Despite its profound influence on public perception across myriad social issues, the entertainment industry continues to largely overlook the pervasive reality of chronic illness, creating a significant disparity between on-screen depictions and real-world health experiences. A recent comprehensive study, spearheaded by the USC Annenberg Inclusion Initiative and supported by Eli Lilly and Company, has starkly revealed this gap, urging Hollywood to embrace more authentic and nuanced portrayals of living with disease. The findings underscore a missed opportunity for storytelling to foster greater understanding, reduce stigma, and ultimately improve public health outcomes.
The Screen’s Enduring Influence on Public Health Perceptions
For decades, film and television have served as powerful conduits, shaping audience perspectives on complex and often sensitive topics. From destigmatizing mental health discussions to fostering greater understanding of addiction and diverse sexualities, the entertainment landscape has historically reflected and, in turn, influenced societal dialogue. However, when it comes to the widespread experience of living with chronic physical illnesses, a crucial aspect of daily life for millions, popular entertainment remains conspicuously silent or, worse, misrepresentative.
The impact of media portrayals extends far beyond mere entertainment. For individuals managing a health condition or caring for a loved one who is, on-screen representation can profoundly influence awareness, challenge prevailing stigmas, and even subtly guide health-seeking behaviors. When narratives resonate with lived experiences, they have the potential to normalize conditions, encourage open dialogue, and empower individuals to take earlier, more informed action regarding their own health.
The Unseen Epidemic: Chronic Illness in America
The prevalence of chronic conditions in the United States is staggering, affecting a significant majority of the population across all age groups. Data indicates that six in ten young adults, eight in ten midlife adults, and a striking nine in ten older adults currently live with at least one chronic health condition. These conditions, ranging from diabetes and heart disease to autoimmune disorders and various forms of cancer, are not isolated incidents but rather woven into the fabric of everyday life for millions of Americans.
Yet, despite this widespread reality, the narratives presented on screen often fail to reflect this demographic truth. The implications of this oversight are substantial, contributing to a lack of public understanding, perpetuating harmful stereotypes, and hindering efforts to address the societal burden of these conditions. The absence of authentic storytelling can leave those affected feeling isolated and misunderstood, while the general public remains largely uninformed about the complexities and nuances of living with chronic illness.
A Landmark Study Reveals the Disparity
Recognizing this critical void, Eli Lilly and Company, a global pharmaceutical leader, partnered with the USC Annenberg Inclusion Initiative to conduct groundbreaking research. The study meticulously examined disease representation across 200 of 2023’s most popular entertainment properties, specifically the top 100 TV series and 100 top-grossing films. Researchers analyzed 8,676 speaking characters to identify patterns and discrepancies in how health conditions were depicted.
The findings painted a clear picture: a significant and concerning gap exists between the real-world prevalence of common diseases and their portrayal in mainstream entertainment. Many of today’s most prevalent chronic diseases were either entirely absent from these popular narratives or relegated to superficial, one-dimensional portrayals that failed to capture the human realities of living with such conditions. This quantitative evidence provides a stark reminder of how Hollywood shapes our understanding of health, often by omission or oversimplification.
Beyond the Numbers: Specific Gaps in Representation
The study delved into specific examples, revealing concerning trends in how certain conditions are depicted, or not depicted at all:
- Obesity: Less than 3% of speaking characters portrayed obesity, despite approximately 37% of Americans living with the condition. Even more troubling, nearly half of these characters were written with unlikeable qualities, and more than one in ten were subjects of jokes or ridicule. This perpetuates harmful stigma and misunderstanding around a complex health issue.
- Underrepresented Conditions: Alzheimer’s disease, dementia, diabetes, and atopic dermatitis each appeared in fewer than 1% of the evaluated characters, despite their widespread impact on millions of lives globally. This near invisibility contributes to a lack of public awareness and funding for research and support.
- Cancer Narratives: When cancer did appear, storylines frequently centered on the most severe stages of illness, treatment, or mortality. Narratives often overlooked the realities of survivorship, long-term management, and the complex emotional and physical journey that extends beyond acute treatment.
- Alzheimer’s and Dementia: Similar to cancer, these narratives predominantly focused on cognitive decline, often at the expense of showcasing the fuller, more complicated realities of living with these conditions, including moments of clarity, the importance of caregiving, and the enduring human spirit.
These findings highlight not just a quantitative deficit but a qualitative one, where existing portrayals often reinforce stereotypes or present incomplete, even misleading, pictures of chronic illness.
The Profound Impact of Authentic Storytelling
Lina Polimeni, Senior Vice President and Chief Marketing Officer, Consumer at Eli Lilly and Company, emphasized the importance of cultural engagement: "Lilly is committed to engaging where culture shapes how people understand disease. When storytelling captures the human realities of living with disease, it can reduce stigma and inspire earlier action." This perspective underscores the pharmaceutical industry’s role in advocating for broader public health understanding, extending beyond medication to the social determinants of health.
Dr. Stacy L. Smith, Founder of the USC Annenberg Inclusion Initiative and the study’s lead author, echoed this sentiment, stating, "Entertainment has the opportunity to lean into the moments that can have a profound impact on us—and in doing so can shape how we think about and approach our own health when we turn off our screens and move in the real world." The opportunity for Hollywood to positively influence how we approach our own health and that of our communities is immense. Authentic representation can empower patients, educate the public, and inspire empathy on a grand scale.
Forging New Narratives: Industry-Wide Collaborations
In response to these findings and to proactively address the representation gap, Lilly is leading a multi-pronged effort. This initiative brings together a diverse coalition of researchers, patient advocates, and influential production partners, including Tribeca Studios, CBS, and Imagine Entertainment. The goal is to foster a collaborative environment where more authentic stories about health can be developed and brought to screen.
A cornerstone of this effort is the USC Annenberg Inclusion Initiative Content Creation Toolkit, championed by Lilly. Developed with invaluable guidance from industry experts and patient advocacy organizations, this toolkit provides practical resources for writers, showrunners, and creators. It offers actionable recommendations and best practices for portraying experiences with illness with greater nuance, accuracy, and empathy, translating academic research into tangible tools for creative professionals. This toolkit is now a foundational resource in Lilly’s broader collaboration with the entertainment industry, aiming to reshape how Hollywood shapes our understanding of health.
The Path Forward: Intentionality and Resources
Authentic and impactful representation is not a byproduct of chance; it emerges from intentional effort and access to the right resources. The process of bringing nuanced stories to the screen requires a conscious commitment from every level of the production pipeline, from initial greenlights to casting decisions and script development. Each choice made along this path directly influences how audiences understand disease and, critically, how they might act on that understanding in their own lives.
Thoughtful storytelling possesses a unique power to build understanding, dismantle stigma, and ignite more informed public conversations about health. By committing to accurate portrayals, the entertainment industry can play a vital role in shifting cultural perceptions, fostering empathy, and encouraging proactive health management. The societal benefits of such a shift are immeasurable, impacting not only individual health outcomes but also broader public health initiatives and policy.
Today, Eli Lilly and Company is actively investing research, resources, and strategic partnerships to empower the industry to make this vision a reality. The stories that culture tells about health fundamentally shape how individuals understand and manage their own well-being. Ultimately, creators hold the pen, dictating which narratives gain visibility and, consequently, how Hollywood shapes our understanding of health for generations to come. For submissions, collaborations, or inquiries about available resources, interested parties are encouraged to reach out to Lilly via [email protected].
