Issue 5: Newspaper frames of childhood lead poisoning
Friday, May 01, 1998The leading environmental threat to children's health is lead poisoning. Both advocates and opponents develop frames that lend support to their positions. The frame is the ideological and practical boundary that guides the process of shaping bits of information into a news story. News articles that set the agenda on lead issues can reflect, reinforce, or challenge stakeholders' frames. We sampled stories in the popular press to identify the frames being put forth on childhood lead poisoning and to determine which frames were applied most often.
Stories on lead poisoning, especially lead abatement and screening, were identified through a search of files maintained by the Lexis/Nexis information service. The time period searched was approximately January 1993 through March 1994. The initial search identified nearly 800 stories. Ninety-seven of these stories were retrieved and reviewed in detail. Many were lengthy features, editorials, or op-eds. Those reviewed included all major stories from newspapers with national readership (New York Times, Washington Post, Los Angeles Times, Chicago Tribune) and a sampling of stories from newspapers in regions with ongoing abatement activity (including Boston, Baltimore, Philadelphia, Hartford, and New Orleans.). A sample from specialty publications such as In Health, Paint and Coatings Journal, and Real Estate Today were also included. Finally, eleven stories published after the original search were identified and reviewed, for a total of 108 articles.
Themes in the stories were compiled and categorized. Many stories relied on one frame throughout. Some were dryly factual, while others related several frames and the people identified with them. The frames described below are those which appeared most often in the stories reviewed. Of course, any single story generally includes only a few elements of the frame, and these elements often appear subtly. Alternative interpretations could be made.
Major frames
Details on the major frames are provided in this table. General themes are summarized below, along with notes on how each frame fits into the overall public discourse about lead abatement and screening.
Frames supporting a strong government role in lead abatement and screening
Responsibility to future generations
The most consistent and perhaps strongest frame is that of intergenerational responsibility: that we must make the world safe for children. The particular power of this frame is its limitlessness, drawing on unbounded feelings of parental love and responsibility. This limitlessness makes irrelevant the fact that today's children have far lower blood-lead levels than their parents because any amount is too much.
This frame may also draw on parental guilt. At a time when we seem unable to provide economic security or safe streets, perhaps lead abatement is one thing we can get right. All we need is money. In this sense, lead abatement also draws on an historical American preference for addressing problems that have technical solutions.
Environmental justice
This frame emphasizes the importance of abatement as a means of redressing risk disparities that follow lines of race and class. The power of this frame is that it casts prevention as an individual right rather than a social good. This preempts much discussion about efficiency, competing resource demands, and other complications. This frame does not require demonstrating that lead exposure is among the most important or remediable manifestations of racism, but simply that it is a manifestation. Then any opponents can be subtly tarred as insensitive to racial and class concerns.
Relying primarily on this frame risks pigeonholing abatement as an issue only of poor or minority groups. As such it could face a developing backlash against related issues such as immigration or affirmative action.
Corporate irresponsibility
Emphasis on the culpability of lead and paint manufacturers is lighter than what might be expected, given their record of suppressing scientific evidence and marketing a hazardous product. Key corporations and their executives seem to have been spared the public wrath now being directed towards the tobacco industry. Use of the corporate irresponsibility frame is mainly limited to problems resulting from current production, such as smelters polluting nearby homes and schools.
Stories on litigation against paint manufacturers could not avoid this frame, but even then the treatment is often light. Perhaps Americans' tendency to ignore history makes accountability fade over the years.
Sloppy lead abatement contractors are also included in this frame. In fact, contractors seem to be blamed for lead-related problems more often and more bitterly than are paint manufacturers.
Threatening environment
This is the weakest and least political of the pro-abatement frames. Assigning no responsibility for the existence of current lead problems, the frame itself is not explicitly stated. Lead poisoning is treated as just one more in a long list of threats that our society (read: "government") must address.
Frames supporting only a limited government role
Parental responsibility
This frame, too, is rarely stated explicitly. It emerges through graphic stories in which parents of poisoned kids express remorse for some preventive measure they wish they had taken, and in extensive "how-to" descriptions of short-term preventive measures. In fact, most individual poisoning stories are cast more or less in this frame. Rarely is the feasibility of the "how-to" measures questioned. (How many parents really wash all their windowsills with TSP every two weeks?) The responsibility of parties other than parents is generally omitted rather than discounted.
Yuppie disease
Stories drawing on this frame generally begin with accounts of rich kids poisoned unwittingly while their parents remodeled their older home, then lament the vast sums the family had to spend addressing lead problems. One key link to broader corporate responsibility emerges in a faint claim that the homeowners should have been warned about the imminent hazard they facedÛÓby the government, their contractor, or someone.
Interestingly, many stories reference this frame with a statement such as, "lead poisoning is becoming a yuppie disease." Many other stories point out that risk is highest among the inner city poor. While both are true, they may at first seem contradictory. Rarely were both mentioned in the same story. Instead, stories usually focused on one element or the other.
Bumbling, indifferent officialdom
The stories reviewed were notable in that much more animosity was directed toward government agencies, especially housing agencies, than towards lead or paint manufacturers. This frame is most common in areas where abatement has begun in public housing. While HUD receives substantial criticism, regional stories often direct far stronger barbs toward local housing authorities.
The message of this frame seems oddly mixed: the government should take care of lead problems, but you can never trust the government to do things right. This combination lets both community-based organizations and elected officials vent their wrath on bureaucrats.
Frames used to argue against a strong government role
Overburdened landlords
This frame is used in some of the strongest attacks against abatement. It carries the implicit threat that the expense of abatement will squeeze many affordable housing units out of the market, and those typically affected by lead poisoning will end up worse off rather than better. This frame appeared frequently in areas where large-scale abatement has begun (such as Massachusetts and Maryland), but was absent in other areas. As nationwide abatement efforts escalate, it would be reasonable to expect wider play for this frame. An interesting twist is that stories using this frame often chronicle the plight of poor landlords facing unaffordable abatement. The image of the poor landlord may undermine portrayal of lead abatement as a class or race issue.
Cost-benefit calculus
This frame portrays screening and abatement as good but naive ideas, suggesting that resources would in fact be better spent on more important problems. The preferred programs are usually education or primary health care. Cost-benefit concerns are among the key points raised by some opponents of large-scale screening and abatement, particularly by a number of practicing pediatricians throughout the country. This frame also underlies the widely covered story of Aspen, Colorado. There, the EPA tried to force the city to spend money on a lead clean-up, when local politicians and physicians were convinced that no problem existed.
While this frame is prominent in scientific and professional journals, and in analytic magazines, it rarely appears in newspaper stories. Perhaps this is because it is typically constructed to appeal to rationalists, but carries little graphic imagery.
That lead poisoning prevention should be abandoned in the interest of primary health care is an ironic twist. Why should health care providers be trying to secure their funding at the expense of a community-based prevention program, rather thanÛÓsayÛÓsupercolliders or prisons? Why are they opposing payment for community-based prevention but not clinical preventive services?
Elements notably absent from current framing
Many points which have been prominent in scholarly debate on lead poisoning prevention are conspicuously absent from popular coverage. Most notable of these is the effect of elevated blood-lead on the population as a whole, in contrast to the effects on a small number of clinically poisoned children. Dr. Herbert Needleman, a leading researcher in the area of childhood lead poisoning, and his successors, have made much of the impact of a five point shift in the IQ of the entire population. Perhaps this is harder to convey than an acute poisoning case, but some would argue that it is more important.
The stories reviewed also gave scant attention to some of the key points raised by some physicians and researchers such as: sharply falling population average blood lead levels, international comparisons (US levels are substantially higher than European), and the extremely low prevalence of lead poisoning in some communities. Also not much covered were key elements of the cost-benefit calculus, such as: which government programs have been cut to provide funding for abatement, or who would ultimately pay any new taxes on lead use. Surprisingly, even the estimated total cost of abatement was rarely mentioned.
Finally, none of the stories mentioned the ambiguities of blood-lead testing, and the potential for kids with moderately elevated blood-lead levels to be labeled or stigmatized. For kids in the 10ÛÒ25 ?g/dl range, test results provide little definitive information. One could expect that, on average, kids in this range have lost 3ÛÒ5 IQ points, but there is nothing to be done about it. The parents' alternatives are few, except to feel guilty. Ignoring this, the stories portray blood-lead testing as a simple, infallible measure. The ambiguities of home testing also received little coverage.
Elements of a public health frame
An ideal public health presentation of lead abatement and screening would benefit by being mindful of three issues. First, it would be more clearly constructed around preventing lead problems in the population as a whole, not just clinical poisoning in a small number of children. Second, it would deal more explicitly with the relationship between lead and problems of race and poverty. And third, it would be mindful that lead abatement will require sustained effort over many years, so a portrayal of crisis may not be appropriate.
Focusing on a few symptomatic children gives good graphic images. It also leaves proponents vulnerable to attack, since the number of such children has in fact declined sharply over several decades. Needleman's research on low-level lead poisoning has shown its effects on populations, not individuals. Consistent with a public health approach, abatement proponents should keep the focus on population exposures. While blood-lead levels in the entire US population have dropped sharply, there remain distinct sub-populations whose levels remain high. Efforts should focus on identifying and protecting these sub-populations, rather than individual children.
Abatement proponents seem to be of mixed mind in linking lead poisoning with problems of race and poverty. The environmental justice frame focuses heavily on it, while the yuppie disease frame goes the other way. Regardless of how responsibility for the problem is assigned, lead abatement will only bring a net benefit to inner-city communities if it is accomplished in ways that support solutions to related problems of race and poverty. That suggests linking abatement more strongly with long-term improvement of housing stock, and linking screening with provision of decent health care. Perhaps links could also be made with education and related social issues. Splitting out lead abatement as yet another categorical program will likely be less than helpful in many cases.
Issue 5 was researched and written by Jim Bellows, MPH, CIH, CSP for the Berkeley Media Studies Group. Edited by Lori Dorfman, DrPH, and Lawrence Wallack, DrPH.
Issue 5 was produced with support from the Alliance to End Childhood Lead Poisoning, Washington, D.C.
Issue is published by Berkeley Media Studies Group , a project of the Public Health Institute.
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