‘Tales of mind over cancer’: Cancer risk and prevention in the Canadian print media

This paper investigates coverage of cancer in three Canadian newspapers in order to explore how the print media presents issues related to cancer risk and prevention. Six months of newspaper coverage was coded and analysed quantitatively to identify trends in coverage. A small subset of these articles was then analysed qualitatively to identify latent and underlying messages. Results from the analysis suggest that coverage emphasised risk management through individual choice and lifestyle change, privileging a discourse of individual control. Conversely, social and environmental risks related to cancer were minimised, despite the emerging academic consensus around the central importance of social and environmental determinants of health. Lifestyle was the most frequently mentioned source of cancer risk. Social and environmental health links were mentioned sparingly, and when environmental links were presented they were contested in ways that lifestyle risks were not. The coverage reflects the prevalent discourse in Canadian society that responsibility for health management risk lies primarily with the individual.     

The silent killer in media stories: Representations of hypertension as health risk factor in French-language Canadian newspapers

The media is recognised as an increasingly important source of information about health risk and disease for non-professionals. The issue for public health actors is the accuracy and objectivity of such information. But the media do not neutrally transmit expert information on health risk; they also contribute to shaping it. Media studies show that the media have their own modus operandi and produce content that satisfies the criteria of newsworthiness and media-value. The objective of our research was to analyse how newspapers represent hypertension as a health risk factor, to examine how these representations relate to media-value characteristics, and to reveal differences between serious, popular, and tabloid newspapers. Our findings show that, in their coverage of hypertension, the newspapers we analysed accentuate features that come closest to media-value characteristics of health risk. The magnitude and undetectable nature of hypertension, and the severity and unpredictability of its consequences, are accentuated in media discourse through various rhetorical devices. Exacerbation of fear is most prevalent in the tabloid newspapers, with more use of scary metaphors and personifications.     

How health managers think about risk and the implications for portfolio theory in health systems

Attention is now being paid in the health economics literature to the insights offered by portfolio theory. Portfolio theory points to the advantages that arise from consideration of both risk and return when setting priorities. Realising these benefits assumes that managers in the health sector have the same understanding of risk as that suggested by the theory. We set out to explore this issue in interviews with health care managers in Alberta, Canada. To provide a point of reference and possible contrast, we also elicit the views of managers in Alberta's main industry, the oil and gas sector. Interviews were held with 25 managers across the two sectors and thematic analysis applied to draw out the main lessons from the interviews. To the oil and gas managers, risk meant opportunity that was worth taking if the return was high enough. To the health managers, risk was seen mainly in epidemiological terms as hazard and something to be avoided at all costs. Rather than reflecting a different understanding of risk, however, health managers had a more nuanced attitude, which is understandable given the consequences of adverse outcomes and the political furore that then follows. The politicisation of risk in health and its association with adverse outcomes suggests that it might be better to avoid this term when thinking about resource allocation across a portfolio of health promoting interventions and to use uncertainty instead.     

Mobile phones and health: Media coverage study of German newspapers on possible adverse health effects of mobile phone use

The scientific debate about potential risks from the radio frequency electromagnetic fields (RF-EMFs) of mobile telecommunication is ongoing, accompanied by considerable media discussion about whether electromagnetic fields from mobile phones cause adverse health effects. Since most people do not make use of scientific databases, the print media are key actors in informing the public about scientific developments concerning potential health risks from mobile telecommunication. In order to analyse the kind of information German print media provide to the public, a media analysis of a sample of German newspapers during the years 2002–2007 was performed: 17 regional and national daily newspapers were analysed along with weekly journals. The results indicate that, besides ambiguous media coverage, there are remarkable differences among the various newspapers in their approach to the topic. Most newspapers highlight unspecified, potentially adverse effects and link mobile phone use to the development of cancer, which is not supported by current scientific knowledge. However, in recent years, a slight shift in the foci of reporting can be observed. As these results show, newspapers increasingly acknowledge the existence of scientific uncertainty and provide more detailed information on the topic.     

How the causes,consequences and solutions for problem gambling are reported in Australian newspapers: a qualitative content analysis

Objective : To inform public health approaches to problem gambling by examining how the news media covers problem gambling, with a particular focus on the causes, consequences and solutions to problem gambling, and the ‘actors’ and sources who influence media coverage. Methods : A qualitative content analysis guided by framing theory analysed coverage of problem gambling in Australian newspapers in the period 1 July 2011 to 30 June 2012. Results : Solutions to problem gambling were more frequently discussed than causes and consequences. A focus on the responsibility of individuals was preferred to reporting that focused on broader social, ecological, and industry determinants of problem gambling. Reporting was highly politicised, with politicians frequently quoted and political issues frequently discussed. In contrast, the community sector, health professionals and problem gamblers were rarely quoted. Conclusions and implications : This analysis has revealed the need for a more proactive, coordinated approach to the media by both public health researchers and health groups. The establishment of a gambling‐specific coalition to push for evidence‐based reform is recommended.     

Barriers to addressing the societal determinants of health: public health units and poverty in Ontario, Canada

Despite Canada's reputation as a leader in health promotion and population health concepts, actual public health practice for the most part remains wedded to downstream strategies focussed on behaviour change. In Canada's largest province this has led to the implementation of a heart health promotion approach focussed on diet, activity and tobacco use. This is so despite increasing evidence that these approaches are generally ineffective, particularly for those at greatest risk. In addition, these strategies appear to divert public and governmental attention away from addressing the broader societal determinants of health. Examples of Ontario public health units that have begun to address societal determinants of health provide a counterbalance to the dominant paradigm that frames health as an individual responsibility. These new approaches focus attention upon the health-threatening effects of governments' regressive social and economic policies in a manner consistent with the best principles of health promotion.     

The ‘moral careers’ of microbes and the rise of the matrons: An analysis of UK national press coverage of methicillin-resistant Staphylococcus aureus (MRSA) 1995–2006

This paper examines similarities and differences in media discourses relating to methicillin resistant Staphylococcus aureus (MRSA) at three important points in the development of the bacterium and its perception by the public over the last decade. We analyse three increasingly large sets of texts from the national media using a variety of complementary qualitative and quantitative methods. As such this paper exploits, develops and empirically assesses an emerging methodological trend in applied linguistics, namely the convergence of critical metaphor analysis, with corpus linguistics and science and technology studies. Using this, the study identifies a shifting media narrative that involves changes in dramatis personae over the decade. First, personified forces of nature, doctors and hospitals are engaged in a battle of evil against good, but also intelligence over stupidity. Second, we are presented with victims of personified bacterial forces and doctors and hospitals cast as perpetrators of crimes of omission by not cleaning hands or wards. Third, the malignant forces of politics try to exploit the evil forces of nature for their own ends while a mediator between the doctors and the potential victims of MRSA emerges and is given political and symbolic power: the modern matron.     

健康传播中健康素养和媒介素养的教育反思

针对健康传播现状,笔者以"大卫生"和"大传播"观为框架,从媒介素养与健康素养教育角度探讨我国健康传播的健康生态营造。     

Media coverage on electromagnetic fields and health: Content analysis of Dutch newspaper articles and websites

The way health risks of electromagnetic fields are portrayed in the media may shape public concerns that the growing exposure to electromagnetic fields in daily life constitutes a health hazard. We analysed the content of information on electromagnetic fields and health in Dutch media to identify aspects that might be linked to the public perception of electromagnetic fields. A systematic search was performed on archives of five major Dutch newspapers (from March 2008 to March 2010) and on the internet (in April 2010). Content analyses included the identification of main characteristics and the context or frame in which the information can be clearly understood. We identified 155 newspaper articles and 23 relevant websites. Analyses showed that the media content often suggested a negative relationship between electromagnetic field exposure and health but lacked detailed information about research, technical aspects, possible biological mechanisms and regulation policy. Regional media predominantly featured conflicts around the placing of electromagnetic equipment. Across all media, information on electromagnetic fields and health was mostly framed in terms of precaution and concern. We conclude that the content does not reflect a scientific perspective, focusing on the nature of and exposure to electromagnetic fields, potential biological mechanisms, the evidence and the magnitude of health effects, but rather seems to follow a layman's perspective of risk. We also discuss ways to improve on the quality of media coverage on electromagnetic fields.     

Issues in notification: Reflections of a public health worker

The objectives of notification are to inform individuals of research results so that they can make informed choices regarding health care and risk reduction behaviors, and to inform workers and employers of results and recommendations in order to take actions to improve workplace health and safety. Many questions confront researchers or public health workers engaged in notification efforts. Who should be notified? What information should be included in notification materials? When should notification occur? How and where should notification take place? What is the socioeconomic context in which notification is occurring? This article presents a public health worker's perspective on these issues. © 1993 Wiley-Liss, Inc.     

The semantics and pragmatics of water notices and the impact on public health

In communicating health risks to the public, it is essential that the message delivered is not misunderstood, as this can lead to risk behaviour. There has been much interest in risk communication and trust, but here we take this further by a cognitive and linguistic analysis of the intended and understood meanings of core words in drinking-water incidents. Based on a questionnaire study of 107 undergraduate UK students using the example of a ‘do not drink’ notice, we found that, although the majority (87.9%) would buy and drink bottled water, as many as 44% would still drink the polluted tapwater. Males and females would generally behave similarly; however, significantly more men would drink water straight from the tap. All in all, 78% of the population – males in particular – could potentially be at risk. We trace the risk behaviour to a misinterpretation of the words drink and not. Public health protection is generally perceived as the choosing of what is safe behaviour and informing the public of appropriate actions in the event of a crisis: however, communicators need to also address the words used to make up risk messages and the prior beliefs that they invoke.     

‘A grim health future’: food risks in the Sydney press

Food scares and newsworthy stories about risks associated with food often receive a high level of attention in the news media. This article examines the reporting of food risks over a recent 14-month period in three metropolitan newspapers available to readers in Sydney. The major topic reported over this time was the relationship between food intake and obesity, which comprised almost half of news stories about food risks. This topic was followed in frequency by the risks associated with primary food production and the risks from processed, restaurant or takeaway food. The article looks in detail at how each of these topics was reported, including the discourses that were employed to give meaning to the news stories. Much emphasis was placed upon personal responsibility for avoiding food risks, particularly in relation to overweight. News stories suggested that Australians, and in particular, Australian children, were facing a crisis in relation to the numbers of people over-eating and becoming fat as a result. The overweight body was represented as grotesque, out of control, unhealthy and unAustralian. In other news stories, various aspects of farming were presented as ‘unnatural’ and thus as rendering foodstuffs risky. Food prepared outside the home was portrayed as far more dangerous than food prepared within the home, with an emphasis in reporting on the potential for contamination in such foods.     

Epistemological barriers to addressing the social determinants of health among public health professionals in Ontario,Canada: a qualitative inquiry

To date, Ontario public health units (PHUs) have generally neglected the social determinants of health (SDH) concept in favor of risk aversion and behaviorally oriented health promotion approaches. Addressing SDH and responding to the presence of health inequities is required under the Ontario Public Health Standards and is a component of provincial public health documents and reports. Nevertheless, units vary in their understanding and application of the SDH concept in their activities. The authors conducted 18 interviews with Medical Officers of Health and lead staff persons from nine Ontario PHUs, in order to better understand how these differences in addressing the SDH among health units come about. The findings suggest that differences in practice largely result from epistemological variations: conceptions of the SDH; the perceived role of public health in addressing them; and understandings concerning the validity of differing forms of evidence and expected outcomes. Drawing from Bachelard’s concept of epistemological barriers and Raphael’s seven discourses on the SDH, we examine the ways in which the participating units discuss and apply the SDH concepts. We argue that a substantial barrier to further action on the SDH is the internalization of discourses and traditions that treat health as individualized and depoliticized.     

Writing the risk of cancer: Cancer risk in public policy

In this paper we examine how cancer risk is written in cancer policy documents from the English speaking OECD nations. We offer an audit of the multiple ways in which cancer risk is conceptualised and presented in health policy and professional contexts with the long term aim of comparing this with lay conceptualisations. Our study sampled cancer policy documents produced by six nations, the World Health Organization and the International Union for Cancer Control since 2000 and analysed them iteratively through questions and codes. Whilst the documents contained a comprehensive range of concepts and locations for cancer risk, our analysis found two predominant representations: firstly, well established metaphors that depict cancer as uniformly dreadful and life threatening; and secondly, through a concentration on five behavioural risk factors (tobacco smoking, drinking alcohol, inadequate nutrition, sun exposure and physical inactivity) and one bodily state (overweight). We discuss the implications of this dual focus and of other tensions within ideas about cancer risk that we identified for risk communication.     

Sources of information about diet and health in a Mediterranean country: Comparison with other European member states

Background: A Pan-European survey was carried out to assessthe main sources of information about healthy diet in the Europeanpopulation and to assess whether these sources differ betweena Mediterranean country and other European populations. Methods:This study belongs to a Pan-European survey on Attitudes toFood, Nutrition and Health. A multistage sampling procedurewas used. Each subject was asked about the main sources of informationon healthy eating. The survey was completed between October1995 and February 1996 in the 15 member states of the EuropeanUnion. The questionnaire was completed by 14,331 persons, approximately1,000 from each member state. Data were quota controlled bysociodemographic factors and all results were weighted for thepurpose of maintaining national representativeness. The participantswere asked to indicate which sources they used more often outof a list with 22 options. They were allowed to select a maximumof two sources. Results: The source of information ‘televisionprogrammes or radio’ was more prevalent in the rest ofthe member states of the European Union (30.9%) than in Spain(25.7%). ‘Health professionals’ were mentioned withsimilar frequency as a source of information in Spain and inthe rest of the European Union. Conclusions: Our results confirmthat mass media play an important role in transferring messagesabout healthy eating to the general public. Increasing the circulationof newspapers in Spain, where a low level of newspapers readingexists, would probably improve the knowledge of the generalpublic.     

基于健康及危险因素的卫生资源配置方法研究

目前的卫生资源配置方法大都是重治轻防观念下的产物,文章建议将卫生资源配置的关口前移,以促进健康的因素以及导致疾病并进而损害健康的危险因素为导向制定卫生资源配置标准。在具体运用以健康及危险因素为导向的卫生资源配置方法时,必须结合地域的具体情况,主要是该区域的人口特征以及疾病谱。考虑到资源本身的有限性,从增强可操作性和提高效率的角度出发,建议先确定危害该区域居民健康的十大疾病,然后分析引发该十大疾病的危险因素(否定性因素),以及预防该十大疾病发生的因素(肯定性因素)。然后针对引发这些否定性因素和肯定性因素的原因进行卫生资源的配置。     

Perceptions of risk in the post-Soviet world: A qualitative study of responses to falling rockets in the Altai region of Siberia

There is widespread concern among people living in some parts of Altai territory in Siberia about potential health effects from fallout from rockets launched from the Baikonur cosmodrome in Kazakhstan. Extensive research has so far failed to provide evidence to support these concerns. As a consequence, the problem has been labelled by Russian scientists as ‘collective psychosocial distress’ or ‘raketophobia’. The aim of this paper is to provide an understanding of the factors underlying popular concerns about rockets. The paper is based on data collected in 2006 using multiple methods (individual semi-structured interviews, natural group discussions, round tables and participant observation). Concerns related to the impact of the rocket launches among the local population were explored. The analytical framework is informed by discourse analysis and discursive psychology. The findings are that the processes of collective social construction amplify risks perceived to be associated with rocket launches. In the Altai context, this social amplification builds on a societal vulnerability triggered by the collapse of the Soviet ideology. The environmental concern provides opportunities for repressed debates to be expressed that emerge from culturally embedded frustrations and fears that would otherwise be ignored by the political agenda. Moreover, the signals that shape the perception of risk are intrinsic components of local information flows, so that the communication process between experts and policy-makers and the local population itself contributes to the amplification of perceived risks. Concern about the health effects of rockets can be traced to the conditions that existed when the USSR ceased to exist. An effective response must address these deep-seated issues.     

卫生监督员突发公共卫生事件报告知识调查

目的 了解黑龙江省卫生监督员对突发公共卫生事件(简称突发事件)相关信息报告职责及相关知识的认知状况.方法 采用分层整群抽样方法,抽取黑龙江省省市县3级卫生监督员进行问卷调查和深入访谈,结合文献研究进行分析.结果 61.5%的卫生监督员认为自己不是突发事件责任报告人,17.8%认为本单位不是突发事件的责任报告单位.46.6%表示不清楚本单位突发事件报告流程.3类报告主体突发事件报告时限知晓率分别为27.3%,21.0%,23.9%.对于食物中毒、急性职业中毒、乙类传染病、霍乱是否为突发事件的正确应答率分别为15.8%,78.2%,40.5%,70.3%.结论 有相当部分卫生监督员不明确自己和本单位在突发事件相关信息报告中的职责,不了解突发事件相关法律、法规及文件中突发事件报告的相关内容,需要采取措施,规范卫生监督机构突发事件报告工作.