Head To Head

Does celebrity involvement in public health campaigns deliver long term benefit? No

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e6362 (Published 25 September 2012) Cite this as: BMJ 2012;345:e6362
  1. Geof Rayner, honorary research fellow
  1. 1City University London, London, UK
  1. mail{at}rayner.uk.com

Simon Chapman (doi:10.1136/bmj.e6364) thinks that the extra publicity that celebrities provide can help promote public health, but Geof Rayner is worried about the insidious influences of celebrity

Can celebrity involvement deliver long term benefit for public health? The short answer is no, for the logical reason that celebrity status is fleeting. Celebrities might impart a short term boost to campaigns—Jamie Oliver showed this at a time when the school meals campaign was wallowing in obscurity—but as the noble Oliver would doubtless accept, celebrities must tread a cautious path of support because of the risk that the celebrity becomes the story, not the campaign.

It’s not until you start delving into the role of celebrity culture on health that the negatives begin to stack up. What celebrity culture does so effectively is promote icons of rampant consumerism and fantasy lifestyle. It’s hardly chance that our society’s manufactured obsession with celebrities has coincided with a period of starkly rising inequality. Multimillionaire football “stars”—mostly from working class backgrounds—give the lie to the idea that anyone can make it or that vast incomes are justified “because I’m worth it.”

Unhealthy influences

Celebrity culture is a by-product of a society experiencing social isolation and loosening social bonds. We know more about celebrities than our extended families. We could hardly not: they are pushed in front of our eyes from all directions. In establishing an emotional attachment to celebrities they become, in effect, the friends we do not know. In truth, celebrity personas are largely fictional, and the individuals themselves less important than the mechanisms that promote them, with reality television shows such as the X Factor creating a production line of replacements.

Economists argue we’ve become a “winner takes all” society, with money and fame filtering to those at the top.1 Celebrities are measured, ranked, and valued by income, status, and product sponsorship possibilities. The US magazine Forbes provides an “annual celebrity 100” list. Those on the list in 2011 earned $4.5bn (£2.8bn; €3.5bn) collectively, a rising proportion of which came from product endorsement. It’s a celebrity’s job to tell people what to wear, what cosmetics to use, or what to eat. Not so long ago one celebrity entertainer, Ronald Reagan, told people what cigarettes to smoke.

Always-on social media feeds celebrity culture. Stephen Fry, the comic actor, has 3.7 million followers on Twitter; pop star Lady Gaga has 8 million and Justin Bieber a staggering 16.4 million. Feeling low after his recent tour, the singer tweeted, “I love my beliebers. Thanks for making me feel better.” The principles are clear: in exposing or inventing their lives celebrities play the role of substitutes, avatars, projections, and proxies. Followers are encouraged to live with them, through them, and possibly for them. The collective mental health effect of these fake friendships remains to be assessed.

Celebrity endorsement

Celebrities help shift products, that much is certain. Perhaps it’s not just economics but also evolution? Our ancient ancestors, forced to choose among potentially lethal wild berries, picked what they recognised. In our image drenched consumer society, our mental equipment receives many thousands of images daily but our subconscious records only a minority and only a few reach through to our conscious behaviour. Even if we don’t actually like the celebrities in the advertisements or voice-overs, the recognition rubs off on the product. But cognitive heuristics can’t explain the power of celebrity any more than genetics explains obesity. Celebrity has become mainstream marketing strategy, even of public bodies like the BBC. It’s even an issue of politics, with Boris Johnson, the mayor of London, overtaking all other UK politicians in the popularity stakes after the publicity associated with this summer’s Olympics.

The mingling of celebrity, business, and politics is hardly new. Possibly the first to employ the power of persona to sell products was Lydia Pinkham (1819-93), America’s first female millionaire. Her bottled restorative elixir for women (in fact, a 40% proof spirit) carried her face, making her recognisable to millions. Her modern analogue could be the actress Gwyneth Paltrow, who through her website encourages her fans to purchase “doctor-formulated” patent remedies like protein shakes and food supplements. Thankfully her widely promoted colon cleansing routines do not form part of the package.

Longer term solutions

New measures are certainly needed to promote public health. Campaign groups like 38 Degrees bring together the lobbying power of thousands of ordinary people through the internet. In the future health campaigners must be nimble across multiple levers of change. Rather than relying on media stunts they need to look to legal action and perhaps more local campaigns—by us, not for us. We can draw inspiration from the old sanitarian movement, whose campaign to clean up a dirty world succeeded, often with unpopular people at the helm.2

Modern health campaigners need to go on the offensive against junk food, alcohol, gambling, and other often celebrity linked, commercial propaganda. Some celebrities might help, but let’s not look for saviours, buoyed by the happy thought that the work is done when a celebrity is involved. That’s a lie too.


Cite this as: BMJ 2012;345:e6362


  • Competing interests: The author has completed the ICMJE unified disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declares no support from any organisation for the submitted work and no financial relationships with any organisation that might have an interest in the submitted work in the previous three years; GR was formerly chair of the UK Public Health Association and board member of No Smoking Day and many other health campaigns. He is chairman of the photography organisation Photofusion.

  • Provenance and peer review: Commissioned; not externally peer reviewed.


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