Wednesday, January 01, 1992Evidence suggests that the media play an important agenda-setting role on social issues.1-3 Scholars have identified specific ways that the news frames stories to fit dominant perceptions of social problems. 4 Gitlin suggests that broadcast news provides a specific frame by presenting information in terms of an event, a person, and a visible conflict that advances the story.4 These journalistic conventions may limit the way in which social issues, including health, are portrayed. Together with its agenda-setting function, the news may determine to a large degree not only which health issues the public thinks about, but also how those issues are thought about.
We examined the content and framing of health issues in the news as part of a larger study of health messages on television. This study was a content analysis of a composite day constructed from 20 one-hour segments, randomly selected from 6:00 am to 2:00 am over the period April 18 to May 7, 1989.
News accounted for 41/2 hours (23%) of the total sample. Of 105 separate news stories included in this sample, 43 (41%) concerned health. Health topics discussed on the news included death or injury (either from homicide, assault, natural disaster, vehicle crashes, explosion, or illness), threats of harm (lead poisoning in the workplace and radon contaminating the nation's schools), drugs (teenage drug and alcohol use at after-prom parties and the war on drugs), and medical stories (a child's fight with cystic fibrosis and his experimental heart-lung transplant as well as various celebrity cases of heart disease). Social issues related to health included stories on a proposed assault weapon ban, child safety (featuring McGruff the Safety Dog), community mental health after mass murder, and protesters demanding more tax money be spent on AIDS and the homeless. Nightline focused on the controversy over new "AIDS self-tests."
Though health was a frequent topic on the news, health stories were not presented from a public health perspective. For example, the cystic fibrosis story featured experimental surgery, portraying the doctor as a high-tech hero, despite his protests that the new surgery was not expected to be a cure. The focus on medical technology and victims in this and other stories served to define and reinforce health problems as individual issues.
A story on radon gas seeping into the nation's classrooms provides another example of the news "frame." The story highlighted the danger, equating radiation levels to "25 000 chest x-rays a year" with a health risk "equivalent to smoking three packs of cigarettes a day." While the news portrayed the Environmental Protection Agency as taking official action by alerting us to the problem, ultimately no agency was held accountable for alleviating the danger. By not asking critical questions about responsibility, the news helped to maintain the dominant news frame that government is watching out for the public's health, perhaps providing a false sense of well-being and contributing to complacency among the public.
In general, health stories were presented in terms of individual behavior or responsibility. Social and economic factors external to the individual were largely ignored whereas biomedical and technological solutions to health problems were emphasized. This contributes to public health problems being understood in isolation from the larger social and political context.5 In sum, journalistic practices likely contribute to the hegemony of individual-level explanations of health issues and so may systematically inhibit a broader public health understanding of health problems.
References
1. Rogers EM, Dearing JW. Agenda-setting research: where has it been, where is it going? Communication Yearbook 11. 1988:555-594.
2. McCombs M, Shaw D. The agenda setting function of mass media. Public Opinion Q. 1972-1973;36:176-187.
3. Iyengar S, Kinder DR. News That Matters. Chicago, Ill: University of Chicago Press; 1987.
4. Gitlin T. The Whole World Is Watching. Berkeley, Calif: University of California Press; 1980.
5. Wallack L. Improving health promotion: media advocacy and social marketing approaches. In: Atkin C, Wallack L, eds.Mass Co unication and Public Health, Complexities and Conflicts. Newbury Park, Calif: Sage Publications Inc; 1990:147-163.
Citation
Wallack, L and Dorfman, L. Television News, Hegemony, and Health. American Journal of Public Health, 82(1):125-6, (letter), 1992.
