the solution given. By engaging in the practice of publishing unlabelled health-related advertorials, lifestyle magazines privilege the pharmaceutical-commercial aspect of health. Covert censorship prevents the publishing of critical or
unfavourable information about the advertisers who are among the biggest providers of health-related products and services in Slovenia. The magazines thus promote and present the pharmaceutical industry in a simplified and one-sided way, stressing its function to solve health problems of people in an effective and non-problematic manner.
The commercialization of journalism in Slovenia and Eastern European countries reached extreme proportions because of the lack of tradition in democratic culture and poor legislative regulation of the media, advertising and other related subjects, and because of the inadequate supervision of law transgressions, small media and advertising market, desire for a quick profit, economic downturns and financial weakness of the media.
We expect that the situation may, at least to some extent, improve once the financial crisis is over and the media get more advertising money again. Yet, some changes in the system will also be necessary. Even though Slovenia has introduced restrictive media regulation and self-regulation mechanisms, media (self) regulation is not yet efficiently implemented in practice and nobody files complaints against those who break the law and ethics codes. As long as this practice is sustained by most key actors on the media scene, and as long as guardians of the law and even competitors refrain from making a formal complaint, violations of norms and laws shall remain hidden from the public. Key actors in the Slovene media industry need to realize that the audience is losing trust in the media and that, in the long term, this kind of production will prove harmful to the whole media industry. The practice of submitting complaints against those who violate the law should be encouraged in the future.
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