Von Feilitzen, Cecilia, and Johanna Stenersen (Eds.). Young People, Media, and Health: Risks and Rights.

Soukup, Paul A.

Von Feilitzen, Cecilia, and Johanna Stenersen (Eds.). Young People, Media, and Health: Risks and Rights. Goteborg. Sweden: NORDICOM, 2015. Pp. 202. ISBN 978-91-86523-89-3 (paper) Kr 250, 28[euro].

This 2014 Yearbook from the NORDICOM Clearinghouse on Children, Youth, and Media addresses the complex relationships among youth, health, and media. While some contributors address long-standing concerns like the link between mental health and violent media content, others expand those risks to examine how young people's media use (time on the Internet, visual screen content, messages, and so on) affect physical and mental health. Still others ask about how young people's access to information (particularly health information) affects them and how access to participation in the media can become a tool for greater social inclusion. These sets of questions broadly define the two parts of the volume: studies on "media use and health risks" and studies on "the right to participation--communication for health and social change."

This yearbook marks a very important move in the study of media and children because it both raises issues of heath in new ways and presents empirical evidence of harm done to children.

In the first part, Leslie Haddon and Sonia Livingstone ("The Relationship between Offline and Online Risks") report on data from the EU Kids Online study to compare offline and online risks in the areas of bullying and viewing pornography, since both occur in these different areas of children's lives. As a context, they draw on early Internet studies (Woolgar, 2002) to point out the importance of the local social context in determining the impact of online material, the evidenc that online or virtual material supplements rather than replaces face-to-face behaviors, and the different ways that young people incorporate online materials and practices into their offline living (p. 7). At the same time, they draw on boyd (2008) to remind us that online material persists over time, is easily scalable and replicable, reaches invisible audiences, and blurs traditional ideas of the public and the private. The EU Kids Online data indicates support for the "risk migration" hypothesis, that is, that children at risk of playground bullying, for example, are more likely to face online bullying (by a factor of 10) and that "seeing sexual materials offline increases the odds of seeing sexual content online" (p. 29), by a factor of 15. A close reading of the data indicates complex relationships among a number of predictors and very complex relationships among the potential harms. "Interestingly, for both being bullied online and seeing sexual images online, experiencing the offline risk seems to result in children being less bothered by the online equivalent" (p. 29).

Reporting on a longitudinal study in Austria, Ingrid Paus-Hasebrink and Jasmin Kulterer ("Socially Disadvantaged Children, Media, and Health"), examine "the role media play in socially disadvantages families with special respect to children between five and 10 years of age" as well as "the relationship between children's media use and health problems" (p. 33). Their case studies indicate that "the circumstances in which children grow up have a severe impact on their development, their health, and their socialization" (p. 42). Many turn to the media as agents of socialization, leaving television, for example, as a chief supplier of role models and behavioral guidance. (Given their circumstances, many of these children lack access to online materials.)

One of the volume's editors, Cecilia von Feilitzen, summarizes some material on violence as a public health problem ("Mediated Violence and Related Risk Factors: Examples and Reflections"). She suggests two roles for the media: a positive one, to raise "awareness about different kinds of violence against children" and, a negative one, to increase "exposure to images of violence and male domination of women and girls due to globalized media and new ICTs [which] can affect opinions, norms, and behavior and is therefore a risk factor in the community" (p. 46). Rather than summarizing years of data on media violence, von Feilitzen instead draws on the UN's Violence Against Children study to present some research examples and questions. For example, studies show consistent findings that exposure to media violence is associated with an increased risk of later aggression and that parental monitoring can decrease that risk (p. 52). Others indicate that such risk is cumulative--the more violent media consumed in different formats, the greater the risk. She also points out that popular culture plays a strong role in young people's development and identity formation and that "for some, the use of mediated violence is a more or less conscious attempt to work through and understand their feelings of anxiety, oppression, frustration or aggression, and circumstances that have contributed to an aggressive environment" (p. 54, italics in original). The overall research collection highlights the need, von Feilitzen concludes, to more clearly identify risk factors and their relative impacts on the lives of children and communities.

In a case study of threats to children in Egypt, Ibrahim Salah ("Stealing Children's Innocence in Egypt: Media Literacy, Human Rights, and Roads of Violence"), draws several themes together, connecting routine violence against children--arrests and sexual abuse of street children, regular beatings in schools, parental neglect--with both media coverage and (the lack of) media literacy education.

It comes as no surprise to regular media consumers that marketing and entertainment have sexualized children and their depictions of children. Jeanne Prinsloo ("Sexualization of Children's Relationship with the Media") cites the American Psychological Association's definition of "sexualization" and then shows how it applies, particularly to the treatment of girl children. She also proposes a theoretical account, examining both structuralist and post-structuralist explanations. The first "approach tends to focus on the context of production and the content of media texts to explain an existing phenomenon. It excludes attention to the audience as active consumers who might negotiate meaning" (pp. 74-75). The latter critiques this view, articularly from a feminist perspective and draws attention to the lack of definition of "healthy sexuality" in these discussions as well as the lack of any attention to power relations, particularly in patriarchal societies. She calls for more empirical work, not only in media depictions of sexualization of children but of children's use of the media and of such depictions.

The next set of essays in the volume present work addressing specific health issues: obesity, sleep and learning, food marketing, and the relation between consumerism and mental health.

The editors reprint the 2011 policy statement of American Academy of Pediatrics (Council on Communications and Media) on "Children, Adolescents, Obesity, and the Media." This remarkably blunt statement, supported by extensive research, sketches the links between childhood obesity and the media. Recognizing that researchers have not determined the exact mechanisms of causation or influence, the pediatrics association still concludes that "sufficient evidence exists to warrant a ban on junk-food or fast-food advertising in children's TV programming" (p. 85). Some of the mechanisms that connect media consumption with obesity include "small, incremental increases in caloric intake (or increases in sedentary activities)," media use "displac[ing] more active pursuits," "unhealthy eating habits and effects of advertising," and the "effect of media on sleeping habits" (pp. 86-89). This latter category shows an indirect link, in that sleep loss connects to snacking, lower energy levels, which lead in turn to less activity, and metabolic changes. The Council recommends that "pediatricians should ask parents and patients two key questions about media use: (1) How much time per day does the child or teenager spend with screen media? And (2) Is there a TV set or unrestricted, unmonitored Internet connection throughout the house, including in the children's bedroom?" (pp. 89-90).

Markus Dworak and Alfred Wiater ("Impact of Excessive Media Exposure on Sleep and Memory in Children and Adolescents") report evidence from their studies of sleep patterns in children. Different kinds of sleep (NREM, REM) play crucial roles in memory and learning. Media consumption (with television viewing and playing exciting video games representing the extremes of involvement with the media) disrupts those essential sleep patterns and thus affects learning. Their theoretical model traces connections from the more acute physiological consequences of media use ("heightened alertness, increased physiological arousal, altered neurotransmission, fright reactions, reduced physical activity, and [perhaps] altered melatonin secretion [due to the bright light of screens])" to sleep problems ("increased onset latency, reduced sleep quality, reduced SWS/REM sleep, anxiety, night awakenings, shortened sleep duration") to learning and memory problems and potential long-term behavioral consequences, such as school performance, metabolic disorders, and risk of hyperactivity disorders (p. 107).

Susan Linn ("Too Many Screens, Too Much Stuff: How Media, Marketing and Commercializa tion Are Harming Children's Heath") calls attention to the contradiction of global spending on improving children's health and the global spending on marketing threats to children's health. Marketing to children has dramatically increased in the last 25 years and creates a pattern of consumerism and brand preferences in children as young as two years old. Moniek Buijzen, Esther Rozendaal, and Simone M. De Droog ("Food Marketing and Child Health") add specific research-based evidence to these claims, examining the role of marketing techniques "such as brand characters and advergames" (p. 121, italics in original); the latter refers to "a custom-built online game in which the brand or logo forms an integral part of the game" (p. 122). Such marketing affects children's diets and family eating habits. Interestingly, Buijzen, Rozendaal, and De Droog point out that this kind of marketing also works to promote healthy eating habits among young children.

The second part of the yearbook presents studies of participatory communication for health and social change. A subset of the larger area of communication for social change studies, the concept seeks to involve children and adolescents in discussions of their own health.

Rafael Obregon and Angela Rojas Martinez ("Communication and Health of Children and Adolescents in Latin America: Toward a Child- and Adolescent-centered Approach") present two case studies of health communication approaches in Colombia. They situate their work in a theoretical discussion of the communication for social change literature as well as in facts about health concerns, paying attention to gender issues in health communication. Among the several recommendations in their conclusions, they include:

* "it is essential that decision makers decisively promote the creation and strengthening of local social communication networks, and coordination with global, national, and regional networks with the purpose of facilitating not only the flow of accurate and reliable information about health services ... but especially effective coordination and participation mechanisms that ensure better health and well-being of children and adolescents."

* "it is also critical to promote monitoring and evaluation mechanisms about existing health programs ... [that build] on participatory processes that allow for the identification of indicators that reflect children's and adolescents' perspectives and complement health outcomes indicators" (p. 146).

In a similar vein Johanna Stenersen ("Body Political and the Mediated Body: Young Women in Nicaragua Talk about Sexual and Reproductive Rights") reports an ethnographic observation of young (13-19 years) Nicaraguan women learning about and discussing "issues related to sexual and reproductive health" (p. 152). She notes the impact of media texts such as telenovelas and the larger social context of government, religion, and family, but also identifies the impact of "socio-economic backgrounds and levels of social control" on "how the informants experienced media and the ways in which they would use different media and communication technologies" (p. 160).

Three other case studies--from Nepal, South Africa, and China--complete the collection. Arvind Singhal ("Youth, Media, and Respectful Conversations about Health: Lessons Learned from an Exemplary Project in Nepal") presents an analysis of "Saathi Sanga Manka Kura (Chatting with My Best Friend," a long-running (11 years) radio program addressed to a youth audience. Designed to be interactive, the program encourages young people to write, text, or post on social media platforms key questions or topics about which they seek information. Program staff respond to all such requests and choose four or five for the weekly show. "Each episode of SSMK combines music with drama and an open, honest conversation between its male and female hosts. SSMK encourages young people to break the silence and cultural taboos surrounding physiological and emotional needs and curiosities that come naturally with puberty" (p. 164). The radio program eventually led to a television program, also addressing life skills for youth. Singhal identifies several important lessons learned from the program, including the value of formative research, the provision of a safe space for discussion, and the value of locally produced media content.

The South African televison program Soul Buddyz also emerged from a formative research consultation. Susan Goldstein ("Children as Agents for Social Change: Soul Buddyz and Soul Buddyz Club") explains how the program targets the 8-12 year old audience and its concerns as manifest in the research (expressing emotions, dealing with parents, lack of aspirations, separation of races). The 26-episode series featured a group of children who met in a park after school; each episode addressed a health issue from the perspective of one or another of the children ("bullying, gun safety, HIV, or sexual abuse," p.170). The children in the show tried to solve their programs, suggesting a model of initiative and empowerment to the audience. Broadcasting in nine languages, the program producers also distributed supporting materials. Subsequent evaluations indicated that the program "reached an unprecedented 67% of the children in the age range, having watched, listed to, or read Soul Buddyz material" (p. 170). Goldstein also presents the model of change that the producers developed as well as a summary of the research detailing four key areas of learning: knowledge, social conscience, social skills, and emotional health.

Bu Wei ("Talking about Violence with Children: A Case Study of Children's Participation in the Communication Plan on Stopping Violence against Children in China") builds on the United Nations Violence against Children report as well as on theories and practices of youth participation in addressing these issues. Bu Wei reports on a pilot project workshop for children in China which addressed four themes: "(1) Our rights; (2) Violence in our lives; (3) Children making changes; and (4) Communication plan" (p. 182).

The final part of the yearbook presents "Statistical Indicators on Children in the World." These include demographics, economic indicators, education and media, health, child maltreatment, and labor.

The yearbook, Young People, Media, and Health: Risks and Rights brings together very important material on youth and media that goes well beyond most studies of influence, use, media literacy, and youth empowerment. The health data alone--perhaps known to specialists--deserves wider distribution and should become part of every media studies course.

Each essay has its own notes and bibliographic reference. The volume provides contact information for each of the contributors.

References

boyd, d. (2008). Why youth [love] social network sites: The role of networked publics in teenage social live. In D. Buckingham (Ed.), Youth, identity, and digital media. Cambridge, MA: MIT Press.

Woolgar, S. (2002). Five rules of virtuality. In S. Woolgar (Ed.), Virtual society: Technology, cyberbole, reality. Oxford: Oxford University Press.

Paul A. Soukup, S.J.

Santa Clara University