Abstract
The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a region that suffers extreme economic, educational, and health disparities. This analysis of a rural region’s local news coverage of health issues demonstrates significant opportunity to engage with rural local media, particularly ethnic media, to disseminate health information. Such a strategy holds considerable promise to advance public health goals using a multilevel approach: From an individual perspective, improving the amount and utility of the information can inform and educate publics in areas with otherwise low levels of health information access. From a policy perspective, improving coverage of the social determinants of health could shape public opinion to support policies that improve health.
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Notes
The search term was “health OR cancer* OR diabet* OR asthma* OR hypertens* OR medicin* OR exercis* OR fitness OR ‘valley fever’ OR ‘Valley Fever’ OR diet OR nutrition OR breastfeed* OR allerg* OR obesit* OR ‘infectious disease’ OR infecti* OR diseas* NOT INCLUDING obitu* OR sewer OR colt* OR flag*”. To account for items that were in Spanish the following search terms were employed “salud OR cancer* OR diabet* OR asm* OR saludabl* OR ‘fiebre de valle’ OR ‘Fiebre de Valle’ OR dieta OR nutricion OR allergia* OR obesidad* OR enfermedad OR ‘enfermedades infecciosas’ OR amamantar”.
Since the study was completed, an independent Spanish-language newspaper has started weekly publication and serves a small community within the county.
References
American Lung Association. (2015). State of the air 2015. Retrieved from http://www.stateoftheair.org/2015/assets/ALA_State_of_the_Air_2015.pdf
Brodie, M., Kjellson, N., Hoff, T., & Parker, M. (1999). Perceptions of Latinos, African Americans, and Whites on media as a health information source. Howard Journal of Communication, 10(3), 147–167.
Caburnay, C. A., Luke, D. A., Cameron, G. T., Cohen, E. L., Fu, Q., Lai, C. L., et al. (2012). Evaluating the Ozioma cancer news service: A community randomized trial in 24 US cities. Preventive Medicine, 54(6), 425–430.
Cohen, E. L., Caburnay, C. A., Len-Ríos, M. E., Poor, T. J., Cameron, G. T., Luke, D. A., et al. (2010). Engaging ethnic media to expand the reach and effectiveness of communication strategies to reduce health disparities. Health Communication, 25(6–7), 569–571.
Colby, S. L., & Ortman, J. M. (2015). Projections of the size and composition of the US population: 2014 to 2060. U.S. Census Bureau Publication No. P25-1143. Washington, DC: U.S. Department of Commerce. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143
Cowan, T. (2005). California’s SJV: A region in transition. Congressional Research Services. RL33184.
Freimuth, V. S., & Quinn, S. C. (2004). The contributions of health communication to eliminating health disparities. American Journal of Public Health, 94(12), 2053–2055.
Friedman, D. B., Tanner, A., & Rose, I. D. (2014). Health journalists’ perceptions of their communities and implications for the delivery of health information in the news. Journal of Community Health, 39(2), 378–385.
Garfrerick, B. H. (2010). The community weekly newspaper: Telling America’s stories. American Journalism, 27(3), 151–157.
Great Valley Center. (2014). Assessing the region via indicators: The economy (4th ed.). Modesto, CA: Great Valley Center.
Hubbell, A. P., & Dearing, J. W. (2003). Local newspapers, community partnerships, and health improvement projects: Their roles in a comprehensive community initiative. Journal of Community Health, 28(5), 363–376.
Joint Center for Political and Economic Studies. (2012). Place matters for health in the San Joaquin Valley: Ensuring opportunities for good health for all. Fresno, CA: Joint Center for Political and Economic Studies and San Joaquin Valley Place Matters Team.
Kalin, S. R., & Fung, T. T. (2013). Comparison of child obesity prevention and control content in mainstream and Spanish-language US parenting magazines. Journal of the Academy of Nutrition and Dietetics, 113(1), 133–140.
Kelly, B., Hornik, R., Romantan, A., Schwartz, J. S., Armstrong, K., DeMichele, A., et al. (2010). Cancer information scanning and seeking in the general population. Journal of Health Communication, 15, 734–753.
Kim, A. E., Kumanyika, S., Shive, D., Igweatu, U., & Kim, S. H. (2010). Coverage and framing of racial and ethnic health disparities in US newspapers, 1996–2005. American Journal of Public Health, 100(S1), S224–S231.
Kondracki, N. L., Wellman, N. S., & Amundson, D. R. (2002). Content analysis: Review of methods and their applications in nutrition education. Journal of Nutrition Education and Behavior, 34, 224–230.
Krieger, J. L., Katz, M. L., Eisenberg, D., Heaner, S., Sarge, M., & Jain, P. (2013). Media coverage of cervical cancer and the HPV vaccine: Implications for geographic health inequities. Health Expectations, 16(3), e1–e12.
Lee, C. J., Ramirez, A. S., Lewis, N., Gray, S. W., & Hornik, R. C. (2012). Looking beyond the Internet: Examining socioeconomic inequalities in cancer information seeking among cancer patients. Health Communication, 27(8), 806–817.
Len-Ríos, M. E. (2012). The potential for communication scholars to set priorities that curb health disparities. Howard Journal of Communications, 23(2), 111–118.
Len-Ríos, M. E., & Hinnant, A. (2014). Health literacy and numeracy: A comparison of magazine health messages. Howard Journal of Communications, 25(3), 235–256.
Livingston, G., Minushkin, S., & Cohn, D. (2008). Hispanics and healthcare in the United States: Access, information and knowledge. A Pew Hispanic Center and Robert Wood Johnson Foundation Research Report. Retrieved from http://pewhispanic.org/files/reports/91.pdf
Manierre, M. (2016). Examining the relationship between flexible resources and health information channel selection. Health Communication, 31(1), 22–34.
Matsaganis, M. D., Katz, V. S., & Ball-Rokeach, S. J. (2010). Understanding ethnic media: Producers, consumers, and societies. Thousand Oaks, CA: Sage.
Metzger, M. J., Flanagin, A. J., Eyal, K., Lemus, D. R., & Mccann, R. M. (2003). Credibility for the 21st century: Integrating perspectives on source, message, and media credibility in the contemporary media environment. Communication Yearbook, 27(1), 293–335. http://doi.org/10.1207/s15567419cy2701_10.
Neuendorf, K. A. (2002). The content analysis guidebook. Thousand Oaks, CA: Sage.
Niederdeppe, J., Bigman, C. A., Gonzales, A. L., & Gollust, S. E. (2013). Communication about health disparities in the mass media. Journal of Communication, 63(1), 8–30.
Nothwehr, F., Chrisman, M., & Andsager, J. L. (2014). Improving rural newspaper coverage of nutrition stories: An educational assessment of editors’ attitudes and learning needs. Health Promotion Practice, 15(6), 849–856.
Pew Research Center. (2016). State of the news media 2016. Retrieved from http://www.journalism.org/2016/06/15/state-of-the-news-media-2016/
Ramadurai, V., Sharf, B. F., & Sharkey, J. R. (2012). Rural food insecurity in the United States as an overlooked site of struggle in health communication. Health Communication, 27(8), 794–805.
Ramírez, A. S. (2013). Effects of ethnic targeting on the perceived effectiveness of cancer prevention messages among latinas and non-latina white women. Journal of Health Communication, 18(10), 1256–1273. http://doi.org/10.1080/10810730.2013.778362.
Ramírez, A. S., Freres, D., Martinez, L. S., Lewis, N., Bourgoin, A., Kelly, B. J., et al. (2013). Information seeking from media and family/friends increases the likelihood of engaging in healthy lifestyle behaviors. Journal of Health Communication, 18(5), 527–542.
Ramirez, A. S., Nelson, D. E., Graff, K., Leyva Vengoechea, B., Galica, K., Banegas, M., et al. (2015). Who seeks Cita Con el Doctor?: Descriptive epidemiology of 20 years of a Spanish-language radio health promotion and education program. Health Education & Behavior, 42(5), 611–620.
Rooks, R. N., Wiltshire, J. C., Elder, K., BeLue, R., & Gary, L. C. (2012). Health information seeking and use outside of the medical encounter: Is it associated with race and ethnicity? Social Science and Medicine, 74, 176–184.
State of California Department of Finance. (2014). Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010–2060. Sacramento, California, December 2014. www.dof.ca.gov/research/demographic/reports/projections/P-3/
Stryker, J. E., Wray, R. J., Hornik, R. C., & Yanovitzky, I. (2006). Validation of database search terms for content analysis: The case of cancer news coverage. Journalism & Mass Communication Quarterly, 83(2), 413–430.
U.S. Census Bureau. (2015). State & county Quickfacts: Merced County CA. Retrieved December 4, 2015, from http://quickfacts.census.gov.
Vanderpool, R. C., Kornfeld, J., Finney Rutten, L., & Squiers, L. (2009). Cancer information-seeking experiences: The implications of Hispanic ethnicity and Spanish language. Journal of Cancer Education, 24(2), 141–147.
Vargas, L. C., & dePyssler, B. J. (1999). U.S. Latino newspapers as health communication resources: A content analysis. The Howard Journal of Communications, 10, 189–205.
Villar, M. E., & Olson, Y. B. (2013). Differences in English-and Spanish-language health news: A comparison of newspapers in two cities. Howard Journal of Communications, 24(1), 57–70.
Viswanath, K. (2006). Public communications and its role in reducing and eliminating health disparities. In Examining the health disparities research plan of the National Institutes of Health: Unfinished business (pp. 215–253). Washington, DC: National Academy of Sciences.
Viswanath, K., & Ackerson, L. K. (2011). Race, ethnicity, language, social class, and health communication inequalities: A nationally representative cross-sectional study. PLoS ONE, 6, e14550.
Viswanath, K., Nagler, R. H., Bigman-Galimore, C. A., Jung, M., McCauley, M., & Ramanadhan, S. (2012). The communications revolution and health inequalities in the 21st century: Implications for cancer control. Cancer Epidemiology, Biomarkers and Prevention, 21(10), 1701–1708.
Wallington, S. F., Blake, K. D., Taylor-Clark, K., & Viswanath, K. (2010). Challenges in covering health disparities in local news media: An exploratory analysis assessing views of journalists. Journal of Community Health, 35(5), 487–494.
Wang, Y., & Rodgers, S. (2013). Reporting on health to ethnic populations: A content analysis of local health news in ethnic versus mainstream newspapers. Howard Journal of Communications, 24(3), 257–274.
Wiltshire, J., Cronin, K., Sarto, G. E., & Brown, R. (2006). Self-advocacy during the medical encounter: Use of health information and racial/ethnic differences. Medical Care, 44, 100–109.
Young, R., Willis, E., Stemmle, J., & Rodgers, S. (2015). Localized health news releases and community newspapers: A method for rural health promotion. Health Promotion Practice, 16(4), 492–500.
Zhao, X. (2010). Cancer information disparities between US-and foreign-born populations. Journal of Health Communication, 15(S3), 5–21.
Acknowledgements
The authors would like to acknowledge Zabrina Campos-Melendez for her assistance with coding verification and the anonymous reviewers for their thoughtful suggestions.
Funding
This study was supported in part by grants from the Hellman Family Foundation and the National Cancer Institute of the National Institutes of Health (Award Number K01CA190659). Neither the Hellman Foundation nor the NIH bears any responsibility for the content reported in this paper.
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Ramírez, A.S., Estrada, E. & Ruiz, A. Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality. J Primary Prevent 38, 345–362 (2017). https://doi.org/10.1007/s10935-017-0466-7
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DOI: https://doi.org/10.1007/s10935-017-0466-7