‘Disease, disaster and despair’? health stories from low- and middle-income countries in the Australian news media

The mass media in high-income nations remain a crucial source of news and information. In relation to health, coverage is dominated by a medical perspective and an individualised view of illness that neglects public health. With regard to foreign news, previous research has shown that reporting tends to be narrow in scope, focused on nations that are significant to the country for which coverage is being produced and usually has an aspect of domestic relevance. These patterns are especially pronounced in relation to news from low- and middle-income countries (LMICs), the coverage of which has long been criticised as limited, negative and stereotyped. However, little is known about the coverage of health stories from these nations. This thesis uses a uniquely large database of Australian television coverage about health to examine how health stories from LMICs are covered in the Australian news media. It provides an overview of mass-media reporting on the subject, examining what locations and health conditions feature in coverage of LMIC health and the extent to which a ‘local Australian angle’ is often key to their newsworthiness. Several case studies from this dataset are also analysed. One, an exemplary story about the transport to Australia and surgical separation of infant conjoined twin girls from Bangladesh – a nation that is otherwise little-covered in the Australian media – is considered from the three key angles for media studies: production (journalism), representation (content) and reception (audience). The medical tourism narrative in the Australian news media is also considered for the way in which it reverses the usual expectations of LMICs as passive and dependent on high-income nations. Finally, the relationship among international development agencies and the news media in Australian in relation to LMIC health is examined. The thesis concludes with general reflections and suggestions for further research

'...a story that's got all the right elements': Australian media audiences talk about the coverage of a health-related story from the developing world

Australian news coverage of low- and middle-income countries (LMICs) generally, and of their health contexts specifically, has long been criticised as problematic. This paper considers an exemplary LMIC health story and presents findings of an audience reception study that examined how different groups of Australian participants responded to it, the possible implications for future LMIC health coverage and for domestic perceptions of global public health. In particular, the paper examines how audiences talked about three of the story’s principal themes and suggests that greater audience engagement with LMIC health news may be possible as the mass-media landscape continues to evolve.National Health and Medical Research Council Capacity Building Grant 571376 (2009-2013)

Media Miracles: The Separation of Conjoined Twins, and Reflections on Minimal Television News Coverage of Health from Low- and Middle-Income Countries

Australian television news and current affairs remain an important source of information for domestic audiences about both health and low- and middle-income countries. In November 2009, the successful surgical separation in Australia of conjoined infant twins from Bangladesh generated large-scale domestic media interest. In the 66 months to October 2010, only 75 health-related stories about Bangladesh were broadcast on Sydney television, 70 of them (93%) about these twins. Drawing on the television database of the Australian Health News Research Collaboration, this paper presents a thematic analysis of the Australian television news and current affairs coverage of the twins and why their case attained such a profile relative to other coverage of health from this nation. In addition to the predictable newsworthiness of a rare and bizarre medical condition and the made-for-television tension inherent in the saga of their arrival, preparation and eventual lengthy operation, prominent themes centred around the story’s opportunities to praise Australian individuals, medical skill and national character. The focus in this story on identified individuals with an uncommon condition requiring tertiary medical intervention only available in a high-income nation contrasts with a lack of coverage of, or critical consideration for, the well-being of anonymous individuals or less culturally-favoured groups, more long-term and mundane health considerations or any broader social or financial context to health issues in low- and middle-income countries. Reportage of foreign health issues appears contingent on the availability of populist ‘rule of rescue’ news frames, arresting footage and dramatic narratives that resonate with audiences’ expectations of such nations. The analysis offered in this paper illuminates the potential implications of such reporting for the wider news space available to health stories from low- and middle-income countries.This work was supported by a Capacity Building Grant from the National Health and Medical Research Council (http://www.nhmrc.gov.au) to the Australian Health News Research Collaboration (2009–2013) [571376]

Australian journalists’ reflections on local coverage of a health-related story from the developing world

Given the limited Australian media coverage of health news from low- and middle-income countries (LMICs), the 2009 story of conjoined Bangladeshi twins Trishna and Krishna was conspicuous for its scale. This paper draws on interviews with journalists who reported the story and considers what those seeking to increase the news exposure given to LMIC health issues might learn from this coverage. It considers, in particular, the extent to which the twins’ story fitted with prevailing journalistic norms and beliefs about both health and news, and suited professional expectations and routines, especially in relation to choice of sources and access to material. Finally, the paper surveys opportunities for broader and deeper coverage of such news in the future

Australian news media framing of medical tourism in low- and middle-income countries: A content review

© 2013 Imison and Schweinsberg; licensee BioMed Central Ltd. Background: Medical tourism - travel across international borders for health care - appears to be growing globally, with patients from high-income nations increasingly visiting low- and middle-income countries to access such services. This paper analyses Australian television and newspaper news and current affairs coverage to examine how medical tourism and these destinations for the practice are represented to media audiences. Methods: Electronic copies of Australian television (n = 66) and newspaper (n = 65) items from 2005-2011 about medical care overseas were coded for patterns of reporting (year, format and type) and story characteristics (geographic and medical foci in the coverage, news actors featured and appeals, credibility and risks of the practice mentioned). Results: Australian media coverage of medical tourism was largely focused on Asia, featuring cosmetic surgery procedures and therapies unavailable domestically. Experts were the most frequently-appearing news actors, followed by patients. Common among the types of appeals mentioned were access to services and low cost. Factors lending credibility included personal testimony, while uncertainty and ethical dilemmas featured strongly among potential risks mentioned from medical tourism. Conclusions: The Australian media coverage of medical tourism was characterised by a narrow range of medical, geographic and ethical concerns, a focus on individual Australian patients and on content presented as being personally relevant for domestic audiences. Medical tourism was portrayed as an exercise of economically-rational consumer choice, but with no attention given to its consequences for the commodification of health or broader political, medical and ethical implications. In this picture, LMICs were no longer passive recipients of aid but providers of a beneficial service to Australian patients

‘Disease, Disaster and Despair’? The Presentation of Health in Low- and Middle-Income Countries on Australian Television

In high-income nations mainstream television news remains an important source of information about both general health issues and low- and middle-income countries (LMICs). However, research on news coverage of health in LMICs is scarce. The present paper examines the general features of Australian television coverage of LMIC health issues, testing the hypotheses that this coverage conforms to the general patterns of foreign news reporting in high-income countries and, in particular, that LMIC health coverage will largely reflect Australian interests. We analysed relevant items from May 2005 – December 2009 from the largest health-related television dataset of its kind, classifying each story on the basis of the region(s) it covered, principal content relating to health in LMICs and the presence of an Australian reference point. LMICs that are culturally proximate and politically significant to Australia had higher levels of reportage than more distant and unengaged nations. Items concerning communicable diseases, injury and aspects of child health generally consonant with ‘disease, disaster and despair’ news frames predominated, with relatively little emphasis given to chronic diseases which are increasingly prevalent in many LMICs. Forty-two percent of LMIC stories had explicit Australian content, such as imported medical expertise or health risk to Australians in LMICs. Media consumers’ perceptions of disease burdens in LMICs and of these nations’ capacity to identify and manage their own health priorities may be distorted by the major news emphasis on exotic disease, disaster and despair stories. Such perceptions may inhibit the development of appropriate policy emphases in high-income countries. In this context, non-government organisations concerned with international development may find it more difficult to strike a balance between crises and enduring issues in their health programming and fundraising efforts.This work was supported by a Capacity Building Grant from the National Health and Medical Research Council (http://www.nhmrc.gov.au) to the Australian Health News Research Collaboration (2009–2013) [571376]

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Effectiveness and cost-effectiveness of community singing on the mental health related quality of life of the older population: a randomized controlled trial

Background: As the population ages, older people account for a greater proportion of the health and social care budget. While some research has been conducted on the use of music therapy for specific clinical populations, little rigorous research has been conducted looking at the value of community singing on the mental health-related quality of life of older people. Aims: To evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in England. Method: A pilot pragmatic individual randomized controlled trial comparing group singing versus usual activities in those aged 60 years or more. Results: 258 participants were recruited across 5 centres in East Kent. At 6 months post-randomisation significant differences were observed in terms of mental health related quality of life measured using the SF12, mean difference 2.35 (95% CI 0.06 to 4.76) in favour of group singing. In addition the intervention was found to be marginally more cost-effective than usual activities. At 3 months significant differences were observed in terms of mental health components of quality of life (4.77; 2.53 to 7.01) anxiety (-1.78; -2.5; -1.06) and depression (-1.52; -2.13 to -0.92). Conclusions: Community group singing appears to have a significant effect on mental health related quality of life, anxiety and depression and may be a useful intervention to maintain and enhance the mental health of the older population

Patient and public involvement: how much do we spend and what are the benefits?

BACKGROUND AND OBJECTIVES: Patient and public involvement (PPI) is seen as a way of helping to shape health policy and ensure a patient-focused health-care system. While evidence indicates that PPI can improve health-care decision making, it also consumes monetary and non-monetary resources. Given the financial climate, it is important to start thinking about the costs and benefits of PPI and how to evaluate it in economic terms. DESIGN: We conducted a literature review to assess the potential benefits and costs of involvement and the challenges in carrying out an economic evaluation of PPI. RESULTS: The benefits of PPI include effects on the design of new projects or services, on NHS governance, on research design and implementation and on citizenship and equity. Economic evaluation of PPI activities is limited. The lack of an appropriate analytical framework, data recording and understanding of the potential costs and benefits of PPI, especially from participants' perspectives, represent serious constraints on the full evaluation of PPI. CONCLUSIONS: By recognizing the value of PPI, health-care providers and commissioners can embed it more effectively within their organizations. Better knowledge of costs may prompt organizations to effectively plan, execute, evaluate and target resources. This should increase the likelihood of more meaningful activity, avoid tokenism and enhance organizational efficiency and reputation