A Comparative Content Analysis Study Of News Articles Related To Health Communication In Two Daily Newspapers

A Comparative Content Analysis Study of News Articles Related to Health
Communication in Two Daily Newspapers
A Dissertation Submitted as Part Fulfilment of
Master of Arts programme in Communication and Journalism
By
Ms.Riddhi Sheth
To
Department of Mass Media
K. C. College, Churchgate
March, 2016 Dr. P. J. Mathew Martin
Mumbai Research Guide
Mass Media Department, Kishinchand Chellaram College,
Churchgate, Mumbai

CERTIFICATE
This is to certify that Ms.Riddhi Sheth, a student of Department of Mass Media, K.C. College
completed her final semester dissertation titled ‘A Comparative Content Analysis Study of News
Articles Related to Health Communication in Two Daily Newspapers’
The dissertation is submitted in partial fulfilment of the requirements of Master of Arts in
Communication and Journalism (MACJ) programme conducted by the Department of
Communication and Journalism, University of Mumbai.
I have guided her on the topic of research and research methods during the short research study.
Dr.P.J.Mathew Martin 1st
March, 2016
Research Guide Mumbai

DECLARATION
This to certify that the dissertation entitled ‘A Comparative Content Analysis Study of News
Articles Related to Health Communication in Two Daily Newspapers’ is the result of my own
study undertaken under the guidance of Dr. P.J. Mathew Martin. This research study has not
been submitted earlier to any other Diploma or Degree.
Ms.Riddhi Sheth 1st
March, 2016
Researcher Mumbai

CERTIFICATE
This is to certify that Miss Riddhi Sheth, a student of Kishinchand Chellaram College, Department
of Communication and Journalism affiliated to Mumbai University, has completed her final semester
dissertation topic titled ‘A Comparative Content Analysis Study of News Articles Related to Health
Communication in Two Daily Newspapers’ during December 2015 to March 2016.
The dissertation is submitted as part fulfilment of Master of Arts in Communication and Journalism
(MACJ) to Communication and Journalism Department in University of Mumbai
Dr. P.J. Mathew Martin has guided the research on various issues and the overall generation and
development process.
I have guided her on various topics, issues and complexities faced during the research study..
1st
of March, 2016
Mumbai
Mrs.Manjula Srinivas Miss Manju Nichani
HOD/Mass Media Dept. Principal
K.C. College, Churchgate, Mumbai. K.C. College, Churchgate, Mumbai
Ms.Riddhi Sheth
Researcher

Table of Contents Page Nos.
ABSTRACT.....................................................................................................................................1
CHAPTER I- INTRODUCTION
1.1 INTRODUCTION…………………………………………………………………………...22
1.2 NEED OF THE STUDY…………………………………………………………………….22
1.3 THEORITICAL BASIS...........................................................................................................23
Agenda Setting Theory…………………………………………………………………………..23
Two Step Flow Theory…………………………………………………………………………..24
Framing Theory………………………………………………………………………………….24
CHAPTER II- REVIEW OF LITERATURE
2.1 Mass Communication……………………..………………………………………………27
2.2 Newspapers…………………………………..……………………………………………29
2.3 Health……………………………………………...………………………………………30
2.4 Concept of mental health……………………………….…………………………………34
2.5 Health Communication……………………………………………………………………41
2.6 Reportage of health in newspapers……………………………….……………………….45
2.7 Reportage of mental health in newspapers………………………………………………..48
2.8 Prevention of diseases……………………………………………………………………..50
2.9 Cause of diseases…………………………………………………………………………..51
2.10 Treatment of diseases…………………………………………………………………….51
CHAPTER III- RESEARCH DESIGN
3.1 Aim…………………………………………………………………………………………..54
3.2 Objectives………………………………...…………………………………………………54
3.3 Research Questions……………………………….…………………………………………54
3.4 Hypothesis………………………………………………...…………………………………55
3.5 Limitations…………………………………………………………………………………...55
3.6 Delimitations…………………………………………………….……………………….....56
3.7 Methodology……………………………………………………..…………………………56

CHAPTER IV- RESULTS AND DISCUSSIONS……………………...……………………….59
CHAPTER V- CONCLUSION……………………………………………………………….....75
APPENDIX………………………………………………………………………………………77
BIBLIOGRAPHY………………………………………………………………………………82

CHARTS AND TABLES PAGE Nos.
 Chart 1.3.1 An example of a health related news article in a newspaper daily 9
 Chart 1.4.1 an example of a mental health related news article in a newspaper
daily
10
 Chart 1.9.1 an example of a health related news article which depicts cause
of a disease
18
 Chart 1.10.1 an example of a health related news article which states
prevention of a disease
20
 Chart 1.11.1 an example of health related news article which depicts
treatment of a disease
21
 Table 4.1.1 Frequency of health related news in newspaper dailies 60
 Chart 4.1.2 Frequency of health related articles 61
 Table 4.2.1 Cross tabulation of health related articles based on area of
reportage
62
 Chart 4.2.2 Significance of health related articles based on area 63
 Table 4.2.3 Frequency in terms of percentage of reportage of health articles
based on area
64
 Table 4.3.1 Cross tabulation of page numbers and number of articles 65
 Chart 4.3.2 Significance of articles based on page number of reportage 66
 Table 4.4.1 Cross tabulation of illnesses being covered in two newspaper
dailies
67
 Chart 4.4.2 Significance of mental health related articles covered in two
newspaper dailies
68
 Table 4.5.1 Frequency of articles covered in two newspaper dailies based on
sections of newspapers
69
 Chart 4.5.2 Frequency of articles based on sections of newspapers reportage 70
 Chart 4.5.3 Newspaper wise classification of articles based on sections of
newspaper reportage
71
 Table 4.6.1 Cross tabulation of articles in terms of cause, prevention and
treatment of diseases
72
 Chart 4.6.2 Classification of news articles based on cause, prevention and
treatment of diseases
73

1
ABSTRACT
The research study is a comparative content analysis study of newspaper articles related to
health communication in two daily newspapers. It has attempted to examine the reportage of
health related news in two dailies. Health communication has a direct influence on the society.
The information related to health communication can be conveyed through various mediums like
newspapers, television and new media. Even though the aspect of health communication has
been prevalent since a long time there are discrepancies in its coverage in newspapers. With the
rise in political, crime and entertainment related news, health related articles have changed their
course and presentation of coverage. Hence this research study helps in identifying and
comparing two daily newspapers for its coverage of health communication articles. The purpose
of this study is to understand and analyse the significance of health communication related
articles in newspapers and comparing them for gauging which area of health is given more
prominence. The different aspects which are undertaken in this research are news articles,
editorials and findings related to health communication.
Content analysis of two English daily newspapers is carried out for the purpose of comparing
and analysing the articles. The two newspapers were studied for the period of 6 months from the
month of July 2015 to December 2015. The study will lay emphasis on factors like placement of
news, presentation of news, source of news, health issue being covered and treatment of the
article.
The study concludes that mental health related news reportage is not significant and also gives
an insight about the coverage of health in terms of area and placement. Further editorial news
articles related to health communication are least covered in both the undertaken newspaper
dailies.
Keywords: health communication, health, content analysis, newspaper dailies, health
articles

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CHAPTER I- INTRODUCTION
Health is a significant aspect of human life. This research study titled, ‘a comparative content
analysis study of news articles related to health communication in two daily newspapers’ will lay
emphasis on the analysis of reportage of health related news in two English daily newspapers
namely The Times of India and Hindustan Times. The research also aims to compare the health
related news in two newspaper dailies with reference to different health aspects.
Health communication is covered in the print medium because it affects the society and also is
relatable at an individual level. Health communication in this research study will take into
consideration all the news related to health like articles, findings, feature articles and editorials.
Method of content analysis is undertaken to take this study forward as this method will help in
gauging the answers; as to what is the significance of health related news in the two newspapers,
the placement of news, the treatment of each printed piece etc.
In order to get a complete idea of the reportage of health communication articles in two daily
newspapers, content analysis is the most appropriate method.
1.1 Mass communication and emergence of newspapers
Tracing back the history of mass communication (Lee) states that mass communication history
is fairly short, although the various forms of mass media that have developed over the years have
made a tremendous impression on the technological, political, economic, social and cultural
trends of every nation. Mass communication, defined as communication reaching large numbers
of people, primarily developed in just the last 500 years.
While going back to the emergence of mass communication, (Lee) highlights that the history of
mass communication is relatively short in the scope of world history. Although news sheets
appeared as early as 100 B.C., most forms of communication reaching large numbers of people
have developed only in the last 500 years. As nations moved from agrarian to industrial based
societies, tremendous social changes influenced the development of mass media.

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The change in the approach of news is evident in print as well as electronic mediums. The print
medium has always been regarded as the informing channel whereas electronic media has
brought with itself the nature of entertainment. Referring to the research by (Ramakrishnan &
Arora, 2010)‘interviews with print and electronic media agencies reveal a marked difference in
their vision and approach. Most print media organizations focus on building awareness, while
TV channels see themselves primarily as a source of entertainment.’
‘The print media which include newspapers, periodicals, newsletters and other channels are
relied upon by the people as credible source of information, education and entertainment. The
print media are known for fearless criticism and service’ (Nautiyal & Dabral, 2012).
The means of mass communication are not just restricted for conveying information but are
also a needful tool which dictates what to think about. It is well assumed that whatever is
published in the print medium might hold some important information than what is not given
coverage. The print medium i.e. newspapers have been credited with the sense of responsibility
and authenticity and it is believed that whatsoever is conveyed through the print medium has
been checked and rechecked and is error less.
Nevertheless there are also disadvantages attached to the print medium in India.
Newspapers have advanced from being mouthpieces of the masses to business houses. With
the same advancement there have been cases of unethical practices in the newspaper
organizations. ‘The corporatization, monopoly, malpractice and corruption, paid news, media
trial and superiority of advertising office are some important negative trends of Indian
newspapers. Now maximum number of big media is in the control of corporate houses. They are
running them like commercial enterprises. Earning of maximum revenues is the main objective
of these newspapers’ (Singh, 2014).
In India, according to the Census 2011 report, the literacy rate is 74.04%. The Census report
also suggests that the female literacy rate was 65.46 per cent whereas the male literacy rate was
over 80 per cent. With the increase in the literacy rate in the country there has also been a
substantial increase in the readership of the newspapers.

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Referring to the Indian scenario, the female literacy levels are still below the male literacy
levels. There is however, an increase in the literacy rate of the youth.
‘The female literacy rate in India is lower compared to the male literacy rate. Compared to
boys, far fewer girls are enrolled in the schools; many of them drop out’ (Nautiyal & Dabral,
2012).
Due to higher literacy levels the curiosity amongst the readers also increased to know more
about things other than just politics and crime. Health as a beat was relatively new and gained
importance in the newspaper only when there was an epidemic. No other special coverage was
yet given to the area of health in comparison to beats like crime, politics and sports. Health as a
beat gained importance only when the newspapers also started having feature articles apart from
news reports.
Health as a separate beat is still emerging from its clichés. However, there is a need to increase
its coverage because people should be made aware of the same. ‘Indian print media’s
contribution in dissemination of health and nutrition information is meager. Quantity of health
and nutrition information catered by regional language daily is less than the English newspaper.
Health and nutrition messages often need to be prioritized as page one reports’ (Maheshwar &
Rao, 2012).
India not only faces developmental problems, but the priority should be on individual and mass
well-being. ‘A developing country like India’s, hurdles of development are burning social
problems like poverty, illiteracy, ignorance, conservatism, unemployment, gender bias such
social, political and cultural factors have led to a number of multifaceted and complex problems
of vicious nature. Among all the developmental issues health care, health promotion has to be
given a special priority’ (Algur, yadavannavar, & Sorganvi, 2012).
‘Newspapers always focused with priority issue like politics, national and international affairs
and give less coverage to health issues’ (Ali, 2013).
Each medium of communication has its own effects and consequences, when it comes to a beat
like health, the informers have a variety of choices as far as mediums are concerned. ‘Any health
communicator has a variety of media from which to choose when attempting to influence health

6
beliefs, behaviors, and policies. These media include, but are not limited to, news media, mass
mediated advertising, and new communication technologies. For different issues and different
audiences, different media may be more or less effective in spreading the desired message’
(Rukhsana Ahmed, 2013).
Because the organizations in the field of news have taken the shape of business models there
have been glitches in coverage. ‘Health issues present less coverage than other issues. Media
owners and polices makers had their own preferences and agenda which influence the coverage
of health related issues’ (Ali, 2013).
The coverage of health has undergone a dynamic change with various other aspects like
NGO’s, health policies, schemes, government decisions etc. The media not only has to convey
about health during an epidemic but also has to inform the masses when formal decisions are
taken by the authorities. As highlighted by (Siddiqui, 2014) ‘the role of the media here is not
only to bring awareness about national health problems, rural health schemes and health policies,
but also to encourage a dialogue among the public including the doctors, researchers, patients,
scholar, NGOs and opinion leaders and public policy makers.’
‘Mass media displays information about health and make people aware so as to prevent the
spread of various diseases’ (Achala Gupta, 2010).
Media plays a very important role in transmitting an intrinsic detail to a large number of
audiences; the message conveyed by the media has an effect on the people who consume it
which can lead to desirable consequences in terms of health behavior, awareness about a
particular disease etc. As stated by (Leask & Claire Hooker, 2010) ‘the mass media has
enormous potential to influence health-related behaviors and perceptions’. ‘Sustained community
health education programs and awareness campaigns used mass media communication for the
prevention of diseases. However, successful media campaign required extensive awareness
program that contains provision of preventive measures’ (Ali, 2013).
‘The mass media is one of the best communication tools to spread the information and create
awareness in the people so that there is acceptance of any idea to create interest. Mass media
displays information about health and make people aware so as to prevent the spread of various
diseases’, according to (Ghanta, 2012).

7
1.2 Newspapers
Newspapers are an account of daily happening. The publication can be a weekly or a daily.
Newspapers are the printed copies which convey about the on goings in the society as per
priority and seriousness of that particular event.
A newspaper consists of text, visuals and graphics. The printed copy is a culmination of events
in a report, feature, editorial or an advertise style. The concept of newspapers contains beats
which talk about various areas related to society like politics, lifestyle, sports, crime,
entertainment, health and many more.
This particular research study will take into consideration two newspaper dailies namely
Hindustan Times and Times of India of Mumbai edition.
‘News media are commercial organizations; the inclusion of health information will be
determined by its likelihood to appeal to the perceived reader’s interests as well as the
maintenance or enhancement of circulation figures, rather than as a public service per se’
(Hellyer & Fraser, 2010).
1.3 Health and its reportage
Health reportage in this particular research study is limited to physical ailments and
psychological illnesses. This research study does not include articles related to policies and
governmental decisions taken with regard to health. Additionally, advertisements are also
discarded in this study. This particular study will take health as a beat and those articles which
showcase any ailment, treatment, diagnosis and prevention measures. The study has also taken
into consideration findings, features and editorial articles.
According to Covering Health Issues: The Role of Newspapers in Ghana (L.Diedong, 2013),
‘news media can play a critical role in awareness and education on public issues and probably
influence decisions about health policies and medical care. A responsible attitude to news
presentation in newspapers would demand greater commitment by the media to project pertinent
issues of health to empower readers’.

8
The reason why mass media is the most important tool in passing information is because it is
used by large number of people on a regular basis. Due to its vast consumption, mass media can
help in creating awareness about various health issues.
Information is reliable only when it is backed by facts and figures and some background check,
the news organizations because of their work ethics have developed a sense of trust amongst the
readers that their reports are checked and rechecked and hence are reliable. ‘Citizens need
quality health information that can help them make informed decisions and the right choices in
regard to their own health, and news media play a key role in providing such quality
information’ (Obregon & Waisbord, 2012).
‘There is evidence that some kinds of media coverage of some health issues make an impact on
public behavior’ (Harrabin, Coote, & Allen, 2003).
Even though health as a genre is widely covered in the news media today, there is no
consistency in its coverage, which leads to an unreliable effect on the readers. ‘Most public
health experts and policy-makers interviewed for the study were unhappy – to a greater or lesser
extent – with the way health issues were covered in the news media. All subscribed to the view
that the media could exert a powerful influence over human behavior and public policy. They
argued that the news media neglected issues that were important to public health, while often
giving undue prominence to ‘scare’ stories’ (Harrabin, Coote, & Allen, 2003).
Chart 1.3.1 An example of a health related news article in a newspaper daily (The article
was printed in the Times of India newspaper daily of Mumbai edition on December 6th
,
2015)

9
Health articles have recently gained limelight amidst the mainstream news. This research paper
focuses on the aspect of health communication, reason being its varied nature of coverage in the
daily newspapers. This study aims to analyze the coverage of health communication related
articles in two daily newspapers.
1.4 Mental health
The research study will not only take into consideration the physical ailments, but will also
highlight the cases of coverage of mental illnesses. Health communication does not just take into
account the physical hassles but also includes communication regarding the psychological
related issues. Mental health reportage in this particular research study includes psychological
illnesses like depression, stress, dementia, Alzheimer’s etc.
The pre conceived notion about mental illnesses is still prevalent in the society which reflects
in the news reports too. ‘Print journalists have often covered mental illness and depression
negatively. This adverse framing seems to engender negative public perceptions towards
individuals suffering from these diseases’ (Patel, 2010).
With numerous health hassles fighting for their space in the print medium, the coverage given
to the mental health related issues is still limited. ‘Psychiatric illnesses are shrouded in the clouds
of stigma and misconceptions. Even in the era of the internet, printed media are still among the
most frequently identified sources of mental health information’ (Deepali Gul, 2015).

10
Chart 1.4.1 An example of a mental health related news article in a newspaper daily (This
article was printed in the Times of India newspaper daily of Mumbai edition on December
10th
, 2015)
Not only is the physical illness a central area which needs to be communicated, mental health
is one area which can be conveyed largely by the media especially newspapers. There have been
assumptions that the coverage of mental health is mostly stereotypical and various clichés are
attached to the same.
As pointed out by (Pirkis & Francis, 2012) the review indicated that ‘the news and information
media is an important source of information about mental health and illness, both for the general
population and for people with mental illness. It is not surprising that the review also found that
the news and information media can have a negative influence on the way people think about
mental illness. The news and information media can encourage people to think that those with
mental illness are violent and dangerous, and can foster a desire for social distance from them’.
It is believed that media organizations cover the aspect of mental health only when it’s
something sensational or vague which will entice the reader to read further. In the book by
(Morris, 2006) it is opined that ‘within the society there are many different ways in which mental
health issues are encountered. There are various factors which have a bearing upon how mental
health themes are covered like commercialism and mental health promotion’. The author further
states about the assumption that ‘what is of great interest to various media providers is the
realization that madness sells.’

11
Coming to the factor mental health promotion (Morris, 2006) suggests that ‘various media
products are used as vehicles to promote mental health too like campaigns’ (Morris, 2006, pp.
14-15).
1.5 Health communication
The most easily relatable aspect of news to the society is health communication. With variety
of beats struggling to gauge the reader’s attention, health communication wins the race as it
relates directly to the individual. The following research paper concentrates on the coverage of
health communication related articles in two English daily newspapers. The study not only will
analyse the significance of health communication related articles in the two newspapers but will
also compare the coverage in terms of significance and beats.
Any news related to health is largely regarded as an informational piece, be it an article about a
new medicine or a mental health related problem etc. Health related news has many more ways
of presenting itself. Many research studies highlight the fact that the news related to health is not
just consumed by the masses or the average public but is also consumed and absorbed by the
policy makers.
Health communication is that aspect of news which is even remotely related to health. Be it a
feature article which talks about a particular aspect of health or a new piece which deals with any
disease or a finding which highlights a new medicine in market. ‘Health communication is not
just restricted to the individual self but can also highlight an epidemic’ (Rukhsana Ahmed,
2013).Health communication, when delivered effectively in mass mediated contexts, has
considerable potential to promote the health of individuals, communities, and populations. Print
media is a powerful source which can put up a gigantic change in the society.
Amidst the beats of crime, politics, sports and entertainment, health as a beat is still struggling
to find its place in the print medium. However, most of health related information is conveyed
through print medium because of its wide reach. Many social institutions, voluntary
organizations, NGO’S and government’s institutions had focused on print media to
communicate, inform and educate the public about health issues. ‘Newspapers always focused
with priority issue like politics, national and international affairs and give less coverage to health
issues’ (Ali, 2013).

12
A particular health communication piece in a newspaper can also highlight an awareness study
based on some health hassle. The primary source of health communication is to communicate the
subject of health to the readers. The term health communication came into being by the members
of the International Communication Association (ICA). An interdisciplinary relationship was
built between health and communication and hence the term health communication.
The two daily newspapers selected for the research are Times of India and Hindustan Times.
The research is undertaken for the span of 6 months. Content analysis method is used for
studying the articles. The articles related to health communication will include news, findings,
editorials and any other news piece of health in both the newspapers.
The articles will be studied according to the elements which describe their significance and
coverage. Aspects like placement of news, presentation of news, pictures used, size of the article,
beats and treatment will be undertaken. The following research paper will highlight the passive
treatment given to health communication related articles amidst the burning beats of politics,
crime and sports.
Even though the masses have become health conscious the treatment given to health related
articles has now taken place of soft news. From the most sought after beat, health articles have
changed their course of presentation and language too. The research will also lay emphasis on
how health articles are covered and how they are perceived by the readers. The frequency of
articles and the space given to them will further answer the significance of health communication
articles. Health communication is undoubtedly mushrooming to a large extent according to
(Henry & Wilson, 2005) ‘health reporting is a major growth area for the media, probably
because it is in demand by the public and it is profitable’.
Health communication as an area is very wide. This research study will focus only on the print
medium i.e. the newspapers, for studying its coverage and presentation. The following research
will also aim at comparing the news pieces and other elements for identifying its significance.
The World Health Organization has also highlighted the importance of health communication
as a branch. The objectives stated by the United States Department of Health and Human
Services, say that health communication reflects every aspect of health be it treatment, diagnosis,

13
prevention, well-being of a society or an individual etc. The stated large area makes health
communication a very important field to explore.
According to the bulletin of the WHO which answers the question of why health
communication is important in public health, ‘Health communication has much to celebrate and
contribute. The field is gaining recognition in part because of its emphasis on combining theory
and practice in understanding communication processes and changing human behavior. This
approach is pertinent at a time when many of the threats to global public health (through diseases
and environmental calamities) are rooted in human behavior. By bringing together researchers
and practitioners from diverse disciplines and adopting multilevel theoretical approaches, health
communicators have a unique opportunity to provide meaningful input in improving and saving
lives’ (Rimal & Lapinski, 2009).
Because health communication is a vast field there are various meanings attached to the term.
As stated by Centers for Disease Control and Prevention, known as CDC and National Cancer
Institute, ‘The study and use of communication strategies to inform and influence individual
decisions that enhance health.’
A report by The Hindu newspaper solely concentrated on answering the question why health
communication is important. The article also described two of the most successful campaigns of
health communication in the Indian scenario. The report stated, ‘In India, two examples of
successful health communication that had considerable impact are polio and HIV. In either case,
a host of agencies worked together to develop a multi-pronged strategy led by communication
professionals. This helped in creating multiple strategies that were used to engage diverse
audiences.’
Health communication is also said to be a process of communication which includes various
directions. The area of health communication is wide and there are no strict rules to define the
process, however, there are certain directions as to how information related to health can be
communicated successfully.
According to (Kreps, 2015) ‘Health communication inquiry, is conducted to understand the
powerful role of communication in health care, with applied health communication inquiry
designed to help people to use communication strategically to achieve health and health care’.

14
The World Health Organization has conveyed the directions which can be used to convey
health related issues or information. The bulletin of WHO states, ‘The principles of evidence-
based care can be used to inform efficient health communication on two counts. First,
communication should have explicit aims. For example, polio eradication has shown that it is
important to distinguish between different ways of accomplishing the same target.’
The bulletin further suggests, ‘Second, evidence-based care encourages us to be systematic and
transparent in reporting processes and outcomes. This makes it easier to see gaps. A major gap in
how we conceive communication strategies is the ‘directional gap’. ‘Communication is often
conceived as communication to members of the public, to patients, to health
consumers, to informal caregivers. Communication comes from health professionals,
governments, researchers, health companies, etc’ (Hill, 2009).
‘There is so much to do that merely telling people what to do is not enough. Health
communication strategies need to evolve accordingly’ (Hill, 2009).
With many research studies in place for directing the process of conveying health related
information, it can be said that there are crafted strategies which can yield the positive results. As
highlighted by (Kreps, 2015) ‘Health communication scholars have developed a rich body of
research and theory that identifies critical communication factors that influence health care and
health promotion, suggesting key communication strategies for improving health outcomes’.
The research study by (K.Suresh, 2016) states that ‘traditionally health education; health
promotion and communication efforts are limited to writing press releases or producing
audio/video clippings, hoardings, posters or pamphlets. Recently that has expanded to
advertorials in press, Radio and TV and social mobilization in the context of Pulse Polio
Immunization for polio eradication. It was generally considered more as an art.’
1.6 Problems of health reportage
It is very much known that the reportage of health related news is not consistent in the print
medium. Health related issues still have a long way to go in terms of coverage. There is also a
hindrance to the problem of reportage about health related news. According to (Siddiqui, 2014)
‘If one goes a little deeper into the issue, then whatever coverage there is about health in Indian

15
media, the most widely mentioned people and sources of information constitute the politicians,
civil servants, charitable trusts, and NGOs rather than the researchers, doctors, scholar/scientists
and the victim (his/her relatives)’.The study further states that ‘it is necessary that newsmakers,
opinion leaders, NGOs workers, patients, doctors, think tanks, economists, scientists and others
come together for better coverage of public health in the media’.
According to various researches and (Siddiqui, 2014) ‘the media fails to cover our healthcare
system adequately. This is not an assumption but a finding that anyone would have while going
through our daily newspapers. If you pick up newspapers of 2 weeks or more and try to locate all
the health issues covered by the regional and national dailies, you will find just one or two stories
on health and the rest of them on fitness and lifestyle’.
When we talk of health communication reportage in the print medium, role of journalists in
covering these pieces also comes into place. Drawing from (Schwitzer, 2005) ‘some journalists
say that their role and responsibility is no different in covering health information than it is in
covering politics, business, or any other topic. In our current era of entanglement, journalists
must investigate and report the possible conflicts of interest among sources of health information
and those who promote a new idea or therapy.’
With jargons and various medical terms involved in the reportage of health related news, it is
inevitable that the journalists have the basic knowledge about the same. The same can become a
hindrance if the journalist is not aware of the terms and is given the task of writing a health
piece.
Drawing from the research study by (Henry & Wilson, 2005) we recognize that ‘there are
different depths of journalism and that journalists face constraints, including commercial
pressures and deadlines that give little time to reflect on stories, which are usually written on the
same day as the press release arrives. Some journalists argue that the media are the messengers
and not the message, and it is up to others to interpret their reporting. And even when they do
have the time, journalists’ face two major challenges—understanding the clinical science and
epidemiology, and dealing with powerful vested interests.’

16
As stated by (Simbra, 2005) , ‘medical news is often simplified, or worse, sensationalized,
because of industry pressures. Because health news sells, it can be and will be promoted—and in
the process, distorted.’
1.7 Content analysis
The content analysis study is a quantitative study which will take into consideration the
samples related to the study and will classify them into quantitative statistics. The statistics will
answer the questions about the significance of health communication related articles in two daily
newspapers. According to (Prasad, 2008) ‘content analysis is described as the scientific study of
content of communication.’
Content analysis is the most preferred method of research in the social sciences and
communication related studies, because it can analyse the patterns in a particular content and can
also identify the changes in the pattern. Referring to the study by (Prasad, 2008), ‘content
analysis is most widely used in social science and mass communication research. It has been
used broadly to understand a wide range of themes such as social change, cultural symbols,
changing trends in the theoretical content of different disciplines, verification of authorship,
changes in the mass media content, nature of news coverage of social issues or social problems
such as atrocities against women, dowry harassment, social movements, ascertaining trends in
propaganda, election issues as reflected in the mass media content, and so on.’
As stated in the research study by (Macnamara, 2005) ‘content analysis is used to study a broad
range of ‘texts’ from transcripts of interviews and discussions in clinical and social research to
the narrative and form of films, TV programs and the editorial and advertising content of
newspapers and magazines.’
With the timely news and instant updates, people are more and more dependent on mass media
for news related to health. The findings and researches on health related issues have considerate
readers due to growing awareness, however the change in the course of its presentation and
significance still has a wide area of unsearched aspects.

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1.8 Public health
Public health is a growing concern for many nations and with the low implementation of
medical facilities and schemes; India is one nation which is always entangled in epidemics and
growing health concerns. With the growing readers, health news is slowly gaining the mileage
especially in the metropolitan cities and this research concentrates only on the Mumbai edition of
the two newspapers.
The public is largely dependent on print medium for health related awareness and information
as the medium is still regarded as the most reliable one.
As highlighted by (Westwood & Westwood, 1999) ‘Many public health issues may be seen as
poor attention grabbers, but are none the less important for the general population’
Health reportage is a tricky beat as it involves loads of details which are otherwise not very
commonly known like medical terminologies; hence the awareness on the part of the journalist is
an important thing which comes into place while reporting about health. As stated by (Mudur,
2005) ‘when a public health situation is involved, health writers and the media can certainly play
a role in quickly delivering important messages to the public. In a sense, then, they do serve as a
component of the health provider community. And this makes it all the more important for health
writers to ensure that they get it absolutely right.’
The report further suggested, ‘Public health authorities across high-burden countries need to
reorder their approach to public health communication. For starters, this communication needs to
be managed by communication professionals and not doctors. Public health communication must
be multi-pronged, regionally suitable and easy too absorb. Finally, public health authorities need
to take up public health communications as a priority’ (Mehra, 2013).

18
1.9 Cause of diseases
Chart 1.9.1 An example of a health related news article which depicts cause of a disease
(This article was published in newspaper daily Hindustan Times on September 6th
, 2015)
Cause of the disease is the risk factor which attracts the disease to affect the individual. The
causes are the reasons which have the potential to affect the wellbeing of an anatomy. History
suggests that individuals have always tried to understand the disease by observing its nature, its
occurrence and the reasons of its occurrence. As highlighted by (Nelson & Williams) from the
earliest times, man has sought to understand the natural forces and risk factors affecting the
patterns of illness and death in society. These theories have evolved as our understanding of the

19
natural world has advanced, sometimes slowly, sometimes when there are profound break
through, with incredible speed.
Many researches have been done to analyze the cause of a particular disease. While some
researchers have sought medical explanations for understanding the cause of the diseases some
have also brought to light the living societal conditions.
As pointed out by (Raphael, 2002) the key means of reducing inequalities in health was
reducing inequalities in income and wealth.
According to (Phipps, 2003) Long-duration poverty has larger (negative) health consequences
than occasional episodes of poverty.
The medical explanations provided by a few researches concentrate only the cause of the
disease leaving alone the economic and social conditions of an individual. According to
(Wynder, 1975) Variables that appear to affect the development of cancer of the pancreas
include a diet high in fat and/or cholesterol and excessive cigarette smoking.
1.10 Prevention of diseases
Prevention of diseases is to take precautions so as to keep the diseases at par from affecting the
individual. The prevention method could be a healthy diet or a fitness regime depending on the
individual or any other method.

20
Chart 1.10.1 An example of a health related news article which states prevention of a
disease (This article was published in newspaper daily Hindustan Times on December 1st
,
2015)
While some researchers have stated that prevention plays a large role in reducing diseases
some have stated that prevention is not very useful when it comes to controlling diseases.
According to (Kirk, 2009) Prevention has not played a big part in health reform discussions to
date. Polling suggests that the public is generally supportive of prevention, but concerned about
affordability. In addition, there is confusion and vagueness in the public’s understanding of
prevention concepts, in part due to historically modest investments in preventive efforts.
Studies also reflect at the fact that prevention of diseases takes a back seat as identification of
the disease itself takes time. As pointed out by (Heymann & Dar, 2014) over the past decades
there has been increasing recognition that the way we deal with infectious disease is often
reactive and too late.

21
Moreover the research by (Heymann & Dar, 2014) also highlights that for emerging infectious
diseases to be prevented, a greater number of skilled staff will be needed, including public
health, veterinary, and environmental scientists.
1.11 Treatment of diseases
Chart 1.11.1 An example of a health related news article which depicts treatment of disease
(This article was published in the newspaper daily Times of India on September 14th
, 2015)

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Treatment of a disease includes cures for that particular disease which has affected the
individual. The treatment may include medication or any other specific procedure.
Researches on treatment of various diseases have been done. A research on treatment of
tuberculosis by (Storla, Yimer, & Bjune, 2008) states that the core problem in delay of diagnosis
and treatment seemed to be a vicious cycle of repeated visits at the same healthcare level,
resulting in nonspecific antibiotic treatment and failure to access specialized Tuberculosis
services.
1.12 NEED OF THE STUDY
The research study is based on the analysis and comparison of health related news in two daily
newspapers namely Times of India and Hindustan Times. The study focuses on the area of health
related news including articles, findings, features and editorials. With the help of content analysis
this study aims to explore the changed significance of health communication related news
articles in newspapers and also aims at studying their reportage.
The study will fulfil the aim of exploring the area of health communication in terms of its
passive coverage and importance. The study will also fulfil the need of how the health
communication articles are conveyed to the readers and how have they undergone a change in
their presentation and reportage. The study aims at answering the questions of mental health
related issues and its coverage in daily newspapers. The research study will provide an insight to
the magnitude of coverage given to mental health related problems and also will highlight which
illness or health hassle is given more coverage.
The content analysis study of health communication is further fruitful to understand the
reportage of the articles related to a particular illness. The concept of health is directly related to
the society at both individual and mass level. Hence, the analysis will also help in understanding
this beat more efficiently.

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1.13 THEORETICAL BASIS
1.13.1 Agenda Setting Theory
The agenda setting theory can be rightly applied to this particular research study. The agenda
setting theory talks about the significance of a particular topic covered. It states that if a
particular news piece is covered more frequently or on a regular basis, the readers or the
audience perceive it as an important piece. Agenda setting theory was introduced by Maxwell
McCombs and Donald Shaw in 1972.
This theory came about during the study of 1968 Presidential elections. McCombs and Shaw
surveyed 100 respondents on what they thought was the most important issue of the elections
and compared to what the media reported.
According to the findings it was opined that media influences the people by telling the people
what to think about. According to (McCombs) ‘the power of the news media to set a nation’s
agenda, to focus public attention on a few key public issues, is an immense and well-documented
influence. Not only do people acquire factual information about public affairs from the news
media, readers and viewers also learn how much importance to attach to a topic on the basis of
the emphasis placed on it in the news. Newspapers provide a host of cues about the salience of
the topics in the daily news – lead story on page one, other front page display, large headlines,
etc.’
When it comes to setting an agenda it is said that news organizations and journalists know
which stories will attract more readers and which stories will create an effect on the readers. As
stated by (Cissel, 2012) ‘the agenda setting theory states that the news media have a large
influence on audiences. News companies and journalists have the ability to dictate what stories
are considered newsworthy and how much prominence and space they are allocated.’
This theory is applicable to this particular research study on health communication as it will
help in identifying the elements which are responsible for the significance of health reportage.
The agenda setting theory emphasis on the fact that if a news piece is covered on a frequent basis
it is assumed as important and the same theory can be applied when examining the reportage of
health related news.

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1.13.2 Two Step Flow Theory
Another theory which can be applied to this particular research study is the Two Step Flow
theory. The Two Step Flow theory was introduced by Paul Lazarsfeld who was a sociologist.
The theory suggests that people form their ideas and beliefs when they are influenced by opinion
leaders. These opinion leaders are however, influenced by media as a whole. The theory takes
into account the indirect influence of media on people. Two Step Flow theory further suggests
that the opinion leaders not only convey the information laid out by the media but also interpret
that information and then convey it to the wider population.
The stated theory is applicable to this research study as it will help in examining how readers
take in the information regarding health which is conveyed to them by the journalists or news
makers. For instance, a feature article related to a particular disease is an interpretation of facts
and figures which is conveyed by an entity to the wider population (in this case reader) which
plays a role in influencing the mindset of the reader.
Another aspect to the two step flow theory is that the role of opinion leaders now have taken
many varied shapes like bloggers, feature writers, experts etc. The introduction of the two step
flow theory was way back in the year 1940s when there was no television and internet and hence
the importance of opinion leaders was much more than today. Today, with varied sources of
information the people might not get overtly influenced by whatever is preached by the opinion
leaders.
Nevertheless, the process of this communication is still prevalent in the print and will be
applicable to this study.
1.13.3 Framing Theory
Every problem or an information piece, can have various interpretations and perceptions, the
Framing Theory highlights the fact that a particular perception of an issue is selected and
presented in a desirable format to gain the right outcome. Goffman was the one who first laid
emphasis on the fact as to how information is presented. The idea was further modified by
(Entman, 1993) who suggested that ‘framing essentially involves selection and salience. To
frame is to select some aspects of a perceived reality and make them more salient in a

25
communicating text, in such a way as to promote a particular problem definition, causal
interpretation, moral evaluation, and/or treatment recommendation for the item described.’
According to (Chong & Druckman, 2007) ‘The major premise of framing theory is that an
issue can be viewed from a variety of perspectives and be construed as having implications for
multiple values or considerations. Framing refers to the process by which people develop a
particular conceptualization of an issue or reorient their thinking about an issue.’
The articles to health in the print are also subject to certain perceptions. The way these articles
are presented in the newspapers do influence the way the readers perceive it. For instance, a
news article on polio could also be presented in the form of a feature or an editorial depending on
its angle.
Newspapers are a daily account of the happenings, this further helps in shaping the desirable
outcome on the part of reader. The study by (Cissel, 2012) states that ‘the news media, and more
specifically print media, serve as valuable sources of information and powerful modes of
communication. This power controls much of what people understand of events that occur
around the world on a daily basis.’
The study further suggests that ‘the way information is transferred to its recipients comes
through various forms of communication, all of which is framed to meet the goals of the
providing source’. The study explains that in social theory, a ‘frame’ consists of a schema of
interpretation, collection of anecdotes, and stereotypes that individuals rely on to understand and
respond to events. In communication, framing defines how news media coverage can shape mass
opinion by using these specific frameworks to help guide their reader to understanding.

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CHAPTER -II REVIEW OF LITERATURE
Mass media has three aims namely, education, entertainment and information. The following
research study deals with the reportage of health communication in two daily newspapers and its
comparison. The two newspapers undertaken for the purpose of the study are Times of India and
Hindustan Times of the Mumbai edition. The coverage of health related articles has been on a
rise than before due to increased awareness about the same. Many studies on the similar stream
have been done. However, this research study will focus not only on the reportage aspect but will
also showcase the comparison of the reportage in the two newspapers with regard to its
presentation.
2.1 Mass communication
Mass communication in simple terms can be explained as an exchange of information to a
large amount of people through a channel of communication.
The meaning of the term mass communication has undergone various changes in the course of
time. In the book by (McQuail, 2010) the term ‘mass communication’ was coined, along with
that of ‘mass media’, early in the twentieth century to describe what was then a new social
phenomenon and a key feature of the emerging modern world that was being built on the
foundations of industrialism and popular democracy. The mass media (a plural form) refer to the
organized means of communicating openly, at a distance, and to many in a short space of time.
McQuail also adds that the occurrence of human communication over time and at a distance is
much older than are the mass media now in use. This process was integral to the organization of
early societies, which persisted for long periods and extended over large areas. Even the element
of large-scale (mass) dissemination of ideas was present at an early point in time, in the
propagation of political and religious awareness and obligations. By the early Middle Ages, the
church in Europe had elaborate and effective means in place to ensure transmission to everyone
without exception. This could be called mass communication, although it was largely
independent of any ‘media’ in the contemporary sense, aside from the sacred texts. When
independent media arrived in the form of printing, authorities of church and state reacted with
alarm at the potential loss of control that this represented and at the opportunities opened up for
disseminating new and deviant ideas.

28
Moving on to the print medium, the book by McQuail traces that ‘the history of modern media
begins with the printed book – certainly a kind of revolution, yet initially only a technical device
for reproducing a range of texts the same as, or similar to, what was already being extensively
copied by hand.’
In the early medieval period, the book was not regarded primarily as a means of
communication. Rather, it was a store or repository of wisdom and especially of sacred writings
and religious texts that had to be kept in uncorrupted form.
As described by (N, 2011) in the book Introduction to Mass Communication it is stated that
‘the word communication was originated from the Latin word ‘communis’ which means
‘common’. Communion, community, communism, commonality, communalism etc. are some
related words having the same linguistic roots. Similarly, newer and newer terms are being
coined as the concept of communication assumes importance day by day.’
In the book by (N, 2011) Aristotle is cited as the pioneer for introducing the process of
communication. ‘Aristotle called the study of communication as ‘rhetoric’ and elaborated three
elements within the process. According to him, communication process composed of a speaker, a
message and a listener. Person at the end of the communication process holds the key to whether
or not communication takes place.’
Further the Lasswell model of communication is also mentioned by (N, 2011) stating that ‘the
most convenient and comprehensive way to describe an act of communication was to answer the
following questions: Who (says) What (to) Whom (in) What Channel (with) What Effect? This
was introduced by Lasswell.’
The process of communication is described in the book Introduction to mass communication as
a component system made up of senders ( the authors, reporters, producers or agencies) who
transmit messages ( the book content, the news reports, texts, visuals, images, sounds or
advertisements) through mass media channels ( books, newspapers, films, magazines, radio,
television or the Internet) to a large group of receivers ( readers, viewers, citizens or consumers)
after the filtering of gatekeepers ( editors, producers or media managers) with some chance for
feedback ( letters to editors, phone calls to news reporters, web-site postings or as audience
members of talk shows or television discussions). The effect of this process may formation of

29
public opinion, acceptance of a particular cultural value, setting the agenda for the society and
the like.
2.2 Newspapers
Newspapers are account of important happenings. A newspaper can be divided period wise like
a daily, monthly or a weekly. The print medium has evolved over the years with sophisticated
technology. A newspaper can have varied number of beats like politics, crime, entertainment,
sports, health, lifestyle etc. or can be concentrated on any one genre.
Denis McQuail’s account of Mass Communication Theory goes back to the history of printing
press. Initially, only religious books and scriptures formed a part of the printing material.
Gradually with awareness and political upheavals newspapers and periodicals came into being.
The lengthy account by McQuail states that the late-nineteenth-century bourgeois newspaper was
a high point in press history and contributed much to our modern understanding of what a
newspaper is or should be.
The ‘high bourgeois’ phase of press history, from about 1850 to the turn of the century, was the
product of several events and circumstances. These included: the triumph of liberalism and the
absence or ending of direct censorship or fiscal constraint; the forging of a business-professional
establishment; plus many social and technological changes favoring the rise of a national or
regional press of high information quality. The new prestige or ‘elite’ press was independent
from the state and from vested interests and was often recognized as a major institution of
political and social life.
The introduction of the printing press was the birth of print medium all over the world. With
cheap technology, materials could be printed in bulk numbers and hence the popularity of the
medium grew two fold. The study by (N, 2011) moves back to the introduction of the printing
press. The study states that ‘in 1457, Johannes Gutenberg invented movable metal types. This
paved the way for mass production of printed materials. Resultantly, presses and publications
spread rapidly first across Europe, then in other continents. Mass production of printed
documents led to democratization of knowledge. In other words, it made knowledge and
education accessible to common people.’

30
With greater availability of awareness and improved techniques, the printed material was now
made available to masses and not only to elites. In simple terms, newspapers came to be known
as documents which highlighted the major issues of the society which needed the attention of the
masses. Coming to the period of newspapers, earlier newspapers were not daily publications as
we see now. They were published weekly or bi-weekly. This was due to the absence of adequate
technology and newsgathering system. By the early 19th century, power press was invented. This
led to fast printing. Invention of telegraph and teleprinter also helped us gather news from remote
places. This all facilitated the introduction of daily newspapers.
The first newspaper was Publick Occurrences published by Ben Harris in 1690. The first
newspaper published in India was the Bengal Gazette by James Augustus Hicky in 1780. It is
also called Hicky’s Gazette.
Due to the reliable history of newspapers, till date the print medium is surviving. It is also said
that when it comes to important issues, people still believe the newspaper reports because they
think it is well researched upon and reliable.
2.3 Health
Health can be described as the wellbeing of an individual. The term not only denotes the
physical wellbeing but also reflects to the mental fitness. Over the time the term health has
undergone various modifications in its definition. According to the usage and purposes, the
meaning of the word has changed a lot.
According to various studies health as a word first appeared in the year 1000 A.D. The word
was used to describe a sound individual and originated in the Old English. Even the spiritual
aspect of an individual was a part of the word health. As stated by (Boruchovitch & Mednick,
2002) ‘For the ancient Greeks, health was always an attribute of paramount importance. Their
initial ideas of health as a divine responsibility and illness as a supernatural phenomenon were
replaced by their recognition of the relevance of personal life habits and environmental factors
for men’s health status. The Greeks’ ideas of health and illness have undoubtedly exerted a major
impact on the Western views of health. However, with advances in the fields of medicine,
science, sociology, psychology, and politics, the more philosophical theories of health began to
be challenged and substituted by more scientific ones.’

31
The study by (Boruchovitch & Mednick, 2002) further states about the meaning of the term
health. It says that ‘earliest notion of health was that a disease-free state represents the traditional
medical concept. This view of health was largely accepted during the first half of the twentieth
century, mainly between physicians and medical personnel. Rather than representing the
presence of certain attributes, health was therefore defined solely in terms of the lack of disease,
symptoms, signs or problems. Major pitfalls of this view of health were both that it
conceptualized health emphasizing illness, and that it neglected the individual as a whole by
overemphasizing specific diseases and parts of the body.’
More ecological and relative notions of health emerged in the 1960s and 1970s. Such
perspectives differed from the previous medical and holistic approaches mainly in two aspects:
first, by conceiving health as a more relative sort of concept and, second, by placing a greater
emphasis on the interrelationships between the environment and the individual’s quality of life.
These ecological and relative definitions of health tended to be were heavily based on an
evaluation of the person’s level of functioning and adaptation to the environment.
As stated by (Nordenfelt, 2007) ‘Health is now considered to be one of our most important
values. Many people, in particular in modern times, have regarded health as one of the most
precious values in life. Health, as well as longevity, should, they think, be protected and
enhanced as much as possible. Thus, the art and science of medicine has received a crucial place
in the modern, both Western and Eastern, society.’
Most of the individuals regard health as the physical fitness, many a times the mental aspect of
the same is ignored. In the ancient times, mental health awareness was meager and various
notions about the same were developed. Though physical ailments had their share of treatments
and medicines, mental illnesses were frowned upon due to their misunderstanding nature.
When it comes to classifying between mental health and physical health, many perceptions
have been made since the ancient times. (Nordenfelt, 2007) suggests that ‘health is a notion
primarily applicable to a human being as a whole. On the other hand, there are more specific
derivative notions. Ever since antiquity, and reinforced by the Cartesian distinction between
body and mind, it has been natural to separate somatic health from mental health.’ The
interpretations of mental health have varied over time.

32
As highlighted by (Hoyman & Ed.D) ‘health as a term was related to whole, sound and
vigorous and the term also was used in a positive tone. Further, Health as a term had more
perceptions like absence of disease, defect and disability. The crucial discovery now which
relates to the meaning of health now is that health is a dynamic process, involving the whole
person and his unique style of living. ‘
As stated by the World Health Organization, health is defined as a complete state of physical,
mental and social well-being, and not merely the absence of disease or infirmity. Further it also
states that health is a resource for everyday life, not the object of living, and is a positive concept
emphasizing social and personal resources as well as physical capabilities. Health is a
fundamental human right, recognized in the Universal Declaration of Human Rights (1948).
The bulletin by the WHO has given four guidelines to address the health related issues which are
as follows-
 Recognition of the universal right to health
 Continued application of health ethics to policy, research and service provision
 Implementation of equity orientated policies and strategies that emphasize solidarity
 Incorporation of a gender perspective into health policies.
These four stated guidelines lay emphasis on first the recognition of health as a universal right
which means that every individual is entitled to the right of being healthy. The second guideline
highlights the need to implement policies, research and provision in the area of health. Thirdly,
the guideline states that policies should be implemented and not only be drawn. The fourth one
suggests that with regard to health gender should also be taken into consideration.
Not only have there been formal definitions of health in the ancient times, internationally too
there have been loads of perceptions of health. As stated by (Tountas, 2009) ‘The ancient Greeks
developed the physiocratic school of thought, realizing that maintaining good health and fighting
illness depend on natural causes and that health and disease cannot be dissociated from particular
physical and social environments nor from human behavior.’

33
According to the Ottawa Charter for health promotion by WHO, the fundamental conditions
and resources for health are peace, shelter, education, food, income, a stable ecosystem,
sustainable resources, social justice and equity. Improvement in health requires a secure
foundation in these basic prerequisites. Good health is a major resource for social, economic and
personal development and an important dimension of quality of life. Political, economic, social,
cultural, environmental, behavioral and biological factors can all favor health or be harmful to it.
Health promotion action aims at making these conditions favorable through advocacy for health.
Book by (Bartos, 2015) highlights the Aristotle’s concepts of health and natural teleology. It
states that ‘the famous Hippocratic concept of self-healing nature which was to have a glorious
future in Western medicine has been recognized as an important precursor of Aristotle’s concept
of natural teleology.’
The study by (C.Ratzan, 2001) further dissects the fact that ‘health – a sound mind and sound
body – was the foundation of the ancient Greek ideal of life. While the aspirations to discover the
truth were the center of ancient Greek democracy more than 2000 years ago, modern day science
has progressed as far as operationalizing this search through experimentation rather than basing
it upon syllogistic logic and the balance of art, nature and science, initially promulgated by the
ancient writings of Plato, Aristotle and Hippocrates.’
Health in the global perspective has different obstacles as compared to the scenario of health in
the Indian context.
The aspect of health closely relates to the standard of living of the people. As health is directly
affected as a result of food consumption and living conditions, the scenario of the population and
their habitat also comes into picture.
As observed in the research study by (Gangolli, Duggal, & Shukla, 2005) ‘Poverty is the real
context of India. Three fourths of the population lives below or at subsistence levels. This means
70-90 per cent of their incomes go towards food and related consumption. In such a context
social security support for health, education, housing etc. becomes critical. Ironically, India has
one of the largest private health sectors in the world with over 80 per cent of ambulatory care
being supported through out-of-pocket expenses. The public health services are very inadequate.
The public curative and hospital services are mostly in the cities where only 25 per cent of the

34
one billion populations reside. Rural areas have mostly preventive and promotive services like
family planning and immunization.’
The stated research study observes the gap between the rural and the urban areas and also
throws light on the fact that rural areas have inadequate facilities when it comes to health. With
poverty levels at high rates, people hardly have any money left for their medical expenses.
(Gangolli, Duggal, & Shukla, 2005) Add that ‘the lack of right to healthcare is the main reason
why health status of the Indian population is unsatisfactory.’
In India political framework cannot be ignored when it comes to the health sector, because all
the policies and health programs are decided and framed by the government. (Gangolli, Duggal,
& Shukla, 2005) Highlight that in concrete terms, the central government has pushed various
national programs (vertical programs for leprosy, tuberculosis, blindness, malaria, smallpox,
diarrhoea, filaria, goitre and now HIV/AIDS) in which the states had little say in deciding the
design and components of these programs. The states have acquiesced to such programs due to
the central government funding that accompanies them. These programs are implemented
uniformly across the length and breadth of the country. Then there are the centre’s own programs
of family planning and universal immunization which the states have to implement. Hence,
central government intervention in the state’s domain of health care activities is an important
feature that needs to be considered in any analysis of public health care services.
The definition of health now not only includes the physical aspect but also takes into account
the mental health and the psychological hassles.
2.4 Concept of mental health
Mental health has been a relatively new area of research as compared to physical illness. The
basic idea of mental health is the social and emotional wellbeing of the mind. This term has had
its share of preconceived notion and assumptions. Due to lack of knowledge about the
happenings of the mental illnesses many people all across the globe believed that it was not an
illness but rather had to do something with the spiritual aspect.

35
Till date, masses are not clearly aware of the mental illnesses and their diagnosis. Mental
illness is something which interferes with the cognition of an individual.
Going to history of the concept of mental health, according to (Bertolote, 2008) ‘the concept of
mental health, given its polysemic nature and its imprecise borders, benefits from a historical
perspective to be better understood. What today is broadly understood by ‘mental health’ can
have its origins tracked back to developments in public health, in clinical psychiatry and in other
branches of knowledge.’
(Bertolote, 2008) Further states that ‘although references to mental health as a state can be
found in the English language well before the 20th century, technical references to mental health
as a field or discipline are not found before 1946.’
According to the formal definition of mental health by the World Health Organization mental
health is defined as a state of well-being in which every individual realizes his or her own
potential, can cope with the normal stresses of life, can work productively and fruitfully, and is
able to make a contribution to her or his community.
The term mental health is already stated in the definition of health by WHO. It thus proves that
in order to define a person’s health, the aspect of mental well-being is very important. In this
particular research study, mental health is included in analysis because it forms a part of the
broad area of health.
As stated by (Herrman & Jané-Llopis, 2012) ‘Mental health is a state of wellbeing in which a
person can use his or her own abilities and cope with the normal stresses of life. Mental health
has a central place in global public health and public health in all countries. Poor mental health is
associated with social inequality and social disconnection. Good mental health contributes to
human, social and economic development. There are strong interconnections between mental and
physical health and behavior.’ The stated research highlights the fact that health as a whole is
interconnected with physical as well as mental well-being.
The field of mental health is relatively new but is growing rapidly with numerous studies on
the subject. Due to more awareness and scholars in the field, the area of mental health has
widened its horizons to large extents.

36
Going back to Aristotle (Herrman & Jané-Llopis, 2012), suggest that ‘Well-being as a concept
was already well developed by Aristotle, who made a distinction between a moral life, which
was necessary to maintain happiness, and a material life, which was necessary to meet basic
needs. He considered wellbeing as multidimensional, with both material and immaterial
dimensions. He also believed that successful communities should share common principles on
what is important for wellbeing and that consultation was essential to develop consensus on what
leads to the good life.’
Today’s definitions of wellbeing reflect modern science as well as the ancient contributions of
Aristotle. The Oxford English dictionary definition, for example, is: the state of being or doing
well in life; happy, healthy or prosperous condition; moral or physical welfare (of a person or
community).
The contemporary definition of mental well-being reflects on the positive side of the
individual’s mind. It takes into account the moral mindset of a person with regard to his or her
decisions which will affect the society.
Other than defining mental health only from a spectator’s view, it is necessary to take cue from
the people who are actually suffering from the mental health illness while defining the same.
The study by (Morant, 1995) highlights that ‘concepts of mental illness - its nature and status -
are central to the social representations of professionals whose work involves care and treatment
of people suffering from mental health problems’. The research further concluded that ‘even
mental health experts do not have a same annotation for the term mental illness. Each and every
expert has their own understanding of the term which reflects their experience with the illness.
This understanding also has a hint of the social stigma attached to the term mental illness.’
Especially in India, there are several false assumptions attached to the term mental illness,
there is hardly nay frank contact between the mental health professionals and the masses due to
lack of awareness. As observed by (Ahmedani, 2011) ‘Mental health stigma operates in society,
is internalized by individuals, and is attributed by health professionals.While stigma remains
evident in society, within individuals themselves, and among health professionals, the ethical
problem of health professional stigma places an additional barrier on clients who seek needed
mental health services.’

37
With various definitions and meanings attached to the term mental health, this stated term has
different meanings globally. Mental health has an altogether different set of challenges when it
comes to the Indian context.
World Health Organization’s action plan for mental health for the year 2013-2020 highlights
the global perspective of the mental health. It states that determinants of mental health and
mental disorders include not only individual attributes such as the ability to manage one's
thoughts, emotions, behaviors and interactions with others, but also social, cultural, economic,
political and environmental factors such as national policies, social protection, living standards,
working conditions, and community social supports. Exposure to adversity at a young age is an
established preventable risk factor for mental disorders.
The action plan further adds that depending on the local context, certain individuals and groups
in society may be placed at a significantly higher risk of experiencing mental health problems.
These vulnerable groups may [but do not necessarily) include members of households living in
poverty, people with chronic health conditions, infants and children exposed to maltreatment and
neglect, adolescents first exposed to substance use, minority groups, indigenous populations,
older people, people experiencing discrimination and human rights violations, lesbian, gay,
bisexual, and transgender persons, prisoners, and people exposed to conflict, natural disasters or
other humanitarian emergencies.
The current global financial crisis provides a powerful example of a macroeconomic factor
leading to cuts in funding despite a concomitant need for more mental health and social services
because of higher rates of mental disorders and suicide as well as the emergence of new
vulnerable groups [for example, the young unemployed). In many societies, mental disorders
related to marginalization and impoverishment, domestic violence and abuse, and overwork and
stress are of growing concern, especially for women's health.
The above action plan lays emphasis on the fact that every society and its set of people deal
with mental health issues at a different level. Each society has a unique set of mental health
hassles which need to be tackled accordingly.
Just where WHO highlights the global scenario, the Indian perspective of the mental health
raises concerns about lack of awareness amongst the masses in the country. According to (Goel,

38
Agarwal, Ichhpujani, & Shrivastava, 2004) ‘Ignorance and prejudice surrounding mental illness,
deprioritisation of mental health plans/programmes amidst ‘basic’ health concerns, such as the
provision of clean/safe drinking water and the prevailing climate of cynicism with regard to any
(especially government) initiatives are major barriers in implementation. The media, particularly
the electronic media, with its phenomenal instant reach can play a vital role in this endeavour.’
Mental illnesses are very much a growing concern, but the means to tackle these illnesses are
still not full proof, lack of psychiatrists, clinics and government plans regarding the same are a
hindrance to the treatment of mental illness. The research study titled Mental Health: An Indian
Perspective by (Goel, Agarwal, Ichhpujani, & Shrivastava, 2004) further also highlights the fact
that due to over growing population and lesser means of treatments the problem of mental illness
is unsolvable. ‘The mental health scene in India at the dawn of the twenty-first century is a
bewildering mosaic of immense impoverishment, asymmetrical distribution of scarce resources,
islands of relative prosperity intermixed with vast areas of deprivation, conflicting interests and
the apparent apathy of governments and the governed alike. In the context of the huge and
perhaps unsustainable levels of over-population, the problems appear to be insoluble.’
India still lacks the awareness about mental health diagnosis, earlier too the hospitals dealing
with mentally ill patients were said to be a unique introduction. As stated by (S.D.Sharma, 2004)
‘the concept of mental hospitals in India was a totally a British conception’. The research
suggests that ‘there is some evidence that modern medicine and hospitals were first brought to
India by the Portuguese during the seventeenth century in Goa, but their impact was limited.
Naturally, the early institutions for the mentally ill in the Indian subcontinent were greatly
influenced by the ideas and concepts as prevalent in England and Europe at that time. Primarily,
mental asylums were built to protect the community from the insane and not to treat them as
normal individuals. Accordingly, these asylums were constructed away from towns with high
enclosures, in dilapidated buildings like the barracks left by the military. Their function was
more custodial and less curative.’
(S.D.Sharma, 2004) Traces back the emergence of mental asylums and highlights that ‘after
Lord Cornwallis’ rule (1786–1793), there was no further development in the growth of lunatic
asylums in other parts of India until 1857, except in the major cities of Calcutta, Bombay and
Madras.’

39
Mental illness is still a new field for the studies, and due to lack of research studies on the
subject the exact figures of the patients and diagnostic centers is yet not clear. With regard to
total and exact figures of people being affected by mental disorders, the research studies have
failed to provide the same as the demographics are constantly changing in India. As observed by
(Menon, 2004) ‘since most studies are descriptive with non-comparability and lack of
uniformity, national estimates even for prioritized mental health problems are not available.
While it is not possible to have a single estimate (there cannot be one estimate) due to large
population variation and wide spectrum of mental health problems, a rough estimate within a
narrow range should be available for comparison with other health problems to compete for the
meagerly available health resources. Estimates should also be available for prioritized mental
health problems in India, based on scientific principles and not ‘off the hat’ numbers.’
India has witnessed phenomenal changes in urbanization, industrialization, migration, media
impact and changing socio-economic levels of individuals and families. The breaking of societal
mechanisms has paved the way for more individual living, with anecdotal evidence of increasing
mental health problems. In this complex scenario, it is to say: whether mental disorders are on
the increase, decrease or stagnant; which disorders are changing; how is this linked to changing
lifestyles; correlation with changing social and micro-and macro-economic policies of successive
governments and many other issues. There is no clear-cut picture emerging on the association
between changing socio-economic and demographic indicators and psychiatric problems. In a
country with a population of more than a billion, information on the causes of mental disorders is
not available.
The study by (Menon, 2004) also states that ‘the obvious lack of analytical studies has also
thwarted the emergence of preventive mental health services in India. Several conditions like
mental retardation, alcoholism, suicide and depression have their roots in the socio-cultural
environment of communities. The lack of information about whether it can be prevented, how it
can be prevented and by what methods has not been addressed region-wise.’
The same is the scenario with the awareness about disabilities as observed by (Menon, 2004).
‘In the Indian context, data are totally lacking at a national level on disabilities, and the resultant
socio-economic impact on the quality of the life of people and their families with regard to

40
mental illness. The health and social outcomes in the heterogeneous Indian community have
remained poorly understood.’
There is no common contact between the patients dealing with mental illness and the doctors
dealing with such illnesses. This lack of communication between the two entities has become a
hurdle in conveying information about mental illnesses. Moreover the research also adds that
‘the gap between the people affected by the mental illness and the researchers have also led to
the misconstrued perception of mental health. A widening gap between the ‘researchers’
definition of a case’ and ‘community perception of mental problems’ and ‘needs of those
requiring care’ are some of the key issues not addressed in the Indian region.’
The Indian scenario of mental health has lots to improvise on. The social aspect cannot be
ignored when one talks about illness. There are certain notions about visiting a psychologist still
prevalent in India; in this case the family becomes the sole supporter of the patient dealing with
mental illness. (MURTHY, 2011)Has suggested that ‘India is a pioneer in the area of involving
family members in the care of the ill. This has been so since the early 1950s. In India, most
people with mental disorders live with their families. The family takes care of them, ensures the
provision of services, and plans and provides for their future. Thus, our family care model is very
important’. Additionally the study states, ‘the role of the family becomes crucial when one takes
cognizance of the acute shortage of affordable professionals, rehabilitation services and
residential facilities, whether in the private or government sector, in India. One should also take
note of the absence of welfare facilities or benefits for persons with mental disorders.’
The research by (MURTHY, 2011) emphasizes on the social construct of the Indian society
where family plays a very important role when it comes to health. The study states how family
becomes too involved when there is a case of mental disorder but due to lack of awareness and
professional intervening, the family has to take care of the individual.
Several studies have been branched out on the coverage of health related news in newspapers.
According to (Singh, 2014) ‘Maximum numbers of subjects are now being covered by the
newspapers. They are giving information about health, education, science, environment, crime,
accident, culture, tourism, literature, information technology, religion; spiritual etc. the stated
research excerpt suggests that health also forms a part of coverage in the newspapers. Health as a

41
beat is also a recognized field in the dailies.’ The following statement opines that amongst all the
fields of politics, sports, religion, environment, crime, and many more health too forms an
integral part of the newspaper coverage.
Referring to the study conducted by (Gangolli, Duggal, & Shukla, 2005) it is stated that ‘there
is an urgent need for a comprehensive Mental Health Policy to meet the needs of people living
with mental illness. Services and laws remain outdated and mental health needs have to be
brought on to the health agenda.’
2.5 Health communication
Health communication is the practice of communicating and disseminating information related
to health to the masses. This information may be a promotional activity, an awareness campaign
or a news piece. Health communication as a whole deals with anything which is related to health
and is communicated to a larger audience.
Many research scholars have interpreted the term health communication as health literacy;
because it usually deals with making people aware of the health hassles and issues.
Coming to the emergence of the research studies on health communication, study by (Ahmad
& Mustaffa, 2012) states that ‘research on health communication at the macro level has emerged
over the last quarter of the 20th century. The realization that prevention could potentially play a
greater role in the improvement of health than treatment has grown as another body of health
communication research.’
According to the study conducted by (Robinson, 2014) et al ‘health communication campaigns
make use of mass media in order to reduce mortality and morbidity through behavior change.’
The study states that ‘the intervention is defined as having two core components reflecting two
social marketing principles: (1) promoting behavior change through multiple communication
channels, one being mass media, and (2) distributing a free or reduced-price product that
facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful
behaviors, or protects against behavior related disease or injury.’

42
Health communication campaigns that combine mass media and other communication
channels with distribution of free or reduced-price health-related products are effective in
improving healthy behaviors.
As observed by (Freimuth, 2000) ‘Most health communicators would agree that there are a
common set of variables considered in the development of a mass media health communication
campaign and a common set of outcomes that one can reasonably expect as a result of a
communication experience. Communication development or independent variables can be
categorized into four broad areas: 1) psychosocial attributes of the receiver, 2) the source or
spokesperson, 3) settings, channels, activities, and materials used to disseminate the message,
and 4) the message itself, including content, tone, type of appeal, audio characteristics, and
visual attributes.’
The stated four areas suggested by (Freimuth, 2000) emphasize on the factors which are
responsible for the outcome of the health communication messages. These four areas are divided
into receiver, the sender, the channel and the nature of the message. The states four criteria
influence the conclusion of the message.
Health communication not only is the way to convey certain information about health to the
people, it also has its share of constraints as pointed out by (Houts, 2006) et al, ‘communication
between health professionals and patients is inherently problematic. Professionals want to
communicate clearly, but tend to use technical terminology because it is precise, because it is
familiar, and often because there are no exactly equivalent non-technical words available.’
Furthermore, they often try to communicate more information than patients can process. Patients,
even those with well-developed language skills, find it difficult to process medical information
because they are unfamiliar with medical terminology.
Due to the jargons it becomes for the common man to gauge what is being conveyed by the
medical expert, this gap leads to loss of understanding.
It is also suggested that the effectiveness of health communications can be significantly
increased by including pictures in the design of new health education materials. Furthermore,
many existing health education materials could be improved by the judicious addition of

43
pictures. More research is needed, but the potential for enhancing health education is clearly
established.
The basic of the area of health communication is observed by (Kreps, 2015) ‘as a young,
relevant, and promising applied field of study that examines the influences of human and
mediated communication on the delivery of health care and the promotion of health. Health
communication inquiry is typically problem-based, identifying serious communication issues
that threaten the quality of health care and health promotion, as well as suggesting evidence-
based health communication interventions, programs, policies, and practices for improving
health outcomes.’
Intrapersonal, interpersonal, group, organizational, and societal levels of communication
perform central roles in promoting health across the continuum of care: prevention, early
detection, diagnosis, treatment, survivorship, and end of life care. Health communication
scholars have developed a rich body of research and theory that identifies critical communication
factors that influence health care and health promotion, suggesting key communication strategies
for improving health outcomes.
(Kreps, 2015) Adds that ‘health communication inquiry, thus, is conducted to understand the
powerful role of communication in health care, with applied health communication inquiry
designed to help people to use communication strategically to achieve health and health care.’
The stated observation opines that health communication too like other communication
processes acts at different levels. It also lays emphasis on the fact that health communication is
important to improve health care amongst the masses.
Health communication according to (Kreps, 2015) ‘operates at intrapersonal, interpersonal,
group and organizational level. Intrapersonal health communication inquiry examines the
symbolic processes that people use to conceptualize health and health care, such as the
development of people’s beliefs, attitudes, and values that predispose their health care behaviors
and decisions.’

44
‘Interpersonal health communication inquiry focuses on the role of communication—such as
information exchange, education, and social support—in dyadic relationships—such as in the
provider–consumer relationship.’
‘Group health communication inquiry examines health communication in small-group settings,
such as families, health care teams, and support groups, with a particular emphasis on identifying
effective and ineffective communication among group members and the factors affecting that
communication.’
‘Organizational health communication inquiry examines how people communicate as they
negotiate the health care system, coordinate interdependent health care groups, mobilize various
health specialists, and share information to enable effective multidisciplinary provision of health
care and the prevention of health risks. Because clinics, hospitals, and medical centers have
evolved as central sites for health care delivery, scholars examine how organizational
communication in those sites supports or impedes achieving key health care and promotion
goals.’
Health Communication has variety of meanings depending on its usage in a particular context.
In the book written by (Schiavo, 2007) ‘Health communication is an evolving and increasingly
prominent field in both public health and the nonprofit and commercial sectors. Therefore, many
authors and organizations have been attempting to define or redefine it over time. Because of the
multidisciplinary nature of health communication, many of the definitions may appear somewhat
different from each other. Nevertheless, when they are analyzed, most point to the role that
health communication can play in influencing and supporting individuals, communities, health
care professionals, policymakers, or special groups to adopt and sustain a behavioral practice or a
social or policy change that will ultimately improve health outcomes.’
The multidisciplinary nature of health communication has broadened the horizon of the
concept. With each different usage and implementation, health communication as a subject is
defined differently.
(Schiavo, 2007) Further states that ‘understanding the true meaning of health communication
and establishing the right context for its implementation may help communication managers and
other health care professionals identify early on the training needs of staff and others who are

45
involved in the communication process.’ In case of this particular research study wherein the
print medium is the mode of communication for health related articles, training of journalists
covering the health beat comes into picture.
2.6 Reportage of health in newspapers
Health articles are now widely covered by newspapers due to greater awareness amongst the
readers. Most of the health related articles have now taken the form of soft news like features and
editorials. As compared to the beats of politics, crime and sports, health related reportage is still
wary.
Many research scholars have analyzed health reportage in different newspapers. The coverage
of health related articles in daily newspapers usually is lesser as compared to other beats. As
stated in the research study (Maheshwar* & Rao, 2012) ‘Indian print media’s contribution in
dissemination of health and nutrition information is meager. Quantity of health and nutrition
information catered by regional language daily is less than the English newspaper.’ The stated
research study suggests that the coverage of health and nutrition information is prevalent but not
in equal terms as other beats. The reportage of health communication also differs between the
English language newspapers and regional newspapers given the fact that the readership and
target audience is different.
The coverage of health related issues in newspapers also have its share of constraints as
suggested by (Leask, Hooker, & King, 2010) ‘time constraints and access to resources and
technical expertise remain the major issues for journalists in producing high quality health and
medical stories.’ The coverage of health issues in media is not only dynamic but also has some
problematic areas. One of the prime concerns of reportage of health issues is lack of expertise
and cross checking of facts. The readers assume that everything published in the newspapers is
verified and checked numerous times. But due to lack of time and resources, journalists often are
not able to verify a certain report which can lead to a hassle.
Attention to these problems is necessary in this research paper because it indirectly reflects to
the significance of reporting of health issues. Even the health experts are said to be displeased
with the way health as a beat is covered in the media. According to the research by (MRDI,
2014) it is suggested that ‘much of the reporting is still based on covering events and, while the

A Comparative Content Analysis Study Of News Articles Related To Health Communication In Two Daily Newspapers

A Comparative Content Analysis Study Of News Articles Related To Health Communication In Two Daily Newspapers

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