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Generating Conflict for Greater Good: Contingency Theory as a
Strategic Tool to Impact Health Disparities in African American Communities
*Crystal Y. Lumpkins (Ph.D. Student) and Jiyang Bae (Ph.D. Student),
**Glen T. Cameron (Ph.D.) and Shelly Rodgers (Ph.D.-MU)
University of Missouri-Columbia
Doug Luke (Ph.D.) and Matt Kreuter (Ph.D.)
St. Louis University
*Contact author:
1691 N. Doulton Drive
Columbia, MO 65202
Phone: (573) 886-8534
E-mail: [log in to unmask] or [log in to unmask]
**Contact author:
214 A. Walter Williams
Columbia, MO 65203
Wk: (573) 884-2607
E-mail: [log in to unmask]
Authors' note: This research was supported by a grant from the
National Cancer Institute, Centers of Excellence in Cancer
Communication Research initiative (1P50CA095815-02)
Paper submitted for peer review to the Minorities and Communication
Division of the Association for Education in Journalism & Mass
Communication Conference in San Antonio, Texas
Submitted: April 1, 2005
ABSTRACT
To assess the use of strategic conflict management as a health
advocacy tool in African American communities, cancer news stories in
Black vs. mainstream newspapers were compared to determine whether
they differed with regard to conflict factors. Conflict factors
included health-related risk factors, health disparities, and
community and personal behavior mobilization. The method was a
content analysis of 24 Black and 12 mainstream newspapers, randomly
selected from the U.S. The results showed that more conflict factors
were present in Black vs. mainstream newspapers. Specifically, more
health disparities for African Americans in the index and comparison
groups were present in the Black vs. mainstream newspapers.
Additionally, personal behavior mobilization was present more often
in Black vs. mainstream newspapers. The findings are congruent with
contingency theory and support the position that conflict factors are
important in media advocacy research that focuses on minority populations.
Black newspapers are an influential voice in the African American
community and a trusted source that African Americans rely on for
important information. Black newspapers have historically been an
institution to fight racial injustice and also to preserve African
American culture (Lacy, Stephens & Soffin, 1991). In many African
American communities, Black newspapers have the same status as other
well respected social institutions like schools and churches (Brown,
1994; Sylvester, 1993).
A national survey of 2,522 African-American households in 1993 showed
that 90% of respondents agreed that Black newspapers provided
information not available in the mainstream press. A majority of
respondents also reported that reading a Black newspaper made them
feel like part of the local community (Sylvester, 1993). In another
national survey conducted in 1993-1994, 69% of African Americans
reported recently reading a Black newspaper. More than half (51 %)
of African Americans who read the newspaper spend 30 minutes or more
reading an issue of a Black newspaper (Sylvester, 1993).
While the Black newspaper is in a position to influence African
Americans, it remains a largely untapped resource to give information
concerning health issues that affect African Americans nationwide,
specifically cancer. Cancer is the second leading cause of death
among African-Americans (American Cancer Society, 1998, 2000); in
fact, Blacks have a higher cancer incidence rate than Whites or any
other racial group (American Cancer Society, 2002). Overall,
approximately 130,800 Blacks were diagnosed with cancer in 2000 and
an estimated 63,500 died from it (Atlanta, GA: American Cancer
Society, 2000; American Cancer Society, Inc., 2000). Among the
leading causes of cancer deaths are lung, colon, rectum, prostate,
breast and pancreas (American Cancer Society, 2000) of which breast
and prostate cancer are substantially higher in Blacks when compared
to Whites.
The purpose then of this paper is to analyze the content of news
stories concerning cancer coverage in Black newspapers to determine
what, if any, conflict factors are used in news stories targeted to
African Americans. Conflict factors in the analysis include
health-related risk factors, health disparities, and community and
personal behavior mobilization. Those conflict factors will then be
compared to those in mainstream newspapers to see if Black newspapers
have better health coverage with regard to conflict factors. This
examination may determine not only what is present on the media
agenda of African Americans with regard to cancer information, but by
knowing what is present, we would also know what is absent in that
agenda. If Black newspapers do a better job of using conflict
factors than mainstream newspapers, this will provide insights into
both the content and tactics used to convey cancer-related
information to Blacks. This information can then be used to create
strategic communication efforts aimed at increasing coverage of
cancer and thereby filling in some gaps of information that would
help African Americans understand cancer more fully and in a
different context.
BACKGROUND
Cancer is an important and potentially polemical issue for African
Americans. The disease disproportionately affects Black men and
women when compared to various ethnic groups. Prostate cancer
disproportionately affects Black men when compared to all other
ethnic groups. They have prostate cancer 50 % more than White men
and Ebony magazine reports that the prostate cancer rate among
African American men is the highest in the world (Ebony, July 2004).
Black women are 28 percent more likely to die of breast cancer than
White women (Lee, 2004). Breast cancer is the most common form of
cancer among African American women. Even though researchers report
African-American women have a slightly lower incidence of breast
cancer as compared to White women, mortality rates are greater
(Cancer Statistics for African Americans, 1996; El-Tamer, Homel, &
Wait, 1999; Komen Breast Cancer Foundation, 1999, Lipkus, Iden,
Terrenoire, & Feaganes, 1999; National Cancer Institute,
1996). Black women are generally diagnosed with breast cancer
younger but the cases are reported to be more aggressive forms of
breast cancer.
Overall, all-site cancer mortality is higher among Blacks than
Whites or other groups, and rates are disproportionate between Black
and White men. Whites who develop cancer have higher survival rates
than Blacks at all stages of diagnosis. These disparities are found
for all of the five leading causes of cancer death (American Cancer
Society, 2002.) Black newspapers, a trusted social institution in
the Black community, can therefore be considered as a venue to
disseminate cancer information aimed at filling gaps of information
that would help African Americans understand the alarming statistics
and disparities.
THEORETICAL FRAMEWORK
Contingency Theory
Our research, guided by the contingency theory of accommodation in
public relations, posits that public relations professionals
determine the stance of an organization toward a given public at a
given time as a consequence of strategic assessment of a welter of
factors. The stance falls upon a continuum that ranges from pure
advocacy to pure accommodation (Reber & Cameron, 2003) depending upon
changing circumstances. Decisions about the degree of advocacy and
related communication strategies comprise the strategic communication
approach of the organization. The strategies may seek to ameliorate
or minimize conflict for the organization, or they may be strategies
to increase conflict as a lever or pressure point to achieve
organizational goals. Applied to cancer news, contingency theory
may suggest the merit of escalating conflict to some degree. If
cancer news stories can present information to African Americans that
use conflict factors, stories might have a better chance of both
being picked up by the media and read with greater interest and
conviction by African American readers.
The contingency theory of accommodation, a public relations theory
that suggests strategies for effective communication between
organizations and their key audiences, essentially views public
relations as strategic management of conflict in the interests of
one's organization (Cancel, Mitrook and Cameron, 1999). Cancel,
Mitrook and Cameron, offered the contingency theory of conflict
management as a "new direction for research in public relations to
better understand how the public relations field manages conflict and
reaches out to publics in the external communication environment,"
(Cancel, et.al 1999, p. 172 ). By raising the level of awareness
through conflict, African American publics, as well as the publics
who deliver health care to African Americans, can be moved toward
greater advocacy on behalf of the population. This theory can serve
as a framework for strategic construction of key health messages in
health news releases disseminated to Black newspapers. The framework
also works for the Black newspaper as it views its readership base as
a key public in the community. Strategic conflict management could
improve the process of communicating health disparities as a strategy
to effect ultimate change in communities.
The underpinnings of this theory then support the argument that
health information disseminated to Black newspapers may effectively
take a conflict-orientation to promulgate a strong, advocative
position that garners more coverage of cancer. The presence of
conflict factors such as health disparities, risk factors and
community mobilization in health news releases disseminated to Black
newspapers could possibly lead to health stories concerning
life-threatening cancers and thus greater awareness among African
Americans. By the same token, newspapers that adhere to civic
journalism principles will also benefit from a strategic use of
conflict in news content to affect the same ends as health advocates.
Civic Journalism
Civic journalism or public journalism becomes central to the
current study as a potential platform for strategic conflict
management in the interests of the local community. This theoretical
framework suggests the role of the media is to exchange traditional
objective coverage for a more active, even proactive, role in the
community (Stein, 1994). Applied to cancer news, civic journalism
would lead to cancer news stories that present information to African
Americans capitalizing on fairly alarming conflict factors in Black
communities to motivate readers; consequently, readers may have a
better chance of receiving pertinent information to reduce risk
factors and health disparities as well as making that information
personally relevant. African Americans would have information and
referral to resources as empowerment mechanisms for change. The
inclusion of such information could then lead to community
mobilization- meaning individuals would be better equipped and able
to take the steps necessary to led healthier lives – as well as to
affect changes in personal risk factors that drive some of the
African American health disparities pertaining to cancer.
Because Black newspapers have been a social institution in the
Black community for decades, Black newspapers compared to mainstream
newspapers can be instrumental in strategically communicating
pertinent cancer news stories by presenting evidence and compelling
stories concerning disparate risk factors, disparate health outcomes,
and disparate health services to generate both community and personal
mobilization. By using the news value of conflict to actually
generate coverage, health communicators may choose to take a more
aggressive contingency stance and thereby raise the awareness and
understanding of cancer as a disease and a health threat in African
American communities.
LITERATURE REVIEW
The Role of Black Newspaper
The Black newspaper, a media outlet that has been around for more
than 170 years, has traditionally been the voice for Blacks. When
journalist John Brown Russworm, and the Rev. Samuel E. Cornish
published the first edition of Freedom's journal in 1827, they were
embarking upon a rich history of championing political and social
cause in the Black community (New York Amsterdam News, 2002).
African American newspapers have been defined as newspapers that are
owned and managed by African Americans and are targeted to African
American consumers – the newspapers then are those that 'serve,
speak, and fight for the black minority," (Wolseley 1989, p. 4).
Black newspapers have traditionally served as an outlet for stories
of interest and also an alternative to mainstream newspapers (Pride &
Wilson 1997; Wolseley, 1972). Historically, the Black press was the
only place that African Americans felt their story could be told and
in some cases reported in an objective manner. Blacks felt that the
Black press more accurately reflected issues in the Black community
and served as an alternative to negative representations of Blacks
(Pride & Wilson 1997; Wolseley, 1972).
In 77 cities throughout the United States with populations of more
than 200,000, 71% or 55 cities have at least one Black newspaper
(Gebbie, 2000; U.S. Bureau of the Census, 1990). The fact that most
Black newspapers are locally controlled shows that there is a
proclivity for these newspapers to be more attentive and responsive
to local issues (Wolsely, 1972; Convissor, Vollinger & Wilbur 1990;
Oliver, & Maney, 2000).
Conflict Factors
The health status among African Americans is disparaging. The
numbers of African Americans suffering due to issues such as
socio-economic, environmental and cancer or disease are
disproportionately high (Marks, Reed, Colby & Ibrahim,
2004). Greater still are statistics which show cancer as the second
leading cause of death among African-Americans (American Cancer
Society, 1998, 2000); cancer incidence and mortality rates are the
highest among African Americans (Jernigan, J., et.al, 2001).
In some cases the health belief among African Americans has created a
barrier of fear and mistrust of doctors and thus prevents them from
participating in treatment or prevention (Matthews, A. K.,
2002). Many African Americans have referred to the Tuskegee
syphilis experiment where hundreds of rural African American men were
denied treatment and misinformed about their medical condition
(Pickle, K., 2002).
Not only has medical personnel and mistrust been barriers, but
access to adequate medical care has contributed to health
disparity. Crisis magazine reports that according to the Census
Bureau, "more than 20 % of African Americans are uninsured, compared
to 15 % of the overall population," (Lee, 2004). The same report
goes on to state that the Agency for Healthcare Research and Quality
found medical bias to be a cause of health care disparities (Lee, 2004).
Risk factors among African Americans are high as well. Living
conditions, such as substandard housing, have had a major impact on
health. Crisis magazine shows that studies have linked race, disease
and hazardous environments (Lee, 2004). The magazine reports that a
1983 study by the U.S. General Accounting Office found that three out
of four hazardous waste landfills in the Southeast were located in
predominately Black or poor neighborhoods. In 1992, another report
by the Environmental Protection Agency released showed that "Blacks
were more likely to be exposed to hazards in their work and living
environments than other groups" (Lee, 2004).
As part of the social environment, the media are in a unique position
to influence when emphasizing specific health topics with a
conflict-orientation in news coverage.
In a study examining conflict issues in news stories, researchers
found that the more prominent the local conflict story is, the less
imbalanced it will be - the higher the reporter's priority for local
conflict, the less imbalanced the conflict stories will be ( Fico &
Balong, 2003).
Race is often tied to coverage of health issues and risk factors and
can be seen as a conflict issue.
In a study that involved 3,400 telephone interviews with African
Americans, Latinos, and Whites, researchers found divergent attitudes
toward media coverage of health issues. African Americans and
Latinos were more critical of health coverage when compared to Whites
and complained that the media lacked coverage of specific health
topics (Levine, Foster, Fullilove, Fullilove, Briggs, Hull, Husaini
and Hennekens, 2001).
In a content analysis of five daily Black newspapers in 2002, the
coverage of HIV/AIDS yielded results that showed the framing of
life-threatening stories concerning health affected public
perception. "Media portrayals of HIV/AIDS and those affected by the
disease can strongly influence public perception of disease and
risk," (Pickle, Quinn & Brown, 2002). Researchers further concluded
that the framing of the "threat" or conflict of the HIV/AIDS epidemic
in these Black newspapers would increase knowledge and ultimately
behavior through efforts of public health practitioners (Pickle et.
al, 2002). By the advocacy stance the Black newspapers took instead
of an accommodative stance in this case, more people were aware of
the dangers of the deadly disease.
In another study, Condit, Parrott, Bates, Bevan and Achter examined
the impact of messages concerning genes and race on attitudes through
an experimental study that exposed participants to Public Service
Announcements about race, genes, and heart disease. Participants
who received a message which specified either 'Whites' or 'Blacks' as
the subject of the message demonstrated increased levels of racism
(Condit et. al, p 402).
This article goes on to state that media scholars have demonstrated
mass-mediated messages do routinely stereotype racial minorities in
the U.S. Robert Entman and Andrew Rojecki are cited as providing
exploration on media content about race and public attitudes. Their
study revealed "negative stereotypes of Blacks in mass media and the
lack of positive images of Blacks, enhance(s) White hostility to
African Americans." The study also showed that media stereotypes
influence predominant attitudes about race among Whites, which Entman
and Rojecki summarize as 'racial denial'" (Condit et. al, p
403). The study states that while the portrayal of racial groups
in relation to health messages is not explicitly stated, social
theorists have hinted that such messages about health might be
problematic. This may be due to "how the media reify race, portray
members of different groups as fundamentally different from each
other or because they assign differing qualities to members of these
different groups," (Condit, et. al, 2004). The researchers conclude
in this study that messages linking genes, health and race do
increase discriminatory attitudes in some audiences and that public
health sources should be careful when linking health, race and
genetics targeted to the public.
Mainstream newspapers should then strengthen ties with the African
American community as the mainstream media has been distrusted among
many African Americans. Mainstream media was said to "sensationalize
and distort information, portraying the lives of people with AIDS as
isolate and desperate," (Pickle et. al, p. 428).
Magazines are also a source that African Americans rely on for
information and show the lack of cancer-related information
disseminated to Blacks in the general media. In the 2000 HIV/AIDS
study, research showed African American magazines lagged behind
mainstream media in AIDS coverage and employed the same terminology
as the mainstream media (Krishnan, Duran, & Winkler, 1997; Landis,
Freimuth & Cameron, 1992). An empirical study of cancer coverage of
the major Black magazines (Ebony, Jet and Essence) from 1987-1994
showed that only 84 stories focused on cancer out of 596 issues and
649 health articles (Hoffman-Goetz et al. 1997).
These conflict factors could heighten health disparity awareness
among Blacks in communities across the country, and thereby help
alleviate health disparities.
After reviewing previous literature, this study concludes that when
Black newspapers and mainstream newspapers are compared, there is a
lack of news coverage concerning health disparities and risk factors
and the coverage needs to be increased to address the health needs of
African Americans. Thus, this study attempts to analyze the coverage
patterns of the two categories of newspapers: Black newspapers and
mainstream newspapers. The following research questions are advanced.
RQ1: What are the similarities and differences between Black vs.
Mainstream newspapers with regard to conflict factors?
Mobilizing Factors
The Black newspaper continues to provide African Americans with an
avenue for public dialogue, addressing issues relevant to Blacks that
the general media does not (Jones-Web et al, 1997; Sylvester, 1994;
Domke 1994). In essence, the Black newspaper has traditionally
served in the capacity of what media scholars call civic or public
journalism. "Public journalism," a type of coverage that encourages
editors to exchange traditional objective coverage, is a way the
media can play an active role in the community (Stein,
1994). Research on community coverage also shows that readers expect
newspapers to be the watchdog and cheerleader for unity in the
community and not simply gatekeepers (Case, 1994).
While studies show African Americans feel Black newspapers cover
health issues related to African Americans more than mainstream
newspapers (Brodie, Jellson, Hoff, Parker, 1990) coverage is centered
on medical advances, news drugs, and medical experts instead of
specific health information that may mobilize readers including risk
reduction, disease prevention and early detection (Centers for Media
and Public Affairs, 1997; Freimuth, Greenberg, DeWitt, Romano,
1984;Milio, 1985; Atkin, Wallack, 1990; Signorielli, N., 1993). Very
few newspaper articles on cancer, in both Black and mainstream,
contain mobilizing information to help the reader take some action to
reduce his or her risk (Hoffman-Goetz, L, 2000; Macdonald,
Hoffman-Goetz, 2001; MacDonald, Hoffman-Goetz, 2002).
In another study where health behavior coverage was examined in more
than 80,000 stories in 1, 354 newspaper issues, health behavior
stories were almost nonexistent. Of 1,373 stories (1. 7%) that
addressed diet, physical activity, or tobacco, only a few were
prominently located in the paper, and only half had a prevention
focus. A large portion of the news stories had no local angle, local
quotes, or call to action for individuals or the community, and a
mere 10% were generated by local reporters (Caburnay, Kreuter, Luke,
Logan, Jacobsen, Reddy, Vempaty, & Zayed 2003).
By the same token, mainstream newspapers should also make strategic
efforts to report and cover stories that concern African American
health. This important role should not be the exclusive purview of
Black newspapers nor ceded to Black newspapers by default. According
to an article in Editor and Publisher, New York Times Managing Editor
Gene Roberts is quoted as saying "'Many newspapers,' he charged, 'are
being run "like chain shoe stores" with no sense of being important
community institutions with critical responsibilities to the
public.' One solution, he offered, would be to make newspapers the
subject of public debate, holding them accountable for covering the
communities they serve, (Case, 1996).
In a qualitative study of television cancer news coverage, African
Americans seeking health information stated that the information was
simply not there for them to get or was convoluted and too hard to
understand. The women in particular wanted to know more about
specifics about breast cancer and how the cancer progresses. With
health communicators and public relations professionals providing
journalists with the necessary information, African Americans can
receive the information they need to get tested or receive proper
medical treatment (Marks, Reed, Colby & Ibrahim, 2004).
Both mainstream and Black newspapers should consider these
mobilizing issues when setting their news agendas. These newspapers
have the responsibility to cover these issues as well as they are to
be the watchdog for society (Stein, 1994). Even though Black
newspapers have a greater presence and are more trusted in the Black
community, mainstream newspapers also may have the responsibility to
add this to their discussion of story ideas and agenda. Conflict
factors used in local cancer-related news stories could not only lead
to a greater awareness but both personal and community mobilization.
After reviewing literature, this study concludes that there is a lack
of news coverage concerning health disparities, risk factors with
regard to mobilizing information in both Black and mainstream
newspapers. Thus, this study attempts to analyze the coverage
patterns of the two categories of newspapers: Black newspapers and
mainstream newspapers. The following research question was asked:
RQ2: What are the similarities and differences between Black vs.
Mainstream newspapers with regard to mobilization factors?
METHOD
The method was a content analysis, a method that analyzes
communication in a systematic, objective and quantitative manner for
the purpose of measuring variables (Kerlinger, 2000). A stratified
random sample of 24 Black and 12 mainstream newspapers were selected
from 24 U.S. cities using the procedures described by Riffe, Lacy and
Fico (1998). All cancer news stories were content analyzed in the 36
newspapers during an 11-month period between January 2004 and
November 2004. A cancer news stories was defined as any story that
contained the term "cancer" or any cancer-related mention (e.g.,
tumor, lump, malignant, etc.) in the headline and/or first two
paragraphs of the news story. These included stories about screening,
detection, treatment and prognosis were among the cancer stories that
were included. Thus, the unit of analysis was the news story, defined
in terms cancer events, issues or features. A total of 1,197 news
stories were coded—796 (66.5%) from Black newspapers and 401 (33.5%)
from Mainstream newspapers.
Coding Categories
We examined two general types of variables—conflict and mobilization
factors. A conflict factor was defined in terms of those facts or
details that highlight risk or health disparities between two or more
groups. There were two types of conflict factors: risk factors and
health disparities, defined below. Mobilization was defined in terms
of those factors or details that would enable individuals to "take
action" or make informed decisions about health behavior, in this
case, cancer behavior. There were two types of mobilization: personal
behavior mobilization and community mobilization, defined below.
Risk Factors Defined
A risk factor was defined in terms of facts or details about
potential causes of cancer that would increase the chance of
developing cancer. Risk factors included: asbestos, diet/nutrition,
exercise, genetics/family history, overweight/obesity, pollution,
radiation, reproductive/hormonal factors, smoking/tobacco,
therapeutic drugs, underweight, and viral risk factors. An "other"
category was also included.
Health Disparities Defined
A health disparity was defined in terms of inequalities or
inequities noted between different demographic groups. For example,
African Americans have a higher overall cancer incidence and
mortality rate compared to Caucasians. We examined both the index and
comparison groups. In the example above, if we were to state that
African Americans are twice as likely to die from cancer then Whites
then African Americans would be the index group and Whites is the
comparison group. If we were to say that African Americans are three
times more likely than Asian Americans to die from cancer, then
African Americans are the index group and Asian Americans are the
comparison group. We also coded types of demographic comparisons
made. In the example above, ethnicity is the demographic comparison.
Other demographic comparisons included gender, age or socioeconomic status.
Mobilization Defined
The two types of mobilization were personal behavior mobilization and
community mobilization. Personal behavior mobilization was defined in
terms of those facts or details that describe how readers can take a
specific action (e.g., call state senator, write a letter to the
editor, get breast cancer screening etc.) to reduce health risks,
prevent cancer or change behavior related to cancer. Community
mobilization was defined in terms of those facts or details that
describe how groups, businesses, organizations, government agencies,
etc. can take a specific action to reduce risks, prevent disease or
impact policy related to cancer.
Coders
Three graduate students (two females and one male) coded the data.
Intercoder reliabilities were calculated using Scott's pi index
(1955), which corrects for the number of categories used and the
probable frequency of use. An overall intercoder agreement of .98 was
reached, which exceeds the minimum accepted reliability of .75.
RESULTS
The first research question pertained to conflict factors.
Specifically, we wanted to examine which conflict factors were
present in Black versus mainstream newspapers and whether these
differed with regard to frequency. Multiple chi-square analyses were
used to examine this research question. As for risk factors, our
results revealed that risk factors differed significantly for Black
versus mainstream newspapers (c2 (11, N=49) =11.062, p>.10). As shown
in Table 1, mainstream newspapers provided more facts about
smoking/tobacco (28.6%) while Black newspapers provided more facts
about genetics/family history (see Table 1).
In terms of health disparities, our results revealed that there were
significant differences between Black and mainstream newspapers when
reporting disparities for the index group (c2 (3, N = 40) = 16.89, p
< .01). Specifically, mainstream newspapers were more likely to use
age as an index (40%) whereas Black newspapers were more likely to
use ethnicity as an index (71%) (see Table 2).
As for the comparison group, Caucasians were more frequently compared
with African Americans in Black newspapers (91%) while Caucasians
were not often compared in mainstream newspapers (50%). African
Americans were not a comparison group in mainstream newspapers
(0.0%). These differences were significant (c2 (3, N = 36) = 17.54, p < .01).
Research question 2 sought to examine the use of mobilizing
information in Black versus mainstream newspapers. Two chi-squares
were conducted to examine this question. Neither newspaper used
community mobilization to a large degree (Black=6.3% and
mainstream=7.1%) and the differences were not statistically
significant (p > .10). However, there was a significant difference
between Black and mainstream newspapers in reporting personal
mobilizing information (c2 (1, N = 153) = 12.59, p <.
01). Specifically, Black newspapers provided personal mobilizing
information (36%) more often than mainstream newspapers (7%).
DISCUSSION AND CONCLUSION
Overview of Results
The primary purpose of this study was to compare cancer news stories
in Black vs. mainstream newspapers to determine whether they differed
with regard to conflict factors. Conflict factors included
health-related risk factors, health disparities, and community and
personal behavior mobilization. The results showed that risk factors,
health disparities and personal behavior mobilization differed
significantly for Black versus mainstream newspapers. Mainstream
newspapers provided more facts about smoking/tobacco while Black
newspapers provided more facts about genetics/family history. Also,
mainstream newspapers were more likely to use age as an index whereas
Black newspapers were more likely to use ethnicity as an index.
Personal behavior mobilization was present more often in Black newspapers.
Implications of Results
The theoretical frameworks used in the study could have far
reaching impact on the way information is gathered and disseminated
by Black newspapers. While Black newspapers generally ascribe to
much of what civic journalism suggests, there could be much to gain
from the contingency theory which suggests the continuum of
communication between an organization and its public continuously
moves depending on the situation. In the case of conflict factors
such as health disparities, risk factors and community and personal
mobilization, the cancer coverage as well as the agenda-building role
of health advocates could be more advocative, even adversarial in approach.
Black newspapers are significantly more likely than mainstream
newspapers to show health disparities in their stories about cancer
using African Americans as the index group and Caucasians as the
comparison group. This fact supports including conflict into news
releases as a way to serve the conflict news value, a known news peg
in the newsmaking literature in general which evidence here suggests
may actually be a stronger news value in Black papers than in
mainstream papers. Conflict, according to contingency theory, would
be a useful strategy in the sense that it elevates the awareness of
the problem and the likelihood of mobilization. However, it should
be noted that the presence of conflict factors, in this case, health
disparities, while significantly higher for Blacks compared to
mainstream, was still very low in Black newspapers (25 out of 1200
stories or 21 out of 1200 stories, depending on group, index or
comparison). There is room to further shift the stance of both
health advocates outside and within Black newspapers. A shift in
stance may be in order for health communicators and for those who use
information subsidies from health information operations as news is
made within the walls of newspapers.
Health communicators have the opportunity to write stories that
could have an impact on how Black newspapers report or cover health
issues and information. If the stories contain conflict factors, the
information may be compelling enough for communities to act and
therefore mobilize them to do something about their
situation. "Studies show that newspapers, magazines, and television
provide people with most of their information about prevailing social
issues," (Pickle, 2002). Thus, media representation of African
Americans suffering or getting treated for cancer can influence
public perception of cancer and risk. Media could then be utilized
to help health communication efforts concerning cancer among African Americans
This examination may determine not only what is present on the media
agenda of African Americans with regard to cancer information, but by
knowing what is present, we would also know what is absent in that
agenda. If Black newspapers do a better job of using conflict
factors than mainstream newspapers, this will provide insights into
both the content and tactics used to convey cancer-related
information to Blacks. This information can then be used to create
strategic communication efforts aimed at filling in the gaps of
information that would help African Americans understand cancer in a
different context.
Limitations and Direction for Future Research
The paper utilized information from content analysis of hundreds of
Black newspapers. Future research could involve qualitative research
that would include talking to editors and reporters at Black
newspapers to find out more about the process of gathering news and
how cancer-related stories are selected. Future research would then
involve analyzing the implication of conflict frames and how the news
value of conflict is used to shape news stories. Media are not only
setting agendas but are in the process of creating frames when
presenting the news. The question of how much conflictual, disparity
coverage is too much, especially as a function of greater or lesser
accompanying information to mobilize the community and the
individual, remains to be studied.
Conclusion
Black newspapers are in a unique place to disseminate health
information to African Americans who are suffering from disparate
conditions pertaining to cancer. Increasing conflict factors such as
risk factors, health disparities and community mobilization in news
stories could offer a way to not only increase health awareness among
Blacks but strengthen community efforts to seek prevention and
treatment of cancer for Blacks. Our findings suggest that there is a
gap of information between Black newspaper coverage and its
audience. While the Black newspaper serves as a civic partner to the
Black community, coverage of disparate risk factors for cancer,
disparate health outcomes, and disparate health services for Blacks
are too rarely included in news fare. Also, community mobilization
factors are rarely mentioned and are reported in stories at about the
same rate as mainstream newspapers. The current study lays the
foundation for theory building in this area and provides possible
conflict factors that can be used in news stories to decrease health
disparities among African Americans.
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Table 1. Percentage of Risk Factors in Black vs. Mainstream Newspapers
Black Mainstream
Risk Factors
Asbestos 3% 0%
Diet/nutrition 9% 21%
Exercise 11% 7%
Genetics/family history 29% 7%
Overweight/obesity 6% 0%
Pollution 3% 0%
Radiation 3% 0%
Reproductive/hormonal factors 6% 7%
Smoking/tobacco 23% 29%
Therapeutic drugs 0% 7%
Viral risk factors 3% 0%
Others 6% 21%
___ ___
TOTAL: 100% 100%
Table 2. Percentage of Health Disparities in Black vs. Mainstream Newspapers
Black Mainstream
Disparity Index
Age 3% 40%
Ethnicity 71% 20%
Gender 26% 20%
Socio-economic status 0% 20%
___ ___
TOTAL: 100% 100%
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