If you’ve an interest in the relationships between media, healthy societies, public health, the digital revolution and the Gov 2.0 agenda, have I got some reading for you…

The Federal Communications Commission in the US has released a 465-page report, The information needs of communities: The changing media landscape in a broadband age.

While largely focused on the US context, it raises many global themes, including issues relevant to Australia. It says that while the digital revolution has utterly transformed how information is created, distributed, shared, and displayed, we are just beginning to wrestle with the implications of these changes.

The report notes that Eric Schmidt, former CEO of Google, estimates that humans now create as much information in two days as we did from the appearance of Homo sapiens through 2003. In a similar vein, while Facebook did not exist in 2003, it now reaches more people than all other major US media outlets combined.

The report also notes that 2010 marked a significant milestone; it was when more Americans were getting their news online than from traditional printed newspapers.

Some of the report’s over-arching recommendations also resonate locally, including that:

  • Greater government transparency will enable both citizens and reporters to more effectively monitor powerful institutions and benefit from public services.
  • Existing government advertising spending should be targeted more toward local media.
  • Nonprofit media need to develop more sustainable business models, especially through private donations.
  • Universal broadband and an open Internet are essential prerequisites for ensuring that the new media landscape serves communities well.
  • Policymakers should take historically underserved communities into account when crafting strategies and rules.

Below I have reproduced the report’s section on health reporting, and a few snippets from its section on online journalism. At the bottom of the post are links to some health-focused coverage of the report in the US.

Health (and remember that Australian news outlets derive substantial health coverage from US and international media sources)

A March 2009 report, entitled The State of Health Journalism in the US produced for the Kaiser Family Foundation, found that the number of health reporters has declined even though reader interest in the topic remains strong. Fewer reporters are doing more work, resulting in “a loss of in-depth, enterprise and policy-related stories.” The report, by Gary Schwitzer, an associate professor of journalism at the University of Minnesota, concluded:

“Interest in health news is as high as it’s ever been, but because the staff and resources available to cover this news have been slashed, the workload on remaining reporters has gone up. Many journalists are writing for multiple platforms, adding multimedia tasks to their workload, having to cover more beats, file more stories, and do it all quicker, in less space, and with fewer resources for training or travel. Demand for ‘quick hit’ stories has gone up, along with ‘news you can use’ and ‘hyper- local’ stories.

“As a result, many in the industry are worried about a loss of in-depth, enterprise and policy-related stories. And newsrooms with reduced staff who are facing pressure to produce are more vulnerable to public relations and advertising pressures. Health news may be particularly challenged by the issues of sponsored segments, purchased stories, and video news releases.”

While specific figures are not available to track newspapers’ reduction in health reporters, the Kaiser report said that, in a survey of members of the Association of Health Care Journalists, 94 percent of respondents said that “bottom-line pressure in news organizations is seriously hurting the quality of health news.”

Further, 40 percent of journalists surveyed said that the number of health reporters at their outlets had gone down during their tenure there, and only 16 percent said the number had increased. In addition, “39 percent said it was at least somewhat likely that their own position would be eliminated in the next few years.”

Losing journalists who cover such a specialized beat as health is significant. Reporters often spend years building up an expertise in the intricacies of medicine. They must learn how to decipher, explain, and put in context complex, confusing, and often controversial developments in treatment and cures, breakthroughs and disappointments. They need to translate medical speak into plain English. They need to be on top of developments in such areas as pharmaceuticals, clinical testing, hospital care, infectious diseases, and genetics. Theirs are not the kinds of stories that other reporters can easily produce.

In 2009, Ferrel Guillory, director of the University of North Carolina’s Program on Public Life, explained in a North Carolina Medical Journal article how the latest staff reductions had impacted health reporting at one paper. “Only a few years ago,” he wrote, “the News & Observer in Raleigh had as many as four reporters assigned to various health- related beats. They covered the big pharmaceutical industry in Research Triangle Park, Chapel Hill-based Blue Cross Blue Shield, the medical schools of the University of North Carolina at Chapel Hill and Duke University, and local hospitals. As of August 2009, the N&O has only one reporter with a primary focus on health.”

Guillory concluded that, although the appetite among the public for health stories remained high, “dependable, continuous” health coverage had diminished. Further, he wrote, journalists (in particular, those on television), focus more on emergencies, public health “scares,” and the announcements of new “cures” and technologies than on important policy matters and major trends in health and health care.

Mark Silverman, editor of the (Nashville) Tennessean recalls the day he stood with a staff researcher in front of a blackboard listing major stories he had hoped the paper would produce in the coming months. One line listed a story about how the state medical board was allowing incompetent doctors to mistreat patients, be disciplined by local hospitals, and then continue practicing medicine at other locations. But that story idea had an “X” next to it, meaning it would not get done, because the paper now had one health reporter instead of two.

While doing research for a book, Maryn McKenna, a former health writer for the Atlanta Journal Constitution, made an astonishing discovery: The “flesh-eating disease”—MRSA, or methicillin-resistant Staphylococcus aureus—was rampant at Folsom Prison in California. In an average year, the highly contagious skin infection kills 19,000 Americans, puts 370,000 in hospitals, and sends an estimated seven million to doctors or emer- gency rooms. “Some guards are getting infected, seriously infected,” McKenna says. “When prison guards go home, they take MRSA with them.” Now, families and friends, wives and children, the convenience-store clerk who hands over change or a lottery ticket are susceptible to the infection, which easily spreads outside the prison into the general and unwitting population. At the time, MRSA had been described in the national and specialty press, but no one had written about the situation at Folsom. “I just kept thinking, ‘I can’t believe nobody’s written about this,” ’ McKenna says. “Why hasn’t it been in the L.A. papers, in the San Francisco papers? It’s not like those are lazy institutions.” She then realized that, as at many newspapers large and small, deep staff cuts had left them unable to cover the story. The crisis went unnoticed until McKenna wrote about it.

Even when they are able to cover a medical story, time-strapped reporters often miss significant pieces of information. In the Kaiser study, more than 75 percent of the 500 stories reviewed concerning treatments, tests, products, or procedures failed to adequately discuss cost. And more than 65 percent failed to quantify the potential benefits and dangers, according to HealthNewsReview.org, a website created by Schwitzer, the author of the Kaiser study.

In the report and on HealthNewsReview.org, complaints abound from seasoned reporters who lament the growth of “press release reporting” and the lack of time they have to check out the veracity of information contained in a press release. Twenty eight percent of health reporters said that they personally get story ideas from public relations firms or marketing outreach somewhat or very often. Among those who work on at least some web content, half said that having to work across different media has resulted in less time and attention for each story, and 59 percent said it meant that they work longer hours.

In an attempt to replace some of the health coverage that disappeared from newspapers, the Kaiser Family Foundation in late 2008 created a nonprofit news service that would produce in-depth coverage of the policy and politics of health care. Kaiser Health News (KHN) hires seasoned journalists to produce stories for its website, KaiserHealthNews.org, and for mainstream news organizations.

Drew Altman, president of the Kaiser Family Foundation, explained to the New York Times why Kaiser Health News was a top priority: “I just never felt there was a bigger need for great, in-depth journalism on health policy and to be a counterweight to all the spin and misinformation and vested interests that dominate the health care system,” he said. “News organizations are every year becoming less capable of producing coverage of these complex issues as their budgets are being slashed.”

In addition to KHN, a number of smaller nonprofits have emerged to provide health care reporting in various states (And Croakey plans to profile one of these at some later stage…)

(references for this section can be found in the full report)


Snippets from online journalism chapter

Web scholar Clay Shirky estimates that the citizens of the world have one trillion hours of free time annually—what he refers to as a “cognitive surplus”—that could be devoted to shared projects and problem solving.

Shirky says some of this is being applied to civically important communal digital projects, for example: Ory Okolloh, a blogger in Kenya, was tracking violence in the aftermath of her country’s December 2007 elections when the government imposed a news blackout. She appealed to her readers for updates on what was happening in their neighborhoods but was quickly overwhelmed by the flood of information she received. Within 72 hours, two volunteer software engineers had designed a platform called “Ushahidi” to help her sort and map the information coming in from mobile phones and the web, so readers could see where violence was occurring and where there were peace efforts. This software has since been used “in Mexico to track electoral fraud, it’s been deployed in Washington, DC, to track snow cleanup and most famously in Haiti in the aftermath of the earthquake,” Shirky says.

In other words, the technological revolution has not merely provided a flood of cool new gizmos. It has also democratized access to the world’s vast storehouse of knowledge and news.

The Internet has brought improvements to news and information ecosystems in a variety of ways:

  • Unlimited space and lower barriers to entry have led to a greater diversity of voices and more choices for consumers.
  • Links make it possible for any piece of content to point toward huge numbers of additional sources of information, allowing an interested reader to access a far greater depth of information.
  • The everyone-is-a-publisher economy has allowed for the rise of a new commentariat, and a system that is arguably more meritocratic than before.
  • Citizen contributions have enhanced the coverage of important topics, including weather events, disaster recovery, local zoning decisions, scheduling of community events, and the quality of public transportation.
  • The cost of some types of reporting has dropped dramatically.


Open Government

One of the frontiers in the drive for government openness is a growing engagement with social media.

Nearly three-quarters of local government jurisdictions around the country use Twitter to push news to citizens and the media, especially with regard to emergency and public safety alerts. About the same number are using Facebook to communicate with citizens, frequently targeting users demographically or by interest.

In addition, governments are involving residents interactively in the gathering and reporting of civic information. “Many cities and counties have developed web-based applications that encourage citizens to submit pictures of potholes in need of repair, garbage needing pick-up, or graffiti that needs to be erased,” says Alan Shark, executive director of the Public Technology Institute, a nonprofit group that supports city and county government.

One example:Boston developed the Citizens Connect application to allow residents and visitors to gather information about the physical state of the city and send that information directly to the appropriate city department through their iPhone. Citizens can attach a photo and capture system-generated Geographic Information System (GIS) coordinates. The Boston Globe reported that, “City officials say the iPhone application is being used mostly by younger residents who have not previously called the hot line.”


Meanwhile, two of the many quoteable quotes from the report:

While the presence of good journalism does not guarantee a healthy democracy, it is fair to say that the absence of good journalism makes a healthy democracy far less likely.

Thomas Jefferson, who loathed many specific newspapers, nonetheless considered a free press so vital that he declared, “Were it left to me to decide whether we should have a government without newspapers or newspapers without a government, I should not hesitate a moment to prefer the latter.” If he were alive today, Jefferson would likely clarify that his dedication was not to “newspapers” per se but to their function: providing citizens the information they need to both pursue happiness and hold accountable government as well as other powerful institutions.


For more health-focused coverage of the report:

• The Association of Health Care Journalists

• Reporting on Health

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