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Health Communication
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Media Coverage of Toxic Risks: A Content Analysis of


Pediatric Environmental Health Information Available
to New and Expecting Mothers
a

Susan Mello
a

Communication Studies, College of Arts, Media and Design, Northeastern University


Published online: 23 Jan 2015.

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To cite this article: Susan Mello (2015): Media Coverage of Toxic Risks: A Content Analysis of Pediatric Environmental Health
Information Available to New and Expecting Mothers, Health Communication, DOI: 10.1080/10410236.2014.930398
To link to this article: http://dx.doi.org/10.1080/10410236.2014.930398

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Health Communication, 00: 111, 2015


Copyright Taylor & Francis Group, LLC
ISSN: 1041-0236 print / 1532-7027 online
DOI: 10.1080/10410236.2014.930398

Media Coverage of Toxic Risks: A Content Analysis


of Pediatric Environmental Health Information Available to New
and Expecting Mothers
Susan Mello

Downloaded by [Susan Mello] at 17:52 30 January 2015

Communication Studies, College of Arts, Media and Design


Northeastern University

Mass media play a central role in providing environmental health information to the public.
Despite several decades of environmental and health communication research, the nature of
environmental health information available to one of the most vulnerable populationsnew
and expecting mothershas received limited attention. To address this gap, this study poses
two questions: (1) How prevalent is information related to prenatal and pediatric environmental health (PPEH) in the media, and (2) how much coverage do the most concerning chemical
threats to PPEH receive? A content analysis of 2,543 texts in popular media sources (i.e.,
the Associated Press [AP], parenting magazines, and parenting websites) from September
2012 to February 2013 revealed that roughly three pieces of PPEH information were made
available to mothers daily. Prior research has shown that media coverage of environmental
health issues has decreased over the years; however, these results suggest that at-risk populations are likely to encounter this type of information in the media. Also, while certain chemicals
received ample coverage (i.e., pesticides, cigarette smoke, mercury), other issues deemed concerning by federal agencies did not (i.e., lead, phthalates). This study also introduces a novel
method for harvesting online content encountered incidentally. Implications of these findings
for communication research and practice are discussed.

The U.S. public health agenda has recently begun to prioritize prenatal and pediatric environmental health (PPEH;
American Academy of Pediatrics Council on Environmental
Health, 2012; Trasande & Liu, 2011). In 2000, Congress
authorized the planning and implementation of the National
Childrens Study, the largest long-term research study ever
conducted in the United States into the effects of environmental influences on childrens health and development
(Eunice Kennedy Shriver National Institute of Child Health
& Human Development, 2012).
Health experts contend that American children are currently facing a new pediatric morbidity (Landrigan et al.,
1998). Patterns of childhood illness have shifted dramatically in the past century, away from infectious diseases

Correspondence should be addressed to Susan Mello, Communication


Studies, College of Arts, Media and Design, Northeastern University,
240 Lake Hall, 360 Huntington Avenue, Boston, MA 02115. E-mail:
susanmello.ma@gmail.com

like poliomyelitis, dysentery, and tuberculosis toward a new


class of chronic and disabling conditions. Rates of childhood
asthma, leukemia, brain cancer, attention deficit hyperactivity disorder, and neurodevelopmental dysfunction have
increased in recent decades, and the potential influence of
environmental toxicants has attracted considerable attention.
As many as two in three cases of cancer are estimated to be
linked to some type of environmental factor, including exposure to tobacco smoke and toxic substances in our air, water,
and soil (Kerrigan & Kelly, 2010).
The U.S. Environmental Protection Agency (EPA)
Toxicity and Exposure Assessment for Childrens Health
(TEACH) spotlights 20 chemicals of concern to childrens
health based on government resources and numerous scientific studies published since 1972 (U.S. Environmental
Protection Agency, 2011). Detailed summaries of these
chemicalsincluding arsenic, benzene, bisphenol A,
mercury, and phthalates, among othersprovide critical
information to the public about exposure rates, toxicity
studies, and risk management considerations.

MELLO

The challenge is that these environmental risks to human


health are not as readily perceptible (Beck, 1992), meaning
we typically cannot see, smell, taste, or in any physiological
way detect their presence. Instead, we rely on policymakers and manufacturers to prevent and mitigate exposure.
But when our innate senses and regulation fall short, we
are forced to rely on external sources of information
particularly the mass mediato increase our awareness of
toxic threats, to formulate risk perceptions, and to guide individual protective behaviors (Adam, Allan, & Carter, 1999;
Slovic, 1987).

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THE ROLE OF MEDIA IN MATERNAL DECISION


MAKING
New mothers arguably encounter a glut of information
about parenting (Carter, 2007). The transition to parenthood
is known to increase attention to information about issues
that may affect a childs well-being, including potential
health threats (Stern, Dietz, & Kalof, 1993). Such information is often acquired from mass media sources, particularly
the Internet (Bernhardt & Felter, 2004; Plantin & Daneback,
2009; Stern, Cotten, & Drentea, 2012). New mothers have
even rated the media as a more important source for parenting information and advice than their own mothers (Madge
& OConnor, 2006).
The social amplification of risk framework (Kasperson
et al., 1988) has been used to explain and predict how the
media can serve as amplifiers of risk signals, increasing the
volume and availability of risk information to the public and
instigating change. Frewer, Miles, and Marsh (2002), for
instance, determined that the volume of reporting risks associated with genetically modified organisms (GMOs) in the
United Kingdom was positively and significantly correlated
with public risk perceptions of GMOs. The framework has
also been applied to studying the impact of risk reporting
on public reactions to mad cow disease (Lewis & Tyshenko,
2009), as well as to understanding parents responses to
media coverage of the MMR vaccination controversy (Petts
& Niemeyer, 2004).
Health behavior change theories (e.g., the health belief
model; Janz & Becker, 1984; Rosenstock, 1974) and corresponding research also suggest that when individuals are
made more aware of risks, they are more likely to report
intentions to increase risk reduction behaviors (Rimal &
Real, 2003). Qualitative studies suggest that a majority
of mothers use the information they acquire from massmediated news and advertising to positively affect the health
of those around them (see Amin & Harrison, 2009; Berry,
Jones, & Iverson, 2011; Gray, Boardman, & Symonds, 2011;
Stern et al., 2012; Warner & Procaccino, 2007). Timeseries analyses have also made a compelling case for the
link between media coverage volume and secular trends in

aspirin administration to children (Soumerai, Ross-Degnan,


& Kahn, 2002) and breastfeeding (Foss & Southwell, 2006).
Despite several decades of environmental and health communication research, the nature of environmental health
information mothers may scan (or encounter during routine
media use; Hornik & Niederdeppe, 2008), to this authors
knowledge, has received very little research attention. In fact,
environmental health in general has been relatively overlooked by health promotion research (Howze, Baldwin, &
Kegler, 2004). Given the rise in intensive mothering and the
ability of certain media to reflect and even shape cultural
shifts in parenting across generations (Hays, 1996; Quirke,
2006), it seems likely that media coverage of unsafe products and emerging scientific evidence could, in part, drive
new mothers to take even greater precautions with young
children. Research has suggested that media coverage of the
risks associated with exposure to bisphenol A (BPA) played
a central role in guiding legislation and regulation of the
chemical in the United States (Kiss, 2013). So I ask, do
the mass media provide environmental health information to
new parents today? And if so, what does that coverage look
like?

MEDIA COVERAGE OF ENVIRONMENTAL HEALTH


A review of the literature reveals that, to date, there have
been no comprehensive content analyses of media coverage
focusing on PPEH. Most research in the domain of pediatric health has examined media depictions of either breast
and formula feeding (e.g., Foss, 2010; Foss & Southwell,
2006; Frerichs, Andsager, Campo, Aquilino, & Stewart
Dyer, 2006; Gage et al., 2013; Stang, Hoss, & Story, 2010),
food advertising in parent magazines (e.g., Manganello,
Clegg Smith, Sudakow, & Summers, 2012), or a single
environmental health threat (e.g., lead poisoning; Bellows,
1998). Other content-analytic research has examined news
coverage of environmental health hazards (e.g., Lichter &
Rothman, 1999) and environmental cancer risk factors (e.g.,
Jensen, Moriarty, Hurley, & Stryker, 2010), but focused more
broadly on the general population.
A journalist for The New York Times recently noted that
it seems surprising to read a newspaper column about chemical safety . . . Its not the kind of thing . . . the news media
cover much (Kristof, 2012). To date, there is limited evidence to support or discredit this observation. In fact, the
research on media coverage volume of environmental health
is mixed. Earlier findings suggest that the prevalence of news
coverage linking the environment to cancer is relatively high.
For example, Freimuth and colleagues (1984) demonstrated
that between 1977 and 1980, environmental factors were the
most frequently mentioned risk factor in newspaper coverage
of cancer, with environmental carcinogens (e.g., pesticides)
receiving three times more coverage than lifestyle-related

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MEDIA COVERAGE OF ENVIRONMENTAL HEALTH

risk factors (e.g., diet and exercise). One of the more extensive content analyses that focused exclusively on media
coverage of environmental cancer risks from 1972 to 1992
(Lichter & Rothman, 1999) revealed that media paid more
attention to human-made chemicals (i.e., industrial solvents,
chemical wastes, plastics manufacturing) than to any other
category of environmental carcinogen (e.g., sunlight).
More recent work paints a different picture of the information environment. Although causes of cancer remain one
of the more prominent topics in cancer-related news (Slater,
Long, Bettinghaus, & Reineke, 2008), a later analysis by
Jensen and colleagues (2010) comparing coverage in 2003 to
Freimuths earlier findings showed that lifestyle had become
the most frequently mentioned risk factor, receiving twice
the amount of coverage as environmental cancer risk factors. Another study on issue dynamics in Swedish public
television news (Djerf-Pierre, 2012) found that coverage of
chemicals, such as biocides, toxic waste, hazardous chemicals, and metals, has declined over the past 50 years to 1% of
total news coverage after peaking at 14% during the 1960s,
the era of Rachel Carson and DDT.
Two additional content analyses focusing on how news
media portray breast cancer (Atkin, Smith, McFeters,
& Ferguson, 2008; Brown, Zavestoski, McCormick,
Mandelbaum, & Luebke, 2001) partially support Jensen
and colleagues results. Paying special attention to coverage of the risks of controllable environmental exposures
(i.e., contaminants, hormone replacement therapy, secondhand smoke, pesticides) and preventive behavior (i.e., diet,
exercise), very few news items were found to address risks
of exposure to contaminants (chemicals, pesticides, secondhand smoke) and even fewer stories made reference to
avoiding them. Brown and colleagues (2001) did show, however, that womens magazines in particular had a higher
percentage of breast cancer articles referencing environmental factors, suggesting at least some key differences in
coverage volume contingent on target audience.

SUMMARIZING CONTENT ANALYTIC GOALS


In summary, despite the growing importance of and attention to prenatal and pediatric environmental health, very
few studies exist that examine media coverage of PPEH
threats. The purpose of this study was to conduct a content
analysis of the PPEH information environment in popular
media sources (i.e., parenting websites, parenting magazines, the Associated Press) during a 6-month period. The
content-analytic review sought to answer two broad research
questions:
RQ1: How prevalent is information about chemical threats
to PPEH in the media?
RQ2: How much media coverage do the most concerning
chemical threats to PPEH receive?

METHOD
Study Population
Specific media sources were selected on the basis of what is
consumed by and available to new and expecting mothers
two key factors in generating an externally valid sampling
frame (Jordan & Manganello, 2009). First, insights for defining the study population parameters based on consumption
rates were drawn from an online pilot survey of 64 new and
expecting mothers.1 According to respondents, PPEH information was most commonly encountered in the following
sources: websites, magazines, and general news.2
To further narrow the scope of the study population, publicly available statistics reporting the availability of key media sources were consulted (Alliance for
Automated Media, 2012; Compete, 2012), a commonly recommended purposive sampling technique (Weare & Lin,
2000). Parenting websites with the highest traffic rates during the prior year were Babycenter.com (53 million unique
visitors) and Parents.com (26.5 million unique visitors). The
parenting magazines with the highest circulation rates during the prior 6 months were Parenting and Parents (both
2.2 million). Finally, Lexis-Nexis was used to identify relevant general news stories from the Associated Press (AP)
domestic wire services (both state and local). The 6-month
time frame ranged from September 1, 2012, to February 28,
2013.
Fourteen PPEH chemical topics were selected as the focus
of the content analysis based on the U.S. EPA TEACH
summaries and mothers concerns reported in the pilot
survey. These included arsenic, lead, mercury, bisphenol
A (BPA), polychlorinated biphenyls (PCBs), phthalates,
pesticides (2,4-D, atrazine, DEET, dichlorvos, pyrethriods,
permethrin, resmethrin), drinking water quality (atrazine,
nitrates/nitrites, trichloroethylene [TCE]), outdoor air pollution (particulate matter [PM], polyvinyl chloride [PVC],
smog, benzene, formaldehyde), cigarette smoke (benzene,
benzo[a]pyrene [BaP], formaldehyde), flame retardants
(polybrominated diphenyl ethers [PBDEs]), cleaning supplies (e.g., bleach), food additives (e.g., dyes, preservatives,
1 In January 2013, a brief pilot survey was fielded using the Survey
Sampling International online panel. To be eligible for the study, female
panelists in the United States must have been pregnant and/or have had at
least one child under age 7 years. The survey was completed by 63 respondents and asked a series of open- and closed-ended questions to determine
from which sources new and expecting mothers acquire information about
chemicals in the environment that may be harmful to childrens health.
Mothers were also asked open- and closed-ended questions to ascertain
which chemicals they believe are most concerning to childrens health. The
study was approved by the universitys institutional review board.
2 General news was operationalized as news from television, radio,
and newspapers. In closed-ended questions, respondents were instructed
to exclude news from newspaper, radio, and television websites from
their responses to website-specific questions in an effort to keep response
categories mutually exclusive and exhaustive.

MELLO
Parents.com

Accessibility
Level
1 click

2 clicks

My Pregnant
Body

My Pregnant
Life

3 clicks

Pregnancy
Nutrition

Pregnancy
Beauty

Toddlers &
Preschoolers

Babies

Pregnancy

Blogs

Health

Safety

Health

Safety

Asthma

Lead
Poisoning

Asthma

Lead
Poisoning

Pregnancy
Health

Autism

Nursery
Safety

Autism

Toy
Safety

Is It Safe?

Down
Syndrome

Parents
News Now

Parenting

Better
Parenting

Toy Recalls

Green
Parenting

Food

Hints & Tips


Food
Safety

Healthy
Eating
Kids
Nutrition
Parents
Nutrition

Nutrition
Home
cleaning
Vaccines

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FIGURE 1 Example of website content sampling procedure using three-click hierarchy for Parents.com.

aspartame, rBGH, trans fat), and an other category (e.g.,


asbestos, perfluorooctanoic acid [PFOA], radon).
Sampling Procedure
Probability and purposive sampling techniques were combined to draw a strong, externally valid sample of websites,
magazines, and news stories that mothers were likely to
encounter during routine media use.
Websites. A sophisticated program was developed by
experienced university-based computer engineers exclusively for the purposes of this study to automatically and
selectively harvest and index individual webpages from
Babycenter.com and Parents.com in real time. The entire
program was developed in C# language and designed
to repeatedly fetch HTML pages for a given set of
Web addresses (e.g., http://www.babycenter.com/is-it-safeduring-pregnancy). The two websites differed in their structure and presentation of online content; thus, two maps were
created for programmers to target harvesting, which included
prespecified sections (n = 103) identified as areas where
PPEH information was likely to be posted.
In order to capture PPEH information likely scanned
by mothers (as opposed to content actively sought), the
novel program was designed to extract content using a
three-click hierarchy. That is, only content accessible to
visitors through three clicksor three levels down from
the homepagewas targeted in the sampling procedure (see
Figure 1 for Parents.com map). The intention of the threeclick rule was to create a snapshot of what a casual website
browser might encounter if she was not actively searching
for PPEH information, but merely came across the content
in a more incidental way.
The initial section mapping took a top-down approach in
which each sites interface and main menus were manually
reviewed to identify areas where relevant content was likely
to be posted. After the top-down mapping was complete,

a bottom-up approach was taken using key terms in the


search bars provided on the homepage of each website to
ensure no relevant areas were overlooked. Articles retrieved
were examined for relevancy. If a site location was found
that had not previously been identified and was reachable
through three clicks from the homepage, the corresponding
Web address was added to the map for harvesting. This verification process resulted in only two additional HTML pages
mapped for Babycenter.com. Content not generated by the
news and editorial teams of the websites (i.e., community
message board posts) was filtered out during this process.
Communication between parents in these forums can provide
valuable social support and has been studied (for review, see
Plantin & Daneback, 2009); however, it is beyond the scope
of this investigation for practical reasons.
In order to keep pace with frequent site updates, each
HTML page was scraped once every 24 hours to extract
relevant information, including headlines, article content,
embedded hyperlinks, and accompanying imagery. A check
was performed at the start of each month to ensure that the
original HTML page maps remained valid. Content was
scraped for a total of 186 days during the course of the
study.3
HTML pages retrieved were then hand coded by two independent coders to determine relevance and then checked for
reliability (e.g., Cohens kappa; Cohen, 1960). After one
practice coding round, intercoder reliability was established
on a random sample of 75 texts (kappa = .84). Ninety
percent of relevant texts were coded as relevant by the second coder, while only 5% of irrelevant texts were coded as
relevant by the second coder.
Magazines. The sampling procedures for magazines
differed from the electronic search used for websites.
3 Dates in 2012 with no content updates on Parents.com: October 7 and
22; December 7, 11, and 24. Dates in 2013 with no content updates on
Parents.com: January 6, 12, and 21; February 3, 10, 16, and 23.

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MEDIA COVERAGE OF ENVIRONMENTAL HEALTH

Sampling methods employed in earlier studies focusing purposively on the most popular parenting magazines (e.g., Foss
& Southwell, 2006; Manganello et al., 2012) were adapted
to determine the eligibility of magazine articles and advertisements for this study. Perhaps most importantly, the time
frame used for magazine sampling was 1 month longer
than for the other two sources in this study (September
2012March 2013). This decision was based on the unique
publishing norms in the magazine industry. Magazine cover
dates are unlike newspapers and websites in that their dates
of publication do not perfectly reflect when information is
released for public consumption. It is standard practice for
monthly magazines to display a cover date that is 1 full
month into the future from the actual publishing or release
date (e.g., an issue dated March 2013 will appear on store
shelves in February 2013). This practice allows magazines
to maintain a current appearance while accounting for time
lags due to shipping and distribution. Because magazines
have a relatively longer shelf life and tend to linger in homes
and doctors offices, it also seemed appropriate to include
September 2012 in the sample, even though it was released
in August 2012. The final magazine sample included a total
of 13 issues: seven issues of Parents and six issues of
Parenting.
Once the issues were collected, each table of contents
was reviewed for signifiers of an environmental health article such as the words toxic, environment, chemical, safety,
or health. Next, the full text of the article was examined to
determine whether it centered on environmental health as
indicated by the headline and/or lead paragraph. Articles
that contained at least one statement about any PPEH-related
toxic threats were eligible for inclusion. Health questionand-answer articles were also reviewed for relevant content
following the same procedure.
In addition, all advertisements in the selected issues were
assessed using the same criteria. For the purposes of this
study, an advertisementdefined as a sponsored image
or text appearing in the magazine specifically for the purpose of selling a product or promoting a specific behavior
(Foss & Southwell, 2006, p. 4)was included if it pertained to prenatal or pediatric environmental health. The
inclusion of magazine advertisements was necessary for
two reasons. First, time-series analyses have shown that
magazine advertisements may influence parents subsequent
health behaviors (Amin & Harrison, 2009; Berry et al., 2011;
Gray et al., 2011), even more so than editorial content (Foss
& Southwell, 2006). Second, ads for eco-friendly products were noticeably common in these outlets. A preliminary
search through less popular parenting magazines distributed
by the same publishers of Parenting and ParentsBabyTalk
and American Baby, respectivelyrevealed that relevant
advertisements actually outnumbered relevant editorial content. Because the volume and availability of risk information
in the media are key drivers in the social amplification of
risk (Kasperson et al., 1988), the significant proportion of

PPEH information in magazine advertisements could not be


overlooked.
News stories. News media coverage was measured
using news from the Associated Press (AP) because it has
been shown to be representative of the national news environment, including newspapers, television, and radio (Fan,
1988; Fan & Tims, 1989; Yanovitzky & Stryker, 2001). AP
stories are used by more than 6,000 broadcast stations and
1,400 daily newspapers in the United States (Associated
Press, 2013; Fan & Holway, 1994). It is also estimated that
AP news content is seen by half of the worlds population
on any given day (Associated Press, 2013). AP content may
differ across individual sources for a variety of reasons (i.e.,
time, space), but the topics themselves being covered tend
to be similar (Fink et al., 1978; Rogers, Dearing, & Chang,
1991). For the purposes of this study, it is therefore reasonable to assume that the prevalence of PPEH issues in the
Associated Press domestic wire services is representative of
the prevalence of these issues in most U.S. news media.
A modified approach to Stryker and colleagues (2006)
search-term validation was used to create individual search
terms for each of the 14 topics specified earlier. After the
creation of the closed search terms, stories retrieved from
Lexis-Nexis were hand coded by two independent coders to
determine relevance and then checked for reliability.
Because the AP wire tends to cover general news rather
than niche information targeted at specific populations
(i.e., pregnant women), it was recognized a priori that a
significant proportion of stories would mention increased
risk to pregnant women and children only briefly within
more general stories about environmental health risks. For
instance, coverage of a new study about arsenic detected
in rice would likely appeal to a mass audience, while
still making mention of the increased risk to vulnerable
populations. Accordingly, even brief mentions of PPEH
risks in stories were considered relevant.
After one practice coding round, intercoder reliability
was established on a random sample of 40 articles pooled
across chemical topics (kappa = .94). Ninety-six percent
of relevant texts were coded as relevant by the second
coder while no irrelevant texts were coded as relevant by
the second coder. Lastly, the finalized closed terms were
run in Lexis-Nexis and sampled articles were coded for
relevance. Of the 299 articles retrieved by the search terms,
198 (66.2%) were relevant.
Content Coding Procedure
All content sampled was coded for article source (1 = The
Associated Press; 2 = Parents.com; 3 = Babycenter.com;
4 = Parents Magazine; 5 = Parenting Magazine), month
(1 = September 2012; 7 = March 2013), and type (1 = AP
news story; 2 = website editorial; 3 = blog; 4 = magazine
editorial; 5 = magazine advertisement). For comparisons

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MELLO

across source type, article source was recoded into a threecategory variable (1 = AP; 2 = websites; 3 = magazines).
To address RQ1, the first set of coding procedures identified how much coverage PPEH issues received during the
study period across sources. For website and AP sources,
this variable was coded and counted electronically. Magazine
coverage was hand coded.
To address RQ2, the second set of coding procedures
identified which of the 14 chemical topics examined in this
study were covered most often. Twelve of the topics coded
included at least one chemical cited in the U.S. EPA TEACH
Summaries. In the pilot survey, mothers expressed particular concerns about food additives and cleaning supplies
two topics not included in the TEACH Summaries. That
being said, it seemed prudent to include these two topics in the content analysis for exploratory purposes. For
all sources, this variable was hand coded. A final category labeled other captured additional PPEH topics (e.g.,
PFOAs, carbon monoxide).
Analytic Procedure
To address RQ1, a period prevalence rate was calculated
based on the number of relevant media content units identified across each source over the six-month period. In this
study, the period prevalence rate (a term often used in epidemiology) provides an estimate of the amount of PPEH
information available during a specified period of time.
Descriptive analysesprimarily basic frequency analyses
and 2 analyseswere also performed to address RQ2.
All analyses were performed using the statistical software
package SPSS Statistics 20 (IBM Corp., 2012).

RESULTS
Prevalence of PPEH Information in the Media
Between September 1, 2013, and February 28, 2013, the
sampling procedure yielded 2,606 hits. Of these, 2,543
(97.6%) were determined to be relevant.4 The period prevalence rate can be loosely interpreted as the amount of
PPEH information available to mothers across the five
media sources during the 6-month period. Here, that figure is 509 pieces of PPEH information, given five sources
in the universe of texts and 2,543 relevant content units.
On average, this would equate to roughly 2.83 pieces of
4 This figure could be characterized as inflated for two reasons. First,
every magazine article sampled (n = 85) was determined to be relevant
as this was a pre-condition in the sampling procedure itself. Second, Webbased content was likely to be relevant, given that it (a) focused exclusively
on pregnant women and young children living in the United States and
(b) underwent an extensive sampling process that filtered out a significant
portion of content unrelated to PPEH before coding even began. By comparison, only 65.8% (n = 194) of stories from the Associated Press were
determined to be relevant.

PPEH information available to mothers in the mass media


per day.5
Fifty-two percent of PPEH information was published by
Babycenter.com, 37% by Parents.com, 8% by the AP Wire,
2% by Parenting Magazine, and 2% by Parents Magazine.
Of articles published by on parenting websites, only 3% were
blogs (versus editorials). As for relevant content published
in magazines, 72% were advertisements (versus editorials).
As noted earlier, the two parenting websites account for
a significant portion of overall coverage, an unsurprising
observation given the space constraints of magazines and
news sources.
Topical Focus of PPEH Information in the Media
News stories. Table 1 shows the percentage of AP
news stories by chemical topic. The most common topics
were outdoor air pollution, cigarette smoke, pesticides, and
mercury. Indoor air quality and cleaning supplies were never
mentioned. Many articles cited research studies demonstrating a link between exposure to chemicals and adverse health
effects in pregnant women and children, as well as the role of
regulation in protecting public health. Because data collection took place during the 2012 presidential election, a number of stories summarized candidates political platforms
(i.e., environmental regulation, public health objectives).
Magazines. Table 1 also shows the percentage of
PPEH information in parenting magazines by chemical
topic. The overall topical focus of information did not vary
significantly across magazine titles: 2 (10, n = 85) = 9.64,
p = .472. The most common topics in both titles were food
additives and cleaning supplies. Nearly all of these hits were
found in advertisements marketing all-natural food and
safer cleaning products. Only 8% of food additive hits came
from editorial content. The proportion of editorial mentions
of the risks associated with cleaners was also low (17%).
Most of the hits related to phthalates (88%) also came from
advertisements promoting phthalate-free personal care
products. Five out of six (83%) total hits for indoor air
quality were also from advertisements for air filters and
testing kits. Lead, PCBs, drinking water quality, and flame
retardants were not mentioned in either magazine during the
study period.
Only one chemical topicpesticidesreceived featured
editorial coverage, meaning the topic was discussed in detail
over several pages of the magazine. An editorial dedicated
to pesticides in Parenting Magazine reported news from the
5 These estimates should not be interpreted as a measure of individual
exposure to PPEH information in these sources, but rather as what was available in the information environment. Here, the likelihood of exposure to any
given piece of PPEH information in the media is ignored, as are encounters
with such information that may have been mediated through medical professionals and interpersonal sources, resulting in an underestimate of total
information availability.

MEDIA COVERAGE OF ENVIRONMENTAL HEALTH


TABLE 1
Frequency and Percentage of PPEH Information by Chemical Topic Within Each Media Source (N = 2,543)
Parentinga

AP

Downloaded by [Susan Mello] at 17:52 30 January 2015

Chemical topic
Arsenic
Lead
Mercury
Bisphenol A (BPA)
Indoor air quality
PCBs
Pesticides
Phthalates
Cleaning supplies
Food additives
Drinking water quality
Outdoor air pollution
Cigarette smoke
Flame retardants
Other topic
Total

Parentsa

Babycenter.comb

Parents.comb

3
6
15
7
0
4
17
1
0
12
3
48
23
1
54
198

2
3
8
4
0
2
9
1
0
6
2
25
12
1
28

0
0
0
2
3
0
2
2
7
16
0
0
2
0
0
35

0
0
0
6
11
0
6
6
20
46
0
0
6
0
0

2
0
1
1
2
0
3
6
5
23
0
1
3
0
3
50

4
0
2
2
4
0
6
12
10
46
0
2
6
0
6

30
49
138
110
11
13
156
60
24
217
88
47
295
19
60
1, 317

2
4
10
8
1
1
12
5
2
16
7
4
22
1
5

7
84
184
48
24
0
86
19
77
144
4
7
143
0
120
947

1
9
19
5
3
0
9
2
8
15
0
1
15
0
13

Note. Other topic included asbestos, carbon monoxide (excluding references in the context of cigarette smoke), dichlorophenol,
PFOA/polytetrafluoroethylene (PTFE)/Teflon, perchloroethylene (perc), radon, styrene/styrofoam, paint fumes, and volatile organic compounds (VOCs).
a 2 (10, n = 85) = 9.64, p = .472.
b 2 (14, n = 2,264) = 302.01, p < .001.

American Academy of Pediatrics on the resurrection of the


organic produce debate in light of new research findings.
A similar feature editorial communicating the PPEH risks of
pesticide exposure in Parents Magazine focused on the threat
of unintentional human exposure to the chemicals during
attempts to keep ones home and garden pest-free.
Websites. Table 1 also shows the percentage of PPEH
information on parenting websites by chemical topic. The
overall topical focus of information varied significantly
across the two websites: 2 (14, n = 2,264) = 302.01,
p < .001. Nearly every chemical topic included in the
analysis received at least some coverage across these two
sites, with the exception of PCBs and flame retardants.
The most common topics were cigarette smoke, food additives, and mercury. While a greater proportion of content
on Babycenter.com focused on cigarette smoke, Parents.com
paid relatively more attention to threats associated with
mercury exposure.
A majority of the information provided about smoking
focused on the risks of prenatal exposure (e.g., preterm
birth, poor reading skills, obesity), as well as the link
between secondhand smoke, childhood asthma, and meningitis. Most articles about food additives discussed the new
U.S. Department of Agriculture (USDA) guidelines regarding trans fat and whether aspartame is safe for pregnant
women. Information about mercury tended to focus on
safe eating during pregnancy (i.e., reducing consumption of
certain types of fish) and the vaccineautism debate.
A primary objective of this study was to determine which
chemical topics are most prevalent in mothers information

environment (RQ2). Upon analyzing the content sampled


from each source, the total frequency of PPEH information
available on parenting websites (n = 2,264) far outnumbered content in both magazines (n = 92) and the Associated
Press (n = 194). To merely count the total number of articles
in estimating prevalence would be to assume that website
content is somehow more readily available or influential to
mothers. These would be strong assumptions, given the lack
of empirical evidence of exposure rates.
In order to remove this potential bias in reporting, the
data were standardized. First, the appearance of each chemical topic by source was calculated (e.g., BPA information
in magazines = 4). Then the total number of relevant PPEH
articles per source type was calculated (e.g., PPEH information in magazines = 85). The appearance of each chemical
topic by source was then divided by the total number of
relevant PPEH articles per source type (e.g., 4/85). This
approach resulted in the percent of information dedicated
to each chemical topic within each type of source (e.g.,
4.71% of PPEH information in magazines was dedicated
to BPA). Finally, percent coverage of each chemical topic
was averaged across the three source types (e.g., 4.71/3).
This approach could be loosely compared to standardizing
multiple measures prior to creating a scale.
Figure 2 shows the total average percentage of information related to each chemical topic across media sources.
Overall, chemical topic prevalence varied significantly
across the three source types: 2 (28, n = 2,543) = 474.84,
p < .001. In total, information related to food additives
was most prevalent, clearly attributable to the large proportion of magazine content (i.e., advertisements) dedicated to

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MELLO

FIGURE 2 Total average percentage of PPEH information across media sources, by chemical topic (N = 2,543): 2 (28, n = 2,543) = 474.84, p < .001.

the topic. Cigarette smoke, pesticides, and mercury were


also prevalent chemical topics. The least prevalent topics
were flame retardants, PCBs, drinking water quality, and
arsenic.

DISCUSSION
This study offers a systematic content analysis of prenatal and pediatric environmental health information covered
in the mass media and most likely consumed by new and
expecting mothers. The study had two primary objectives:
(a) to estimate the prevalence of PPEH information in the
media, and (b) to determine how much media coverage
the most concerning chemical threats to PPEH receive.
Here, the findings reported above are summarized, followed
by a discussion of the studys strengths, limitations, and
implications.
Prevalence of PPEH Information in the Media (RQ1)
Results showed that during the study period, roughly three
pieces of PPEH information were made available to mothers across these sources daily. The period prevalence rate
was based on the fact that there were just over 2,500 relevant articles across five sources between September 2, 2012,
and February 28, 2013. Overall, the amount of PPEH information available to mothers was most prevalent on parenting
websites, followed by stories from the Associated Press, and
then parenting magazines. Because the Internet serves as a
primary source of health information for new and expecting mothers (Bernhardt & Felter, 2004; Plantin & Daneback,
2009; Stern et al., 2012), this difference in coverage volume
across sources may have important implications for which
health issues mothers learn about and prioritize.

These findings suggest that the mass media do in fact


communicate PPEH information. Thus, even if the prevalence of news coverage of environmental health risks has
decreased over the years as demonstrated by prior research
(Atkin et al., 2008; Brown et al., 2001; Freimuth et al.,
1984; Jensen et al., 2010), this may not correspond to
a parallel decrease in exposure, particularly among new
and expecting mothers, who have alternative sources that
present this type of information. Of course, what we do
not know from this work is how the prevalence of PPEH
information affects an average mothers exposure to such
information.
Of particular interest is the type of coverage PPEH
receives in parenting magazines, in which 72% of relevant
content came in the form of advertising versus editorials.
This begs several questions: (a) whether mothers process
these messages differently; (b) whether such advertising
appeals influence self-efficacy and/or consumer behavior;
and (c) whether risk communicators should feel compelled
to address such an imbalance. Lastly, given the scope of
this study it is impossible to compare PPEH exposure to
other types of nonenvironmental health information mothers encounter (e.g., sudden infant death syndrome). The
field would benefit from future research studies that further
examine each of these important issues.

Topical Focus of PPEH Information in the Media (RQ2)


Results showed that food additives, cigarette smoke, pesticides, and mercury were the most prevalent PPEH topics in
the media during the study period. Note that food additives
are not under the purview of the U.S. EPA and thus not considered of high concern by the agency; nevertheless, they do
account for a considerable amount of media coverage. The
least prevalent topics were flame retardants, PCBs, drinking

Downloaded by [Susan Mello] at 17:52 30 January 2015

MEDIA COVERAGE OF ENVIRONMENTAL HEALTH

water quality, and arseniceven though all four issues are


labeled concerning by the U.S. EPA.
While it was surprising that the more novel human-made
threats (i.e., phthalates, flame retardants) did not receive significant coverage, what was perhaps more surprising was the
relatively small amount of media attention received by lead.
Almost none of the content in parenting magazines or the
AP wire discussed lead threats to children. Even websites
paid relatively little attention to the issue (only 6% of PPEH
information sampled from Babycenter.com and Parents.com
addressed lead). Although childhood lead poisoning rates
have significantly declined over the years in the United
States, it remains a national public health priority. There
are still substantial returns to investing in lead hazard control, including savings to special education and health care
upwards of $250 billion (Gould, 2009). Just recently, the
U.S. EPA launched a communication campaign to educate
parents of the dangers of lead paint and safe home renovation. These results show that media coverage may not
always reflect the public health agenda for increasing awareness of and motivating behavior change related to certain
PPEH threats, particularly when a threat is perceived to be
low and/or under control.
Strengths and Limitations
First, the inclusion of multiple sources offered a strong representation of the information environment new mothers likely
encounter during routine media use (Stryker, Moriarty, &
Jensen, 2008). Not only is the AP wire used by over 85%
of U.S. newspapers, it also provides a reasonably representative sample of the national news environment, including
radio and television. Because coverage of various health topics in print and television network news has been shown to
be correlated with topics on the AP wire (see Niederdeppe,
2006; Romantan, 2004; Yanovitzky & Blitz, 2000), the
inclusion of AP stories offered a practical snapshot of
general media attention to pediatric environmental health
information.
Nevertheless, a range of additional sources exists that
focus more frequently and intensely on prenatal and
pediatric health (e.g., FitPregnancy Magazine) or on environmental health (e.g., EnvironmentalWorkingGroup.org)
than those included in the study. Content from these sources
could provide an even denser and richer sampling of risk
information in this area; however, it was unlikely that a large
segment of the parenting population would be exposed to
these sources. Because the chosen magazines and websites
are leaders in the world of parenting information, it is at
least likely that they are generally reflective of other sources
not examined here.
Second, the inclusion of website content required that
the study be conducted over a relatively shorter period
of time than most content analyses and time series investigations. Because websites are asynchronous and constantly revised, they pose a unique challenge for content

analysisa challenge McMillan (2000) equates to applying


a microscope to a moving target. Articles may be posted
one day and revised or taken down the next. It was impossible to retroactively harvest valid data from the target
websites; thus, to reduce unknown bias in the sample, it was
necessary to harvest online content frequently and in real
time. To maintain consistency, the time frame was kept the
same for all sources.
Implications
As patterns of childhood illness shift dramatically away from
infectious diseases toward a new class of chronic and disabling conditions, the role of environmental toxicants will
likely garner more attention from researchers, policymakers,
parents, and the mass media. This study serves as the first
quantitative content analysis to examine multiple chemical
topics across a variety of mass media sources.
On a descriptive level, a systematic tally of prominent
chemical topics in the media is useful for pediatric health
communicators, researchers, and, to a certain extent, moms.
The analysis provides new insight into where PPEH information isand perhaps more importantly, is notavailable.
Understanding what mothers may encounter while navigating the vast information environment can help public health
practitioners plan more effective interventions and evaluate
the success of their own communication efforts.
On a theoretical level, a media effects hypothesis based
on the social amplification of risk framework would suggest that mothers should have higher risk perceptions and
greater intentions to engage in risk-reducing behaviors for
those chemicals receiving the greatest volume of media
coverage. Of course, this is mere speculation, and further
research connecting this content-analytic work with complementary survey data is necessary to further substantiate
any causal claims. On a practical level, the introduction of
a new approach to harvesting Web-based content encountered incidentallyor during routine website browsingis
also an important contribution to a field typically focused on
active information seeking online.
Environmental health has not yet achieved the same level
of perceived importance in communication research as it has
in public health. Hopefully, this analysis begins to bridge that
divide and bring PPEH closer to the forefront of the field of
health communication.
ACKNOWLEDGMENTS
The author would like to thank Robert Hornik, Joseph
Cappella, Paul Messaris, and two anonymous reviewers for
their insightful comments on improving earlier versions of
this article.
FUNDING
The author is grateful to the Wharton Risk Management and
Decision Processes Center for funding the study.

10

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