Book Review: In Sickness and in Health: How Information and Knowledge are Related to Health Behaviour

Almost ten years ago I began researching consumer health information provision at a time when health information professionals were taking stock of how the coordinated media strategies of HIV/AIDS prevention agencies had impacted on reducing contagion rates amongst the most ‘at-risk’ groups in western societies. The coherence of these campaigns was doubtless key in producing behaviours which helped reduce infection rates. More recently, conflicting media reports on possible connections between the MMR vaccine and autism did little to alleviate the concerns of worried parents. How health information is communicated, received and assessed by various social publics remains a contentious issue, yet one which remains hugely important. In Sickness and in Health is a scholarly piece of research arising from an academic thesis. Publications following a thesis structure can often make for difficult reading, but Eriksson-Backa’s readable style does much to clarify and synthesize the literature in the field without oversimplifying. The study is conducted in a Finnish context, but researchers from other locales should not be deterred from utilizing the work. This is particularly the case in Chapters 2 to 9 which provide succinct reviews of theoretical developments of the key components of the work. Health is discussed in relation to behaviour, information and knowledge. The study is conducted from a cognitive perspective (which Eriksson-Backa points out has been popular in information science research for almost 30 years) but her discussion of the various contributions to these three interrelated fields endeavours to encapsulate alternative approaches too. Eriksson-Backa’s research concern is ‘to examine the relationship between the existing knowledge level in health matters among Finns, and the health behaviour and the preference for information sources on health related to nutrition’. Her empirical research methodology consists of qualitative and quantitative data collection on a population who are grouped as diabetics, pregnant women and otherwise healthy control subjects. Her interviews with subjects utilize an interesting mélange: a structured interview; additionally ‘the respondents were asked to relate the advice they would give to someone about how to live a healthy day’. Although most of the material collected was subjected to a qualitative analysis, respondents were grouped, and certain correlations tested, using statistical tools. The results are quite detailed and several correlations and comparisons are offered. The cluster analysis revealed three clusters which represented preferences for sources of health information: professionals (n = 19, mostly members of the diabetic group); popularized science (n = 20, mostly pregnant women); and everyday information (n = 11). ‘General interest’ was the main reason for seeking health information, but changes in an individual’s health status resulted in increases in interest in information finding. Satisfaction with information concerning food and health was highest amongst the group relying on health professionals, and lowest with those relying on the media. This latter point is underscored by a noted desire that the media would not sensationalize such information or amplify the significance of negligible events. Throughout the discussion of her results, comparisons are made with similar studies conducted in other countries which demonstrate the differences, and sometimes similarities, between different national cultures. For example, the pregnant women in Eriksson-Backa’s study tend to rely most on popularized science or everyday information, as opposed to American women who rely more heavily on health providers. Eriksson-Backa shares some of her experiences of conducting research, such as the reaction of interviewees to the presence of a tape recorder and the use of a question list when time constraints are pressing, which should be of interest to students embarking on a period of data collection. The results section on health information, knowledge and behaviour reports numerous findings such as these, and it is perhaps an injustice that more cannot be reported by this brief review. Eriksson-Backa’s summary answers to her two top-level questions (‘Is there a relationship between the information sources a person uses and his existing knowledge on health and food?’ and ‘Is there a relationship between received or acquired information and knowledge on nutrition and health and the health and eating behaviour of an individual?’)