'Health What?' My Long Strange Trip Building Health Communication Inquiry

March 2, 2023

This is an autoethnographic analysis of the 50-plus years I’ve spent passionately promoting health communication inquiry. What a long, strange trip it’s been! This essay is grounded in my long-term commitment to health communication scholarship, establishing this area of inquiry, promoting health communication education, research, and application, building interdisciplinary and interprofessional partnerships, and sharing health communication scholarship broadly.  

I relish the relevance of health communication inquiry for reducing suffering and improving lives, and am tremendously proud of, grateful for (and sometimes amazed by) its sustained growth. Adapting the classic catchphrase from the Saturday Night Live comedy sketch character Chico Escuela recounting his professional baseball career, I would say that “Health communication has been very, very good to me!” Together with many partners, I have been able to nurture this important research area and share where health communication inquiry should go in the future. 

My story begins in the early 1970s when I was an intrepid, headstrong, undergraduate who decided to study Communication and health at the University of Colorado, Boulder. However, I couldn’t find any classes on this topic, or faculty working in health communication. My interest in health communication wasn’t embraced or understood by my faculty mentors who saw it as a rather strange and perhaps even dangerous area of study.  

When I asked about health communication, faculty would often ask me, “Health what? What do you know about health? Do you think you are a doctor? Aren’t you concerned about interfering with health care for those who are seriously ill? Why don’t you stick with established areas of Communication scholarship?” 

When I proposed a dissertation topic several years later as a doctoral student at the University of Southern California that examined doctor-patient communication, none of the graduate faculty felt qualified to direct that line of research. As a result, I had to study another more familiar dissertation research topic. Perhaps the initial resistance I encountered to studying health communication made me even more determined to pursue it? I remain convinced that health communication is a most important area for investigation, research, theory, and application that is central to navigating health and illness, and that with concerted effort, scholars who study it can dramatically help improve health outcomes in society. 

The Power of Health Communication 

I am often asked what motivated me to study health communication? The answer is simple. My mother influenced my choice. She was a licensed physical therapist who worked and studied at the Mayo Clinic before I was born. 

While I was growing up, she delivered care part-time, at home, providing therapy to neighbors and family friends who suffered from serious health challenges like advanced polio, paralysis, muscular dystrophy, and amputation. My mother impressed me by effectively supporting and motivating her patients with engaging interpersonal communication. It helped them cope with serious physical and emotional health problems and enhanced their quality of life. Because of her, I wanted to learn how to use  Communication to promote health.  

Over the years, my interest in the power of health communication was reinforced by varied experiences I had within the health care system where I observed good and bad uses of communication to address health challenges. Those experiences also strengthened my commitment to study health communication. 

Growing the Field of Health Communication 

Even as a student, I had many early opportunities to apply what I was learning about health communication. During my doctoral studies I was able to introduce and teach undergraduate courses on health communication, including with hospital nurses who were required to study communication to earn their undergraduate nursing degrees. I learned a lot by helping these nurses address the many communication challenges they faced in care delivery. As a consultant to hospitals, I conducted in-service communication training programs for doctors, nurses, pharmacists, and therapists, learning about their need for effective interprofessional health communication. Working with practicing health care providers made me aware of how important and complex communication is in the delivery of care and health promotion. 

While completing my undergraduate studies, in 1974, I connected  with other early health communication scholars at the International Communication Association (ICA) conference in Portland, Oregon. Together with this emerging community of fledgling health communication scholars, I helped introduce the ICA Health Communication Division, the first official health communication interest group. Over the next several years, I helped introduce several additional health communication interest groups, including the large and very active NCA Health Communication Division, which I served as the founding Division Chair.  

These interest groups provided new institutional legitimacy to health communication study. I actively supported these groups as an officer, newsletter editor, presenter of conference papers-panels-workshops, and collaborated with interest group members on important health communication research and writing projects, including co-authoring with Barbara Thornton “Health Communication: Theory and Practice,” one of the field’s first comprehensive textbooks. 

A major milestone in my evolution as a health communication scholar occurred when officials at the National Cancer Institute (NCI) invited me in the mid-1980’s to work with them on an important cancer information dissemination initiative, the Physician Data Query (PDQ) program. This initiative collected and shared the latest evidence-based cancer treatment information with physicians around the country. 

The NCI bought out my annual faculty contract from Rutgers University, where I was an assistant professor, and I moved with my then-young family to the Washington, DC area. My job at NCI was to help evaluate and refine this important cancer communication program that had the potential to save millions of lives! I learned so much that year about cancer prevention and control, health promotion, and health communication on a national scale. I expanded my knowledge about the centrality of health information, the effective use of health information technologies, the functioning of major federal health agencies (NIH, CDC, FDA, NLM), and about conducting big science, evaluation research, intervention science, and community-based-participatory research which  all became central parts of my work for the next 40 years as an active health communication scholar. 

Into the Future  

Informed by my health communication journey that has spanned more than half a century, I suggest eight interrelated directions for future health communication inquiry: 

  • Information is a critically important resource to deliver care and promote health. Health communication research must focus on designing and implementing strategic evidence-based Communication programs, policies, practices, and tools that use multiple media and adaptive messages, to disseminate meaningful, motivating, and actionable health information to health care consumers, providers, and policymakers. 
  • Health information technology is here to stay. We need research that will guide the design of health information systems, which will communicate effectively with different audiences, are easy for people to use, provide information people can understand and apply in their lives, and adapt to changing health information needs over time. 
  • Health communication is both local and global. We need to develop health communication research programs that inform health information practices within and between nations and we need to build both local and global collaborations that address serious health risks, including problems with misinformation, and resistance to adopt important health promotion practices. 
  • The quality of health communication is an important topic for research to help improve active participation in health care and health promotion. Efforts are needed to promote health communication competencies that enable meaningful sharing of relevant information between health care providers and consumers. 
  • Families and communities are central stages for the delivery of health information, support, and caregiving and should be central sites for health communication research. 
  • Health communication surveillance research (social epidemiology) should be conducted regularly to inform the public about imminent health risks, such as pandemics, so preparations can be made to build the health infrastructure for prevention and response needed to address health crises, save lives, and promote quality of life during health emergencies. This means that standing health information tracking programs need to be established and funded to identify emerging problems and share response information rapidly, clearly, and effectively over time. 
  • Policymakers must recognize how important effective health communication is in society. To do that, health communication researchers must inform them about health risks, health care delivery system deficits, and the needs of vulnerable and at-risk populations. Health communication research can help promote health equity in society, within communities, and across and between nations. 
  • We need more large-scale transdisciplinary health communication research initiatives that use “big science”—the study of large representative populations that carefully design and implement appropriate quantitative and qualitative research methods to effectively address important research questions, provide description, implementation, and evaluation data, collect data over time, and work participatively with members of populations being studied. These translational studies will often demand research funding. Health communication scholars need to work closely with funding agencies to conduct these rigorous large-scale studies.  


Gary L. Kreps, is a University Distinguished Professor and Director of the Center for Health and Risk Communication at George Mason University.