The Ecology of Health Knowledge in the United States

An individual’s health decisions and knowledge stem from the norms of family, peers, and communities; media sources; and federal, state, and local policy. Many of these factors stem from a historical evolution and regional idiosyncrasies, including differences in levels of state funding, public health communications, and community health knowledge. Although there is evidence that these factors contribute to health in several domains, no past research has examined the ecology of this body of knowledge or its evolution over time. This project will investigate the interplay of these ecological factors at the state and county level to predict over-time changes in health knowledge in critical health areas, including HIV, diet, smoking, substance use, and exercise. The project will study a sample of 1500 United States residents and county-level information in the media, as well as health policies and norms. After understanding key factors affecting health knowledge, we will conduct an experiment with a new sample of participants (N = 1,000; Aim 2). Participants will be randomized to conditions that combine the key knowledge, policy, and communication factors identified in Aim 1. The project will be informed by extensive pilot data on health policy, public health communications, and health information across states and over time, as well as experience recruiting and managing large longitudinal studies. The team includes expertise in public health, psychology, medicine, communication, public policy, and economics, and will leverage the resources of the University of Pennsylvania, the Penn CFAR, and the Annenberg Public Policy Center (APPC) to conduct cutting-edge research about the determinants of health knowledge.