This research investigated the relationship between medical activities, public events, and media coverage of breast cancer during a thirty-six-- -year period.1 There was substantial support for medical attention preceding media attention to breast cancer, and some evidence of medical attention following media coverage. There were extremely high, significant correlations between numbers of medical journal articles and newspaper, magazine, and TV coverage. Time-series analysis revealed a two-way, concurrent relationship between breast cancer funding and media coverage. Public events (prominent women acknowledging their breast cancer) significantly affected media coverage. There was a twoway concurrent relationship between breast cancer incidence and TV coverage.
The diffusion of medical information to health practitioners and the public has been a long-standing, fundamental U.S. governmental and social priority.2 Health communicators, government agencies, and related nonprofit organizations have long relied on mass media to aid in this dissemination. If the media are a major conduit for medical news, what kind of role can health communicators expect mass media to play regarding specific health problems?
Take for example "the Big C," as John Wayne called it. Although the mortality rate for some types of cancer has improved dramatically, the overall mortality rate for breast cancer in the United States is virtually the same now as it was sixty years ago.3 Meanwhile, print coverage of breast cancer has mushroomed: the New York Times and all U.S. magazines published a total of three stories in 1960 and 149 stories in 1995. What does this suggest about the influence of societal institutions (such as the medical community) on the reporting of medical problems? Are there additional factors that influence the role that media play regarding public health issues? This research investigates these questions for one particular health problem, breast cancer.
According to a macro framework, the mass media are an integrated part of the overall social system, dependent on the cooperation of other institutions within it for news. Within this framework, scholars seek to understand the interaction of media with other social units, such as medicine. As a social institution, medicine has numerous system controls, exercised inside and outside the health care delivery system. There are barriers to entering the field, including a lengthy and expensive education, apprenticeship, and stiff competition. Licensing and medical journal publication constitute additional controls, but practitioners are afforded a great deal of status and authority once licensed. Gandy4 noted that those in the health care industry to a large extent control the formulation of health policy through their ability to define problems, specify alternatives, and choose between benefits and costs. A reliance on technological devices and physician-driven care5 constitute system controls that are part of the accepted public image of health care.
The interdependencies between medicine, government, insurance companies, and private businesses reinforce this dominant ideology and the role of physicians as primary providers of medical information. Government-sponsored research, primarily funneled through the National Institutes of Health (NIH), helps drive the demand for technology and directly supports medical schools. Stevens6 reported that nearly half of the faculty at U.S. medical schools got part of their salaries from NIH-sponsored research. The U.S. government is the world's largest single drug buyer through its purchases for the military and public health services.7 Gandy8 has noted parallels between the defense and health care industries, such as defense-- electronics firms that develop new medical devices.
Because of its technical, specialized nature, medical information is channeled and controlled by numerous gatekeepers,9 constituting a one-way information flow from medical journals, physicians, and researchers. …