Media Analysis and Public Health

Contemporary Issues in Critical Public Health

Lesley Henderson, Shona Hilton, Judith Green, Lesley Henderson, Shona Hilton, Judith Green

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000458640
• Edition: 1
• Topic: Law
• Subtopic: Medical Law
• Index: Law

This volume showcases new approaches to studying public health in traditional and emerging media, suggesting that we need more analyses that focus on the production of media and on power dynamics, as well as studies of audience reception of media messages.

The collection asks a variety of questions about the role of media in analysing public health. Contributors ask: who is influential in producing the stories we see in the press and on social media? Who benefits, and who is damaged, by media debates on health topics? They investigate the role of big business in seeking to shape public opinion and consumption in print and online media; how issues such as hand washing come to be framed over time by newspapers; how conflicts over immunisations get covered; how health promotion messages do their work; and the positive role of online media in helping foster drug safety. Together, they reach the conclusion that since mass media is a crucial element of civic society, more in-depth understanding of how it works and what impacts it has on public health is essential.

Given the crucial role of the media in shaping health debates, pushing certain issues up the policy agenda, defining problems for audiences and presenting potential solutions, this book's analysis will be of interest to all those studying how the media shape policy, as well as public health researchers with an interest in mass communication. This book was originally published as a special issue of Critical Public Health.

1 How the food, beverage and alcohol industries presented the Public Health Responsibility Deal in UK print and online media reports

Nick Douglas, Cecile Knai, Mark Petticrew, Elizabeth Eastmure, Mary Alison Durand and Nicholas Mays

ABSTRACT

The Public Health Responsibility Deal (RD) in England is a public–private partnership between government, industry and other stakeholders aiming to improve public health in four key areas: food, alcohol, health at work and physical activity. Wider literature shows that industry engages in framing of public health policy problems, solutions and its role in solutions that is favourable to its interests. As part of an evaluation of the RD, we conducted a media analysis to explore how industry spokespersons (from commercial enterprises, trade associations and social aspects/public relations organisations) represented the RD in newspaper and online reports. We systematically searched databases indexing articles of British national newspapers and the online news services of national broadcasters for articles published between 2010 and 2015. After application of inclusion criteria, we identified 247 relevant articles. We extracted direct quotations by industry spokespersons and analysed them thematically. Media reporting about the RD provided industry spokespersons with a high-profile platform to present frames relating to food, beverages and alcohol that were favourable to advancing or protecting industry positions and agendas. Framing of issues addressed responsibility for public health problems, policy options and the role of industry, also legitimising industry spokespersons to advocate a position on how public health policy should evolve. Media analysis can elucidate industry discourses around public health and examine their engagement in framing to extend their influence in public health policy.

Introduction

The Public Health Responsibility Deal (RD) was launched in 2011 as a public–private partnership consisting of voluntary agreements between government, industry and other stakeholders in England aiming to improve public health (Department of Health, 2011). Signatories pledge to undertake public health-related activity as part of four networks: food, alcohol, health at work and physical activity.

Media reports can play a crucial role in selecting issues for public attention, policy agenda setting, framing issues in a particular way and shaping perceptions about who is responsible for social problems (Kim & Willis, 2007). Framing is an integral technique of media reporting. It can function to enable the construction of meaning and the provision of a logic that renders an issue comprehensible; shape the parameters of a public policy debate (i.e. problem definition, causal attribution, recommended remedial action); identify an issue or problem as political in nature; identify legitimate participants/commentators; and open up some policy options/solutions while closing down others (Hawkins & Holden, 2013; Nixon et al., 2015).

Studies have identified how alcohol, food and beverage industries engage in framing to influence public discourse about public health problems, solutions and the role of industry in those solutions that is favourable to their interests (Brownell & Warner, 2009; Casswell, 2013; Hawkins & Holden, 2013; Mialon, Swinburn, & Sacks, 2015). Hawkins and Holden (2013), drawing on Snow and Benford (1988) and Benford and Snow (2000), offer a useful conceptual schema for understanding framing activity by industry actors: diagnostic framing seeks to define the problems, prognostic framing offers solutions to the problems identified and motivational framing seeks to enlist support and move people to act to effect social change.

As part of a larger, independent evaluation of the RD commissioned by the English Department of Health in 2013, we conducted a media analysis of public statements in newspaper articles and online news reports by industry spokespersons. The term ‘industry’ refers here to food and drinks producers, manufacturers, wholesalers, retailers, trade associations and social aspects/public relations organisations funded by relevant industries (Babor, 2009). We sought to explore whether and how industry spokespersons framed and presented the RD in ways that protected their commercial interests and promoted core business goals. Our analysis of news reports about the RD examined how industry spokespersons framed the public health challenges the RD was designed to address, their preferred policy solutions and their role as RD partners. We focused on industry spokespersons as industry participation in the RD was a contentious issue, with the UK Faculty of Public Health withdrawing from the RD and its president stating that industry interests were being prioritised over public health, alongside the withdrawal of a number of non-governmental health organisations (Boseley, 2011; Limb, 2013; Panjwani & Caraher, 2014).

Methods

Searching

We identified print and online news articles containing direct quotations from spokespersons about the RD. Table 1 summarises the process we undertook to search for, screen, code and analyse the articles identified.

During March 2015, we searched for articles published between 31 October 2010 and 28 February 2015 in all national daily newspapers in (mainland) Britain via two newspaper article databases (LexisNexis and ProQuest). This included newspapers reflecting editorial styles ranging across the political spectrum and those that featured longer, in-depth articles as well as those written in a brief, tabloid style. We also searched the websites of three main national television news broadcasters providing online news coverage (BBC News, Channel 4 News, Sky News) for the same time period, using each website’s search facility. We identified 606 articles in total (see Supplementary Material – Figure 1). Search terms used were ‘Public Health Responsibility Deal’ or ‘responsibility deal’.

Screening

After preliminary screening of database search records to remove duplicates and non-relevant articles, 399 articles remained. Full-text articles were imported into Endnote 7 for data management. Two researchers independently performed a second screening to remove duplicates and those that contained no specific reference to or quotations about the RD. We used the criteria in Table 1 to categorise the articles. After independent categorisation, we identified an initial difference between the two researchers’ assessments regarding around 10% of articles. This was resolved in all cases following review and discussion so that an agreed classification was reached without need for referral to a third designated researcher. Following this process, 247 articles that were about the RD and/or contained quotations about the RD were identified and imported into NVivo 10 for textual analysis (see Supplementary Material – Figure 1).

Table 1. Methods.

1.1. Summary of methods
Search	• Dates of searches: March 2015 • Dates of articles: 31/10/10 and 28/2/15 • Search terms: ‘Public Health Responsibility Deal’ or ‘responsibility deal’ • Databases searched: LexisNexis and ProQuest • Websites searched: BBC News, Channel 4 News, Sky News
Screening	• Full text downloaded to Endnote 7 • Duplicates – removed • Articles with no specific references to the RD – removed • Articles with no quotations about the RD – removed • Two researchers independently screened articles according to selection criteria – see 1.2 • 10% discrepancy in designation of articles identified – resolved following review and discussion without need for review by third researcher
Coding and textual analysis	• Articles categorised 3 or 4 imported into NVivo 10 • Articles read in full • Quotations from each article extracted – name of the speaker and organisational attribution (where given) recorded • Coding conducted according to principles of Braun and Clarke’s (2006) approach to thematic analysis by first author • 20% of thematic coding reviewed by second author – no discrepancies identified
1.2. Article categorisation criteria
1. Not substantively about the RD 2. Is about the RD but contains no quotes 3. Not substatively about the RD but does contain quotes about it. (Articles were also ranked 3 where there was reference to the RD but quotes referred to ‘voluntary agreements’ or where the context made it explicit that the person quoted was referring to the RD even if the specific phrase RD was not used.) 4. Substantively about the RD and contains quotes about the RD

Coding and analysis

We read all articles and extracted only text from each article that was clearly identifiable as a direct quotation (we retained additional surrounding text to preserve original context and meaning). The only exceptions were comment pieces by identified authors or letters to the editor, which we treated as extended quotations. The name of the speaker and organisational attribution (where given) were recorded and speakers were grouped by organisational type (see Supplementary Material – Figure 2).

We then reread all quotations in full. The first author then coded and analysed them according to Braun and Clarke’s (2006) approach to thematic analysis, using an inductive approach, i.e. generating themes in a grounded way from the data rather than using a priori categories. Examples of coding are provided as illustration (see Supplementary Material – Table 2). The second researcher examined 20% of the thematic coding. No discrepancies were identified.

We then extracted the quotations attributed to industry spokespersons. The data analysed were 83 coded excerpts containing quotations from 68 articles.

A thematic map was generated based on the inductive coding of quotations from these spokespersons, representing the discursive themes deployed (see Supplementary Material – Figure 3). In accordance with the thematic map, we present findings on positive and critical views about the RD by spokespersons quoted; the balance of content in quotations regarding the four RD networks; representations of the public health challenges and the role of industry; preferred policy responses; and reputation enhancement and corporate social responsibility. Articles that featured the quotations presented in the following findings are listed in Supplementary Material –Table 3.

Findings

Data from 21 different newspapers and the online news services of three TV broadcasters were included. Of the 247 articles analysed, the most common sources were The Guardian (n = 47, 19%) and Daily Mail Newspapers (n = 35, 14%), and BBC News online (n = 33, 13%), cumulatively accounting for almost half of the articles analysed (n = 115, 46%) (see Supplementary Material – Figure 4). Of the 218 spokespersons, government (n = 54) and industry (n = 48) representatives were most often quoted, followed by those from NGOs (n = 37) (see Supplementary Material – Figure 2). The findings as follows focus on the analysis of quotations attributed to industry spokespersons.

With the exception of the dissenting voices discussed below, quotations about the RD from industry spokespersons were frequently expressed in positive terms, with phrases such as ‘practical, measurable, deliverable’, ‘positive and progressive work’, ‘the start of a journey’ and ‘significant development’ used.

These pledges represent a great start to what we hope will be a long-term shared plan to improve alcohol awareness and reduce alcohol harm. Stefan Orlowski, Heineken (News of the World, 2011 March 13).

Although there are four RD networks (food, alcohol, health at work and physical activity), almost all of the quotes concerned food and/or alcohol or referred to the RD and participation in general terms, with very little material regarding the latter two networks. Only two quotes substantively addressed physical activity and health at work, both of which referred to an ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Citation Information
• Notes on Contributors
• Preface: Media, Evidence and Debate
• Introduction – The media and public health: where next for critical analysis?
• 1 How the food, beverage and alcohol industries presented the Public Health Responsibility Deal in UK print and online media reports
• 2 Public engagement and the role of the media in post-marketing drug safety: the case of Eltroxin® (levothyroxine) in New Zealand
• 3 How alcohol marketing engages users with alcohol brand content on Facebook: an Indian and Australian perspective
• 4 ‘To drink or not to drink’: media framing of evidence and debate about alcohol consumption in pregnancy
• 5 Working up a lather: the rise (and fall?) of hand hygiene in Canadian newspapers, 1986–2015
• 6 Diet, exercise…and drugs: social constructions of healthy lifestyles in weight-related prescription drug advertisements
• 7 ‘I cannot explain it. I knew it was wrong’: a public account of cigarette smoking in pregnancy
• 8 Perception and translation of numbers: the case of a health campaign in Denmark
• 9 Newspaper coverage of childhood immunisation in Australia: a lens into conflicts within public health
• 10 Is social isolation a public health issue? A media analysis in Aotearoa/New Zealand
• Index