Does Media Epidemiology Correspond
with Social Epidemiology of Obesity?
Sarah Gollust, Ijeoma Eboh, Colleen Barry
A d
Academy
Health
H lth
Disparities Special Interest Group
J ne 26,
June
26 2010
Acknowledgements



Jeffrey Then
Hauchie Pang
g
Funding
 Robert
Wood Johnson Foundation Healthy Eating
Research Program (#65055)
 Robert Wood Johnson Foundation Health & Society
Scholars Program @ U of Penn (pilot grant)
News Media and Public Opinion

News media can influence Americans’ opinions about health
policy topics (agenda-setting, framing)



R
Researchers
h generally
ll llookk att content
t t off text
t t
Images shape public perceptions of issues, social groups at risk,
social norms,
norms stigma (e.g.,
(
Gibson
Gib
& Zillman
Zill
2000;
2000 G
Gerbner
b
& Gross
G
1976)
Understanding news media portrayals of disparities in obesity
begs an image-based approach

<15% of news articles about overweight/obesity (1995-2005) (N=262)
mentioned race/ethnicity of individuals or groups affected (Saguy & Gruys 2010)
News Images and Demographic Perceptions

Insert Gilens figure here
• Time, Newsweek, U.S. News
articles
i l about
b poverty
(N=1,256)
• 6,117 poor individuals
p
in photos
p
(race
(
depicted
coded for 72%)
Gilens, “The News Media and Racialization of Poverty”, Why Americans Hate Welfare. 1999
Research Questions


What do images accompanying news articles about
obesity convey about obesity and disparities?
How does this “media epidemiology” compare to
what we know about obesity’s
y social epidemiology?
p
gy

Disparities by gender/race/ethnicity/SES
Methods: Data collection
Selecting media
Selecting sources
• News-magazines
• Newsweek and Time
• Full-text coverage
in EbscoHost for
1984-2009
Search strategy
Data collection
• EbscoHost
• “overweight or obes*”
• 354 articles
• 311 (88%) found and
scanned
Methods: Developing a Coding Scheme
• Exclusion criteria
(content, image,
image of at
least 1 person)
• Date
• Length
• Number of
images
•
•
•
•
•
Size
Caption
Setting
Image type
# of
people
• Appearance
(overweight or
not, gender,
race/ethnicity
race/ethnicity,
age, SES)
• Behavior
Inter‐rater reliability assessments (% agreement > 85%; kappas >0.67)
Newsweek, J
June 12, 2000
12 2000
Methods: Epidemiological Data

Relevant epidemiological statistics: proportion of
overweight Americans in each demographic group
 Not
% of African Americans adults who are overweight
(75.7%), but % of overweight adults who are African
American (13.1%)


Obesity
y data from NHANES
Demographic data from American Community
Survey
Results: Sample (N=311
(N 311 articles)
Number of Time and Newsweek Articles about Overweight/Obesity,
1984-2009
IOM, Childhood Obesity, 2004
45
40
35
WHO, 2002/2003/2004
30
25
20
15
10
5
0
Surgeon General Report, 2001
Newsweek
Time
2010, Obama, Let’s Move
Results: Sample



176 of 311 (56.6%) articles excluded (focus not
overweight/obesity in humans; article had no
images; images not of people)
135 articles contained 240 images
g
240 images of 374 people
 172
(46
(46.2%)
2%) are ooverweight
erweight or obese
 202 (54.0%) are healthy weight
Changing Media Demographics of
Overweight/Obesity
/
1984-2009
(N=172)
Age
Child
A
Adult
18-65
86
Adult 65 or older
Unclear
61 (36%)
03 (59%)
( 9%)
103
6 (3.5%)
2 (1.2%)
Race/ethnicity
White
Nonwhite
Black
Hispanic
Other
Unclear
121 (70.4%)
27 (15.7%)
13 (7.6%)
9 (5.2%)
4 (2.4%)
24 (14.0%)
Gender
Female
Male
Unclear
81 (47.1%)
86 (50.0%)
5 (2.9%)
Before 2001
(N=42)
2001-2004
(N=70)
2005-2009
(N=60)
Changing Media Demographics of
Overweight/Obesity
/
1984-2009
(N=172)
Before 2001
(N=42)
2001-2004
(N=70)
2005-2009
(N=60)
Age
Child
A
Adult
18-65
86
Adult 65 or older
Unclear
61 (36%)
03 (59%)
( 9%)
103
6 (3.5%)
2 (1.2%)
11 (26.2%)
24 (57.1%)
(
%)
6 (14.3%)
1 (2.5%)
29 (41.4%)
4 (58.6%)
41
( 8 6%)
0
0
21 (35.0%)
38 (63.3%)
(63 3%)
0
0
Race/ethnicity
White
Nonwhite
Black
Hispanic
Other
Unclear
121 (70.4%)
27 (15.7%)
13 (7.6%)
9 (5.2%)
4 (2.4%)
24 (14.0%)
35 (83.3%)
3 (7.1%)
2 (4.8%)
1 (2.4%)
0
4 (9.5%)
44 (62.9%)
12 (17.1%)
6 (8.6%)
5 (7.1%)
1 (1.5%)
14 (20.0%)
42 (70.0%)
12 (20.0%)
5 (8.3%)
3 (5.0%)
3 (5.0%)
6 (10.0%)
Gender
Female
Male
Unclear
81 (47.1%)
86 (50.0%)
5 (2.9%)
24 (57.1%)
18 (43%)
1 (2.4%)
29 (41.4%)
39 (55.7%)
2 (2.9%)
33 (55.0%)
24 (40.0%)
3 (5%)
Note: Only 2 depictions of overweight/obese as explicitly poor (in 2008)
Do the News Media Represent Epi?
2005-2009
Magazines
U.S.*
U.S.
Overweight/ obese children (n=21)
Male
42.9%
52.7%
Female
57.1%
47.0%
White
70.0%
63.1%
Bl k
Black
10.5%
16.2%
15.8%
Overweight/obese adults (n=38)
26.2%
Male
41.7%
53.2%
Female
58.3%
47.1%
White
84.9%
77.6%
Black
6.3%
13.1%
Hispanic/Latino
0%
15 5%
15.5%
65 or older
0%
17.8%
Hispanic/Latino
*Demographic/
g p /
epidemiological data from 2008 NHANES and 2008 ACS
Note: Media sample drops as missing any observations for which coding was “indeterminable”
Discussion

Research in other policy arenas has demonstrated associations
between media depictions of the population affected by
societal problems and the public’s
public s willingness to support
policies aimed at combating those problems




News media
ed a fairly
a y accu
accurately
a e y reflect
e ec thee demographic
de og ap c composition
co pos o of
o
the overweight population in America, in the latter period of the study
Very little explicit illustration of the poor obese or the elderly obese
Under-representation of Hispanic/Latino adults
Increasing attention to depictions of children among the overweight

Reflects rising political salience of childhood obesity (e.g.,
(e g “Let’s
Let s Move”)
Move )
Limitations & Future Directions


Restricted sample (two magazines)
 No TV, Internet, newspaper, advertisements
 No ethnic or specialty magazines
Declining news-magazine readership over time period





Increasing SES of readership (Pew 2009)
Cannot disentangle journalistic norms from representations of obesity
Relatively small sample sizes of individuals depicted
Subjectivity (but careful training and reliability)
Cannot make causal inferences as to the effect of these photos
on public perceptions

Future experimentall workk can tease out public
bl response to media
d
depictions of obesity
Thank you!
Contact me at sgollust@wharton.upenn.edu
Coding weight (Adults)
Thompson and Gray (1995) Development and Validation of a New Body‐Image Assessment Scale, Journal of Personality Assessment, 64:2, 258‐269
Coding weight (Children)
Truby and Paxton. 2002. Development of the Children’s Body Image Scale.
British Journal of Clinical Psychology.
Psychology 41: 185-203
185 203.
Declining Magazine Readership, 1988
1988-2008
2008
Source: Audit Bureau of Circulations & Pew Project for Excellence in Journalism “The State of the News Media, 2009”
Rising Income of News Magazine Readers
Source: Mediamark Research & Pew Project for Excellence in Journalism “The State of the News Media, 2009”
Other social/behavioral depictions





11.2% of overweight are depicted eating; 6.8%
drinking
22.4% exercising
None are smoking
20% are shown anonymous (i.e., no head)
Among those with faces visible, 46% happy, 2.3%
sad
Poverty Depictions of Obesity
June 2008,
Time
Poverty Depictions of Obesity
June 2008,
Time
Methods: Coding


Training, inter-rater reliability assessments (kappas
>0.67)
Person-level variables
Weight
g (validated
(
“silhouette” scales to measure bodyy mass
among children and adults)
 Gender
 Age (<18, 18-65, 65+)
 Race/ethnicity
 SES (poor, neither poor/wealthy, wealthy)
 Affect ((facial expression)
p
)
 Behavior (diet, exercise, activity level, isolation)

Characteristics of Articles / Images
Article-Level
i l
l Features (N=135)
(
)
News Outlet
Newsweek
Time
56 (41.5%)
79 (58.5%)
Years
1986-1995
9
99
1996-2002
2003-2006
2007-2009
14 ((10.4%)
%)
31 (23.0%)
70 (51.9%)
20 (14.8%)
(
)
Number of images per article
1.8 (median = 1; 70% have 1 image)
Image-Level Features (N=240)
Image Type
Photo
Illustration
211 (87.9%)
29 (12.1%)
Number of people per image
1.8 (median=1; 63.3% show 1 person)
Do the News Media Represent Epi?
Magazines
(2000-2009)
U.S.*
(2003-2006)
Overweight/ obese children (n=57)
Male
54.4%
52.5%
F
Female
l
45.6%
47.5%
White
73.1%
68.5%
Black
12.0%
18.6%
Hispanic/Latino
10.0%
Overweight/obese adults (n=77)
24.8%
Male
46.8%
53.9%
Female
53.3%
46.1%
White
83 1%
83.1%
82 0%
82.0%
Black
7.8%
13.8%
Hispanic/Latino
6.3%
14.4%
65 or older
0.0%
17.8%
*Demographic/
g p /
epidemiological data from 2003‐2006 NHANES and 2005 ACS
Note: Media sample drops as missing any observations for which coding was “indeterminable”