Health News and Responsibility. Lesa Hatley Major

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      The marked increase in communication framing research over the past few decades can be traced back to the acceptance of the sociological view of frames (Cacciatore, Scheufele & Iyengar, 2016). The growth included studies examining news reports containing thematic and episodic framing, a type of emphasis framing. Thematic framing involves placing a problem or issue in a broader context, and episodic framing places the emphasis on an individual or single event (Iyengar, 1991).

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      Next, we turn to a brief discussion of the accessibility–applicability distinction, because it is important to identify how cognitive mechanisms involved in framing effects operate in comparison to other theories. This is not a broad discussion of the accessibility-applicability distinction and the processes behind framing, priming and agenda-setting (see e.g. Cacciatore, Scheufele, & Iyengar, 2016; Scheufele & Tewksbury, 2007). Priming and agenda-setting, Price and Tewksbury (1997) argue, are “accessibility effects; that is, they are based on memory-based models of information processing” (Scheufele & Tewksbury, 2007, p.15). Agenda-setting and priming theories posit the news media make specific issues or facets of issues more accessible (i.e., easily remembered) for individuals. This process impacts the criteria audience members use when shaping attitudes about political candidates and issues/problems (Scheufele & Tewksbury, 2007).

      Accessibility is specifically different from framing as an applicability process and effect (Scheufele & Tewksbury, 2007). Applicability suggests a connection among two concepts and after reading or viewing a message containing both, audience members accept the two are connected (Price & Tewksbury, 1997). For example, a news story may suggest a connection between external determinants (education, environment) and a health problem. The story may propose the best way to think about the health of individuals is through a consideration of whether individuals have access to nutritious food or safe living environment. Thus, the news story has created a connection between external determinants and health, as opposed to individual behavior as the only determinant of health.

      Framing rooted in Gestalt Psychology and attribution theory, explores the tendency among people to detect patterns in pieces of information consistent with preexisting cognitive schemas (Scheufele & Iyengar, 2017). Gestalt Psychology, a school of thought founded by Max Wertheimer, is based on the concept of a unified or meaningful whole. Framing operates on applicability effects to invoke particular interpretive schemas, thus determining how information is processed (Scheufele, 2000). Put simply, how information is presented or framed will influence the schema individuals call upon to process information.

      In psychology, a schema (plural schemas) is defined as a pattern of thought or behavior that categorizes information and the associations among them (DiMaggio, 1997). Schemas are critical to understanding framing effects. A primary assumption of framing theories is the locus of effect lies within the explanation of an issue presented in news coverage about the issue. “It is the underlying interpretive schemas that have been made applicable to the issue that are the central effect of a frame” (Scheufele & Tewksbury, 2007, p. 14). Framing effects are about how we think about issues not if we think about issues (Scheufele & Tewksbury, 2007).

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      Based upon that assertion, Iyengar’s (1987) experimental study of framing effects of news stories about terrorism demonstrates news frames can influence attributions of responsibility. Iyengar found study participants were more likely to attribute responsibility to individual terrorists after reading stories with an episodic frame (single event or individual). On the other hand, when news stories connected terrorism events to a more general political context (thematic frame), participants were more likely to consider alternatives as being responsible and considering social reforms as possible solutions for the issue (Cacciatore, Scheufele, & Iyengar, 2016).

      Media scholars commonly use the label ‘‘frame’’ in two ways (Chong & Druckman, 2007; Druckman, 2001; Scheufele, 1999). A media frame refers to the words, images, and phrases the communicator (e.g., a politician, journalist) chooses when communicating information about an issue or event to an audience (Gamson & Modigliani, 1987, 1989). The frame contains the details, evidence, arguments, etc. the speaker sees as significant about an issue or event and uses when presenting the story about the issue or event (Chong & Druckman, 2007). The individual frame refers to a person’s cognitive understanding of a specific situation or issue (e.g., Goffman, 1974). Unlike frames in communication, which reflect a speaker’s emphasis, frames in thought refer to what an audience member believes to be the most salient aspect of an issue (Chong & Druckman, 2007). Both frames are critical as we move to a discussion of thematic and episodic frames, news, and attribution of responsibility.

      Framing in news describes the deliberate and active journalistic process of including or excluding information to create a story. A primary function of journalism is defining problems, identifying who or what is to blame and the harmful actions that have occurred, as well as diagnosing and making assessments about causes and potential solutions (Entman, 1993). Journalists use frames to communicate all of these. The news media do not discuss issues (causes and solutions) and events in isolation. Journalists reflect and influence both the public’s and policymakers’ attitudes and beliefs about health and other social issues (Rogers & Dearing, 1996; Chapman & Lupton, 1994; Chong & Druckman, 2007; MacKenzie, Johnson, & Chapman, 2009).

      How discussions and assertions about causality unfold in public discourse is key in the placement of issues onto the policy agenda, while also influencing political partnerships and determining potential plans of action (Stone, 1989, 2002). This complex and key process is known as attribution of responsibility—a discussion of who or what is to blame a problem and who or what is responsible for resolving a problem. Arguments and claims concerning responsibility attribution may be determined by whether actions are deemed purposeful and consequences ←15 | 16→intentional (Stone, 2002) or whether issues are depicted without any link to a specific cause (Kensicki, 2004).

      Media effect studies show journalists frame an issue in news coverage can shape “what the public thinks it is becoming informed about, which in turn often determines how people take sides on political issues” (Zaller, 1992, p. 8). As detailed earlier, Iyengar (1991) identified news frames as either episodic or thematic. Episodic frames simplify complex issues to the level of anecdotal evidence, leading readers or viewers to blame individuals for health and social issues. Audience members receive little context in episodic coverage, which can lead them to blame individuals for the problem and accountable for the solution.

      Thematic frames can have the opposite effect on audience members by emphasizing broader trends and social conditions, increasing the perception that society and government can play a part in solving social problems. News stories using thematic frames foster a sense of shared public responsibility. When the public holds a view of societal responsibility it encourages collective action and garners support for policies. Because framing plays such an important role in both public opinion formation about who or what is to blame and who or what is responsible for solving the issue/problem, it is easy to understand why health communication scholars and public health scholars are attracted to studying thematic and episodic frames in health news.

Thematic and Episodic Frames in Health News

      Wallack, Dorfman, Jernigan and Themba (1993) introduced media advocacy as a strategy in the public health community in 1994. The researchers define media advocacy as the strategic use of mass media to advance public policy initiatives. They differentiate their strategy from other types of mass media strategies in several key ways. Like thematic frames, media advocacy encourages a shift in focus to the societal from individual, to the political from individual, and to advocating for policy and the environment away from personal behavior. The public health scholars advocate that improvements in health status come about primarily from gaining more power over the policy environment rather than simply encouraging the public to learn more about health behaviors. The thematic news frames work well with this strategy of public health communication.

      Similar to social issues and political issues, most health issues in news coverage can be boiled down to questions of responsibility—who