Cause Celeb: How Star Power Impacts Public Health


Contemporary society is “celebrity-obsessed,”1 with celebrities garnering feelings of awe and near-worship.2 Celebrities influence an array of attitudes and behaviors, including those that affect our health because celebrities are “highly influential people whose actions and decisions are watched and often emulated by wide audiences.”3

Celebrities “frequently give medical advice and people often follow it.”4 This phenomenon is a double-edged sword because celebrities can have both a positive and a negative impact on patients' health behaviors. For example, after the basketball player Earvin “Magic” Johnson announced that he was HIV-positive, there was a surge in calls to the Center for Disease Control and Prevention's National AIDS Hotline by people seeking AIDS-related information.5,6 Angelina Jolie's public announcement of her double mastectomy led to an increase in the number of high-risk patient screenings for the BRCA1 gene.7  In 1999, American politician Bob Dole raised awareness of erectile dysfunction.4 And Michael J. Fox has raised over $450 million dollars for research into Parkinson's disease.8

On the other hand, there are celebrities whose messages have had detrimental impact on public health. For example, actress Christina Applegate supported MRI screening for early detection of breast cancer, although this has not been endorsed by evidence-based consensus statements for women at average breast cancer risk.9 Actress Susanne Somers advocates bioidentical hormones to reverse aging and proteolytic enzyme therapy for pancreatic cancer, neither of which is evidence-based.4 Jenny McCarthy has been a vocal opponent of vaccinations, due to concerns about autism, a claim that has been discredited repeatedly by reputable medical authorities.4 And actress Gwyneth Paltrow's Website advocates inserting jade eggs into the vagina to “increase vaginal muscle tone, hormonal balance, and feminine energy in general.”10

Celebrity influence is a complex phenomenon that involves biological, psychological, and social processes, according to Hoffman and Tan, whose review of wide array of electronic databases4 (Table 1) identified 14 mechanisms that account for “why people adore celebrities and trust their medical advice. These mechanisms include herd behavior (the tendency to make decisions based on what others have done in similar situations) and meaning transfer (consuming items to acquire the traits of the endorsing celebrity).

The researchers noted that the extent to which people are influenced by celebrities cannot be attributed to health illiteracy, but rather “may stem from very particular processes, such as a desire to acquire these traits that make celebrities special, the activation of neural pathways involved in enhancing trust, or the spread of behaviors through social networks.”4

Take-Home Lessons for Clinicians

The authors encouraged health professionals “to discuss the merits and faults of celebrity medical advice with patients and ensure that patients know how to access and assess credible health information.” It is important not to be annoyed or dismiss celebrity-recommended remedies, as this can weaken the physician-patient relationship, especially “in cases of strong celebrity adoration,” the authors cautioned. Rather, healthcare professionals should use these discussions as “meaningful opportunities” to begin important educational conversations that inform patients about beneficial health behaviors, and trust in physicians.4

It is also important for the medical community to “improve its efforts to increase public understanding of health issues and discredit the most egregious examples of celebrity advice.” The authors recommended enacting restrictions on celebrity endorsements, requiring celebrities to disclose any conflicts of interest, or actually working with the celebrities themselves—ie, partnering with them in “productive ways to disseminate the best available research evidence.” Celebrity advice then becomes a “powerful tool for health literacy and health promotion” and allows celebrities to become “important partners in improving public health.4