Coverage of common causes of death in the UK media

Is there a correlation between the diseases you read about in the news and what is actually likely to kill you?

Williamson, Skinner and Hocken (2011) studied the 10 most daily read newspapers in the UK s (The Sun, Daily Mail, The Mirror, The Telegraph, The Times, Daily Express, Daily Star, The Guardian, The Independent and the Financial Times) for a year, in order to see whether there's a correlation between the media reporting of illness and death and actual statistics.

Most common causes of death in the UK, according to the Office for National Statistics (table from the paper)

They searched each paper's site and recognized 18,482 articles covering the most common causes of death in the UK. They used 'media friendly' terms when it was necessary (for example: 'heart attack' instead of ‘ischaemic heart disease’).

The most common conditions reported were the Flu/pneumonia (6525 articles, 35.2%), ischaemic heart disease (3849 articles, 20.8%) and dementia (2577 articles, 13.9%). The least reported conditions were obstructive pulmonary disease (COPD) (95 articles, 0.5% of total) and heart failure (547 articles, 3%).

Pneumonia: third most common cause of death in the UK

In comparison with the number of deaths they cause every year, the Flu ⁄ pneumonia, prostate cancer, dementia and breast cancer have been mentioned extensively in the media. On the other hand, Cerebrovascular accidents (CVAs) and chronic obstructive pulmonary disease (COPD) are very underrepresented in the media.

The study suffers from several flaws: for one, the researchers don't know in which context their search terms appeared in the media; why were these diseases reported? They hypothesize, for example, that "prostate cancer" could have been reported because of the coverage of the Libyan Lockerbie bomber, Al-Meghari, or that the search term 'flu' could actually been 'swine flu' but they can't be sure.

There is, in my opinion, a large difference between a story mentioning prostate cancer as the reason for Al-Meghari's release from prison and a story about prostate cancer from the medical point of view. The Swine Flu has been indeed covered intensively lately, but that doesn't mean that the 'regular' flu has been covered, even though it's a common cause of death. The Swine Flu falls under 'health scare' while the regular flu doesn't, and treating both as 'flu' kind of misses the point. This study is more about "how many times diseases' names appear in the press" than about "the media and representations of common diseases".

Swine Flu: sexier than the regular flu

Williamson, J.M., Skinner, C. I., & Hocken, D.B. (2011). Death and illness as depicted in the media International journal of clinical practice, 65 (5) : 21489079

Pig's blood, tobacco control and mass media

Pigs play an important role in the western culture, mostly as guests of honor in many meals. A less known role of pigs, or, to be precise, of pigs' blood (‘porcine haemoglobin’) is as part of what is called ‘biofilter’ in certain cigarette brands. Developed by Greek researchers, said 'biofilter' is supposed to make cigarette smoking healthier (it doesn't).

According to Valavanidis, Vlachogianni & Fiotakis (2009)

"Filters (so called “bio-filters”) with antioxidant compounds impregnated in active carbon canaffect only marginally the composition and toxicity of solid and gaseous phases of cigarette smoke."

Marketed as healthier, the BF helped the cigarette company SEKAP to become the second largest Greek cigarette manufacturer, with the BF cigarettes capturing 6% of the Greek market the month after they were launched. The company also export their cigarettes to Europe, Asia, Africa and the Middle East. By the time healthier smoking claims were outlawed by the Greek government, in 2002, the product already acquired a 'healthy' image.

An Australian organization decided, as part of a tobacco control project (funded by the cancer institute of New South Wales) to alert the media, through press releases, to several tobacco-related issues. They issued a press release in March 2010 ("New book on pig products reveals problems for Islamic, Jewish and vegetarian smokers"). It is important to note that at least in Australia, tobacco companies aren't obligated to reveal their cigarettes' ingredients.

As part of the research, the authors studied the coverage of the press release online. The story was covered all over the globe, including by the Daily Mail, the Calcutta News and even by The Colbert Report. The less thrilling part was that no media, except for an Israeli TV channel and a group of journalists one of the authors encountered during a visit to Indonesia, contacted the authors. They all based their coverage on a newswire (AAP) media release.

The pig blood's news created confusing, and author Simon Chapman received emails, mainly from Muslims, who wanted to know which cigarette brands were 'safe'. The the South African National Halaal Association issued an anti-smoking leaflet (fig. 1). The Iranians blamed 'the Zionists' for the 'tainted cigarettes'. Cigarette companies such as Japan Tobacco International, Philip Morris were quick to publish denials.

Overall, the authors consider 'unorthodox' framing was considered a success in alerting the public to the secretive nature of the tobacco companies and the lack of regulation on tobacco products. I think that for Orthodox Jews and Muslims it is another reason to stop smoking: I mean, dying of lung cancer and going to hell?!

Mackenzie R, & Chapman S (2011). Pig's blood in cigarette filters: how a single news release highlighted tobacco industry concealment of cigarette ingredients. Tobacco control, 20 (2), 169-72 PMID: 2117285

Valavanidis, A., Vlachogianni, T., & Fiotakis, K. (2009). Tobacco Smoke: Involvement of Reactive Oxygen Species and Stable Free Radicals in Mechanisms of Oxidative Damage, Carcinogenesis and Synergistic Effects with Other Respirable Particles International Journal of Environmental Research and Public Health, 6 (2), 445-462 DOI: 10.3390/ijerph6020445

Cancer coverage and its sources

The average person acquires most of hers or his health knowledge from the media. The question is, where do the media acquire that knowledge?

Moriarty et al. (2010) tried to answer this question by studying the 2003 cancer coverage in 44 major American newspapers (they started with 50, but had difficulties obtaining full-text coverage for six of them). Their final sample included 3,656 in-depth cancer articles that were coded for topics, aspects of cancer continuum (prevention, treatment, etc.), sources and clinical trials.

The most frequently cited sources were research institutions (29.73%), followed by medical journals (12.30%), ACS (9.57%) and NCI (4.54%).

Ten most cited sources:

1. New England Journal of Medicine
2. Journal of the National Cancer Institute
3. Journal of the American Medical Association
4. Johns Hopkins University
5. Memorial Sloan Kettering Cancer Center
6. Genentech
7. Fred Hutchinson Cancer Center
8. Harvard University
9. H. Lee Moffitt Cancer Center
10. Science

Sources and story type

The most popular subjects were personal profiles of people with cancer, cancer research and cancer fundraisers/benefits. Research institutions were the most popular sources in almost every story type. In comparison, medical journals were mostly cited in cancer research stories. Pharmaceutical companies were rarely cited, and when they were, it was mostly in reports of cancer research and stocks.

Sources and the cancer continuum

Treatment was the most mentioned aspect of the cancer continuum (in nearly 75% of the articles). Detection was mentioned in about half of the articles. Of all aspects, prevention was the least likely to appear in stories.

Clinical trials and their tone

Out of the 317 stories about clinical trials, more than half (53.6%) cited a research institution. Medical journals were also cited frequently. The general tone of clinical trials coverage was optimistic (more than half the stories) with most of the other stories having a neutral or balanced tone. Articles that cited medical journals or pharmaceutical companies were significally more likely to be optimistic.

Overall, sources in cancer coverage change according to the type of the story. The ACS, for example, was frequently cited in awareness/education stories. Research articles frequently cited medical journals. The most interesting finding is that pharmaceutical companies aren't a main source for cancer stories (it could be, however, that those companies funded the research reported. The paper didn't look into funding sources). The authors mention that it's possible the reason for the large amounts of research institutions mentions is that the reporters rely on said institutions press releases.

Moriarty, C., Jensen, J., & Stryker, J. (2009). Frequently cited sources in cancer news coverage: a content analysis examining the relationship between cancer news content and source citation Cancer Causes & Control, 21 (1), 41-49 DOI: 10.1007/s10552-009-9432-x

Don't say you found aliens (unless you actually have)

Unlike with health and medicine press releases (Woloshin and Schwartz have a few good papers about the matter) I haven't seen much research about other scientific press release. That's why I was glad to find the paper "Credibility of science communication: An exploratory study of astronomy press releases" by Nielsen et al. (2007).

They conducted 11 in-depth interviews with journalists, scientists and public information officers, and came up with several conclusions regarding the accuracy and credibility of astronomy press releases.

• Credibility was defined by the interviewees as "being honest and doing your homework." Hype was defined as overstating the importance of results in order to increase visibility.

Credibility problems with press releases

Problems were usually caused by either the press release trying to make the issuing institution look better, or trying to make other institutions look worse.

1. The level of communication effort: finding some well-known person to tell the media how much the research described in the press release is significant to science.
2. The wording of the press release: even if it is possible you found alien life, keep that question mark at the end of "Alien life found?".
3. Dictating the timing of a press release: we just happened to discover something really important, just in time for the annual budget meeting! Other time-related sins are publishing the press release before the peer-review paper is out, and timing the release to screw up the competition's own press release or event.
4. Omission of reference to other scientists' work: this isn't the 17th century. It is hardly likely you did everything by yourself, or haven't built on some previous research.
5. Unjust comparison with other facilities.

Good ways to avoid lack of credibility (which can be in science, unlike in politics, problematic) is to have internal referees to the press release before its publication. Also, the importance of a peer-reviewed paper backing the press release can't be overstated.

Despited everything said here, the authors' overall conclusion is that "...credibility problems for astronomy press release do not exist, though examples certainly exist."

I find this conclusion very encouraging.

Nielsen, L. H., Torpe Jørgensen, N., Jantzen, K., & Christensen, L. L. (2007). Credibility of science communication: An exploratory study of astronomy press releases Proceedings from the IAU/National Observatory of Athens/ESA/ESO Conference, Athens, Greece.