The coverage of prostate cancer and impotence in four popular men's magazines (1991-2000).

The purpose of this study was to explore popular press coverage of two men's health issues, prostate cancer and impotence, in four magazines with large male readerships. The four magazines examined were: Gentleman's Quarterly, Esquire, Men's Health, and Ebony published between 1991 and 2000. Content was compared between the first half and the second half of the decade, which featured a public cancer education campaign; the release of the impotence drug, Viagra[R] (sildenafil citrate); and large increases in magazine advertising revenue from drug companies. Results show magazines ran more articles on prostate cancer and impotence after 1995; coverage was usually presented in an informational manner; content provided information on prevention, diagnosis, and treatment of the diseases; and men wrote most of the stories.

Keywords: men's health issues, prostate cancer, impotence, media/magazine coverage, Viagra[R]

**********

Managing personal health and health-related behavior is an intricate and complicated process. Pinpointing exactly what makes a person decide to take some action concerning his or her health would be an enormous task. Studies have shown the media are useful resources for health information for people in their decision-making process (Wright, 1975; Yows, 1991). Within the larger population of the mass media are popular magazines. Magazines targeted to the male audience, or magazines with large numbers of male readers, can be a source of health information.

Discourse concerning men's health must first attempt to define exactly what may be considered "men's health." The topic can be described as the prevention and diagnoses of illnesses that afflict the male population. Men's health should also include the personal well-being and quality of life of men. Some of the more prevalent health issues identified include cardiovascular or heart disease, diabetes, prostate issues, sexually transmitted diseases and other communicable diseases, erectile dysfunction or impotence, suicide, cancer, and accidents/injuries (Men's Health Network, 2001). In recent years, more consumer magazines are attempting to include health-related information in their stories (Featherstone, 1998; Reese, 2000). In addition, during the past 10 years, support groups have attempted to draw media attention to two health-related issues, prostate cancer and impotence (Reese, 2000).

According to the Centers for Disease Control (CDC), prostate cancer is the second leading cancer, after skin cancer, diagnosed among men in the United States. Prostate cancer is also second only to lung cancer as a cause of cancer deaths. The American Cancer Society predicted 180,400 new cases of prostate cancer would be diagnosed in 2000 and that approximately 31,900 men would die of the disease (CDC, 1999). The incidence rate among African-American men is also very high. According to the Surveillance, Epidemiology, and End Results (SEER) data, U.S. blacks have the highest rates of this cancer in the world (Wilcox, 1998). The mortality rate for black men is also twice as high as the mortality rate for other men (PCPRG, 1998). In general, 80 percent of the clinically diagnosed cases of prostate cancer occur with men aged 65 years or older (CDC, 1999).

Another significant issue concerning men's health is impotence, medically known as erectile dysfunction. The primary cause of impotence is a narrowing or clogging of penile arteries due to arteriosclerosis. Implications from prostate cancer, most notably nerve signal damage, have been linked to impotence ("Ten Overturned Health 'Truths,'" 2000). However, impotence is also related to anything that promotes clogged arteries--including inactivity, a diet high in saturated fat, and smoking or causes from impaired nerve function, such as diabetes. Reports indicate as many as 30 million men in the United States may have varying degrees of erectile dysfunction (Lipman, 1998).

Because prostate cancer and impotence occur in a part of a man's body associated with sexuality, the impact on masculinity is an important consideration. Researchers have suggested that a pattern of hegemonic masculinity exists in U.S. society that relates to how men approach health problems (Schofield et al., 2000). The emphasis on machismo results in men ignoring health problems and resisting visits to the doctor because admitting weakness can be seen as a threat to their identity. Men's bodies are seen as instruments that they use to prove to themselves and others that their masculinity is intact (Seidler, 1997). Sexual activity becomes a way of confirming manhood. Prostate cancer and impotence are threats to male masculinity and sexuality that can have psychosocial implications resulting in a loss of selfesteem and sexual self-concept (Bokhour et al., 2001).

There are two medical benchmarks concerning prostate cancer and impotence, which involve the medical community's attempt to involve the media in a discourse about these issues. Since 1966, the Prostate Cancer Initiative (PCI), a national program developed by the American Cancer Society (ACS) and the Cancer Research Institute (CRI), has served clinical research, patient care, and public education needs (ACS, 2001). One such effort began in 1997. CRI (1997), along with US TOO, the largest men's cancer organization in the world, launched an educational initiative to educate men about the detection, diagnosis, and management of the disease. The Prostate Review Group, composed of more than 100 members of the prostate cancer communities, also met in 1997 to advance research and education of the disease (PCPRG, 1998).

The second noteworthy development in male-related health issues came in 1998 with the release of the drug sildenafil citrate, aimed at assisting the problem of impotence (ACS, 2001). Sildenafil citrate is best known by its brand name, Viagra[R]. The drug was originally designed to treat angina until patients reported an increase in erections as a side-effect (Ault, 1998). The drug's producer, Pfizer Corporation, then re-released and branded it as a possible treatment for erectile dysfunction. Pfizer has claimed the drug makes it possible for men with impotence to have an erection when aroused (Viagra-Rx.net, 2001). The erection occurs because Viagra[R] widens dilated penile blood vessels (Lipman, 1998). Immediately after the Food and Drug Administration approved Viagra[R], public interest and curiosity about its ability fueled the demand for the drug. Almost three million prescriptions were written for Viagra[R] in the first three months of its release (Lipman, 1998).

This paper suggests that the education program about prostate cancer and the publicity concerning Viagra[R] provide an opportunity to compare magazine coverage concerning men's health topics. Popular men's magazines, like most media, aim to follow readers' concerns and interests. Theoretically, a magazine provides content to attract, inform, and serve the reader, thereby ensuring an audience for its advertisers. Part of the responsibility of a men's magazine to its readers would be to provide health information on topics that impact their well-being. That is not its only objective. Economic, political, and organizational constraints impact all forms of media production (Croteau & Hoynes, 2000). At times, those factors may influence the decision-making process to varying degrees. In the past decade, the concentration of media ownership has emphasized the importance of the business side of the media industry.

Popular men's magazines have another incentive for including health-related topics: advertising dollars. Pharmaceutical advertisers have increased their spending in all magazines dramatically during the past 11 years. Direct-to-consumer drug advertising in magazines totalled only $12 million in 1989 but increased to $313 million in 1995 and $600 million in 1996, 1997, and 1998 (Case, 1999; Colford, 1997). Those numbers soared to more than $900 million in 1999 and more than $1.1 billion in 2000 (MPA, 2001). The 75-fold increase during that time represents an astronomical surge in spending by the pharmaceutical industry. In comparison, total media advertising revenues in the United States rose from an estimated $126 billion in 1991 to more than $200 billion in 1999, an increase of 59% (Cardona, 2000; Coen, 1992). Thus, advertising spending by pharmaceutical companies was expanding at a much faster rate than advertising revenue in general.

In their attempts to maintain or seek advertising revenue, editorial staffs at some magazines have felt pressure to provide advertisers with favorable content. This "mutual back-scratching" is evidenced by advertorial sections, single-sponsored issues, and special ad sections (Brady, 1993; Kerwin, 1997). Questions about editorial integrity were traced to the placement of ads next to favorable stories about products (Brady, 1993; Goldberg, 1996). Most magazine editors claim that giving favorable editorial considerations to advertisers is taboo (Goldberg, 1996). In their defense, these editors argue their primary concern is providing value that serves the readers' best interests.

LITERATURE REVIEW

This study is one of the few to examine how men's health issues have been covered in popular magazines. While a number of researchers have explored the coverage of general health topics in magazines, the search found only one specific to men's health. Clarke (1999) examined select print articles on prostate cancer between 1974 and 1995 but found only 35 articles on the topic over the 20-year time span. Shaulis (1998) analyzed exercise messages in magazine articles from 1925 to 1968. The study concluded that exercise information from the magazines during that period (1925 to 1968) was often incomplete and/or emphasized quick results. Inaccurate information was also found in an examination of magazine coverage of mental health topics. For instance, Barton (1996) found that many magazines provided a negative image of mental health services.

Some research has focused on a particular health concern, for instance, cigarette smoking. One study in particular examined the coverage of smoking-related dangers in article content and the presence of cigarette advertisements in U.S. magazines. The authors found support for the belief that the magazines restricted their coverage of smoking dangers out of fear of economic reprisals by tobacco advertisers (Warner, Goldenhar, & McLaughlin, 1992). A similar study analyzed editorial and advertising content of six women's magazines for the coverage of smoking-related health hazards (Kessler, 1989). After finding no substantive coverage of any of the health hazards associated with smoking, Kessler (1989) also argued that tobacco advertising revenue and the lack of coverage were connected.

Most of the research on health coverage in magazines has focused primarily on content in women's magazines. Miller (1980) examined the coverage of health-related content in six women's magazines between 1976 and 1978. Miller stated that magazines served as a major source of health information, which emphasized promotion, practices, and preventative orientation. However, that study is one of the few to praise the print medium's efforts to raise the public's awareness of health issues.

In the past decade, several scholars have provided arguments that the print media's treatment of public health issues has been both sparse and superficial. Sacks (1991) examined seven women's magazines for their coverage of national health promotion and objectives. The author found only limited coverage of information concerning many health problems that affect women. In an analysis of articles about breast cancer, Olive (1996) reported that women's magazines provided contradictory information on screening guidelines and failed to report the power women have in battling the disease. Another study showed women's magazines gave their readers very little information about the risks and treatment of colon cancer (Gerlach, Marino, Weed, & Hoffman-Goetz, 1997). Reed (1990) examined women's magazines for the existence of "mobilizing information," which might encourage readers suffering from eating disorders to take some action concerning their dilemmas. Reed found 51 articles about the topic in 14 magazines during the 1980s with less than half of them containing specific mobilizing information. While women's magazines were found to provide a sustained level of coverage concerning rape, Benedict (1994) found the articles upheld some of the myths of rape and often reported only the titillating aspects of the crime. In sum, these studies typify the need for better coverage of all health-related issues to the general public.

Medical and media scholars have established the research area of press coverage concerning health issues, primarily focusing on women. What is missing is the beginning of the study of men's health coverage. This purpose of this study is to lay a foundation for that research. Based on past research, the following research questions guided this study:

RQ1: What kind of coverage did four magazines with large numbers of male readers provide about prostate cancer and impotence in the past decade?

RQ2: Did coverage about prostate cancer in those magazines change in the 1990s?

RQ3: Did coverage about impotence change during the decade?

METHOD

SAMPLE

This study examined article content in three magazines directed toward a male audience in the United States and one directed at African Americans. The magazines were Men's Health, Esquire, GQ (Gentleman's Quarterly), and Ebony. Each of the magazines emphasizes lifestyle and/or health-related issues.

* Men's Health: Information for men on fitness, nutrition, sports, self-care, relationships, work, and travel.

* Esquire: A lifestyle magazine for professional men 30-49 years old.

* GQ: Fashion and lifestyle magazine for men.

* Ebony: A general interest picture magazine, which concentrates on stories of primary interest to African-American readers. (Standard Periodical Directory, 1999)

Of the men's magazines, Men's Health has the largest circulation, more than its two closest competitors, GQ and Esquire combined (see Table 1). While lifestyle magazines like GQ and Esquire used to focus primarily on news, fashion, and male fantasies, they have allocated more pages to men's health and fitness in recent years (Featherstone, 1998). Ebony was selected for this study because prostate cancer has a higher rate of incidence among African-American men. The magazine has a large circulation, but its male readers constitute fewer than half of that number. Another compelling reason for including Ebony is that it has the highest readership of any magazine among black men (32%), outdistancing both Jet (26.7%) and Sports Illustrated (23.4%) (MRI, 2003). That percentage is further supported by marketing reports that show 35 percent of African-American men read any type of men's magazines and only 15 percent of African-American men read health magazines (MRI, 2003).

A limitation of the data from the four magazines should be noted. More than half of the male readers of each of the four magazines were 44 years old or younger (Table 2). While impotence can strike men of any age, the American Cancer Society recommends that men who do not have any serious medical problems should be tested for prostate cancer at age 50, while men at high risk should begin testing at age 45 (ACS, 2005). These four magazines may believe prostate cancer is not a serious health issue for the majority of their readers.

Data were collected from the four magazines during a 10-year period, 1991 through 2000. That period was selected due to the increased education campaign effort about prostate cancer, the introduction of the impotence drug, Viagra[R] and the dramatic rise of advertising expenditures in magazines from pharmaceutical companies. During the 10 years, GQ, Esquire and Ebony published on a monthly basis, while Men's Health issued 10 magazines each year (see Table 1). Since it was important to locate all stories relating to the topics, the total population of magazines was examined. The total number of magazines for which data were available was 460. An article was classified as pertaining to the topic if it specifically discussed prostate cancer, impotence, or both health problems.

After each article was selected and read, two coders classified information according to a coding scheme adapted from Miller (1980). The instrument described thematic content (reporting scientific study or offering information only), health education concept focus (orientation toward prevention/diagnosis, treatment, equally divided, and other), references to authoritative sources, references to Viagra[R], references to prostate cancer education, authorship credentials (staff writer, medical professional, professional writer, consumer/reader, and other), and the gender of the author. There were two coders for this study (see Code Sheet). A Holsti's test produced an intercoder reliability score of .91.

RESULTS

From January 1, 1991, to December 31, 2000, 64 articles on prostate cancer and/or impotence were published in the four magazines. Most of the articles focused on prostate cancer (n = 42). Coverage of impotence was found less often (n = 18), while magazines rarely included both health topics in the same article (n = 4). Men's Health published the majority of articles (n = 46), followed by GQ (n = 9), Esquire (n = 6), and Ebony (n = 3).

GQ was the only magazine to provide a fairly equal number of stories on each issue (Table 3). The impotence topic was discussed less than half as much as prostate cancer in Men's Health. Even though 32 percent of Ebony's readers are black men (see Table 1), there was a total absence in the magazine of the coverage of impotence. The three prostate cancer articles during the 10-year span are also insufficient, considering the number of African-American men stricken with the disease (Wilcox, 1998).

The survey period displayed a definite reporting trend. The most articles appeared in 1997 (n = 14) and 1998 (n = 14), while the fewest appeared in 1991 (n = 1) and 1992 (n = 2) (see Figure 1).

[FIGURE 1 OMITTED]

The first research question of this study was to explore the content in stories dealing with the two health issues. Across all years studied, data indicate content of the articles relied primarily on information about the illnesses (70.3%). Content reporting a scientific study appeared less frequently (29.7%).

The health education concept focus of the articles was distributed much more evenly than other categories. The magazines published articles on prevention and diagnosis (40.6%) only slightly more often than on treatment (34.4%). Both education concepts were discussed 25% of the time.

The articles' authors used authority figures as a source of their information in most stories. Authoritative sources were found in 76.6% of the articles.

The majority of the articles were written by a professional writer or named staff writer (82.8%), followed by noncited staff members (15.6%) and medical professional (1.6%).

Male writers (81.3%) authored most of the stories. Only two female writers (3.1%) wrote prostate cancer and/or impotence articles during the period. Anonymous authors (15.6%) accounted for the rest of the findings.

Research questions two and three in this study asked whether there were any changes in coverage of prostate cancer and impotence in the 1990s. In order to investigate this subject, the articles' publication dates were merged into two new variables. The decade was split into two equal sections, 1991 through 1995 and 1996 through 2000. One of the justifications for the division is that several cancer organizations implemented a national educational and promotional campaign about prostate cancer in 1996 (ACS, 2001). Another reason concerns the publicity prior to and immediately following the release of the impotence drug Viagra[R] in 1998 (Lipman, 1998). Finally, magazine advertising revenues from pharmaceutical companies, which would possibly benefit from increased public knowledge of drug therapies and testing devices for these health issues, doubled in 1996 (Colford, 1997).

Results show that when the decade is split, the coverage of prostate cancer and impotence changed. As Figure 2 shows, the coverage of prostate cancer was significantly different during the two periods. The disease received more coverage during 1996-2000 (n = 32) than during 1991-1995 (n = 0). Analysis of the coverage of impotence showed increases in the second half of the decade as well. Magazines discussed the topic only slightly more often after 1995 (n = 11) than before (n = 7).

[FIGURE 2 OMITTED]

DISCUSSION

This study showed that information about the prevention, diagnosis, and treatment of two major men's health issues, prostate cancer and impotence, has increased in selected media during the 1990s. The only other study on this topic found only 35 articles in selected magazines between 1974 and 1995 (Clarke, 1999). The four men's magazines studied in this research easily surpassed that number in less than half the time. Whether the push to include more of this information in magazines with large numbers of male readers has come from cancer awareness groups, the major U.S. drug companies, or independent editorial decision making is not known. However, some questions can be raised about the ties between pharmaceutical companies, advocacy groups, and journalists.

The largest sponsor of medical research in the U.S., and consequently the largest disseminator of information concerning that research, is the pharmaceutical industry (PHRMA, 2005). The goals of a pharmaceutical company's marketing department include having supportive articles in specialist journals and the mainstream press (Lancet, 2002). The industry has been shown to provide incentives to journalists in order to generate publicity about the release of a drug and its potential benefits (Sweet, 2001). Controversy arose in the 1990s regarding the number of impotency stories that appeared in the Australian media when it was reported that Pfizer sponsored journalists to attend an impotence conference in Paris (Sweet, 2001).

The pharmaceutical industry has also attempted to build alliances with advocacy groups to gain endorsements when marketing drugs (Bittar, 2001). As prescriptions for Viagra[R] fell off, Pfizer started an education campaign for erectile dysfunction (Freeman, 1999). The pitch from anti-impotence drug manufacturers was designed to make erectile dysfunction appear to be an "inevitability of middle age" (Fass, 2003). Does raising consumer awareness produce an informed patient or undermine a doctor's authority to determine the best treatment?

Beyond the quantitative data analysis, a qualitative examination of the content provides some support for the problems men have in dealing with health issues. The discourse in articles recognized the sensitivity necessary in presenting serious health topics to a male audience. A recent study has shown that men are three times less likely than women to go to a doctor (Reese, 2000). The study also indicated that, when men are sick, they usually wait as long as possible to seek medical attention (Reese, 2000). The articles analyzed in this study usually acknowledged that many men do not tend to their health needs often enough. However, an effort to integrate health and illness into regular magazine coverage has the potential to overcome attitudinal and psychological barriers to healthy behavior.

Past research on the media's coverage of health topics has demonstrated that effective and accurate communication is also essential (Gerlach, Marino, Weed, & Hoffman-Goetz, 1997; Olive 1996; Sacks, 1991). Understanding men's fears of health topics, the messages in magazine articles have had to follow different guidelines. Jean Bonhomme, president of the Black Men's Health Network, stated, "The health care system needs to present itself as a partner to men's masculinity. It needs to be positioned as a way for men to maintain strength, performance and virility" (quoted in Reese, 2000, p. 6). There was some support that discourse in these magazines was framed in a way that drew men's attention away from their fears. Many articles used masculine terms as a substitution for penis, such as "plumbing parts," "private parts," "male plumbing," "the Willy," "Mr. Happy," and "muscles of love." The manly descriptions also continued for the word "impotence." Some authors phrased erectile dysfunction as "die hard," "all rise," "raising the dead," and "raising the Titanic." Since the results of this study showed that men wrote most of the articles, the authors were apparently speaking in terms they felt their audience would prefer.

This study's findings show that beyond the superficial language choices, selected magazines are addressing the important issues dealing with prostate cancer and impotence. The articles discussed prevention measures and the promotion of lifestyle changes for each disease. Information concerning prostate cancer usually contained references to PSA screening. Medical care and treatment were included as well.

This study is one of the first to examine how the press covers health issues particular to men. The coverage found in these four magazines may represent limited examples. Also, the amount of coverage in Men's Health far outweighs what was found in Ebony. Future studies should include a popular magazine targeted solely to African-American men. Future research might also expand the data base by examining other men's magazines. The coverage of other health-related topics, like heart disease, should also be investigated.

In the past decade, popular magazines have started the process of educating U.S. men about prostate cancer and impotence. The responsibility for progress lies not only with the media but also with the key players in health issues: nonprofit and government policy organizations and pharmaceutical companies.

Correspondence concerning this article should be addressed to William Hoon, Western Illinois University, 313 Sallee Hall, Macomb, IL 61455. Electonic mail: [e-mail].

REFERENCES

American Cancer Society (ACS). (2001). Prostate cancer: What is it? Retrieved April 5, 2001, from http://www.cancer.org/cancerinfo/load_cont.asp?st=wi &ct=36&language=english.

American Cancer Society (ACS) (2005). How is prostate cancer found? Retrieved March 8, 2005, from http://www.cancer.org/docroot/CRI/content/ CRI_2_2_3x_How_prostate_cancer_found_36.asp?sitearea=.

Ault, A. (1998, April 4). First pill for male impotence approved in USA. Lancet, 351, 1037.

Barton, D.A. (1996). Content analysis of mental health topics in high-circulation consumer magazines. Dissertation Abstracts International, 57(08), 4972B.

Benedict, L.F. (1994). Coverage of rape in women's magazines from 1960 to 1990: An index of social change. Dissertation Abstracts International, 55(12), 3671A.

Bokhour, B., Clark, J., Inui, T., Silliman, R., & Talcott, J. (2001). Sexuality after treatment for early prostate cancer: Exploring the meanings of "erectile dysfunction." Journal of General Internal Medicine, 16, 649-655.

Brady, J. (1993). The erosion of editorial integrity. Folio: The Magazine for Magazine Management, 22(13), 36-40.

Case, T. (1999, March 15). Print Rx spending declines as marketers turn to TV. Advertising Age, 70, 52-54.

Centers for Disease Control (CDC). (1999). Prostate cancer: Can we reduce deaths and preserve quality of life? Retrieved April 5, 2001, from http://www.cdc.gov.cancer/prostate/pros98.htm.

Clarke, J. (1999). Prostate cancer's hegemonic masculinity in select print mass media depictions (1974-1995). Health Communication, 11, 59-75.

Colford, P. (1997, October 20). DTC ads: Just what the doctor ordered (direct-to-consumer pharmaceutical ads). Mediaweek, 7, 46-49.

Croteau, D., & Hoynes, W. (2000). Media Society: Industries, images, and audiences (2nd edition). Thousand Oaks, CA: Pine Forge Press.

Featherstone, L. (1998). "Boys will be girls." Columbia Journalism Review, 37, 60-63.

Fine, J. (2001, February 19). Circ still slow for magazines. Advertising Age, 72, 12.

Gadsden, G. (2000). The male Voice in women's magazines. Gender Issues, 18, 49-58.

Gerlach, K., Marino, C., Weed, D., & Hoffman-Goetz, L. (1997). Lack of colon cancer coverage in seven women's magazines. Women & Health, 25, 57.

Goldberg, S. (1996). Do the ads tempt the editors? Kiplinger's Personal Finance Magazine, 50, 45-49.

Hesterman, V. (1987, August). You've come a long way, baby--Or have you? Women's magazines, cigarette advertisements, health articles and editorial autonomy. Paper presented at the Annual Meeting of the Association for Education in Journalism and Mass Communication, San Antonio, TX.

Houn, F., Huerta, E., & Lemon, S. (1995). The association between alcohol and breast cancer: Popular press coverage of research. American Journal of Public Health, 85(8), 1082-1086.

Kerwin, A. (1997, October 27). Advertisers are from Mars, editors are from Venus ... if only this usually happy couple would stop fighting in public. Advertising Age, 68, 1-4.

Kessler, L. (Summer 1989). Women's magazines' coverage of smoking-related health hazards. Journalism Quarterly, 66(2), 316-322,445.

Lipman, M. (September 1998). Viagra: A potent pill for potency problems. Consumer Reports on Health, 10, 11.

Magazine Publishers of America. (2001). MPA factsheet. Retrieved April 26, 2001, from http://www.magazine.org/resources/fact_sheets/adv2_9_01.html.

Mediamark Research, Inc. (MRI). (2003). Fall 2003 Media Demographics report. Retrieved March 7, 2005, from http://www.mediamark.com.

Mediamark Research Inc. (MRI). (Spring 1997). Mediamark research magazine total audiences report. New York, N.Y.: Advertising Research Foundation.

Men's Health Network. (2000). Strategy statement. Retrieved April 19, 2001, from http://www.menshealth.network.org/new_goals.html.

Miller, A. E. (1980). A descriptive analysis of health-related articles in six leading women's magazines: Content coverage and readership profile. (Doctoral dissertation, Southern Illinois University at Carbondale, 1980). Dissertation Abstracts International, 41(02), 0543A.

NCI (National Cancer Institute). (1997) Press release. Retrieved April 19,2001, from http://rex.nci.nih.gov/INTRFCE_GIFS/MASSMED_INTR_DOC.htm.

Olive, T.E. (1996). Cultural and collective stories of health and illness: An analysis of women's stories and media representations of breast cancer. Dissertation Abstracts International, 57(07), 2722A.

Pharmaceutical Research and Manufacturers of America (PHRMA). (2005). R&D investment by pharmaceutical companies tops $38 billion in 2004. Retrieved March 3, 2005, from http://www.phrma.org.mediaroom/press/releases/ 18.02.2005.1128.cfm.

Prostate Cancer Progress Review Group (PCPRG). (1998). "Defeating prostate cancer: Crucial directions for research." Report of the Prostate Cancer Progress Review Group.

Reed, B. (1990). The link between mobilizing information and service journalism as applied to women's magazine coverage of eating disorders. Paper presented at the annual meeting of the Association for Education in Journalism and Mass Communication, Minneapolis, MN.

Reese, S. (2000). Real men don't eat quiche (or go to doctors). Business and Health, 18, 4-6.

Sabo, D. (2000). Men's health studies: Origins and trends. Journal of American College Health, 49, 133-145.

Sacks, S.A. (1991). A descriptive analysis of health-related articles in seven leading women's magazines published in 1989. Dissertation Abstracts International, 57(07), 2421A.

Schofield, T., Connell, R., Walker, L., Wood, J., & Butland, D. (2000). Understanding men's health and illness: A gender-relations approach to policy, research, and practice. Journal of American College Health, 48, 247-256.

Shaulis, D.E. (1998). Exercising authority: A critical history of exercise messages in popular magazines, 1925-1968. Dissertation Abstracts International, 59(10), 3922A.

Standard Periodical Directory. (22nd Ed.) (1999). New York: Oxbridge Communications, Inc.

Ten overturned health "truths." (2000, December). Consumer Reports on Health, 12(1), 4-6.

Viagra-Rx.net. (2000). Frequently asked questions about Viagra. Retrieved April 5, 2001, from http://www.viagra-rx.net/faq.htm.

Vigorito, A., & Curry, T. (1998). Marketing masculinity: Gender identity and popular magazines. Sex Roles: A Journal of Research, 39, 135-153.

Warner, K., Goldenhar, L., & McLaughlin, C. (1992, January 30). Cigarette advertising and magazine coverage of the hazards of smoking. New England Journal of Medicine, 336, 305-309.

Wilcox, W. (Ed.). (1999). Public health sourcebook. Detroit, MI: Omnigraphics, Inc.

Wright, W. (1975). Mass media as sources of medical information. Journal of Communication, 25(3), 171-173.

Yows, S.R. (1991, May). The role of perceived threat in reducing health knowledge gaps. Paper presented at the Annual Meeting of the International Communication Association, Chicago, IL.

CODING SHEET

Magazine:
   1 GQ
   2 Esquire
   3 Ebony
   4 Men's Health

Date: Month and year of publication

Health issue:
   1 Impotence
   2 Prostate cancer
   3 Both

Thematic content:
   1 Reporting scientific study
   2 Offering information only
   3 Fictional account

The focus of the article:
   1 Prevention/Diagnosis oriented
   2 Treatment oriented
   3 Equally distributed between prevent/diagnosis and treatment
   4 Other

Reference to authoritative source:
   1 Yes
   2 No

Reference to Viagra[R]:
   1 Yes
   2 No

Reference to prostate education initiative:
   1 Yes
   2 No

Authorship--credentials:
   1 Not cited, staff
   2 Cited-medical professional
   3 Cited-professional writer
   4 Consumer/reader
   5 Other

Authorship--gender:
   1 Male
   2 Female

WILLIAM HOON

Western Illinois University, Macomb, IL

Table 1
Profile of Four Leading Men's Magazines

Title of       Frequency   Circulation     Percent        Percent
magazine                                 male readers      black
                                                        male readers

Esquire         Monthly       717,113       69.3%           4.8%

Ebony           Monthly     1,732,117       49.2%          32.0%

Gentleman's     Monthly       814,804       75.3%           9.5%
Quarterly
(GQ)

Men's Health   10 x yr.     1,718,319       83.3%          11.6%

Note. MRI (Mediamark Research, Inc.) Fall 2003 Media Demographics.

Table 2
Distribution of Magazine by Age of Male Readers

Age        Ebony         Esquire           GQ        Men's Health

18-24      19.4%          12.8%          20.4%          19.0%
25-34      19.8%          23.8%          32.9%          28.6%
35-44      24.9%          17.9%          27.9%          24.5%
45-54      18.2%          19.2%          11.0%          15.3%
55-64      11.5%          16.2%           6.3%           8.3%
65+         6.2%          10.1%           1.5%           4.3%
Total       100%           100%           100%           100%

Note. MRI (Mediamark Research, Inc.) Fall 2003 Media Demographics.

Table 3
Number of Prostate Cancer and Impotence Articles
Published in Four U.S. Magazines from 1991 to 2000

Magazine title    Impotence   Prostate cancer

GQ                    4              5
Esquire               1              5
Ebony                 0              3
Men's Health         13             33
Total                18             46

Table 4
Number of Issue Topics in Articles Published
in Four U.S. Magazines from 1991 to 2000

Issue

Impotence                                  18
Prostate cancer                            42
Impotence and prostate cancer               4
Total                                      64

Table 5
Frequency of the Author's Credentials
in Articles Published in Four U.S.
Magazines from 1991 to 2000

Author's Credentials

Not-cited, staff                           10
Cited, medical professional                 1
Cited, professional writer                 53