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Pointing Fingers
Pointing Fingers:
Victim Blaming and News Coverage of African-Americans, Health and Public Policy in Two Major Metropolitan Newspapers
Nicole Myeshia Mikel
University of Florida
Gainesville, Florida 32611
(352) 846-6068
E-mail: [log in to unmask]
Submitted to the Minorities and Communication Division (Student Competition) for the Association of Education in Journalism and Mass Communication Annual Meeting, August 2000
Pointing Fingers:
Victim Blaming and News Coverage of African-Americans, Health and Public Policy in Two Major Metropolitan Newspapers
Abstract
The presence of victim blaming of African-Americans and their health issues, as it relates to public policy, was examined through the content analysis of two newspapers, the Cleveland Plain Dealer and the New Orleans Times Picayune, from November 1997 to November 1998. Overall, the Times Picayune published more victim blaming articles than the Plain Dealer. Also, male reporters did more victim blaming as was more blatant than their female counterparts.
Pointing Fingers:
Victim Blaming and News Coverage of African-Americans, Health and Public Policy in Two Major Metropolitan Newspapers
In their seminal 1972 study, McCombs and Shaw defined agenda setting. Their look at the 1968 U.S. presidential election demonstrated that audiences learn about public issues and their importance based on emphasis in the news media.
Today, the research focus has changed. After nearly 30 years, researchers are finding that the theory of agenda setting has evolved in such the media no longer tell the public simply what to think about. Researchers are now finding that media may be influencing what audiences think (McCombs and Shaw, 1993). This second level of agenda setting suggests that the way the attribute of an object or issue is emphasized in the media affect how the public shape their opinions of it. This area is closely related to framing, which proposes that the way a news story is organized, written, presented and published will affect the meaning the audience derives from the story (Pan and Kosicki, 1990).
Little research has addressed agenda setting, framing and their effect on newspaper coverage of health issues and developing public policy. The present study analyzed the content of health articles concerning governmental policy changes and examines the attribute of victim blaming within the context of the stories.
Mass media has been shown to be major sources of information on various health problems (Allen et al., 1992; Austin, 1995; Wallack, 1990). Newspapers constantly publish articles on health topics. Approximately one-fourth of all daily newspaper articles focus on health-related issues (Atkins and Arkin, 1990). In an article on popular medical journals and their agenda-setting capabilities, Squires (1986) noted how the Associated Press and United Press International carried more than 300 medical and science stories based upon new findings published in the Journal of the American Medical Association, the New England Journal of Medicine and Science. At that rate, a health or science article would have been published almost every day that year. It is likely that the number of health-related article have slightly increased since the 1998 Squires article.
Similarly, relatively few studies have examined the relationship between African-Americans and health issues. Newspapers, however, have sought to inform the general public of their plight. Journalists often write series documenting shoddy living conditions, crime-filled neighborhoods and inadequate nutrition. In the spring of 1998, the Associated Press produced a feature on the racial divide of health care in this nation. A similar article was published in USA Today in January of 1999. The stories often discuss curable and correctable illnesses that go unchecked and the inability of some to make trips to a health care provider. Deficient diets of high salt, high fat foods and expensive prescriptions are also the subjects of stories. If they only ate properly, they would_ If they simply went to the hospital, they could_ If they remembered to take their medicine every day, they should_ Often the newspaper articles, which are supposed to help the African-American community through exposure of their problems, blame them for their health-related misfortunes. As a result, public policy is often formulated based upon the information received from print media.
Public policy, as it relates to African-Americans and health issues, is a significant issue, itself. Weiss (1974) noted that policy-makers often look to the news media for information on policy issues. In terms of health care policy, policy-makers are also indirectly affected by the news media as societal members associated with the health care policy debate utilize the news media for their information (Miller, 1986). Additionally, past studies have demonstrated that the media agenda emphasize developing health policies by putting the issues on the public agenda (Culbertson and Stempel, 1985) as well as swaying the opinions of the public and the policy-makers (Protess et al., 1991).
The present research, through a content analysis of New Orleans Times-Picayune and Cleveland Plain Dealer, examines newspaper articles that discuss health, African-Americans and public policy. It was possible that victim blaming, whether subtle or blatant, would emerge in the text. The data demonstrated that the article type and placement, the sex of the reporter, the illness of discussion, environmental factors associated with the illness and the source of developing public policy (e.g. federal, state or local government) will have an effect on the amount of victim blaming observed.
Agenda-setting and Framing
In his 1922 book Public Opinion, Walter Lippmann argued that the news media provide people with pictures in their heads of a outside world that they are unable to see. The public will then transfer salience to certain issues based on the priorities of the media agenda. McCombs and Shaw later developed Lippmann's early notions with their study of the 1968 presidential election. "Audiences not only learn about public issues and other matters from the media, they also learn how much importance to attach to an issue or topic from the emphasis the media placed on it" (McCombs and Shaw, 1972). Tipton et al. (1975) demonstrated, in a study of statewide elections, that there were strong relationships between the frequency in which issues were mentioned in the public and newspaper coverage. The media agenda is directly responsible for the public agenda.
In terms of the current study, the salient health issues of African-Americans in New Orleans and Cleveland may be based on coverage in their respective newspapers. For instance, if a series of articles are published on high cholesterol in "soul food" and the city's offer of free public cholesterol screenings, it is likely that more African-Americans, who read the newspaper, will lower their fat intake and utilize the free health care services based on the bombardment of messages received from the newspapers.
In many of the past agenda setting studies, an object, usually a public issue, has been the element of analysis. There are characteristics, however, which seem to define each object. These attributes can vary in salience just as the salience of the object themselves vary. In the study, victim blaming is one attribute that can be analyzed as it relates to newspaper coverage of African Americans and health issues.
The analysis of the transmission of object salience has been attributed to first-level agenda setting. However, new research has begun to look at the transmission of attribute salience, which is the focus of second-level agenda setting. Bernard Cohen (1963), in discussing the basic ideas of agenda setting, wrote, "the press may not be successful much of the time in telling people what to think, but it is stunningly successful in telling its readers what to think about."
Second-level agenda setting takes the early theory a step further by suggesting that the news media tell people how to think about a certain object. In a study of the 1976 presidential election, Weaver, Graber, McCombs and Eyal (1981) noted a relationship between the media's attribute agenda (coverage in the Chicago Tribune) and the public agenda of attributes (i.e. the Illinois voters' opinions of the candidates). Becker and McCombs (1978) found a similar correlation between the attribute agendas of New York Democrats and the agenda of attributes of Newsweek. Though neither of these studies were designed to study the second-level of agenda setting, they provide evidence that the news media can influence the attributes the public links to a political candidate (McCombs, Llamas, Escobar and Rey, 1997).
The impact of news frames on the public agenda has been closely related to second-level agenda setting. Tankard et al. (1991) defined framing as "the central organizing ideas for news content that supplies a context and suggests what the issue is through the used of selection, emphasis, exclusion and elaboration." In discussing framing and salience, Entman (1993) stated that "to frame is to select some aspects of a perceived reality and make them more salient in a communicating text, in such a way as to promote a particular problem definition, causal interpretation, moral evaluation and/or treatment recommendation for the item described." In the context of second-level agenda setting, Entman maintains that in framing, attributes are selected and added to the discussion of a certain object.
The present study examined the attribute of victim blaming and how it relates to newspaper coverage of health issues and African-Americans. Substantive sub-issues such as the sex of the journalist and the illness of emphasis in the articles were also analyzed based on their correspondence to the victim blaming attribute.
Victim Blaming
In North American society, there is a tendency to localize both the source of a problem and the solution to the suffering individuals (Muller, Caldwell and Hunter, 1994; Ryan, 1971). This was referred to as "blaming the victim." As and example, the impoverished and indigent members of our society are seen as lazy and nonchalant instead of being limited in their life options and opportunities. Behavioral scientists have utilized theoretical frameworks, such as the just world theory (Lerner, 1980; Smith, Keating, Hester and Mitchell, 1976; Rubin and Peplau, 1973; MacLean and Shaw, 1988), the theory of defensive attribution (Shaver, 1980; Burger, 1981) and the locus of control theory (Muller, Caldwell and Hunter, 1994; Paulsen, 1979; Thornton, Robbins and Johnson, 1981; Phares and Lamiell, 1975) to explain why individuals will place blame squarely on the shoulders of the victim.
For the present study, an operational definition of victim blaming was formulated based on past research studies in behavioral science (Muller, Caldwell and Hunter, 1994). The term was defined as an instance within a newspaper article in which individuals associated with the story were blamed for past, present and future circumstances. In this context, written cues from the journalists as well as statements from persons within the story were sources of victim blaming.
The concept of victim blaming was divided into two types: subtle and blatant. In subtle victim blaming, a single reference is made by the reporter, or an individual situated within the story, that holds the persons of focus accountable for their situations. This instance is classified as subtle, because the words may have been used inadvertently or unconsciously. As an example, a 1998 Chicago Sun-Times story titled "Prescriptions for change: Healthy lifestyle campaign targets African-Americans" contained the following sentence: "Giving African-Americans the tools to make positive changes in their own lives is a primary goal of the healthy living campaign." Throughout the remainder of the article, there were no other references to the need of African-Americans to take responsibility for their health; therefore, this article can be classified as containing subtle victim blaming.
In blatant victim blaming, the individuals involved in the story are criticized repeatedly for their health problems. A 1998 article in the Atlanta Journal and Constitution titled "Book promoted as aid in blacks' health care" had at least two references to African-Americans and their health responsibilities. "While poverty and lack of access to affordable health care are contributors to some problems_people can improve their health through lifestyle changes." "_Cultural attitudes also need to be adjusted with an eye toward proper diet and exercise." The previous excerpts illustrate instances of blatant victim blaming as well as the types of statements the research focused on.
African-Americans, their health and the average American: What is the problem?
The African-American community has been plagued with illnesses, such as hypertension, heart disease and high blood pressure, for centuries. The group and other minorities continue to have disproportionately higher rates of these diseases than whites (George, 1995; Bailey, 1991). Thomas (1992) discusses that with scientific advances in the management of chronic illnesses, diseases such as hypertension and diabetes should not lead to disability and premature death. The world has become more health conscious and people are changing their lifestyles to protect their health. "Unfortunately, African-Americans have not befitted equitably from the scientific and technological advances of the medical profession or various national prevention and educational efforts" (pg. 837).
In a 1994 study, the Centers for Disease Control and Prevention compiled findings concerning the health of African-Americans. It was shown that self-reported hypertension, diabetes and heart disease were higher than whites for both sexes. "From 1986-1990, hypertension and diabetes were among the most common self-reported [and clinically reported] chronic conditions among African-Americans_" (pp. 2-19).
Hypertension is one of the most important health problems affecting the
African-American community in rural and urban populations. They are 2 to 4 more times likely than whites to develop hypertension by age 50 and 3 to 4 times more likely to suffer a stroke in relation to the illness (James, 1994).
Between the age groups 18-44 years and 45-64 years, hypertension quadrupled for African-American men (8.6% to 32.8%) and women (11.5% to 43.0%). In adjusting for age, African-American women have a prevalence 43 percent higher than African-American men (CDC, 1994, pp.2-17).
Diabetes is the third most commonly ranked reported illness among African-Americans. The number of cases of the illness increases six- to ten-fold with age. Following age-adjustments, the prevalence of diabetes was 18 percent higher for African-American women than for men of the same community (CDC, 1994, pp.2-19).
The Governor's Task Force for Black and Minority Health in Ohio discussed in a 1987 report that diabetes was the sixth leading cause of death for the state's minority residents. In 1984, more than 2,000 deaths were attributed to the disease with 20.9% of those being non-whites. The percentage of the deaths for whites was 18.6%. Of 35,000 diabetic African-American Ohioans, 66% of them were female (Ohio, 1987).
In comparison to whites, the racial health disparity between African-Americans is tremendous. This includes:
ù neonatal mortality (110% higher in African-American),
ù mortality due to diabetes (2x the rate of whites),
ù mortality due to heart disease (1.25% higher),
ù mortality due to stroke (80% higher), and
ù nephritis, nephrosis and nephrotic syndrome (3x the rate of whites)(Davis et al., 1995).
The elevated risk of death for African-Americans across such a broad range of illnesses continue to concern health care providers. Suicide is the only cause of death that African-Americans have an extremely lower rate than whites (Williams, 1998; Thomas, 1992). A federal 1980 Report of the Secretary's Task Force on Black and Minority Health demonstrated that there were 59,000 excess deaths for blacks in the U.S. in 1980. Almost 60,000 African-Americans died who would not have died if their mortality experience were the same as the white population.
With the lack of information on victim blaming in the newspaper coverage of African-American, health and public policy, there is some unanswered research questions:
1. How often do newspapers employ victim blaming in their coverage of African-Americans and health?
2. Do Northern and Southern newspapers differ on their coverage of African-Americans and health?
The way in which health and public policy articles are presented to the public, which includes its placement in the paper or the length of the article, is important because the presentation can greatly affect how African-Americans perceive the information within the article. A brief story on heart disease may cause this group to examine it differently than a series on obesity. The article may also be negatively if the writers choose to present an image of blame directed at African-Americans and their health. Readers learn attributes from coverage. If the attributes of health coverage show victim blaming, the reader may think African-Americans are solely responsible for their health plight.
The selection of the newspapers was based on location. In the early 1900s, African-Americans began to migrate from the rural South to the urban North. Jones (1969) showed that the urbanization of rural African-Americans had done little to alter their traditional meal patterns over the past decades. Only living conditions and social situations had changed. The strength of culture and heritage had survived the in-migration and evolution of the small farmer and sharecropper into the urban, educated northerner. For this reason, the health of the two groups should be similar when based upon their nutritional intake.
Methodology
Any newspaper article pertaining to health, African-Americans and public policy that appeared in the New Orleans Times-Picayune and the Cleveland Plain Dealer between January 1997 to December 1997 was included in the analysis. A keyword search was performed on Lexis-Nexis Academic Universe, using the phrases "African-Americans and health" and "blacks and health." Searches were also performed using the words "African-Americans" or "blacks" with the names of illnesses (e.g. heart disease, hypertension). Those results, however, mirrored the results of the phrase searches.
The New Orleans Times-Picayune and the Cleveland Plain Dealer newspapers were chosen for study based on the cities' large African-American population. There are two medical schools, numerous hospitals and a school of tropical medicine and public health in New Orleans. Cleveland is the home of three major hospitals and a large medical school. Obviously, the health of this segment of the population is extremely important.
Only two newspapers (i.e. the Cleveland Plain Dealer and the New Orleans Times-Picayune) were analyzed, because it was important to fully examine victim blaming and its related attributes through an in-depth analysis, which included headlines and other textual cues.
The time period was selected based upon the release of the final data for the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994. The results of the six-year study are analyzed by the National Center of Health Statistics, a branch of the Centers for Disease Control in two phases - Phase 1 (1988-91) and Phase 2 (1991-94). By 1993, the first phase findings were published in various journals. With the final release of the data in 1997, it is likely that newspaper coverage of health issues. Stories on public policy would also increase based upon the government's concern with the data.
The content analysis of the articles focused on two areas:
Newspaper coverage
ù Article type, including hard news, features, profiles, editorials and columns.
ù Article placement, including headline, other front page, other (Section A), other (rest of paper), special features section, special health section and editorial/column.
ù Sex of the reporter, including male, female and unable to determine
ù Origin of government effort in emerging public policy, including federal, state, local (parish, county or city), other or none.
ù Illness of emphasis in story, including heart disease, hypertension, high blood pressure, obesity, malnutrition, cancer, AIDS/HIV, other and none.
ù Environmental factors associated with African-Americans and their health, including crime-ridden neighborhoods, deficient diets, poverty (low socioeconomic status), lack of access to health care, lack of prescription usage, lack of education or none.
The unit of analysis for the news coverage variable was the article.
Victim blaming
ù Presence of victim blaming, including subtle (single reference) and blatant (more than one reference).
ù Intent of victim blaming, including positive, negative and neutral.
The unit of analysis for the victim blaming attribute was the paragraph. Using Holsti's (1969) formula, the intercoder reliability across the categories averaged .81, which is an acceptable level.
Results
The content analysis yielded 27 articles and 618 paragraphs. The Plain Dealer had victim blaming present in 26 of 416 paragraphs, while it was present in 35 out of 202 Times-Picayune paragraphs. The chi-square value was 18.75 (p( .001, suggesting that the Times-Picayune was more likely to have victim blaming of African-Americans present in its articles (Table 1).
Of these paragraphs with victim blaming present, the subtle and blatant forms were each observed half of the time in the Times-Picayune. The Plain Dealer was subtle with its victim blaming 70.6% of the time and blatant 29.4% of the time. The chi-square value of 9.227 (p( .001), suggesting that despite the increased likelihood of victim blaming articles in the Times-Picayune, the Plain Dealer is more likely to have subtle victim blaming when there are such articles in the newspaper. On the other hand, the Times-Picayune was more prone to blame victims blatantly (Table 2).
Male reporters were more inclined to victim blame in Times-Picayune
[chi-square = 20.23, (p( .001),]. The Plain Dealer had more female reporters blame African-Americans for their health problems (Table 3). There was no evidence to support which newspaper had the most neutral, positive and negative victim blaming statements [chi-square = 4.102, (p =.129)]. Based on frequencies, however, the Plain Dealer printed more neutral and positive statements, while the Times-Picayune published more negative statements (Table 4).
For both newspapers, hard news stories were more likely to have victim blaming. Similarly, in terms of article placement, both newspapers printed most of their victim blaming stories in the first section of the paper (Section A) (Table 5).
In a majority of the articles for both newspapers, emerging public policy and its governmental origin were not mentioned. When the government was involved, it was usually the federal government (Table 6).
In over a quarter of its articles, the Plain Dealer emphasized illnesses other than those commonly associated specifically with African-Americans and their health, such as Alzheimer's disease. The Times-Picayune reporters focused mainly on heart disease. AIDS/HIV was the second highest illness of focus for both newspapers. A lack of access to health care was the environmental factor most linked with victim blaming in both newspapers. A lack of education accounted for the next common factor in the New Orleans paper, while the Cleveland paper often did not include an environmental issue in their articles (Table 7).
Discussion
In victim blaming, either the reporter or an individual associated with the news of a story could blame another individual (in this case, African-Americans) for their unfortunate circumstances. Though such a phenomenon is possible in news reporting, it is not always present. It is likely that newspaper administrators are making more editorial decisions that shed African-Americans in a sympathetic light.
On the surface, 61 paragraphs out of 618 (27 out of the 906 articles) looks like a relatively low number of instances of victim blaming - only 10% of the paragraphs had victim blaming. Since most articles discuss health problems overall, however, the fact that African-Americans were blamed at such percentage at all is rather significant.
When victim blaming is observed in both newspapers, it is more likely to be found in a hard news story. Here, the sources of the story are probably unable to rehearse what they are going to say prior to the reporter's interview. Thus, they utter the first words that come to their minds. In terms of location, most victim blaming of African-Americans will be placed in the first section of the newspaper where the audience is more likely to read about them. There was no difference on the amount of victim blaming and the type of article and its location, though.
In Cleveland, a female Plain Dealer reporter is going to be more inclined to blame African-Americans for their health problems in a subtle manner in her articles, while male Times-Picayune reporters will do the same, but in a more blatant fashion. In this instance, gender is tied closely with the newspaper coverage and victim blaming. It is difficult, however, to relate the intent of the statement to the amount of coverage. Since men are more prone to blame African-Americans blatantly, they will also do so in the most negative manner, sparing no feelings along the way. Women, on the other hand, are subtle and positive (or neutral) when they point the finger. As an example, in a November 1997 Plain Dealer article a female reporter quoted the president of the Black Economic Union as saying "Black men show up in medical records from the time they're infants to age 15; then they don't show up again until they're in their 60s_This could be a catalyst for black men to change that statistic." The use of the statement demonstrated that the journalist included a positive victim blaming comment in her piece. Also, it was the only comment of its kind, thus the victim blaming was subtle. In the case of a male reporter from the Times-Picayune, a June 1998 article included the statements:
"It [the health disparity] has to do with a lack of education and a lack of access_many African-Americans still use the emergency room as their primary physician," "They're [black people] working, so they're proud_they don't want to come and see a doctor for free," and "_Mistrust of the health-care system is rampant among black people_." Here, the reporter repeatedly used quotes that blamed African-Americans for their health in a negative manner.
Environmentally, both news vehicles will normally fault a lack of access to health care for poor health standards. A lack of education or no particular factor at all will be cited for an African-American's failure to maintain a healthy lifestyle. In the north, the newspaper will not usually fail to mention any illness when engaging in victim blaming, but the southern paper will expectedly associate heart disease with its victim. Though African-Americans have maintained the same meal patterns, despite time and migration, southern food tends to be higher in fat and cholesterol. For this reason, it is logical that heart disease would be more related to the poor health of African-Americans. The high prevalence of AIDS/HIV among the African-American population is becoming of increased importance, hence, both newspapers will discuss the disease more openly in their articles.
The northern or southern newspaper that has published a victim blaming article usually will not do so in relation to any emerging public policy. In this instance, the papers are demonstrating that African-Americans are responsible for their health issues constantly, not only when a government agency begins enact legislation to assist them.
Second-level agenda setting states that the way the attribute of an object is presented in the media affects how the members of public shape their opinion of it. Framing, a closely related theory, demonstrates that how an article is packaged affects the meaning an audience derives from a story. The data from this study suggested that the way a story was packaged by a newspaper (i.e. article type and placement) and the reporters' contributions (i.e. illness of emphasis and environmental factors) affect the presence of the victim blaming attribute in the articles. Though the attribute salience to the public was not noted in the examination of the northern and southern newspapers, the presence of the attribute in 27 articles demonstrates that it can be measured in later studies. In the future, it will be important to observe if second-level agenda setting and the attribute salience of victim blaming has affected the self-perceived health outlook of African-Americans following exposure to the attribute in newspaper articles. Will the minority group dislike the newspaper for revealing its faults, or will it internalize the message and enact change?
It is also imperative to observe whether the race of the reporter has any affect on the amount of victim blaming. African-American reporters may be more inclined to not lay blame on the shoulders of their people, while other races, which have no communal ties, will not spare the "rod" when it comes to issues of African-American health.
Table 1 - Number of victim blaming paragraphs in articles with victim blaming present
Plain Dealer Times-Picayune
Victim blaming 26 35
No victim blaming 390 167
Pearson's chi-square = 18.75 p(.001
Table 2 - Percentages of subtle and blatant victim blaming
Plain Dealer Times-Picayune
subtle 70.6% 50.0%
blatant 29.4% 50.0%
Pearson's chi-square = 9.227 p(.001
Table 3 - Percentages of victim blaming based on the gender of the reporters*
Plain Dealer Times-Picayune
male 29.4% 60%
female 58.8% 30%
Pearson's chi-square = 20.23 p(.001
*The percentage of reporters with indeterminable genders was 11.8% (Plain Dealer) and 10% (Times-Picayune).
Table 4 - Percentages of neutral, positive and negative victim blaming statements**
Plain Dealer Times-Picayune
Neutral 58.8% 50%
Positive 23.5% 20%
Negative 17.6% 30%
Pearson's chi-square = 4.102 (p=.129)
**not statistically significant
Table 5 - Frequencies victim blaming article types and their placement
Plain Dealer Times-Picayune
Hard news = 47.1% Hard news = 60%
Article Type Features = 41.2% Features = 20%
Editorials = 11.8% Columns = 20%
Headline story = 5.9% Other front page = 10%
Other (Sec. A) = 11.8% Other (Sec. A) = 40%
Article Rest of paper = 41.2% Rest of paper = 30%
Placement
Special features = 11.8% Special features = 20%
Special health = 11.8%
Editorial/column = 17.6%
Table 6 - Frequencies of the origin of governmental efforts, emerging public policy and victim blaming
Plain Dealer Times-Picayune
Federal 35.3% 20%
State --- ---
Local 5.9% 10%
Other --- ---
None 58.8% 70%
Table 7 - Frequencies for the illnesses of emphasis and the environmental factors associated with African-Americans and their health
Plain Dealer Times-Picayune
Heart disease = 5.9% Heart disease = 30%
High b.p. = 5.9% Hypertension = 10%
Illness of focus Cancer = 17.6% AIDS/HIV = 20%
AIDS/HIV = 23.5% Other = 10%
Other = 35.3% None = 30%
None = 11.8%
None = 41.2% Deficient diets = 10%
Poverty = 5.9% Poverty = 20%
Environmental %
Factors Lack of access = 41.2% Lack of access = 40
Lack of educ. = 11.8% Lack of educ. = 30%
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Pointing Fingers