Setting the Agenda: The Mass Media and Public Opinion

Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities.Biases are complex but systematic, differing by racial/ethnic group and not limited to love–hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions.Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health.

Under the Radar: How Unexamined Biases in Decision-Making Processes in Clinical Interactions Can Contribute to Health Care Disparities

Context
Health inequalities are systematic differences in health among social groups that are caused by unequal exposure to—and distributions of—the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts.

/pdf/advocacy-for-health-equity-a-synthesis-review-145tj5ralo.pdf

Advocacy for Health Equity: A Synthesis Review

This study examines whether changing the way news stories report on health can induce shifts in readers' perceptions of problems of obesity, diabetes, immigrant health, and smoking. The authors manipulated two variables in a controlled experiment: the quality of sourcing-the number of sources and their expertise-and the framing-changing from an episodic, traditional frame to a thematic frame that incorporated information on context, risk factors, prevention strategies, and social attributions of responsibility. The authors found that a thematic frame made readers more supportive of public policy changes and encouraged them to improve their own health behaviors. However, it did not alter their attributions of responsibility for health problems from one of blaming individuals to seeing the larger social factors. Adding richer sourcing to the thematic frame did not increase these effects, nor did readers find the thematic stories to be more interesting, relevant, believable, important, and informative. In addition, there were differential results because of story topics that represent uncontrolled effects. The implications for improving health reporting to encourage positive change in society are discussed.

Testing the effect of framing and sourcing in health news stories.

The Public's Response to the U.S. Preventive Services Task Force's 2009 Recommendations on Mammography Screening

OBJECTIVES: We examined how causes of and solutions to racial/ethnic health disparities are covered and framed in newspapers over time

METHODS: We used LexisNexis to identify articles on racial/ethnic health disparities published from 1996 through 2005 in 40 US newspapers We coded articles for diseases and racial/ethnic groups mentioned; whether causes and solutions were framed as genetic, behavioral, health care, or societal responsibility; and whether a social-justice rationale for eliminating racial/ethnic health disparities was invoked

RESULTS: We identified 3823 racial/ethnic health disparity articles Coverage peaked in 1998 and has declined since Disparities in HIV/AIDS, cardiovascular disease, and cancer generated the most coverage Articles focused primarily on African Americans Only 30% of articles provided causal or solution explanations, with academic researchers providing the most causal explanations and advocacy groups providing the most solutions For both causes and solutions, behavioral explanations dominated the discourse, followed by societal, health care, and genetic explanations Only 4% of articles invoked a social-justice rationale

CONCLUSIONS: The dominance of behavioral explanations may limit public support for policy solutions to eliminate racial/ethnic health disparities Future research should examine the design and dissemination of effective messages about the social determinants of health

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.2009.171678

Coverage and framing of racial and ethnic health disparities in US newspapers, 1996-2005.

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Coverage and framing of racial and ethnic health disparities in US newspapers, 1996-2005.