Communication Policy to Reduce Health Disparities: A Cross-Language Content Analysis of YouTube Television Advertising

IntroductionThis study aimed to identify disparate health-related marketing across English- and Spanish-language television networks in New York City (NYC), ultimately to inform policy that can counteract disproportionate health-related marketing that provides harmful content to, and withholds beneficial information from, Latinx populations.MethodsA two-week composite sample of primetime English-language (NBC and CBS) and Spanish-language (Telemundo and Univision) television networks from YouTube TV was randomly drawn from September 7-27, 2022 in NYC. A total of 9,314 health-related television advertisements were identified for systematic media content analysis and coded into categories: alcohol, core or noncore foods/beverages, mental health/tobacco prevention, health insurance, medical centers, and pharmaceuticals. Analyses conducted in 2022-2024 included intercoder reliability, and descriptive and rate difference estimates using total advertisement broadcasting time in the full sample and sub-samples by language networks on YouTube TV.ResultsCompared to NYC primetime English-television networks, Spanish-television networks broadcasted greater health-adverse advertisements per hour for alcohol (Rate Difference [RD]=4.91; 95%CI=3.96,5.85) and noncore foods/beverages (RD=13.43; 95%CI=11.52,15.34), and fewer health-beneficial advertisements per hour for mental health/tobacco prevention (RD=-0.99; 95%CI=-1.45,-0.54), health insurance (RD=-1.00; 95%CI=-1.44,-0.57), medical centers (RD=-0.55; 95%CI=-1.23, 0.12), and pharmaceuticals (RD=-5.72; 95%CI=-7.32,-4.11).ConclusionsMulti-level policy innovation and implementation is required to mitigate primetime television marketing strategies that contribute to health inequities.