Highlights of the First Thirty-Five Years

The following history, titled: Highlights From the First Thirty-Five Years, was authored by Jay A. Winsten in September 2022, with additional edits contributed in January 2023. The complete original PDF is available by request; please contact the Center for the History of Medicine. 

Over the past five decades, the field of Health Communication has emerged as a central component of public health. Communication initiatives have strengthened public understanding of science; informed and influenced the development of health-related public policies; and motivated populations large and small to adopt changes in behavior to prevent disease and injury and promote good health. These pages trace one particular path, among many, that have contributed to the growth and recognition of Health Communication as a core component of public health research and practice.

In 1975, Dean Howard H. Hiatt of the Harvard School of Public Health (HSPH) recruited Jay A. Winsten, Ph.D., then a postdoctoral fellow in molecular biology at Harvard Medical School (HMS) who had strong interests in journalism and public policy, to create an Office of Health Policy Information (OHPI) within the Office of the Dean. OHPI’s mission was to develop mechanisms to transfer knowledge gained from the School’s research and scholarship to people who could use it—policymakers, journalists, and the general public. Winsten also served as Director of Foundation and Government Relations.

In 1985, HSPH Dean Harvey V. Fineberg asked Winsten to conceptualize, develop, and direct the first university-based Center for Health Communication (CHC). The Center had three primary objectives: to demonstrate how an academic institution could harness the power of mass communication to promote widespread adoption of healthy behaviors; to strengthen the quality and prominence of news coverage of public health problems and solutions; and to help prepare future leaders in public health to effectively execute the public-communication components of their responsibilities.

Under Winsten’s leadership, the Center created the first mid-career fellowship program for journalists who cover public health and medicine; offered courses and seminars on health communication; convened researchers and practitioners to examine how strategic communication can influence public policy, social norms, and individual behavior; tested strategies to harness the power of mass communication to advance the public’s health, leveraging broadcast TV, advertising placements, and other tactics to promote healthy behavior; and published recommendations for the design and conduct of local and national media campaigns to advance the public’s health.

The Center became best known for spearheading the National Designated Driver Campaign—the first successful effort to mobilize the Hollywood entertainment community to support a pro-social cause. Launched in 1988, the campaign demonstrated how the "designated driver" concept could be imported from the Nordic countries and rapidly diffused through American society via mass communication, thereby catalyzing a fundamental shift in social norms relating to driving-after-drinking (the leading cause of death among young adults in the United States).

At the Center’s request, television writers and producers depicted the use of designated drivers within fictional story lines of more than 160 prime-time TV episodes during four television seasons starting in 1998. The campaign was endorsed by unanimous resolution of the board of directors of the Writers Guild of America, West.  The Center served as catalyst and information source, balancing its advocacy with respect for writers’ creative freedom. Dr. Frank Stanton, former CBS president, and Grant Tinker, former NBC chairman, were instrumental in opening doors for Winsten in Hollywood.

A 1991 Roper Poll found that 52% of Americans under 30 had served as a designated driver or been driven home by one. Among frequent drinkers of all ages, 54% had been driven home by a designated driver. Reflecting the concept’s new-found prominence, the term “designated driver” appeared in the Random House College Dictionary in 1991. Alcohol-related traffic fatalities declined by 25% between 1988-1992, compared to 0% change in the preceding three years; non-alcohol-related traffic fatalities fell by only 5% between 1988-1992. The campaign was credited as an important factor, among other factors, contributing to the downward trend.

 A report from the Henry J. Kaiser Family Foundation stated, “The National Designated Driver Campaign developed by the Harvard School of Public Health’s Center for Health Communication, is widely considered to be the first successful effort to partner with the Hollywood community to promote health messages in prime-time programming.”

The Chronicle of Philanthropy reported, “Many grant makers say it was the success of the campaign that persuaded them that skillful work with news and entertainment media can bring about social change."

In 1999, Dean Barry R. Bloom revised the School’s mission statement—for the first time since its founding in 1923—to elevate “communication” to a position of prominence alongside research and education, as reflected in the 1999-2000 Course Catalogue: “Our overarching mission is to advance the public's health through learning, discovery, and communication."

Other CHC campaigns followed over the next 25 years, including initiatives to help prevent youth violence, recruit volunteer mentors for young people from underprivileged circumstances, eliminate the depiction of tobacco smoking in movies rated for young audiences; and reduce road fatalities and injuries caused by distracted driving.