Exploring the Dynamics in the Environmental Discourse: The Longitudinal Interaction Among Public Opinion, Presidential Opinion, Media Coverage, Policymaking in 3 Decades and an Integrated Model of Media Effects

Using data on environmental issues drawn from 41 series of poll questions and federal outlay in 43 years (1965-2007) and a content analysis of newspaper articles, television news summaries, and presidential documents in 28 years (1980-2007), with the multivariate Granger Causality test based on Vector Autoregression (VAR) models and bivariate Granger Causality (F and Chi-squire) tests, the study finds that public opinion has little influences on federal environmental expenditure in the past several decades. It also finds that for the presidents, the media, and the public, their agendas (volume of information) cause a change in the agenda and frame building and setting processes are essentially confirmed by the multivariate test, but feedback influences are also identified through the bivariate tests. The multivariate test also shows an influence from the presidential agenda to the public agenda on environmental issues, with no influence identified the other way around. The implications of the proposed five-level integrated model of media effects are also discussed

Colorectal cancer screening, perceived discrimination, and low-income and trust in doctors: a survey of minority patients

<p>Abstract</p> <p>Background</p> <p>Completion of colorectal cancer (CRC) screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT) among a low-income, minority primary care population in an urban setting.</p> <p>Methods</p> <p>We recruited a convenience sample of adults over age 40 (n = 282) from a federally qualified community health center (70% African American). Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening.</p> <p>Results</p> <p>Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p < 0.01). The trend was for older participants to express more trust (p = 0.09) and less perceived discrimination (p < 0.01). Neither trust nor discrimination was associated with race or education. Trust was higher among participants over 50 who were up-to-date on FOBT screening vs. those who were not (31 vs. 29 (median), p < 0.05 by T-test). Among those over 50, up-to-date FOBT screening was nearly associated with high trust (p < 0.06; 95% CI 0.99, 1.28) and low perceived discrimination (p < 0.01; 95% CI 0.76, 0.96). Nevertheless, in multivariate-modeling, age and income explained FOBT completion better than race, trust and discrimination.</p> <p>Conclusion</p> <p>Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.</p