Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality
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.
KeywordsNewspapers Mass media Latino Social determinants of health Content analysis
The authors would like to acknowledge Zabrina Campos-Melendez for her assistance with coding verification and the anonymous reviewers for their thoughtful suggestions.
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.
Compliance With Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
- American Lung Association. (2015). State of the air 2015. Retrieved from http://www.stateoftheair.org/2015/assets/ALA_State_of_the_Air_2015.pdf
- 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.Google Scholar
- Garfrerick, B. H. (2010). The community weekly newspaper: Telling America’s stories. American Journalism, 27(3), 151–157.Google Scholar
- Great Valley Center. (2014). Assessing the region via indicators: The economy (4th ed.). Modesto, CA: Great Valley Center.Google Scholar
- 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.Google Scholar
- 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
- Matsaganis, M. D., Katz, V. S., & Ball-Rokeach, S. J. (2010). Understanding ethnic media: Producers, consumers, and societies. Thousand Oaks, CA: Sage.Google Scholar
- 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.CrossRefGoogle Scholar
- Neuendorf, K. A. (2002). The content analysis guidebook. Thousand Oaks, CA: Sage.Google Scholar
- 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/
- 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.CrossRefPubMedPubMedCentralGoogle Scholar
- 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.CrossRefGoogle Scholar
- 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/
- U.S. Census Bureau. (2015). State & county Quickfacts: Merced County CA. Retrieved December 4, 2015, from http://quickfacts.census.gov.
- 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.Google Scholar
- 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.CrossRefPubMedPubMedCentralGoogle Scholar