Hello, I'm Ellen Wartella and welcome to this episode of the Architects of Communication Scholarship podcast series, a production of the ICA Podcast Network. Today, our architect is K. Viswanath, a world-renowned health communication scholar known for his work in communication inequalities, and how they relate to poverty and health disparities. His research also revolves around understanding how knowledge translation could address health disparities. Professor Viswanath is Lee Kum Kee Professor of Health Communication in the Department of Social and Behavioral Sciences at the Harvard T. H. Chan School of Public Health and in the McGraw-Patterson Center for Population Sciences at the Dana-Farber Cancer Institute. He is the founding Director of the Enhancing Communications for Health Outcomes (ECHO) Laboratory. He is the Co-Editor of four books and monographs on media and health and the Editor of the Social and Behavioral Research section of the 12-volume International Encyclopedia of Communication. He received the Dale Brashers Distinguished Mentorship Award from the National Communication Association, the Outstanding Health Communication Scholar Award jointly given by the International Communication Association and the National Communication Association and the Mayhew Derryberry Award from the American Public Health Association (APHA). He is also a Fellow of the International Communication Association and the Society for Behavioral Medicine. Today, Professor Viswanath is in conversation with Edmund Lee, an assistant professor at the Wee Kim Wee School of Communication and Information at Nanyang Technological University, Singapore. Edmund was a postdoctoral research fellow in Professor Viswanath’s lab from 2018 to 2020. Here is Edmund.
Hello, Professor Vish, it is really great to have you here. And I'm excited to be speaking with you today and to learn more about your work and journey.
Good morning Edmund. Thank you for having me.
As we know, every hero or superhero has an origin story of how they became who they are. Perhaps we could start off that way by getting to know your origin story.
Sure, I am far from presumptuous enough to assume a role of a superhero. But my journey started in India, where most of the journey is actually meandering. Some people have great plans in life, and they move forward in attaining the mileposts in that life of goals they have. Mine is not like that. Initially, I knew what I did not want to do with my life more than what I wanted to do with my life. But I always had a natural interest in social sciences and humanities. Growing up in India, science and engineering is much more emphasized than humanities and social sciences. Somehow I ended up going to a journalism school because I did not know what else to do. I liked writing, I liked journalism. I thought, I will hang around for a couple of years in the master's program and then decide what I want to do. I loved it. And I did very well without any effort. In the process, I began learning about communication as a social sciences topic, an area of inquiry, but I still didn't have a clear idea. Then I worked, post-master's, for the Indian national satellite television project. That project sent me to do participant observations in a number of villages in my home state. The idea was that those observations would be used to produce development-oriented programs in TV. That crystallized my thinking that media have the potential to promote social change. I decided to specialize in communication, and more deeply as a social science area. So I went to Minnesota, got trained there, and in the process, learned deeper aspects of communication from my professors. As Robert Frost, the famous poet said, “Way leads on to way,” and here I am doing health communication research.
That's really an interesting background story, Professor Vish, how you started off in journalism, and ended in research. Based on your experience, how has social science changed when you first started as compared to where it is now?
I don't think I'm particularly competent to survey how social sciences have changed over time, but I do think the field of communication has evolved, with influence from both humanities and social sciences. When I joined the communications program, there was this huge debate in the field raging between so-called critical communication scholars and so-called social science type researchers. So that debate: whether anything is possible to empirical scrutiny as an area of inquiry in communication versus that nothing can be all empirical research should be eschewed and society and its organization should be questioned was the sight of the other group. These two groups were debating intensely. There are some of us who were in the middle of this, who were focused on gathering empirical data but wanted to study social change from the perspective of power distribution and resource distribution. It was difficult for some of us to take that middle path, where we were continuing to do this empirical research yet informed fundamentally by the values of equity, justice, community engagement–all these things that we take for granted today. The field has evolved since then. There is a certain acceptance that there are different areas of inquiry, that both are reasonable, legitimate ways of studying something like this. That's one big change in the field. The second big change, Edmund, is, I think today, most of us will agree that research is qualitative and quantitative. In fact, slowly mixed methods research has become the buzzword. The third way the field changed, again, influenced by social sciences, is there is a greater interest in how to apply what we are doing research in promoting social change. The burgeoning of the field of health communication is a good illustration of that. Health communication was a very small area of inquiry. But now, it's one of the largest divisions in ICA. The last point I want to say, I think the field has become much more interdisciplinary as a result of interest in other areas. One example, health, including public health, has taken deep interest in communication, because they realized communication as a field has a lot to contribute for health promotion, as well as in healthcare settings. I was recruited to the National Institutes of Health to advance two huge initiatives that had far-reaching influence on the field of health communication, in particular, communication in general. I'm very grateful for that opportunity. That has made, in a way, the field much more interdisciplinary, where we are attracting and working with people from public health, clinical research like cancer prevention, cardiovascular disease, social medical areas, as well as we are now working with computational scientists, which has engineers. I think those are some of the ways in which the field has changed.
Wow, that's really a fascinating journey in terms of how our field has evolved. It's a bold move to take the middle ground back then. In your earlier years, who are the mentors that shaped the way that you approach communication?
I don't know whether I thought it was a bold move because a lot of it was taken for granted by me and my classmates because we were so protected by our mentors. And our mentors actually provided that umbrella for us to make these inquiries in a bold way. So I went to my graduate school and PhD at Minnesota School of Journalism and Mass Communication. And I had the tremendous privilege of studying at the time under teachers who followed a variety of scholarly persuasions. But my own work was profoundly influenced by those who, at that time, were considered much more social-scientific empirical areas of inquiry. Primarily, Phil Tichenor, George Donohue and Clarice Olien, who are very well-known for their knowledge gap hypothesis. The more interesting work is what we call community studies, where they looked at pluralism, structure of a community, and how that structure influenced media coverage, community conflict, and distribution of knowledge. This is now called the conflict sociology perspective. Jerry Kline, the founder of Communication Research (the journal), took me under his umbrella and gave me an opportunity to work with John Finnegan, and the famous Minnesota Heart Health Program, one of the three cardiovascular trials in the country at the time, which had a profound influence on communication. And then Roy Carter, the professor who was more of a methodologist. These are people who I followed in my own area of inquiry, even though I was influenced by others, too. Often people think mentoring is all about what classes you take or how you choose your career. For me, mentoring is really providing a nurturing environment in which I'm able to thrive. That's what my mentors did for me. There are times when they took me out and bought me lunches. Here is a foreign student who hardly had a penny in his pocket. Lots of mentors, also, became sponsors in my life early on helping me, nominating me for awards and fellowships.
Certainly. I think mentors really play a huge role in determining someone else's career. You mentioned that some of your work is really influenced by what you call the community structures in the Minnesota study. There's a lot of parallels between what they do and in your work in communication inequalities. Would you be able to walk us through what exactly would be constituted communication inequalities and your research program surrounding it?
I mentioned knowledge gap hypothesis, which essentially argued that as knowledge and information flows into a community, the information or knowledge is acquired at a faster rate by those from higher socioeconomic status compared to those from a lower socioeconomic status. As a result of which, the knowledge gap between them widens. Now, there were a number of factors identified by them, which either exacerbate those gaps or bridge them. Early on, I published a number of papers in that area. But over time, my thinking has evolved and expanded as I moved into health, starting with the Minnesota Heart Health Program, working with John Finnegan. Subsequently, I realized that knowledge is necessary most of the time, but not always sufficient, because the opportunity structure to act on that knowledge may or may not exist for certain groups. As I began looking at it, I felt compelled to expand the definition from knowledge to larger issues of communication resources: access to information, as well as ability to act on it. That's when I evolved into developing this framework called communication inequalities. In essence, what we are arguing is that communication inequalities are manifest in two broad ways. These are differences between social groups in producing, processing, and disseminating knowledge and communication resources. Those inequalities are experienced between different groups. They also manifest individually as differences in accessing, processing, and ability to act on information among individuals and groups. So one example, if you take a large organization with a multi-billion dollar industry, like the tobacco industry, and you take a small organization, which is fighting that big tobacco industry, differences in resources between those two groups become very clear when you're talking about communication inequalities. In the United States, the tobacco industry spends roughly $10 billion in marketing tobacco. You take all the state's organizations that are in the business of tobacco control, like those of us, they don't have $10 billion. Tobacco industry: what is it marketing? Think about it for a second. It is really marketing distortion of information. That is an inequality between the tobacco industry and the tobacco control groups. So the last point I want to say on it is when people in the area of public health introduce this idea of social determinants framework. The idea of social determinants framework is that inequalities in health outcomes, are contributed by social conditions and social inequalities. The so-called social determinants, such as race, ethnicity, class, geography, caste, tribe, and the differences in resource structures among these different groups cause these unequal health outcomes. But the mechanisms were always a point of contention and question: how does that happen? My team came in and argued one way to explain that is through communication inequalities. We argued and demonstrated through a series of studies and papers that social determinants of health are what I call social drivers of inequalities. They contribute to inequalities and communication, which in turn, contribute to inequalities in health outcomes. So if you can bridge inequalities in communication, that is one addressable social determinant that could potentially bridge inequalities in health outcomes. So that is the framework that we have been pushing. What it showed for me is a pathway where I'm doing that empirical inquiry, collecting data, but the questions I am asking are informed by my values, about equity about justice.
I do see there's a momentum and a lot of attention being paid to communication inequalities in recent years. What do you think are the next big intellectual questions for communication scholars, particularly in the field of communication inequalities or health disparities, that you think they need to address in the next decade?
There are a few questions that continue to bug me. One, I think we still do not understand the pernicious effect of poverty and deprivation and its contribution to inequalities and communication. There are some interesting possibilities emerging. But let me say this. When you are poor, there is the stereotype that somehow the poor are not interested in X, so “Oh, they may not be interested in computers or internet” and that is a popular discourse out there. My argument is somehow poverty poses certain challenges, both in terms of accessing resources, but also the stress added, which could influence how you process information and influence how you act on that information. We still don't seem to be paying enough attention to that for some reason. With growing inequalities in the society, how do we really center equity in everything we do? Number two, if you really want to develop solutions, you have to work with the community. You have to work with the stakeholders. The biggest question is how do you engage the stakeholders into the part of the research process? A third area is how does this knowledge we are generating translate into influencing policy and practice? How do we make our research useful to practitioners, to policymakers, to our stakeholders? To do that, we need help from all disciplines.
What do you think are the big challenges, barriers and even opportunities that communication scholarship can make a contribution in the translational component of research?
Yes. So there are a few challenges. One of them is our own parochial approach to what is valued in the field. I often get inquiries from early stage investigators who want to do the work I'm doing right now in my lab. They like the fact that I published widely in a variety of journals, not just in communication, and they come to me and often say, “But I can't. I'm afraid I won't be get I won't get tenure, if I do what you're doing. I'm expected to publish in three journals that are acceptable.” That's a huge challenge for our early stage investigators. They are the best and brightest hope for me. We have to broaden that field of publication. Where do we publish? I have encouraged and nominated early stage investigators in our field to committees on National Academy of Sciences, for example. There are times when I want to give the opportunity to early stage investigators in our field and other people. And there were times when one or two of them said “Oh, I can't do it because service doesn't count in my field, and I may not get promoted.” Yet again, that's a disservice because these investigators had a lot to offer on those committees. So I think the so-called leaders in the field have to broaden the definition. At the end of the day, you have to ask, “Why do I want to do this?” Who cares whether I'm getting one more publication or not? What is the outcome of my research? What problem is it shedding light on? What problem is it solving?
As we come to the end of this interview, I just want to ask you, as you reflect back, what have been the most surprising or unexpected findings in your work?
I personally think the surprise to me, is my own evolution and thinking of involving stakeholders in producing solutions for social change. That did not come to me naturally: the idea that expertise is diffused and multi-focused. As somebody with a PhD trained in social sciences and communication, I always thought, “Okay, so now I'm an expert.” The biggest surprise is people: how resilient they are, how smart they are, and how much we need to work with them. We often use the term we should empower them. No, we are not going to empower anybody. They have the power. We have to concede and recognize that the solutions and smarts lie with them. They have a different kind of expertise, and we have to work together.
Since this podcast series is entitled, Architects of Communication Scholarship, what would you say that you have built that you are most proud of?
I'm not vain enough to say that, but let me highlight a few things that I somehow contributed to the field. One, thanks to a couple of people at NIH: the great Barbara Rimer, who's now the Dean of School of Public Health at the University of North Carolina, and Robert Croyle, who was the director of the Behavioral Research program and then the Division of Cancer Control. They give me opportunities to build the field through those two initiatives: the Health Information National Trends Survey, which is the first public-used data set in the field of communications, and the Centers of Excellence in Cancer Communication Research, the first major center. Those two have taken on and spawned the careers of dozens of people. And so I'm quite grateful for the part I played in that. I'm also grateful for my lab, including members such as you, who taught me a lot. My postdocs, my research assistants, my team and my colleagues who contributed a lot to the work we are doing–who do that day in and day out while I'm going around giving talks. And I'm also grateful for introducing the issue of equity and justice from a communication inequalities perspective to the field. I think that a lot of people are working in justice and power. I'm grateful to them. I was able to build on that to introduce a particular framework, the so-called structural influence model, which you are familiar, providing an ecological framework for understanding communication inequalities and how they contribute to social inequalities. And that framework, I think, hopefully will provide a pathway to study this and address this, including recently the idea that is taking off, Edmund, which you and I contributed to: the idea of data absenteeism, the idea that data on certain groups is not collected routinely. And they are dismissed as hard-to-reach groups, whereas I have always said it: these people are hardly reached because of the way we have structured the way we collect data and ask questions. Putting that in front of the field to allow people to ask questions around that, I think is another area I'm grateful for.
Thank you so much, Professor Vish.
Thank you so much for having me.
This episode of Architects of Communication Scholarship podcast series is presented by the International Communication Association Podcast Network and is sponsored by The School of Communication at Hong Kong Baptist University. This episode was produced by Dominic Bonelli. Our executive producer is DeVante Brown. Our Production Consultant is Nick Song. The theme music is by Humans Win. For more information about our participants on this episode, as well as our sponsor, be sure to check the episode description. Thanks for listening.
