A qualitative content analysis of the representations of health, income and income distribution in the Canadian press

Abstract

For both the lay public and policy makers, the media are an important source of health information. While media discourses about health are not uniform, some perspectives are more commonly reported than others. In reviewing Canadian media on health, the biomedical, the lifestyle, and the social determinants’ models of disease aetiology can all be found; however, more critical components of the social determinants’ model, such as income and income distribution, receive limited attention. Income and its distribution is a key social determinant of health because of its interconnectedness with many other health determinants, yet it remains an underreported theme in media discourse. Using a qualitative content analysis, this study examines the relationship between health, income and its distribution as represented in two major national Canadian newspapers. My findings illustrate that in such agenda-setting Canadian newspapers, the relationship between health, income and income distribution was not presented as a salient determinant of health. This was manifest through low frequency of coverage, article positioning and news article structure. Health researchers and health care professionals contributed little to the discussion of the health-income relationship within Canadian media. When the relationship was acknowledged, it was journalists themselves who attempted to move the agenda forward. The responsibility and burden for this complex relationship was primarily positioned from a systemic perspective. While the focus on social responsibilities rather than on individual responsibilities was encouraging, the overall discussion of the health-income relationship was located primarily within the access to health care debate; where poverty or low income was positioned as a barrier to access. These observations highlight tensions around current views of health and the challenges for policymakers, health researchers, health professionals and the lay public to move away from biomedical notions of health.