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Problems with media coverage of health policy…and some suggested solutions

Health policy, let’s be honest, is a turn off for most media managers and editors. Given a choice between a cancer breakthrough (even if it is only in rats) and a change to how health services are delivered or financed, you know which one will get the splash.

Who can blame them, really. Health policy is confusing – it’s difficult to ever confidently say that doing X will cause Y – and it’s made even more so by the strife of interests that dominates policymaking and public debate.

So it’s not really at all surprising that a recent study of media coverage of health care reform in the US found most media reports tended to focus on the biff rather than the policy issues.

But one trouble with this, as the study suggests, is that media coverage can exacerbate public confusion about important policy issues, rather than helping to clarify them and contribute to an informed community.

The study, released by the Pew Research Center’s Project for Excellence in Journalism and available in full here, involved more than 5,500 health care stories in the mainstream media from June 2009 through March 2010.

One conclusion is that the opponents of health care legislation won the message war. A Nexis search of key terms in the health care debate found that opponents’ terms appeared almost twice as often (about 18,000 times) as supporters’ top terms (about 11,000).

“In short, the opponents’ attacks on government-run health care resonated more widely than the supporters’ attacks on the insurance industry,” the researchers said. “Boiled down to its essence, the opponents’ attack on big government resonated more in the media than the supporters’ attack on greedy insurance firms.”

Another key finding was the debate centered more on politics than the workings of the health care system. 41% of health care coverage focused on the tactics and strategy of the debate while various reform proposals filled another 23%. But only 9% of the coverage focused on a core issue – how the US health care system currently functions. And this for an industry that consumes one-sixth of the US gross domestic product and affects virtually every citizen.

The authors noted: “The health care issue could be covered from various angles. There is the politics of the issue. There is the substance of the bill. There is the lobbying effort. There is the impact of the economic crisis on health care. And there is coverage of the health care system itself, what works and what doesn’t, what needs to be fixed and what is all right.

“While there was certainly a lot of coverage of the bill, the framing and mix of what got covered may have contributed to the public’s confusion on the issue. While the largest component, by far, focused on politics, only a small fraction highlighted the issue at the core of the debate—how the U. health care industry actually functions.”

Newspapers were the only sector to really devote significant coverage to the workings of the health care system.

A few quick thoughts about the relevance of the study for Australia:

• It would be useful to have a similar study done here. It might help inform health reform efforts over coming decades, and it would be interesting to know both the similarities and the differences between US and Oz reporting.

• These findings are, of course, not only relevant for health policy but salient for reporting of all complex policy issues. In case you missed it, the ABC’s Jonathan  Holmes analysed the reporting of the resource super profits tax at The Drum recently. He had some useful suggestions, including that media outlets should consider linking from news articles to background analytic/explanatory pieces.

This could work well in health. Every time, the Daily Telegraph or whoever runs a story about a hospital patient’s preventable death, this could link to a backgrounder on quality and safety issues, giving some broader context to both the problems and the policies that are attempting to address these issues.

I’m sure Croakey readers could think of plenty of other common health headlines where a backgrounder piece might be useful.

If media organisations don’t take up these suggestions, perhaps there’s room for the academic or not-for-profit sector to do so.

Perhaps a health policy variant of the Behind the Headlines service in the UK, which tends to focus on clinical issues and aims to provide “an unbiased and evidence-based analysis of health stories that make the news”.

Something like this for health policy stories could be very helpful, for both the media and our audiences.

Comments 4

  1. Trevor Kerr says:

    Here’s one.
    Bugs winning as antibiotic use on the rise.
    The bald statement Professor Turnidge says the cost of developing new antibiotics is somewhere between $500 million and $1billion by a medical expert is accepted, apparently, without question.
    The same “data” is presented often in arguments about costs (and, hence, availability) of pharmaceutical products.
    The journalist should ask about the origins of the figures. Failure to do so, with each iteration, adds to loss of trust in medical opinion, and in public confidence in the media to pursue facts rather than merely to regurgitate press releases and scripted talking points.

  2. Croakey says:

    Professor Stephen Leeder, of the Menzies Centre for Health Policy at the University of Sydney, has asked that this comment be posted on his behalf:

    Academics often find policy debate exceptionally frustrating because their variety of evidence does not trump that of the politicians, doctors, patients, journalists and managers. What is WRONG with these people, they wonder, that they do not immediately, or even often, do what the academic evidence shows is right?

    Probably NOTHING is wrong with these people, anymore than there is anything necessarily wrong with people who speak a language different to yours. Evidence is such a compelling word, but evidence in trials in a court of law has a completely different meaning to evidence in randomised trials in a ward. Aeons ago I attended a weekend seminar where the organisers were seeking to achieve reconciliation between lawyers and clinical epidemiologists. The wine was good, the ambience warm, but when it came time for farewells, the able counsel jauntily said to the epi people, “Thank you and cheerio, but I hope you don’t expect us to take any notice of all that stastistics (sic) stuff!”

    So the languages of the makers of biometrical evidence and politicians and managers and clinicians are so different that it is a wonder that policy ever emerges – and works – that has bits and pieces from all traditions. There is nothing disgusting or flawed about this reality. It is what policy IS.

    By all means let us have better background documents and knowledge brokers and detailers. They will all help. But so long as we live in a democracy, policy will be the final common pathway whereby evidence from different traditions, opinion, experience, expedience and much else is combined. Of course the study of such a mess is below the dignity of many people engaged in health research, but that’s life. The molecule is altogether too much of a mess for the physicist who lives to learn more about the positron. That is not to deny the value, however, of molecular science. Or even science (perish the thought) that takes as out of health academia into the rough and tumble real world.

    So if those reporting on and writing about health policy find it to be a bit of a headache, my reaction is, “Tough: that’s reality: apply your able minds to it and do your best!”

  3. Jennifer Doggett says:

    It’s easy to blame journalists for not doing a great job of covering health policy/public health issues but those of us working in these areas have to take some responsibility for the poor coverage these issues often get in the media. I’ve been on the receiving end of medica/advocacy efforts from this sector and was continually frustrated by how badly many health experts/groups are at selling their issues to the media, the community and politicians (with some notable exceptions – Simon Chapman, Ian Hickie and Peter Brooks are three which come immediately to mind).

    Yes many journalists do a poor job but most of them don’t have the luxury of building up expertise in a specific subject area. It’s a tough job being a tabloid journo and our job as health advocates is to make it as easy as possible for them to write the sort of story we want, not to continually berate them for the fact that the Daily Telegraph isn’t the New England Journal of Medicine.

    If I was given two press releases on agricultural policy or superannuation regulation (or some other issue I know nothing about) and an out-of-date list of contacts from a colleague who use to work on the issue 5 years ago and told to come up with a story by lunchtime, I wouldn’t do any better than the average rank and file journo and probably a lot worse.

    Yes a new public health regulation might have less intrinsic media appeal that a ‘breakthrough’ in treating cancer. But that just means more effort needs to be put into selling it and thinking carefully about how it is communicated to the media and other stakeholders. This doesn’t mean hiring expensive public relations consultants – it just means treating the communication/advocacy component of an issue as seriously as the research involved.

    It’s true that most people don’t understand how the health system works and that the lack of media coverage of this issue contributes to this. This is not peculiar to the health sector, there are only a few issues which generate their own media headlines. Perhaps if those of us who do have some knowledge of the health system took more responsibility for communicating our views effectively, we might find that consumers become more engaged and themselves put pressure on media outlets to lift their game.

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Pregnancy and childbirth
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Acknowledgement
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Health in All Policies
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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
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Population Health Congress 2015
2016 conferences
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#cphce2016
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2017 conferences
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