Criterion #5 Does the story commit disease-mongering?


Sometimes “new” conditions or diseases aren’t really health problems at all — they’re actually just opportunities for those who stand to gain by medicalizing (and monetizing) normal states of health, known as disease-mongering. Readers aren’t well-served by stories that exaggerate or oversell conditions.

disease mongering

19% of the news stories we’ve reviewed were rated Not Satisfactory on this criterion.

There are different forms of “mongering,” including:

  • turning risk factors into diseases, with the implication that, then, these must be treated (e.g., low bone mineral density becomes osteoporosis);
  • misrepresentation of the natural history and/or severity of a disease (e.g., early-stage low-grade prostate cancer);
  • medicalization of minor or transient variations in function (e.g. temporary erectile dysfunction);
  • medicalization of normal states (aging, baldness, wrinkles, shyness, menopause);
  • exaggeration of how common a disorder is (e.g., using rating scales to ‘diagnose’ chronic dry eye; see “not satisfactory” story examples below).

Identifying disease mongering is a matter of judgment. Sometimes it is obvious. Sometimes there’s a fine line about whether an article on irritable bowel disorder, erectile dysfunction, restless leg syndrome or osteoporosis (all of which can be serious for some sufferers) is misrepresenting the condition to the public.

Note: Most of the conditions we list are not life-threatening. The grand-daddy of disease-mongering is fixating on LDL cholesterol numbers instead of evaluating whether studies showed a change in how well or how long people live–and whether treatment results in fewer cases of heart disease or fewer deaths.

Beware of statistics that may inflate the seriousness of a condition. Beware of articles that exaggerate the human consequences of a condition – “millions of us are suffering in silence with toenail fungus.” Suffering?

Beware of interviews with “worst-case” patients – holding such patients up as examples as if their experiences were representative of all with this condition.

We also think it’s useful to discuss the prevalence of the condition under discussion–and if that prevalence could possibly be inflated.

Gary Schwitzer is publisher of HealthNewsReview.org:

Satisfactory examples

Informative, intelligent coverage of osteoporosis drug tradeoffs
When discussing osteopenia, the Wall Street Journal story included a quote from an expert that osteopenia “isn’t a disease. It merely tells us that bone density is in the lower part of normal range. There are an awful lot of people who fall into that category who may never get osteoporosis.” Hurray for paragraphs like this one, which help readers understand what a potentially scary medical term actually means and tells them not to panic.

Washington Post wisely quantifies severe side effects and deaths from CAR-T cell therapy
The story does not engage in disease mongering, and did a nice job discussing the prevalence of this type of cancer. It states: “The treatment is for adults with certain types of large B-cell lymphoma who have not responded to or who have relapsed after at least two other kinds of treatment, such as chemotherapy and bone-marrow transplants. The group numbers about 7,500 patients a year in the United States.”

New surgical method for uterine fibroids gets thorough look by Inquirer
The Philadelphia Inquirer story does a good job of avoiding disease mongering, saying that fibroids often cause no symptoms and that they only rarely affect fertility or can be cancerous.

Not Satisfactory examples

Classic disease-mongering: Fox News story on Marisa Tomei’s struggle with chronic dry eye
This is pretty clearly as over-the-top disease mongering as you’ll find, and the helpful-sounding self-diagnostic questionnaire is a huge red flag indicating that people are about to be turned into patients. Also, turning chronic dry eye into an acronym–“CDE”–elevates it to medical jargon status.

Five Nobel laureates backing antiaging dietary supplement
The premise of the new supplement — one that is never challenged by the Boston Globe story — is that aging is somehow a “condition” that needs to be treated with a new medicine. Loss of muscle and other aspects of aging are normal changes that people experience as they age — not conditions in need of a cure. The framing of aging as a “condition” opens the door to expensive and untested approaches that waste money and encourage the use of more pills that can interact unpredictably. The story should have done more to resist this framing.

Reuters story on new drug for excessive sweating was less informative than the news release
We’re told in the story that about 3.9 million Americans suffer from excessive underarm sweating. But based on what analysis? What’s the source for that figure, and is it trustworthy? Sweating is something every single human does–abundantly–so is it really a disease?

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