Content analysis of media coverage of health inequalities in Canada, 2008

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The Canadian media's interest in health inequalities is relatively limited. A small number of large circulation media could not be included in the corpus studied; however, in all the media reviewed, a total of only 81 relevant articles or news items were found to have been published in 2008, which indicates that, collectively, the Canadian press devotes an average of 7 articles per month to this subject.
This means that health inequalities do not receive much media coverage. Nevertheless, the high number of units of information per document identified through this study indicates that the media consider the topic to be important. For this topic, the average was 13.5 units of information per document in 2008, which greatly exceeds the average of 6.2 units, which the Laboratory has observed over the past 25 years. This indicates that the media publish in-depth articles when they cover health inequalities. A total of 1,094 units were identified in 81 articles.
Reports and conferences focused on health inequalities have a major impact on press coverage. Thus, of the 10 events that the Laboratory was specifically mandated to track, seven were ultimately traced in the corpus studied. These generated almost half the content studied (43.8%). The Final Report of the World Health Organization's Commission on Social Determinants of Health had a particularly significant impact on newspapers; it alone produced almost a quarter (23.9%) of coverage.
Only the content focused on the reports and conferences was evaluated. The media reported the generally pessimistic conclusions of these events, to such an extent that the orientation of coverage reached a score of negative 40.7.¹
Four subjects stood out, with each generating more than 10% of content. These include social class² (visibility of 15.7% and reporting orientation of -9.3), the health system (13.3% and -3.7), place (11.6% and -15.3) and health inequalities in general (10.7% and -4.3).
The media reported the main causes of health inequalities to be poverty (10.8%) and social inequality (10.3%), which affects the general health of the population (16.9%) and explains the high visibility of social class as an associated subject. The press also pointed to the health system's lack of resources and the difficulty certain social groups have accessing (5.8%) the health system. The newspapers stressed the importance of government intervention (11.2%). Differences in life expectancy (3.6%) tied to place (districts and countries) received particular attention in the press. Other issues of concern were women (3.5%), Aboriginal peoples (3.2%) and children (3.0%).
The Toronto Star (13.5%) and The StarPhoenix of Saskatoon (12.2%) showed more interest in health inequalities than the other newspapers in the corpus. The StarPhoenix showed particular interest in a study carried out by the Saskatoon Health Region, which explains the volume of units traced to this publication. Two francophone dailies ranked 3^rd and 4^th in terms of volume: Le Devoir (6.7%) and La Presse (6.4%). Other media produced less than 5% of content each.
Grouped by region, the Ontario media (25.5%) showed the most interest in the issue of health inequalities. They placed ahead of Québec (22.0%), Saskatchewan (17.1%) and British Columbia (12.8%). Three quarters of the units identified were found in Anglophone media (74.1%).
With respect to the location referred to in the content examined, the articles were most concerned with international news (25.2%), and high visibility was given to the World Health Organization (WHO) reports dealing with health inequalities on a global scale. Next in prevalence was content referring to Canada in general (20.1%), then to Ontario (15.4%) and Saskatchewan (14.4%). The media in the latter province proved more voluble than that of other regions because of the interest shown by the Saskatoon StarPhoenix in a study conducted by the Saskatoon Health Region.
A third (34.1%) of the press coverage was based on citations, which is higher than the average of 30%, which has been observed by Laboratory. Monique Bégin, a member of the Commission on Social Determinants of Health and former Canadian Minister of Health and Welfare, received the most visibility (5.3%). She was cited more often than Michael Marmot, Chair of the WHO Commission on Social Determinants of Health. The WHO was particularly well represented; cumulatively, its actors were cited in 7.5% of content.
The months of August (28.0%) and November (28.3%) generated more than half of the content found (56.3%). The publication in August of the WHO report on the social determinants of health and that in November on health disparities in Saskatoon heightened media interest during these periods.