of responsibility for social and health issues and persuasion of public opinion support possibly leading to action.
Second, news coverage of health issues has increased dramatically during the past fifty years. A 2001 study by Pierce and Gilpin published in Tobacco Control found a direct link between smoking cessation in middle age adults and news coverage of smoking and health between the years of 1950 and 1980. In 2008, Pew Research Center listed health news as the 8th biggest subject in the national news, comprising 3.6% of all coverage. The amount was more than three times the coverage for education or transportation, but less than coverage about foreign affairs, crime, or natural disasters. Despite significant changes in the media landscape allowing people immediate access to health-related information on websites and social media, news coverage remains a vital force in shaping the way we think about and discuss health (Walsh-Childers, Braddock, Rabaza & Schwitzer, 2018; Major, 2018).
Third, health communication research in academia has developed over the last thirty-five years as a thriving and significant field. Scholars in this area investigate the roles performed by human and mediated communication in health care delivery and health promotion and journalism while benefiting from ample funding opportunities not readily available to other areas of communication research (Kreps et al, 1998). This has led to an increase in health communication research programs.
We believe these three trends converge with Iyengar’s (1991) introduction of thematic and episodic frames as a way to categorize news frames and study their effects, and accounts for the prevalence of scholarly research on thematic and episodic frames in health news. This premise is discussed in the remainder of the chapter.
As Cacciatore, Scheufele, and Iyengar (2016) noted, “Framing has emerged as one of the most popular areas of research for scholars in communication. For evidence of this, one need look no further than our conference programs or the pages of our ←12 | 13→flagship journals” (p. 8). Most scholars agree the foundations of framing is found in sociology and psychology. Through these two unrelated academic approaches, we find the origins of equivalence framing and emphasis framing.
Psychology-rooted framing refers to how the same information is altered when presented to audiences. Kahneman and Tversky (1979, 1984) introduced what has been identified as equivalency framing because it relies upon dissimilar but logically equivalent words or phrases to create the framing effect. Their 1981 “Asian disease” experiment examined the effects of equivalent information except for changes of gains versus losses (Tversky & Kahneman, 1981). The researchers presented participants with a story detailing a hypothetical outbreak of an uncommon Asian disease threatening to kill 600 people. After reading the story, individuals were presented with a gain option (lives saved) as opposed to a loss option (lives lost) for dealing with the crisis. Participants were significantly more risk averse when presented with the option of saving lives (gain) but risk seeking when the same information was presented in terms of losing lives (loss). Across a variety of issues, these researchers found individual preference is conditional on how information is presented or contextualized as opposed to the expected usefulness of the choice (e.g. Kahneman & Tversky, 1981; Kahneman, 2011; Cacciatore, Scheufele & Iyengar, 2016).
“Emphasis framing” comes from a sociology-rooted approach. “Emphasis framing” involves focusing on one set of considerations over another. Instead of presenting logically equivalent information to the audience member in a story, emphasis framing offers individuals one set of facts or arguments over another. The sociological tradition views framing as a means of understanding how people construct meaning and make sense of the everyday world (Ferree et al., 2002).
Goffman, the first to introduce the sociological approach to framing, defined framing as a way people could use interpretive schemas to both organize and understand the information encountered in daily life (Goffman, 1974; Cacciatore, Scheufele, & Iyengar, 2016). Later, Gamson and Modigliani (1987) defined frames as ‘‘a central organizing idea or story line that provides meaning to an unfolding strip of events …. The frame suggests what the controversy is about, the essence of the issue’’ (p. 143). Clearly, some scholars examining news coverage would find this approach beneficial.
The marked increase in communication framing research over the past few decades can be traced back to the acceptance of the sociological view of frames (Cacciatore, Scheufele & Iyengar, 2016). The growth included studies examining news reports containing thematic and episodic framing, a type of emphasis framing. Thematic framing involves placing a problem or issue in a broader context, and episodic framing places the emphasis on an individual or single event (Iyengar, 1991).
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Next, we turn to a brief discussion of the accessibility–applicability distinction, because it is important to identify how cognitive mechanisms involved in framing effects operate in comparison to other theories. This is not a broad discussion of the accessibility-applicability distinction and the processes behind framing, priming and agenda-setting (see e.g. Cacciatore, Scheufele, & Iyengar, 2016; Scheufele & Tewksbury, 2007). Priming and agenda-setting, Price and Tewksbury (1997) argue, are “accessibility effects; that is, they are based on memory-based models of information processing” (Scheufele & Tewksbury, 2007, p.15). Agenda-setting and priming theories posit the news media make specific issues or facets of issues more accessible (i.e., easily remembered) for individuals. This process impacts the criteria audience members use when shaping attitudes about political candidates and issues/problems (Scheufele & Tewksbury, 2007).
Accessibility is specifically different from framing as an applicability process and effect (Scheufele & Tewksbury, 2007). Applicability suggests a connection among two concepts and after reading or viewing a message containing both, audience members accept the two are connected (Price & Tewksbury, 1997). For example, a news story may suggest a connection between external determinants (education, environment) and a health problem. The story may propose the best way to think about the health of individuals is through a consideration of whether individuals have access to nutritious food or safe living environment. Thus, the news story has created a connection between external determinants and health, as opposed to individual behavior as the only determinant of health.
Framing rooted in Gestalt Psychology and attribution theory, explores the tendency among people to detect patterns in pieces of information consistent with preexisting cognitive schemas (Scheufele & Iyengar, 2017). Gestalt Psychology, a school of thought founded by Max Wertheimer, is based on the concept of a unified or meaningful whole. Framing operates on applicability effects to invoke particular interpretive schemas, thus determining how information is processed (Scheufele, 2000). Put simply, how information is presented or framed will influence the schema individuals call upon to process information.
In psychology, a schema (plural schemas) is defined as a pattern of thought or behavior that categorizes information and the associations among them (DiMaggio, 1997). Schemas are critical to understanding framing effects. A primary assumption of framing theories is the locus of effect lies within the explanation of an issue presented in news coverage about the issue. “It is the underlying interpretive schemas that have been made applicable to the issue that are the central effect of a frame” (Scheufele & Tewksbury, 2007, p. 14). Framing effects are about how we think about issues not if we think about issues (Scheufele & Tewksbury, 2007).
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Based upon that assertion, Iyengar’s (1987) experimental study of framing effects of news stories about terrorism demonstrates news frames can influence attributions of responsibility. Iyengar found study participants were more likely to attribute responsibility to individual terrorists after reading stories with an episodic frame (single event or individual). On the other hand, when news stories connected terrorism events to a more general political context (thematic frame), participants were more likely to consider
