ABC’s 2013 Catalyst program may contribute to up to 2,900 heart attacks and strokes

Media coverage of health issues, via advertising campaigns or in the form of news and current affairs coverage, can powerfully influence community understanding of disease, health risks and notions of who is responsible for doing something about these problems.

Often the impact of this coverage happens in “slow burn” fashion. Public understanding and access to emerging new information – and the debates accompanying it – gradually translate into personal relevance, concern, behaviour change and support for legislative or regulatory action.

But there have also been many casebook examples of how media coverage of health issues can have dramatic, rapid and sometimes sustained effects on health-related behaviours, both positive and negative.

News of Kylie Minogue’s breast cancer diagnosis in 2005, for example, was followed by an unprecedented 101% increase in the number of women aged 40 to 69 booking in for their first mammogram.

There was also a concerning 20% increase in younger women, at very low risk for breast cancer, who underwent mammographic screening.

Similarly, widespread news coverage in 2002 about serious negative risks of using hormone replacement therapy (HRT), was associated with an 18% fall in HRT use in California.

But sometimes even very limited, small-scale news coverage can also trigger widespread effects.

In 2005, the ABC-TV Catalyst program ran a single item – seen by a quarter of Australian households – on the importance of iodine in the diet to prevent iodine deficiency disease.

This was followed by an immediate 5.2% jump in national sales of iodised salt. Table salt has never been advertised, discounted or commercially promoted in Australia, so the increase was hard to explain by anything other than the Catalyst program.

Today, researchers from the University of Sydney and the Australian National University report on the impact of another Catalyst program. In October 2013, Catalyst broadcast a segment highly critical of statins, a class of drug used for lowering cholesterol.

The program questioned the link between cholesterol and heart disease, and suggested the benefit of statins in preventing cardiovascular disease was exaggerated.

There was extensive criticism of the program, including from the ABC’s own Norman Swan and the ABC later removed the episodes from the Catalyst website after an internal review found that the episodes had breached its impartiality standards.

The new report in the Medical Journal of Australia used Pharmaceutical Benefits Scheme data of 191,000 people and found an immediate fall of some half a million fewer statins dispensed to patients in the eight months following the Catalyst broadcasts.

The authors wrote:

This translated to an estimated 60,897 fewer people taking statins over the eight months examined. If patients continue to avoid statins over the next five years, this could result in between 1,522 and 2,900 preventable, and potentially fatal, heart attacks and strokes.

One of the study authors, Associate Professor Sallie Pearson, Scientific Director of the Centre of Research Excellence in Medicines and Ageing at the University of Sydney, said:

What is particularly concerning is that this drop in use was seen in people who were at high risk of cardiovascular disease – for example, those who were also taking medications for diabetes. Heart attacks and strokes are the main killers of people with diabetes.

Statins are recommended for people at high risk of cardiovascular disease because they have been shown to be effective. Like all medications, they have risks and benefits and should only be used as recommended.

The study authors wrote:

Even though the observed effect was relatively small, the prevalence of statin use in Australia and their established efficacy means that a large number of people are affected, and may suffer unnecessary consequences.