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

Introduction: This study aimed to identify disparate health-related marketing across English- and Spanish-language television networks in New York City, ultimately to inform policy that can counteract disproportionate health-related marketing that provides harmful content to and withholds beneficial information from Latinx populations. Methods: A 2-week composite sample of primetime English-language (National Broadcasting Company and Columbia Broadcasting System) and Spanish-language (Telemundo and Univision) television networks from YouTube television was randomly drawn from September 7, 2022 to September 27, 2022 in New York City. 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 subsamples by language networks on YouTube television. Results: Spanish television networks broadcast greater health-adverse advertisements per hour for alcohol (rate difference=4.91; 95% CI=3.96, 5.85) and noncore foods/beverages (rate difference=13.43; 95% CI=11.52, 15.34) and fewer health-beneficial advertisements per hour for mental health/tobacco prevention (rate difference= −0.99; 95% CI= −1.45, −0.54), health insurance (rate difference= −1.00; 95% CI= −1.44, −0.57), medical centers (rate difference= −0.55; 95% CI= −1.23, 0.12), and pharmaceuticals (rate difference= −5.72; 95% CI= −7.32, −4.11) than New York City primetime English television networks. Conclusions: Multilevel policy innovation and implementation are required to mitigate primetime television marketing strategies that contribute to health inequities.