Detailed information on the AAP Provisional Section on Media, American Academy of Pediatrics.

Links to sites designed especially for teenage girls, from the U.S. Department of Health and Human Services' Office on Women's Health.

E-mail Jen Anderson with questions or comments on this story.

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Market for girls creates issues, awareness 

Erin Attermeier is growing up in a society that places a large focus on advertising, especially to people her age.    (Photo by Jen Anderson)

The Attermeiers’ home on Garfield Avenue is straight from the cover of a home and garden magazine, with yellow brick, quaint arched windows, and climbing vines everywhere.  It is a comfortable house, built for a family, located in a quiet residential corner of Eau Claire 

In this house, Mark and Kathy Attermeier lead a relatively normal life.  He practices family medicine; she is a homemaker with a degree in English education.  They have lived in Eau Claire for 22 years, and have two daughters: a bubbly 13-year-old named Ann, and Erin, who is 15.

Erin is the mellower of the two Attermeier girls.  She wears her hair short and dyed in streaks.  She dresses in loose-fitting jeans and whatever else is comfortable.  She is quiet around strangers but has nothing but smiles for the people she knows. 

She plays hockey and soccer, and sees a lot of movies at the Cameo Budget Theatre downtown.  She likes skateboarding, and does it well.  She likes boys, as most 15-year-old girls do.  She is thinking about joining the Army or the Air Force when she’s old enough, and might become an engineer when she grows up.  She writes poetry and songs for guitar, with the hopes of starting a band.  She dreams.

Erin, like most teenagers in America, also watches television from time to time.  She said she will watch programs on music channels like MTV, that are geared for audiences her age.  She also notices that a lot of the advertisements on those stations are aimed at teenagers. 

It bothers her sometimes when ads seem to target her and her peers, Erin said. 

“I think they’re really annoying after awhile.”

Advertisements and marketing strategies aimed at teens are increasing in response to a growing teen market.  The American Academy of Pediatrics’ Committee on Communications estimates that children in the United States watch approximately 360,000 advertisements on television before they graduate high school.  Also according to the AAP, advertising is entering the classrooms in school, through current events programs like Channel One that run ads in addition to information.  The current debate is over what kind of significant effects this exposure to teen advertising will have on America’s youth.

Studies have already shown that there is a market for teenage girls through magazines.  The Kaiser Family Foundation is a nonprofit organization that provides information to the health care profession, the media, and the public.  The foundation’s 2004 fact sheet indicates that the teen magazine market more than tripled in 10 years, from five magazines in 1990, up to 19 in 2000. 

Also, women’s fashion magazines that cross over into the teen market are becoming more and more popular, with names such as CosmoGirl!, Elle Girl, and Teen Vogue.  The foundation asserts that the most prevalent themes in magazines aimed at teenage girls relate to appearance, dating, and fashion.  Fewer articles focus on themes like self-confidence, family, school and careers.  And, according to the fact sheet, even fewer focus on health-related issues like alcohol, smoking, and sex.

Persistent sellers, persistent dangers: The cigarette and alcohol markets

Alcohol and cigarette advertisements are common in American society, and are highly visible through media such as billboards, magazines, and television.  Experts say that both of these markets have a history of targeting young people.

The National Household Survey on Drug Abuse studies Americans aged 12 and older every year.  In 2000, the survey reported that 41.7 percent of the 12 to 17-year-olds surveyed had used alcohol in their lifetime, and 33 percent had used in the past year.

A research study in 2003 at the Institute for Health Promotion and Disease Prevention Research, part of the University of Southern California’s School of Medicine, measured the links between alcohol use among teenagers and the types of exposure to alcohol advertising. 

Teens from eight schools in the Los Angeles area answered questions on how much television they watched, how often they saw alcohol commercials, how much they liked the commercials, and personal questions about their alcohol usage.

The teenagers also watched clips from commercials for alcohol and non-alcohol products, and then attempted to name the product and brand advertised in each.

The results of the study showed that exposure to alcohol ads was linked in some ways to the use of alcohol among teenagers. 

In addition to alcohol, the tobacco industry has found a market in adolescents in the United States.  According to the AAP, sales to minors total around $476 million every year for Camel brand cigarettes alone.

An update provided by the Food and Drug Administration estimates that teenagers buy about 516 million packs of cigarettes and 26 million containers of chewing tobacco every year.  The update also said that the average teen smoker starts at 14 or 15 years old. 

According to the FDA, more than 4 million children and adolescents in the United States use tobacco products, and it is relatively easy for minors to illegally obtain them.  Vending machines, mail-order sales, free samples at malls or sporting events, and self-service displays are easy access for children and teenagers.

The FDA maintains that tobacco promotion is also entering the youth market through “non-tobacco items,” like clothing apparel, and through sponsorship of sports activities.

This trend leaves parents of teenagers like Erin Attermeier with obvious concerns.  Mark and Kathy Attermeier are worried about the kind of influences the alcohol and cigarette markets, along with other teen-oriented markets, are having on their daughters.

Kathy Attermeier said that while tobacco has the worst reputation for underage marketing, alcohol ads are subtle messages telling young people it is acceptable to drink, and those are the only messages teens are receiving.

“We have a schizophrenic attitude toward alcohol,” she said.  “What worries me is that we don’t have a viable balancer to these ads.”

She also said that there is a bigger issue at hand besides just cigarette and alcohol advertisements; namely, the emphasis that is placed on sexual topics that children and teens are exposed to at young ages.

“Things get serious too early, and kids don’t have time to be kids,” she said.  “Thirteen years old nowadays is older than it used to be.”

Growing up too fast: Teenage girls and sexuality

In Mark Attermeier’s opinion, early sexual experience is the most obvious effect of marketing campaigns on the way teenage girls think.  He practices family medicine in Eau Claire.  In his practice, he sees a lot of teenage girls with the same kinds of issues, relating to body image and sexuality.

He also said the music market, one of the more popular teenage markets, can be one of the most harmful.

“You have sex, drugs, violence, and misogyny, the deification of the worst parts of each gender,” he said.  “You promote aggression in males, and hypersexuality and submission in females.”

A focus group study of adolescents and their parents, published in 2004, attempted to determine the connections between teenagers’ sexuality and how much importance they gave to sexual content in the media.

The study revealed that parents were concerned about the effect of media content on their children, while the teenagers themselves were indifferent about sex in the media.

The authors concluded that the teens’ apathetic tone about media content had to change before the issue of sexuality could be addressed completely. 

Erin’s mother is most concerned about the sexualization of teenage girls through marketing.

“Everything is for a sexual reason,” she said.  “Even breath commercials.  It’s not about health, but instead tells you that you can’t kiss someone with bad breath.  It’s directed to women and girls, and the message is ‘You better care about it'.”

Kathy Attermeier said she also sees glaring sexual stereotypes in commercials, especially in those promoting cleaning products, as well as in lingerie advertisements for companies like Victoria’s Secret.

“It teaches males and females the wrong things,” she said. 

Reflecting un-reality: Advertising a girl’s body image

Related to concerns of sexuality and sexual roles with teenagers is the issue of body image.  According to the Eating Disorders Coalition for Research, Policy & Action—a national group of organizations that advocate eating disorder policy at the federal level—90 percent of Americans that are diagnosed with an eating disorder each year are teenagers and young women. 

The coalition also asserts that 40 to 60 percent of girls in high school are on a diet, and that 30 to 40 percent of girls in junior high school worry about how much they weigh.

Kris Terhark is a counselor at Memorial High School in Eau Claire, the same high school Erin Attermeier attends.  In graduate school, Terhark wrote her masters’ thesis on the relationship between eating disorders and body image of high school girls.

From her research, she concluded that the media, along with family and peers, had the largest impact on girls’ perceptions of their bodies.

“If you look at the history, we went from the voluptuous woman, and now it’s the more athletic phase, the ‘strong woman',” she said.  “What sells is if you look good or if you’re skinny.”

According to the U.S. Department of Health and Human Services’ Office on Women’s Health, the number of American women with eating disorders is increasing, and that body image issues are emerging in girls as young as 9 years old.

The Office on Women’s Health also mentioned that while eating disorders are shaped by a number of factors, including genetics and peer influence, society’s focus on a thin “ideal” female body has distorted ideas of body image in young people.

In an article from AAP News, the official newsmagazine of the AAP, the author supports the idea that eating disorders may be the only way girls can handle conflicting food and body images in American culture. 

Terhark said teenage girls are sensitive to what society dictates as ideal.  She is the founder of the Body Image project group at Memorial High School, which started last November.

The group of 12 teenage girls met once a week for the entire school year to talk about issues relating to body image.  Terhark said the group brought a group of girls together from diverse backgrounds.

“Some girls I knew, and asked them to participate,” she said.  “Some girls were there who wanted to help a friend.  There were girls who had body image distortions, and there were some girls with anorexia and other eating disorders.”

During their first meetings, Terhark said, the girls outlined what they wanted to accomplish from the project.  Nutrition, family, friends and the media were leading topics of discussion.

“The media was big on their minds,” Terhark said.  “We watched a video of a girl in a fat suit and talked about why image is such a big thing.”

The final activity of the year sent the girls out to Oakwood Mall in Eau Claire.  At the mall, they talked to managers in different retail stores that marketed to teenagers.  Most of the questions were about what sizes of girls’ clothing the stores carried, and what sizes were displayed on the store mannequins, Terhark said.

Looking back, Terhark said she realized that the Body Image group was more of a support group than an actual project, and an important resource for girls at the high school.

“I’m trying to get it going again,” she said.

Terhark’s colleague, Sandy Ayers, is one of Memorial High School’s school psychologists.  Ayers sees about 10 students per week for individual counseling.  About 90 percent of those students are girls, she said, and they cover a range of issues from body image to depression.

One of the effects of marketing to teenage girls, Ayers said, is that the characteristics of some markets like clothing lines tend to diminish a girl’s sense of value as a person.  Clothes that advertise for “size zero or less” are a problem for girls and are important to address, she said.

“They need to take a look at understanding the whole person beyond what size you wear,” Ayers said.  “My goal is to be present, and to provide encouragement of what steps they are making.”

Erin is also perceptive when it comes to other girls her age.  She says a lot of issues at school stem from clothing and body image.  She said that people get judged if they don’t look or act a certain way, and there is a lot of stereotyping about appearance. 

“If you don’t look like everyone else, you’ll have a bad year, pretty much,” she said.  “If you don’t look like you walked out of a magazine, you’re out.”

Erin’s friend, Taylor Anton, 16, also attends Memorial.  She agrees that since the goal at school is to fit in, people who don’t wear the right clothes are automatic targets.

“If I wear pants that aren’t designer jeans, I will get a comment,” she said.  “I deal with that a lot.”

Both girls noted that the clothing advertisements they see on television don’t often help the situation.

Clothes and poses of models in women’s clothing ads tend to look provocative, Anton said.  “With the younger people, everything is short, tight, and low-cut.”

The media as a counterbalance: “Entertainment education” for teenagers

While some focus on the negative effects of marketing to teenagers, other professionals have taken a different stance.  They believe media and advertising can be useful tools to educate teens about issues they face in a world full of contradicting media messages.  They refer to this alternative as entertainment education, or “infotainment.”

Dr. Holly Falik practiced general pediatrics in New York for 18 years.  Now she is the chair of public relations for the Wisconsin chapter of the AAP.  She also holds a position on the executive committee of the AAP’s Provisional Section on Media.

The section was formed in July of 2003, and is devoted to working with the news media, parents, children and adolescents in order to increase media awareness and advocate health.

“We know there can be good and bad messages in the media,” Falik said.

What is needed, Falik said, is to educate teenagers about the messages in media so they know what is affecting them, and why.

“If we could show kids they were being manipulated, they’d stop,” she said.  “Kids don’t want to be manipulated.”

A 2004 brief from the Kaiser Family Foundation defined entertainment education as placing an educational message into entertainment content in order to give information and promote healthy habits to people. Television is usually the primary medium.

Falik is an advocate for increasing teens' knowledge of media. (Photo courtesy of the WI Medical Society)

The article asserts that the Kaiser Family Foundation has cooperated with several networks to include health-related messages into television programs such as “ER” and programs on MTV.

Falik said that while there is still a lot to address concerning marketing and teenagers, steps are definitely being made.

“I think the media is the most effective way to reach the largest number of people in terms of information and different ways of thinking,” she said.

Falik said it is important to educate parents and teenagers about the media and what it does.  She also said the members of the media should be knowledgeable about the conflicting messages they are sending out to teens.

“It is the privilege of the media to educate people,” she said.  “But educating the media is just as important.”

In the meantime, girls like Erin Attermeier and Taylor Anton are trying to cope with the aspects of teenage life that are already difficult: the pressures of family, friends and school.

Curled up on the sofa, in jeans and an overlarge sweatshirt, with a hat perched crookedly on her hair, Erin says her definition of cool is different from a lot of people she goes to school with.

“It’s people not afraid to be who they are,” she said.  “People who don’t try to fit in.”