The Impact of Celebrity and Influencer Illness Disclosures

ABSTRACT

When celebrities, political figures, influencers, or anyone with a large following publicly disclose an illness or die, the news becomes a de facto public health campaign. Until health communicators began studying such disclosures and the effects of the following waves of media coverage, however, it was not known to what extent these events impacted the public. A growing body of research has empirically documented these events and examined the factors that predict which types of audiences are most affected and why. Beyond motivating research opportunities, celebrity and influencer health disclosures or deaths can impact calls to hotlines, views on health-related websites, discussions of related topics on social media, behavioral changes relevant to the disclosure, increased news coverage of celebrity health research, integration of celebrity health narratives into strategic health campaigns, and even policy changes. We provide an overview of research conducted in this area and detail examples of the impact that celebrity health disclosures and studies about those disclosures have had on public discourse and public health.

When celebrities, political figures, influencers, or others with a large following publicly disclose an illness or die, the news can become a de facto large-scale public health campaign. Particularly for people who identified with or felt like they knew the celebrity, news of health-related disclosures or their death can be an impactful moment in their lives. A meta-analysis of 14 studies with more than 5,700 participants found that when an audience member feels a sense of attachment or affinity with the affected public figure, they are more likely to engage in the health-related behavior relevant to the celebrity disclosure (Kresovich & Noar, 2020).

Until health communicators began studying the effects of such disclosures (and of the waves of media coverage that follow them), it was not known to what extent these events had an impact, or among whom they had an impact. Indeed, a growing body of health communication research has documented these events. For instance, basketball star Earvin “Magic” Johnson’s HIV disclosure in 1991 initiated a series of studies aiming to show how celebrity health disclosures can shape audience health-related interpersonal communication and behavioral intentions (Basil & Brown, 1994). One such study found that people who felt emotionally connected with Johnson were, then, more personally concerned about HIV and AIDS among heterosexual individuals, and they also showed higher intentions to reduce high-risk sexual behaviors than did people who did not have a strong emotional connection with Johnson (Brown & Basil, 1995). Decades later, after actor Charlie Sheen revealed in 2015 that he had been diagnosed with HIV in 2011, not only did internet searchers about HIV/AIDS increase (Ayers et al., 2016; Francis et al., 2019), but so did sales of at-home HIV test kits (Allem et al., 2017).

When actress Angelina Jolie published an editorial in May of 2013 in The New York Times about how she had tested positive for the BRCA1 gene and had undergone a prophylactic bilateral mastectomy, internet search queries for terms related to breast cancer increased 112% the day of the editorial and remained 35% higher over the week after the editorial (Noar et al., 2015). Subsequent survey research also found that women who identified with Jolie or felt a parasocial connection with her were more likely to intend to pursue genetic testing, with some differences based on demographics and family history (Kosenko et al., 2016).

Although news coverage of public figure health disclosures has had an observable impact on public health behaviors for many decades (Brown & Potosky, 1990), social media have also given rise to considerations that such news can quickly change public perceptions and actions. For instance, in a survey conducted the day after actor Tom Hanks’ publicized his March 2020 COVID-19 diagnosis via his social media accounts, nearly half of participants stated that the news changed their perceptions or behaviors related to the emerging health threat (Myrick & Willoughby, 2022). Later experimental research comparing news about Hanks getting COVID-19 versus a non-celebrity helped confirm that Hanks’ celebrity status – and audience involvement with him – helped make his disclosure strongly impactful on public perceptions of the infection (Cohen, 2020).

Individual celebrity health disclosures or deaths can impact various segments of the population differently, depending on their personal and demographic connections with the public figure. For instance, after news broke that Black actor Chadwick Boseman died from colon cancer in August of 2020, there was a significant increase in web-based activity (e.g., Google searches and relevant Wikipedia page visits) related to colon cancer, particularly in areas of the US with a higher proportion of Black Americans (Naik et al., 2021). Survey research found that Black Americans also rewatched Boseman’s movies and used social media platforms to connect with other fans more so than White Americans, giving us insights into how celebrity deaths can affect different groups of people (Myrick et al., 2022). In another example, when hip-hop artist “Kid Cudi” disclosed his struggles with depression in 2016, the hashtag #YouGoodMan emerged on Twitter along with significant engagement on this topic on the platform amongst Black men (Francis, 2021).

Conceptually, not all celebrity disclosures should have the same, or any effect: It would depend on the who the celebrity is, the amount of media coverage generated by the disclosure, audience involvement with that celebrity, the emotions aroused by the health condition or outcome itself, and whether the celebrity modeled helpful, medically-informed behaviors or instead spread misinformation (Myrick & Willoughby, 2021; Noar et al., 2014). For instance, one analysis of the impact of public figure announcements of pancreatic cancer on public search behaviors found that out of 25 well-known figures who had the condition, only a few disclosures significantly changed the amount of search queries (Noar et al., 2013).

Moreover, the fact that disclosures could result in negative effects on the public should not be overlooked. For instance, Australian singer Kylie Minogue’s breast cancer diagnosis at age 36 appears to have resulted in mammography over-screening among young women, potentially leading to reduced screening cost effectiveness and increased false positives (Kelaher et al., 2008). However, the bulk of the aforementioned research shows that there are many instances when celebrity disclosures can positively shape public emotions, thoughts, and behavior. As such, this line of research has had its own impact outside of health communication scholarship, including on public outreach and audience segmentation efforts.

Defining impact

The academic research on the influences of celebrity health disclosures and deaths on audiences is an important first step in showing that this topic has impacted society. This work is often used by other scholars to inform their own research. For instance, the meta-analysis of celebrity health disclosure effects on audience behavioral intentions published in 2020 (Kresovich & Noar, 2020) has already been cited nearly 40 times in subsequent research.

This body of academic research includes studies with other metrics of impact, such as calls to hotlines and internet searches (Noar et al., 2014). Additionally, changes in public health communication strategies, shifts in news reporting around celebrity health disclosures and deaths, and an increase in celebrity and influencer willingness to disclose and further discuss personal health issues all point to the fact that this literature has a demonstrated power to shape communication efforts and health outcomes.

Impact in practice

Organizational use of celebrities in public health campaigns gives weight to impact that the research findings have had on practice. The Centers for Disease Control and Prevention (CDC) has featured celebrity disclosure communication research in its’ monthly health communication e-mail newsletter and as part of its Gateway to Health Communication website (Centers for Disease Control and Prevention, 2023). In its public-facing communication efforts, the CDC has started to actively integrate celebrities into some of its campaign, like its use of Olympic sprinter Allyson Felix, alongside less famous Black women, in its campaign about Black maternal health (Centers for Disease Control and Prevention, 2022). As another example, the American Cancer Society has a history of involving celebrity influencers as part of promotional efforts, including asking them to use specific hashtags on their own social media accounts (American Cancer Society, 2019). The American Cancer Society (2023) currently has brand ambassadors, such as television personality and investor Daymond John, professional football player Dak Prescott, sports broadcaster Brian Custer, and singer-songwriter Mackenzie Porter working with the organization to apply their stardom to cancer awareness messaging.

Journalists often cover how celebrity deaths shape individuals, such as this headline from a Texas television news station: “Sugar Land man credits Chadwick Boseman for awareness of colon cancer after 2021 diagnosis” (KTRK, 2022). Reporters have also started describing the psychological factors predicting the effects of these celebrity health events on the public. In doing so, journalists have interviewed many health communication experts for their stories. For instance, CNN featured multiple researchers in a web story about the effects of various celebrity illness disclosures ranging from Magic Johnson, Charlie Sheen, and Angelina Jolie (Howard, 2017).

Health disclosures also have the potential to change policy. Claire Oliver (an Australian citizen) was diagnosed with melanoma at the age of 21, which she attributed to her use of tanning beds. Her story picked up significant media coverage and she became an activist on the issue, with 60 Minutes Australia interviewing her in 2007, just days before her death at the age of 26 (Makin & Dobbinson, 2009). Her story influenced policy changes regarding tanning beds in Australia, including a ban on commercial solariums that was implemented in 2015 in much of the country (Anderson, 2017).

When academic researchers publish studies on the effects of celebrity health disclosures, it also gives reporters a news hook for talking about the connections between celebrity disclosures or deaths, audience involvement with those celebrities, and the public health implications. It is now common for reporters to write about communication-related phenomena, such as the impact that identification and parasocial relationships with celebrities can have on particular audiences, and not just on the health event itself (Justich, 2023). For example, the Myrick and Willoughby (2022) study about Tom Hanks’ COVID-19 disclosure was featured on dozens of news websites and has an Altmetric score of 256 as of November 2023 (Altmetric is a company that quantifies public attention to academic publications; Altmetric, 2023).

This news coverage of research about celebrity deaths or illness disclosures then provides an opportunity for a second wave of news coverage that can have public impact: the first wave being news stories about the disclosure itself and the second being news stories about studies of the impact of the disclosure on the public. Given the importance of multiple doses of health information in spurring behavior change (Hornik, 2013, 2016), this second round of news coverage may amplify the public health effects of these events by serving as an additional cue to action as well as reinforcing the initial implications of the celebrity health disclosure for many audiences.

Furthermore, recognizing the broad interest in and public health importance of celebrity health news, journalists have also begun putting links to high-quality, relevant resources in their stories about celebrity disclosures. For example, when Angelina Jolie revealed that she had tested positive for the BRCA1 gene and had undergone a prophylactic bilateral mastectomy, there was a 795-fold increase in views of National Cancer Institute (NCI) breast cancer fact sheet about preventative mastectomies, with more than 69,000 views on the day of Jolie’s disclosure (Juthe et al., 2015). Whereas prior to the Jolie disclosure visits to these fact sheets tended to come from Google searches, on the day of her New York Times op-ed about it, nearly half of all visits to these NCI fact sheets came from news source referrals.

Finally, the study of these illness disclosures seems to have impacted celebrities themselves. For instance, Charlie Sheen tweeted about how affected he was by data about the public impact of his HIV illness disclosure, and he subsequently began speaking out more about HIV/AIDS. In another example, given the notably public response to Jolie’s 2013 editorial about her prophylactic double mastectomy, she followed up with a second editorial about her surgery to remove her ovaries and fallopian tubes two years later (Jolie Pitt, 2015). Likewise, after seeing the public response to his 2013 social media disclosure of a basal cell carcinoma diagnosis (Pavelko et al., 2017), Australian actor Hugh Jackman has shared news of his multiple subsequent biopsies on his social media accounts and his story is featured by groups like the Skin Cancer Foundation in hopes of continuing to raise awareness and aid skin cancer prevention efforts (Venosa, 2023). These examples all show how celebrity health disclosure events can also impact the disclosure themselves, resulting in them talking even more about the health issues at hand. As such, these disclosures may have an impact on public discourse about health issues far beyond the initial disclosure event.

Conclusion

Prior to the existence of health communication literature on celebrity and influencer disclosures, it was not known whether these events had much impact on public health. We now know that such events can have major and occasionally sustained impacts on public attitudes and behaviors. These impacts are more likely for audiences who feel psychologically connected to the celebrity who is disclosing the illness. Additionally, health-related organizations (e.g., the CDC, ACS) have been finding ways to apply this body of knowledge in areas related to public health outreach and engagement. The celebrity disclosures discussed here are just some of the many examples of this phenomenon and demonstrate how the health communication field advances an understanding of real-world opportunities to improve population health. Future work could examine additional outcomes indicative of impact in this line of research, such as mentions in policy settings (e.g., congressional hearings or executive orders), discussions relevant to mechanisms of impact in spaces for public discourse, such as social media users discussing parasocial relationships, negative unintended consequences of disclosures, or cross-citations of these studies in non-communication fields, indicating that this work may be shaping inquiry across fields.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.