Demands for ‘off‐licence’ access to trastuzumab (Herceptin): content analysis of UK newspaper articles

Background Sensationalized reporting styles and a distorted framing of health‐care issues in newspapers may trigger inappropriate commissioning decisions. We evaluated UK press coverage of pre‐licensing access to trastuzumab (Herceptin) for early breast cancer as a case study. Methods and findings Content analysis of newspaper articles published between April 2005 and May 2006 were coded by two researchers for interest groups represented, claims made and sensationalized reporting. Disagreements in coding were resolved by a third researcher. One thousand and ninety published articles were identified in the study period and a 20% sample (n = 218) was included in the content analysis. Most articles (76%, 95% CI 71–82) included claims about the clinical benefits of trastuzumab, and this was significantly higher than those expressing the uncertainty surrounding such benefits (6%, 95% CI 3–9) or those that discussed the potential harms (5%, 95% CI 2–8). Articles were significantly more likely to feature claims made by a breast cancer survivor or family member than any other interest group (P < 0.0001). Almost half of the articles carried some message to the effect that trastuzumab would make the difference between life and death (47%, 95% CI 40–53). Over a quarter (28%, 95% CI 22–34) suggested that trastuzumab is a ‘miracle drug’ or similar. Conclusions The benefits of drugs are highlighted, frequently using sensationalist language, without equal consideration of uncertainty or risks. Health‐care purchasers should express decisions in opportunity cost terms; journalists should give fairer coverage to such arguments.     

Age analysis of newspaper coverage of mental illness

In this study, we examine newspaper coverage of mental illness in children and adults taken from 6 weeks during a 1-year period. Articles were coded for (1) type of article; (2) types of disorders named or described; (3) themes related to crime, attributions of the disorder, treatments, and critiques of the mental health system; and (4) "elements of responsible journalism," including inclusion of perspectives from mental health experts, statistics related to mental illness, referrals to additional sources of information, and avoidance of slang terminology. We examine how these variables differ by the age of the group discussed in the article: children/adolescents and adults/older adults. One thousand two hundred fifty-two articles were coded for these four clusters as well as age of group discussed in the article. Inter-rater correlations of two independent judges were satisfactory for 10% of the stories. Age group comparisons revealed that the child articles contained a significantly higher proportion of feature articles; were significantly more likely to discuss behavior and conduct disorders, and alcohol and drug abuse, attention deficit hyperactivity disorder (ADHD), anxiety disorders, and eating disorders, and to contain themes of causation, treatment, and critiques of the mental health system. The adult articles contained a significantly higher proportion of episodic news stories and were significantly more likely to present themes of dangerousness and crime. Our analysis found that child articles were significantly more likely to incorporate elements of responsible journalism, while adult articles were significantly more likely to use stigmatizing terminology. Our report encourages journalists to develop contextually comprehensive and informative presentations of mental illness and issues surrounding the mental health system for all population groups in order to provide readers with accurate information within the context of general social trends and relevant expert opinion.     

Framing of Australian newspaper coverage of a secondhand smoke injury claim: Lessons for media advocacy

This paper focuses on newspaper coverage of the Marlene Sharp legal case in Australia, concerning a non-smoking bar worker who was awarded damages for laryngeal cancer caused by passive smoking. All Australian metropolitan and Victorian regional newspaper coverage of the case was obtained from a commercial media monitoring agency for the month of May 2001, yielding 100 articles for analysis. A qualitative text analysis was conducted on newspaper articles, coding for content, tone and frame. Coverage of the outcome of the Marlene Sharp case was predominantly positive for tobacco control, with positive coverage (45% of articles) outweighing negative coverage (13% of articles) by a factor of 3 to 1. The most commonly occurring frame (27% of articles) advanced the view that legislation to protect workers from secondhand smoke is appropriate, even overdue, and encouraged the government to create smoke-free policies to protect workers. Other common frames positive for tobacco control included ‘smoking as socially unacceptable’ (9%) and ‘smoking as a societal problem’ (9%). Of articles framed negatively for tobacco control, ‘individual rights’ (5%) and ‘system cynicism’ (5%) were most common. Legal cases present special opportunities for public health media advocates to bring a human face to the need to progress passage of smoke-free policies.     

Mumps and the media: changes in the reporting of mumps in response to newspaper coverage

OBJECTIVE: To determine the links between national newspaper coverage of mumps after a press release and increased reports of clinical mumps cases. DESIGN AND SETTING: A cross sectional study involving people aged 15-24 years in the West Midlands, and England and Wales. Reported mumps cases were obtained from statutory notifications of infectious diseases to the Health Protection Agency and reports to the Royal College of General Practitioners Weekly Returns Service. Data on newspaper coverage was obtained by retrospectively reviewing the Health Protection Agency press archives. MAIN OUTCOME MEASURE: The effect of newspaper coverage was assessed by examining the 4 weeks before the press release (weeks 15-18 of the year), a 2-week period that included the week of the press release (weeks 19-20) and 4 weeks after the press release (weeks 21-24). MAIN RESULTS: Mumps notification rates were declining before increased newspaper coverage. Significant increases in national (from 28.3/100 000 population (95% CI 26.5 to 30.1) in weeks 18 to 42.8 (95% CI 40.6 to 45) in week 20) and local (from 9.8 (95% CI 7.4 to 12.1) to 21.2 (95% CI 17.7 to 24.6)) notification rates were seen after increased newspaper coverage. Reports rapidly declined after decreased media interest. CONCLUSIONS: The reported incidence rate of mumps seems to be markedly influenced by the level of newspaper coverage. This has implications for surveillance activities.     

Financial incentives to encourage healthy behaviour: an analysis of UK media coverage

Background Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. Objective To describe UK mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Design Thematic content analysis. Subjects National and local news coverage in newspapers, news media targeted at health‐care providers and popular websites between January 2005 and February 2010. Setting UK mass media. Results The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health‐care provider interests dominated favourable coverage; opposition came from rival politicians, taxpayers’ representatives, certain charities and from some journalists themselves. Conclusions Those promoting incentive schemes for people who might be regarded as ‘undeserving’ should plan a media strategy that anticipates their public reception.     

The power of a frame: an analysis of newspaper coverage of tobacco issues--United States, 1985-1996

For more than three decades, public policy makers and public health officials have had conclusive evidence of the hazards of tobacco use, yet tobacco products remain legal, accessible, and acceptable in our society. Public health advocates have been unable to develop a consistent, coordinated message powerful enough to combat the influence of the tobacco industry. Studying the way in which the tobacco issue has been framed in the mass media over the past decade may provide important clues as to why public health efforts to overcome the tobacco industry's influence on public policy and on tobacco use have not been entirely successful. This paper describes and analyzes the predominant framing tactics used by the tobacco industry and by tobacco control advocates for the last 11 years by reviewing 179 front-page articles from the New York Times and the Washington Post during this period. We conclude that while the tobacco industry has created a central message and theme which has been used constructively and consistently over time, the tobacco control movement has not developed a consistent, powerful, and compelling message. Developing such a message may be important if the nation is to restore progress in reducing tobacco use.     

Securitising health: Australian newspaper coverage of pandemic influenza

This paper analyses contemporary Australian newspaper coverage of the threat of pandemic influenza in humans, specifically in the light of recent transformations in biomedical and public health understandings of infectious disease as continuously emerging. Our analysis suggests that the spectre of pandemic influenza is characterised, in newspaper accounts, as invoking a specific form of nation building. The Australian nation is depicted as successfully securing itself in the face of a threat from Asia (and in the absence of an effective international health body). What is described in newspaper accounts reflects a shift in the public health response to infectious disease. This response does not entail a direct focus on protecting either the population or national territory. Instead, it involves the continuous rehearsal of readiness to react to disasters through the networking of government and private agencies responsible for maintaining critical infrastructure. In this way, coverage of pandemic influenza positions health as central to national security, with little reporting of the reasons for or the potential implications of this alliance. Thus, the imperative to 'be prepared' is presented as self-evident.     

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.     

Nationwide newspaper coverage of physician-assisted suicide: a community structure approach

Using a community structure approach linking city characteristics and variations in media coverage, the authors examined newspaper coverage of physician-assisted suicide. A nationwide sample of 15 city newspapers yielded 288 articles in a four year period. Content analysis of article "prominence" (placement, headline size, story length, presence of photos) and overall article direction (favorable, unfavorable, or balanced/neutral) yielded a combined and widely varied single score "Media Vector" or measure of issue "projection" for each newspaper. Correlation and factor analysis yielded two significant city characteristic factors: a "stakeholder" factor, age (percent over 75) associated with unfavorable coverage of physician-assisted suicide (r = -.491; p = 000); and an "access" factor--combining media access (newspaper circulation, cable stations, FM or AM stations) and health care access (health care facilities, physicians)--linked to favorable coverage (r = .472; p = .000), combining to account for 46.3 percent of the variance. Western US newspapers and public opinion are most favorable to physician-assisted suicide.     

Readiness to change: newspaper coverage of tobacco farming and diversification.

Diversification, like tobacco use prevention and cessation, is an important public health concern. The multilevel patterns of tobacco dependency suggest the need for public health approaches to the "tobacco problem." To understand how newspaper and wire service journalists cover issues involving diversification among tobacco farmers, the authors performed a content analysis of a subset of 100 articles on diversification and tobacco farming. Prochaska and DiClemente's stages of change model was applied to the "problem behavior" of tobacco farming. Among news accounts relating to tobacco farmers or tobacco farming, print media accounts gave relatively little attention to the issue of diversification. Farmers in the sample of news accounts were generally cognizant of pressures to diversify away from reliance on tobacco cultivation but were frustrated due to obstacles to diversification such as limited diversification options and relative absence of infrastructure supports. Community leaders and policy-relevant sources generally supported diversification.     

Repertoires of ADHD in UK newspaper media

This article takes a discursive approach to examine how Attention Deficit Hyperactivity Disorder has been represented and debated in UK newspapers in the last decade. Two repertoires of ADHD were identified as the biological and the psychosocial. Subject positions such as problem child, abnormal or ordinary naughty child and ineffectual or neglectful parents are embedded in these alternative versions of ADHD. The biological repertoire justifies and encourages drug treatment for problem children while the psychosocial repertoire makes available the subject position of ordinary naughty child and supports moral judgements about poor parenting practices in a 'sick society'. Such representations have challenged the media medicalization of ADHD common in a previous decade. Although the biological and the psychosocial repertoires are competing explanations for ADHD, they both perform a common function in representing families as in need of regulation.     

A survey of newspaper coverage of HCFA hospital mortality data

A study that assessed newspaper coverage of the 1986 Hospital Mortality Data for Medicare Patients released by the Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services is described. Media interpretation of Federal information about the quality of hospital medical care is also discussed. A sample of 68 articles from newspapers serving urban areas of various sizes in all regions of the United States was analyzed. Articles were coded into classifications according to how the news was played, headline bias (positive-negative-neutral), hospital mentions, quote sources, explanations for excessively high mortality rates, urban area population, and geographic region. The findings indicated that HCFA's release of the 1986 hospital mortality data received heavy news coverage. There were twice as many negative headlines as positive ones, although nearly 95 percent of the hospitals had mortality rates within expected ranges. Quotes from representatives of hospitals predominated in the newspaper articles, and they often blamed some aspect of the HCFA data for higher-than-expected mortality rates. Newspaper attention to the quality of hospital care clearly raised consumer awareness of the idea that health care quality can vary. The newspaper articles, however, provided no guidance on obtaining valid data or on using it to make health care choices.     

Framing pub smoking bans: an analysis of Australian print news media coverage, March 1996-March 2003

OBJECTIVE: To investigate framing strategies used by the Australian Hotels Association (AHA) and tobacco control groups to (respectively) resist or advocate laws providing smoke free bars. METHODS: Online archives of Australian print media were searched 1996 to 2003. A thematic analysis of all statements made by AHA spokespeople and tobacco control advocates was conducted. Direct quotes or journalistic summaries of statements attributed to named people were coded into four broad themes and the slant of articles coded. RESULTS: More than three times as many articles reported issues that were positive (n = 171) than negative (n = 48) for tobacco control objectives. The AHA emphasised negative economic issues and cultural/ideological frames about cultural identity, while tobacco control interests emphasised health concerns as well as cultural/ideological frames about threats to inequitable workplace policies. CONCLUSIONS: Smoke free bars have now been secured, suggesting that health advocates' position prevailed. The inability of the AHA to avoid the core health arguments, its wildly exaggerated economic predictions, and its frequent recourse to claiming smoke bans threatened nostalgic but outmoded vistas of Australian day to day life were decidedly backward looking and comparatively easily dismissed as being out of touch with views held by many in contemporary Australia. Health groups' emphasis on the unfairness in denying the most occupationally exposed group the same protection that all other workers enjoyed under law was powerfully and consistently argued. Australia's recent success in securing dates for the implementation of smoke free pubs is likely to have owed much to the enduring media advocacy by health groups.     

Gender issues in newspaper coverage of people with disabilities: a Canada-Israel comparison

This research compared how over a three-month period Canadian and Israeli newspapers wrote about females and males with disabilities. The results showed that in both countries there was significantly greater coverage of males than females. In addition, different (and stereotypical) types of details were used to describe the two groups, and females were associated with different kinds of problems than males, including a higher incidence of violence and victimization. There were also some significant differences between the male and female journalists in this study, and evidence of sexism within the newspaper industry. This paper concludes with some ideas for altering the images of disabled women in the media.     

Framing access to medicines in developing countries: an analysis of media coverage of Canada's Access to Medicines Regime

Background  

In September 2003, the Canadian government committed to developing legislation that would facilitate greater access to affordable medicines for developing countries. Over the course of eight months, the legislation, now known as Canada's Access to Medicines Regime (CAMR), went through a controversial policy development process and the newspaper media was one of the major venues in which the policy debates took place. The purpose of this study was to examine how the media framed CAMR to determine how policy goals were conceptualized, which stakeholder interests controlled the public debate and how these variables related to the public policy process.     

Oral health in the printed media: analysis of newspaper articles in the years 2004-2009

This study seeks to outline the main characteristics of the texts on oral health that appeared in the printed media in the State of Espírito Santo from 2004 to 2009, in order to analyze and compare the issues, approaches and journalistic relevance related to the theme prioritized in A Tribuna and A Gazeta newspapers. Exploratory documentary research was conducted, based on quantitative content analysis of the material, which established that the issues included ranged from information about oral health policies, community service and prevention of oral health diseases, to the "aesthetic tendencies" of the smile. It also covered the dissemination of new technologies and dental specialties and there was a predominance of even-numbered pages, fewer first page texts and full-page coverage. This implies a moderate appreciation of these issues, different editorial projects, plus the difference in target audience that determined the journalistic standard and the predominance of specialized sources. Despite the oral health articles not revealing journalistic "scoops", they can be reworked using conscious journalistic techniques, in order to elicit the extraordinary from the ordinary, giving rise to texts of social relevance in both newspapers.