Hollywood has in recent years been undergoing a much-needed, long-awaited transformation in its portrayals of women and people of color in movies and TV. Now, Eli Lilly is hoping to spark a similar change in how common diseases are represented on-screen, too.
The Big Pharma recently sponsored a study by the USC Annenberg Inclusion Initiative that analyzed the 100 highest-grossing movies of 2023 and the 100 most popular TV series of the same year to look for portrayals of obesity, cancer, dementia, diabetes and eczema.
The results proved underwhelming, leading the study’s authors to describe a “disease of invisibility.”
“While movies and Hollywood and pop culture—storytelling in general—represent life, disease and illness are part of everybody’s life … and are almost completely absent,” Lina Polimeni, Lilly’s chief corporate brand officer, told Fierce Pharma Marketing in an interview.
Across the nearly 8,700 speaking characters included in the analysis, the most common of the five conditions was obesity, which was found in only 2.8% of characters—compared to almost 40% of the U.S. population. What's more, these characters were often depicted with negative traits, in superficial roles and as the butt of the joke, therefore “perpetuating stigma around obesity,” the Lilly exec said.
Just 0.16% of the characters included had cancer, even though it’s estimated that 40% of people will be diagnosed with some form of the disease throughout their lifetimes. Those few portrayals also left much to be desired.
“You either don't see cancer, so you think it’s very rare that it happens, or when you do see it, it’s usually a death sentence,” Polimeni said. “And so that creates kind of a sense of hopelessness for people that is actually not the way medicine works, because cancer is very treatable, especially with early detection.”
Even fewer, 0.1%, were shown with dementia. Most were men, even though women are more likely to develop dementia, and almost all were elderly, despite rising rates of early-onset cases among those aged 30 to 64. Even the portrayal of older people with the disease fell short of actual numbers, as just 1.3% of the elderly characters analyzed showed symptoms of dementia, compared to the 4% to 10% of Americans over 65 who have been diagnosed.
Polimeni also highlighted several examples in which characters with Alzheimer’s disease were shown miraculously getting their memories back after connecting with a loved one—which she called “a disservice” to viewers.
“Film and television is kind of how we all create our understanding of life, to some degree,” she said. “There could be people that are thinking, ‘If I only can reach the person I love in the right way, they could regain their memory,’ and not understanding that this is truly a degenerative disease.”
Meanwhile, a single character among the thousands analyzed had diabetes; in the real world, about 10% of U.S. adults have been diagnosed with diabetes, plus another 3% who have not yet been diagnosed.
Eczema was practically nonexistent on-screen: There were no specific mentions of the condition that affects around 7% of U.S. adults, and fewer than 1% of characters had skin symptoms that might indicate eczema.
The study’s findings led to a “big ‘aha’” for Lilly, Polimeni said.
“As an American population, we are living longer than ever, yet 129 million people work with and live with obesity and other chronic diseases,” she said. “And so to see that that is reflected poorly in the content that we consume every day, when the average American still spends over 33 hours a week consuming episodic television—there’s so much potential in making sure that accurate representation is not just about information, it’s more so about creating hope and a full understanding that this is part of the lived experience.”
With that in mind, Lilly plans to use the analysis to encourage more accurate representation of disease on-screen. If sponsoring the study was step one, step two will now comprise “a combination of things that can have short-term impact and long-lasting impact,” Polimeni said.
That’ll include an ongoing partnership with the Annenberg Inclusion Initiative—which she described as “a beacon of influence and a source of authority for this type of conversation within Hollywood”—as well as new team-ups with production studios and other partners throughout the entertainment industry “that are interested in telling the real story of people and understand that disease is part of that.”
Education will be a major component of those partnerships and Lilly’s ongoing work in the space, according to Polimeni.
“I think where we can help a lot as a company is … to get either in the writing room or with people that can influence the writing room and just educate them about what disease is,” she said. “One of the key findings in the discussions following the study has really been the fact that this doesn’t have to change anything—in the sense that you can still write a great comedy line, you can still write a joke, you can still write a great dramatic script, because that’s how life is, and disease is part of that.”
Lilly’s commitment to improving how disease is portrayed in media ties into its habit of “[leaning] into cultural moments and cultural conversations that can help impact health”—as in its 2024 commercials that took aim at obesity stigma and called out off-label use of GLP-1 meds during the Hollywood award season, Polimeni noted.
“As a company, we want people to live longer and healthier lives. Part of that is medicine; that’s one thing that we do,” she said. “But the bigger outcome for initiatives like this is to have an accurate depiction, so that people can have informed conversations and also so that hope can stay alive.”