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Journalist’s TradeThe Missing Voices in Coverage of HealthNurses’ experience and research is vital to, but absent from, these stories.By Bernice BureshEarlier this year a University ofPennsylvania research group reportedthat a noninvasive interventioncould prevent the repeatedhospitalizations of high-risk elderlypatients, improve their overall care,and save taxpayers millions of dollars.Sound like a candidate for a goodhealth story? The editors of The Journalof the American Medical Associationthought so. They chose it as thetop item for the packet of news releasessent out to reporters about articlesin the February 17 issue of JAMA.But this story didn’t get the kind ofplay JAMA studies often do. It did notgo entirely unnoticed—it went on theAssociated Press wire, National PublicRadio did a report on it, and a handfulof newspapers gave it a paragraph ortwo. The Philadelphia Inquirer’sMichael Vitez developed the JAMA studyinto a piece on the care needs of therapidly expanding number of elderswho live with multiple chronic illnesses,and the Inquirer ran the piece on thefront page. By and large, though, themedia were uninterested.There may have been several reasonswhy other journalists ignored thestudy. Perhaps old people aren’t anappealing subject even though theircare has a tremendous impact on healthcare costs, the allocation of social servicesand the demands on familycaregivers. Maybe there was a lot ofcompeting news that day. But as someonewho has watched this happen timeand time again, I can’t help but thinkthat the determining factor was thatthe university researchers were nursesand the intervention they tested wasnursing care.This conclusion stems from manyyears of writing about nursing andmonitoring the coverage of this profession.Nurses are so consistently over-looked in news coverage about healthand health care that it is hard not tothink that prejudice is at least partlyresponsible. In a study I led nine yearsago, my colleagues and I found nursesand nursing to be all but absent in thehealth coverage of three of the nation’stop newspapers. Not surprisingly, physiciansaccounted for almost one-thirdof 908 sources who were directlyquoted in the stories we analyzed.However, sources from government,business, education, nonprofits, evenpatients and family members as well asnonprofessional hospital workers alsowere quoted more often than nurses.The voices and views of nurses camethrough in only 10 of the 908 quotes.A broader study commissioned in1997 by the nursing honor societySigma Theta Tau International foundlittle improvement. Named for the lateNancy Woodhull, a news executive andexpert on women and the media, therecent study, like ours, found numerousexamples of nurses being passedover in favor of other sources—evenwhen it is clear that nurses would bethe most logical sources. For example,a Chicago Tribune article (September14, 1997) focused on lay midwives andthe legal prohibitions which preventthem from practicing in Illinois if theydon’t have a nursing degree. Thearticle’s sources included lay midwivesand a physician but no practicing certifiednurse midwives.Nurses’ invisibility in the news isnoticeable in all aspects of health coverage.My analyses indicate that onefourthto one-third of health news reportsare devoted to coverage ofresearch findings. That’s a conservativeestimate if you also count thespinoffs—backgrounders, columns andfeatures—prompted by research studies.It is very difficult, if not impossible,to identify a column, television healthprogram, or health section that regularlyincludes findings from nursingstudies in its reportage.Lack of attention to nursing researchis a serious oversight because much ofthis burgeoning field is devoted to themost significant health care issue ofour time—the care and treatment ofthose with chronic illness. Thanks tothe many biomedical, surgical and acutecare advances of the last half century,instead of being quickly killed by seriousillness, large portions of our populationlive for lengthy periods and intoadvanced age with chronic diseases orconditions. These include cancer, heartNurses are so consistently overlooked in newscoverage about health and health care that it ishard not to think that prejudice is at leastpartly responsible.disease, arthritis, high blood pressure,birth abnormalities, osteoporosis, diabetesand so on. Increasingly the “diagnosisand cure” medical model is inadequatein this environment. Ongoingcare and management of these conditionsis needed, and that care is thecrux of nursing research.A case in point is the JAMA study.Penn nursing researchers randomly52 Nieman Reports / Fall 1999