Shifting the story towards prevention: An analysis of public health facts in news coverage about Minnesota’s measles outbreak

Theoretical Background and research questions/hypothesis:

Understanding how media are used during public health outbreaks, and the context in which public health information provided by local and state health departments “break through” into the news environment can help identify effective response strategies for public information officers managing a measles crisis. Media attention to recent measles outbreaks has galvanized attention to lack of age-appropriate immunization in priority populations, but also raises stories of personal blame, misinformation, and concerns for how to address harmful personal anecdotes.

This study examined news coverage of the 2017 Minnesota measles outbreak to examine the reach and quality of coverage. Research questions included:

1. How did local, state, and national news coverage differ?
2. Who speaks and who was left out of the conversation?
3. How do public health facts about measles and immunization appear in the news?
4. How did messages from the Minnesota Department of Health (MDH) penetrate the news coverage?

Methods:

A random sample of online-available news stories were coded to achieve reliability (kalpha >.70). We examined news coverage of 708 articles published in the state and nation between the first reported case of measles and the public announcement by MDH that the outbreak had ended.

Results:

The inclusion of measles and immunization public health facts appeared infrequently, but when they did appear, there was no difference in whether they appeared in local, state, national or international sources. Facts about measles included things like severity of the disease. Facts about immunization included things like consequences of low immunization rates. Stories containing measles facts were significantly more likely to include a call to action, referred to as personal mobilization cues (p <.05). Stories that contained immunization facts were also significantly more likely to include personal mobilization cues (p <.05) than those that did not.

Stories referencing MDH press releases were not significantly more likely to include facts about measles, but they were significantly more likely to include immunization facts (p <.05). Of sampled stories, 12.5% containing a measles fact included a personal anecdote; 7.7% of sampled stories containing an immunization fact did so.

Early in the outbreak, increased immunization was by far the most commonly proposed solution to ending measles outbreaks. Additionally, public health officials discussing the outbreak centered in the Minnesota Somali community dominated the news. In subsequent weeks, we saw a rise in coverage of local (and community-based) immunization programs and reporting on increased immunization activity in the Somali community. There was also an emerging narrative about lack of immunization as a threat to public health.

Conclusions:

Public health officials were a key source of information, and their messages about immunization were more likely to be included in media coverage. Working with media to have public health facts about immunization and measles included in media coverage increases the chances of personal mobilization cues.

Implications for research and/or practice:

Understanding the sources of information and how information was presented can help communicators develop a more effective media strategy during a public health crisis. This can improve news coverage and shift the discourse towards preventing outbreaks and building resilient communities.