Have Celebs Crossed the Line on Health Advice?
When first lady Betty Ford announced that she had had a mastectomy in 1974, patient advocates say, it was groundbreaking. Breast-cancer survivors at the time were often afraid to mention their treatment, even to friends.
Today, many people in the public eye, particularly celebrities, feel comfortable sharing their medical problems.
Brooke Shields has acknowledged her postpartum depression. Michael J. Fox has written about his struggle with Parkinson's disease. Elizabeth Taylor updated fans about her heart surgery through Twitter.
Doctors say they can understand why patients sympathize with celebrities and closely follow their battles with serious illnesses.
"It helps people to realize that health problems they have affect even celebrities," says pediatrician Aaron Carroll, director of Indiana University's Center for Health Policy and Professionalism Research. "Knowing that a rich and famous person can have the same problem as you or me makes it seem more fair, maybe.
"It also can make it easier to talk about your own problem, because a celebrity has the same issue."
Yet celebrities - who can command huge audiences and sell thousands of books - have a special responsibility to get their facts right, says Bradford Hesse, who studies health communication at the National Cancer Institute. Many doctors say they're troubled by stars who cross the line from sharing their stories to championing questionable or even dangerous medical advice.
- Tom Cruise in 2005 began a spat with Shields and drew criticism from mental health professionals when he railed against antidepressants and Ritalin on the "Today" show, dismissing psychiatry as a "pseudoscience."
- Actress Jenny McCarthy, who has an autistic son, has written several books linking autism with childhood vaccinations, even though a host of scientific studies show that vaccines are safe and not the cause of increasing autism rates.
- Actress Suzanne Somers - already well-known for her diet books and ThighMaster products - in October released her 18th book, "Knockout," which experts describe as a catalogue of unproven or long-debunked alternative cancer "cures."
Doctors and public health groups say they struggle over the best way to respond to celebrity claims.
At Every Child By Two, an immunization campaign co-founded by former first lady Rosalynn Carter, board members were initially inclined to ignore celebrities who question vaccine safety, says executive director Amy Pisani. Now, the group spends 80 percent of its time explaining why vaccines are still critical.
"We were poised to start working in Africa," Pisani says. "But we were forced to pull back just to re-educate people here in the United States."
For good or bad, research shows that stars exert powerful influence not just on popular opinion, but on public health.
- Vaccines. A USA TODAY/Gallup Poll of 1,017 adults found that more than half were aware of McCarthy's warnings about childhood shots. More than 40 percent of adults familiar with her message - 23 percent of all adults surveyed - say McCarthy's claims have made them more likely to question vaccine safety. The Nov. 20-22 poll had a margin of error of plus or minus 4 percentage points.
- Colorectal cancer screening. The number of colonoscopies rose 20 percent in the year after TV news anchor Katie Couric, who lost her husband to the disease, had an on-air screening in 2001, according to a study in the Archivesof Internal Medicine.
- HIV screening. The number of people being tested for HIV increased after Magic Johnson revealed in 1991 that he had tested positive for the virus, according to a study in New York state.
- Breast cancer screening. Diagnoses rose slightly in the year after Ford's mastectomy, possibly because more women were motivated to get mammograms, says the American Cancer Society's Otis Brawley.
- Breast cancer surgery. Nancy Reagan's mastectomy in 1987 may have influenced patients' choice of treatment. The number of women getting lumpectomies, instead of more extensive mastectomies, declined 25 percent in the months after Reagan's surgery, according to a study in The Journal of the American Medical Association.
Celebrities have the power to do tremendous good, Hesse says. Lance Armstrong, who survived testicular cancer, has advocated for funding and policy changes to help cancer patients and has raised more than $325 million through his foundation.
"People like Katie Couric and Lance Armstrong can do a lot to teach people that it is important to talk to their doctors about screening for cancer," Hesse says. "Some would say they have done more for the cause of public awareness for cancer than most scientists."
Yet celebrities also can spread misinformation much faster than the average person with a wacky theory, Hesse says.
Correcting that misinformation - even with a mountain of evidence - can be a challenge, says Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia. "It's much easier to scare people than to unscare them," Offit says.
By swaying parents to delay or reject childhood vaccines, celebrities could undermine efforts to protect newborns and other vulnerable children from devastating diseases, says pediatrician Martin Myers, executive director of the National Network for Immunization Information.
"I worry about these celebrities who confuse people," Myers says. "I don't think they know how much damage they can cause."
'The university of Google'
Some psychologists say that celebrity activists are part of a larger trend, in which survivors of serious illness feel less of a stigma about speaking out and find it therapeutic to help others in a similar situation.
"Giving to other people has a profound way of rewarding us," says the NCI's Julia Rowland. "It's a way to make meaning out of a situation. ... You tell other people how to cope, and it helps you cope, too."
Others note that celebrities give voice to frustrations shared by many Americans.
"If someone has a heartfelt belief that something ought to be on the radar screen of America, they ought to put it out there, because believe me, other people are saying it anyway," says Mehmet Oz, a heart surgeon and host of "The Dr. Oz Show." ''I'd rather have it come up publicly and have Larry King have a debate about it."
Studies show that doctors still have great influence. About 68 percent of people trust their doctors "a lot," according to a 2007 survey by the NCI, giving them higher ratings than any other source, such as family, friends, the government, the Internet or other media.
In a televised debate, however, Oz says that a telegenic actor has a natural advantage over bespectacled scientists, however well-meaning and knowledgeable.
Yet personal testimonies, however compelling, also can be misleading, says Offit, who helped develop a vaccine against a deadly infection called rotavirus.
As a patient or parent, "you know about your particular situation, but that doesn't make you an expert in the field," Offit says. "It's part of our culture now. We believe we can be experts by simply looking on the Internet."
In her book Mother Warriors, McCarthy, who declined to be interviewed for this story, says she learned about autism from "the university of Google."
Explaining complex science - especially in the few minutes allotted on a TV program - is challenging, Carroll says. Audiences sympathize with McCarthy, who says she doesn't need science because she observes her son, Evan, every day. "At home," she writes, "Evan is my science."
"How can you argue with that?" Carroll asks. "It's her child. It's her body. They win."
That's why Pisani says she urges parents to speak out about the need for vaccines. Actress Amanda Peet now works with vaccine groups, encouraging parents to get their medical advice from doctors, rather than celebrities like herself.
Oz says doctors must do a better job of putting a human face on medical questions while showing that they take people's concerns seriously.
"Ten percent of people are going to believe in Suzanne Somers anyway," Oz says. "What I don't want is to have 50 percent more people go there."