title: Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality.
abstract: The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a region that suffers extreme economic, educational, and health disparities. This analysis of a rural region's local news coverage of health issues demonstrates significant opportunity to engage with rural local media, particularly ethnic media, to disseminate health information. Such a strategy holds considerable promise to advance public health goals using a multilevel approach: From an individual perspective, improving the amount and utility of the information can inform and educate publics in areas with otherwise low levels of health information access. From a policy perspective, improving coverage of the social determinants of health could shape public opinion to support policies that improve health.
authors.affiliation: School of Social Sciences, Humanities, and Arts, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA. a.susana.ramirez@gmail.com.
authors.forename: A Susana
authors.identifier: http://orcid.org/0000-0002-9095-5358
authors.initials: AS
authors.lastname: Ramírez
authors.affiliation: School of Social Sciences, Humanities, and Arts, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA.
authors.forename: Erendira
authors.initials: E
authors.lastname: Estrada
authors.affiliation: School of Social Sciences, Humanities, and Arts, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA.
authors.forename: Ariana
authors.initials: A
authors.lastname: Ruiz
mesh_terms: D022126:Access to Information; D002140:California; D006266:Health Education; D066275:Health Information Exchange; D006801:Humans; D008402:Mass Media; D012424:Rural Population
keywords: Content analysis; Latino; Mass media; Newspapers; Social determinants of health