How journalists frame racial disparities in health matters

Journalists often cover health disparities with racial comparisons like Black people are 40% more likely to die of colorectal cancer than most other racial groups; non-Hispanic white people are at higher risk of melanoma than Black or Hispanic people; and Black people are 1.5 times more likely to have high blood pressure than white Americans.

Highlighting these differences is important to illuminate health disparities that are the product of systemic racism and other sociocultural, political and economic forces.

But the way writers present such information can influence how people perceive their own health risks.

When covering disparities, journalists, TV presenters and researchers tend to highlight differences between groups - and stories often lead with the negative, highlighting the groups at greater risk, says Jiawei Liu, a health communication and public policy researcher at Cornell University.

Although communicators and researchers often assume that comparing two social groups might lead the one at greater risk to act in ways that help them "catch up with people who are less at risk for the disease," Liu says. "This is not necessarily true."

Liu and Jeff Niederdeppe, a health communication researcher at Cornell University, study the effects of media framing on people's health behaviors as well as public policy. In a new study, the team found that if news is framed in a way that contrasts one social group against another, stories about health disparities might lead to misperceptions and polarization.

For their analysis, the team turned to peer-reviewed scientific literature that examined how lay audiences absorbed news about health disparities. The 17 experiments they identified spanned health messages and news stories about melanoma rates, colon cancer screening, COVID-19 vaccination, heart disease, and more. Sixteen of the 17 compared racial groups to one another, and a few also included geographic, gender and economic comparisons.

Many of these studies analyzed, in one way or another, whether reading or watching news about their disease risk convinced people to engage in healthier behaviors, like exercising more or getting a timely colonoscopy. Ideally, rates of healthy behaviors would increase amongst people who learn they are at a higher risk of disease than other racial groups.

But social comparisons between, say, Black and white people, does not consistently lead to this outcome. In most of the studies the researchers examined, comparing two racial groups made no significant difference. And in some experiments, the comparison reduced people's intent to engage in healthier choices.

It's not as simple as people knowing they're more at risk and so choosing healthier behaviors, Liu said.

On the other hand, when a comparison describes one group as "high risk," it can result in the other group perceiving themselves as being at "low risk" of a disease.

"When you put two numbers side by side, it creates this contrast," Liu said.

In future studies, the researchers plan to explore whether that misperception might cause people to ignore health risks altogether.

At a societal level, Liu adds, comparisons between racial or ethnic groups can lead to a sense of "othering" - and thus trigger polarized feelings about policies that aim to achieve health equity.

"Social comparison can cue this group-based thinking," he said. "It's a kind of 'us versus them' framing instead of realizing that if the disparity were reduced, everyone would be better off."

Tips for Journalists

The researchers offered strategies for journalists who want to increase the impact of stories about health disparities:

1. Active Framing: Writing in active voice and naming the causes of health inequity, whether it's a lack of access to care, implicit bias, or other factors, can minimize the impression that differences in health of racial or ethnic groups are a result of biological variation.
2. Add Context: Even in a short article, adding historical context on how disparities have reduced can reduce the risk of polarization.
3. Highlight Assets: Readers often underestimate the prevalence of healthy behaviors in minoritized communities. For instance, a story about disparities in colorectal cancer rates could emphasize that Black adults are among the most likely to undergo regular preventive screening. In other research, Liu and Niederdeppe have found that highlighting the prevalence of such healthy behaviors can encourage readers to follow suit.