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Interface - Comunicação, Saúde, Educação

Print version ISSN 1414-3283On-line version ISSN 1807-5762

Interface (Botucatu) vol.23  Botucatu  2019  Epub Apr 04, 2019

https://doi.org/10.1590/interface.180095 

Review

Journal coverage on issues of interest to Brazilian Collective Health: a literature review*

Andrea Langbecker(a) 
http://orcid.org/0000-0001-5292-8220

Marcelo Eduardo Pfeiffer Castellanos(b) 
http://orcid.org/0000-0002-4977-5574

Robson da Fonseca Neves(c) 
http://orcid.org/0000-0002-3889-560X

Daniel Catalan-Matamoros(d) 
http://orcid.org/0000-0002-3086-6812

(a) Universidade Federal da Bahia. Rua Basílio da Gama, s/nº, bairro Canela. Salvador, BA, Brasil. 40110-040. <alangbecker@hotmail.com>

(b) Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador, BA, Brasil. <mcastellanos@ufba.br>

(c) Departamento de Fisioterapia, Universidade Federal da Paraíba. João Pessoa, PB, Brasil. <robsonfisioba@gmail.com>

(d) Departamento de Periodismo y Comunicación Audiovisual, Universidad Carlos III de Madrid. Madri, Espanha. <dacatala@hum.uc3m.es>


ABSTRACT

There is a lack of reviews regarding the journalistic coverage about topics of interest for the Brazilian Collective Health. This study aimed to analyze the profile of scientific publications between 2000 and 2015, about news reporting public health issues. It included 64 articles, organized in categories such as: subject, data production, methods of analysis and media investigated. The predominant theme was media coverage of diseases, with emphasis on infectious diseases. Qualitative studies, documentary research and both discourse and content analyses were prevalent. Newspapers were the most researched media. In conclusion, important challenges in this field emerge: the low diversity of themes and approaches adopted, as well as the media investigated, and the need to enlarge the scope of methodological strategies.

Key words: Scoping review; Media; Journalistic coverage of health

RESUMO

É escassa a produção de revisão de literatura sobre a cobertura jornalística de temas de interesse para a Saúde Coletiva. O presente estudo teve como objetivo caracterizar o perfil da produção científica, publicada de 2000 a 2015, voltada para a análise de notícias que tratam de temas da saúde das populações. Os 64 manuscritos incluídos foram organizados nas seguintes categorias: tema, produção de dados, métodos de análise e meios de comunicação investigados. A temática predominante foi a cobertura midiática sobre as enfermidades, com destaque para as infecciosas. Prevaleceram os estudos qualitativos, a pesquisa documental e análises de discurso e de conteúdo. O jornal foi o meio de comunicação mais pesquisado. Conclui-se que são importantes desafios deste campo: a baixa diversidade de temas e enfoques adotados, bem como de meios investigados, e a necessidade de se ampliar o escopo de estratégias metodológicas.

Palavras-Chave: Scoping review; Mídia; Cobertura jornalística em saúde

RESUMEN

Es escasa la producción de revisión de literatura sobre la cobertura periodística de temas de interés para la Salud Colectiva brasileña. El presente estudio tuvo el objetivo de caracterizar el perfil de la producción científica, publicada de 2000 a 2015, enfocada en el análisis de noticias que tratan de temas de la salud de las poblaciones. Los 64 manuscritos incluidos se organizaron en las siguientes categorías: tema, producción de datos, métodos de análisis y medios de comunicación investigados. La temática predominante fue la cobertura mediática sobre las enfermedades, con destaque para las infecciosas. Prevalecieron los estudios cualitativos, la investigación documental y análisis de discurso y de contenido. El periódico fue el medio de comunicación más investigado. Se concluye que en este campo son desafíos importantes: la baja diversidad de temas y enfoques, así como de medios investigados y la necesidad de ampliar el alcance de estrategias metodológicas.

Palabras-clave: Scoping review; Media; Cobertura periodística en salud

Introduction

Journalism shows a growing interest in the delivery of health content1-2. Most of the newspapers with the largest circulation in the country (both printed and digital) have spaces dedicated to the theme. In the case of the Folha de São Paulo, there is the daily “Health + Science” and the weekly Equilíbrio and Saúde. Globo also publishes health, science and technology news in the Society section. The Estadão has a daily health magazine and the southern Zero Hour, the weekly supplement Caderno Vida3.

This theme may still be present in several daily newspaper editorials, such as in Cidade when addressing issues related to the emergency service units; in Police, when portraying the aggression to health professionals in public hospitals; in the section of Politics, when bringing the speech of authorities on the financing of the public health system, as well as in Sports, when it publishes some news on diets for runners2.

This subject also regularly receives the pages of magazines Veja, Isto É, Época and television programs3, in addition to its presence in news sites and social networks, expanding the possibilities of content delivery on health.

How is journalistic coverage when it comes to topics of interest to Brazilian collective health? In this paper it is understood as an interdisciplinary field, aimed to the understanding of health and the explanation of the social determinants of the health-disease process. Its aim is not only for the individual, but also for the community, with a priority focus on health promotion, contemplating likewise the prevention and care of diseases and diseases4.

Despite the relevance of this question, there are few review studies in health and communication that contribute to illuminate this issue. According to Terrón et al.5, analyzing the publications on communication in the public health journals available in the Scielo database, covering eleven countries including Brazil, the number of articles published on this subject for a period of ten years was inexpressive.

With the purpose of painting a broad outline, as well as identifying gaps, the present study sought to characterize the profile of scientific production in the health area - from 2000 to 2015 - that analyzed journalistic coverage on topics pertinent to this field.

Methodological strategy

The scoping review - methodological option of the present work - aims to map the main concepts on a given theme. It is characterized by avoiding starting from a specific question and, as it proposes to bring a general overview, it does not make a qualitative analysis of the material. It allows including studies with different designs and methodologies. It also has as main function to point the gaps in the knowledge of the object in question6. In North America, specifically Canada, the tradition of developing scoping review is strong; in Brazil however, the use of this method is still scarce.

A systematic search was carried out in the databases of the Virtual Health Library (VHL), which brings together national and international databases of articles in Portuguese, English and Spanish (Chart 1), with success on the bases described in Figure 1. The period investigated was from 2000 to 2015 because it is more representative of the scientific production of the field of communication and health in Brazil, due to its recent structuring, and the beginning of more significant initiatives date from the end of the 90s7. The first scientific journal in Brazil and Latin America with this focus, the magazine Interface - Communication, Health, Education, for example, was released in 19978.

Chart 1 Keywords and cross-keyword strategy 

MEDIA Media AND public health; Media AND Single Health System (SUS); Media AND health; Media AND disease; Press AND health; Press AND disease.
JOURNALISM News coverage AND Unique Health System; Journal coverage and public health; Newspapers AND public health; Newspapers AND Single Health System; Newspapers AND disease; News AND public health; News AND Single Health System (SUS); Journalism AND health; Journalism AND disease.

Figure 1 Search strategy and synthesis of the process of obtaining the selected articles 

We understand journalistic coverage not only as the act of covering a series of facts, which result in the news being conveyed, but also as a “verification and angulation strategy”9 (p. 1), which includes the news production process. We still consider the public’s perspective regarding the coverage of the issue.

The following inclusion criteria were adopted: empirical studies whose objective was to investigate the Brazilian journalistic coverage on issues, problems or themes pertinent to Brazilian Collective Health; studies that analyzed the generalist media, except the studies that analyzed concomitantly generalist and specialized media.

Were excluded: articles in which the focus of journalistic coverage on individual health did not establish any connection with a collective perspective; empirical studies that referred to the media without presenting data related to the media; studies that analyzed the specialized media.

The steps of the process of obtaining the selected articles were guided by the “Guidance for conducting systematic scoping reviews”10. In this proposal, the first author and the third author made the initial selection of articles and the fourth author made the final review, expressing any doubts. In order to expand the search, the articles obtained from the cross-references were included. Those articles are the references captured from articles included in the review (Figure 1).

Results and discussion

A total of 64 articles were selected for analysis (Figure 1). These manuscripts were organized in the following categories: themes, data production, methods of analysis and media investigated. Some subcategories were created from these, taking as reference the frequency of appearance within the investigated studies. They also fulfilled the function of grouping elements that were repeated infrequently among the included articles.

We categorized 11 themes in which the scientific production focused mainly on the journalistic coverage of “physical and mental diseases”, as specified in Chart 2. It is important to note however, that no databases of the field of communication were included, and that that inclusion may have resulted in another configuration to these results, as warned by Terrón et al.5

Chart 2 Diseases as the main theme of scientific production 

Themes Authors N. %
Physical and mental illnesses Diniz and Guedes11; Castro12; Jurberg and Macchiute13; Jurberg e Verjovsky14; Jurberg et al.15; Jurberg, Gouveia e Belisário16; Jurberg and Macchiute17; Bertol18; Silva, Bousfielde and Cardoso19; França, Abreu and Siqueira20; Ferraz and Gomes21; Villela and Natal22; Malinverni, Cuenca and Brigagão23; Lódola and Góis Júnior24; Maciel-Lima et al.25; Medeiros and Massarani26; Medeiros and Massarani27; Ferraz and Gomes28; Silva and Camargo29; Spink et al.30; Rangel-S31; Bevilacqua et al.32; Villela and Natal33; Schneider, Tavares and Musse34; Rangel-S35; Tomita e Padula36, Guarniero, Bellinghini and Gattaz37; Soares and Caponi38; Rios et al.39; Santos and Cardoso40. 30 46,88
Brazilian National Health System -SUS Machado41, Menegon42; Silva and Rasera43,44; Morais et al.45; Scremin e Javorski46; Luz, Cambraia and Gontijo47; Ortona and Fortes48; Silva, Pereira and Lopes Filho49. 9 14,06
Drugs Lacerda, Mastroianni and Noto50; Romanini and Roso51; Conceição et al.52; Macedo, Roso and Lara53; Noto et al.54; Ronzani et al.55. 6 9,38
Medication Ortega et al.56; Nascimento57; Diniz and Castro58; Leandro and Santos59; Saraiva et al.60. 5 7,80
Violence Njaine61; Garbin and Fischer62; Campos, Vieira and Mota63; Saraiva e Coutinho64. 4 6,25
Risk Di Giulio et al.65; Spink, Medrado and Mello66; Di Giulio, Pereira e Figueiredo67. 3 4,69
Oral Health Cavaca et al.68; Cavaca, Gentilli and Marcolino69. 2 3,13
Abortion Fontes70; Souza and Brandão71. 2 3,13
Elderly Stacheski and Massi72. 1 1,56
Women’s Health Oliveira et al.73. 1 1,56
Suicide Côrtea, Khoury and Mussi74. 1 1,56
Total 64 100%

Among those of physical origin, research on infectious diseases (Chart 3), such as: H1N1 influenza (28.57%), dengue (21.43%), AIDS (14.28%), yellow fever (14.28%), encephalitis (7.14%), meningitis (7.14%) and visceral leishmaniasis (7.14%). Of the most investigated, the studies found that the focus of coverage on the H1N1 flu epidemic was centered on panic, risk, and fear related to the disease. In the case of dengue, the research pointed to accountability and culpability of the population on its occurrence.

Chart 3 Characterization of the profile of physical diseases analyzed 

Illnesses Authors N. %
Infectious França, Abreu and Siqueira20; Ferraz and Gomes21; Villela and Natal22,33; Malinverni, Cuenca and Brigagão23; Lódola and Góis Júnior24; Maciel-Lima et al.25; Medeiros and Massarani26,27; Ferraz and Gomes28; Silva and Camargo29; Spink et al.30; Bevilacqua et al.32; Schneider, Tavares and Musse34. 14 53,85
Chronic Castro12; Jurberg and Macchiute13,17; Jurberg and Verjovsky14; Jurberg et al.15; Jurberg, Gouveia and Belisário16; Bertol18; Silva, Bousfield and Cardoso19. 8 30,77
Intoxication Rangel-S31,35; Tomita and Padula36. 3 11,54
Genetic Diniz and Guedes11 1 3,84
Total 26 100

To Waisbord75, these two diseases have priority in the Latin American media agenda, composing what are known as “epidemic media” cycles (related to the dynamics of topics in the journalistic agenda). Some factors that, according to the author75, contribute putting the H1N1 flu and dengue fever in the information cycle are, among others, oriented: because the speed and expansion of cases fit the journalistic requirement to convey updated information daily; and the two diseases extrapolate the social and geographical divisions of other diseases by being transmitted with high effectiveness between different groups. As they do not focus only on low-resource populations, as they do with other diseases, they impact where the media and its audiences live and work, thus counting on greater journalistic value.

These findings make us reflect how diseases tend to be shown by the media in isolation, without considering the social determinants, and can change the focus of the population’s perception of the origin of the problem, as well as legitimize the State’s lack of responsibility in this regard76. It is not in question the perspective of adopting a paternalistic attitude towards the population and a criminalist towards the State, but rather of offering an opportunity for a more comprehensive critique to be made through what is published by the press.

Non-communicable chronic diseases (NCDs) - which significantly impact the population and the health system itself - accounted for about 70% of deaths in 2007, becoming a priority health demand in the country77. Part of this group are those related to the circulatory system, the number one cause of death, followed by cancer, which occupies second place in the ranking. In this review, we did not find studies on journalistic coverage for circulatory diseases.

Regarding cancer, the most investigated chronic disease, we found seven studies12-18, whose majority was conducted by the same researcher13-17. Part of them showed that the media gave more space to news about prevention12-14,16, although the focus on the coverage of scientific research was also present12,17,18. We found only one study on hypertension19. However, no studies on diabetes have been found, despite the increase in the prevalence of this disease in the country77.

There was a low number of researches that looked at mental illnesses and disorders37,39-41, despite its expressive prevalence, reaching between 20% and 56% of the Brazilian adult population, mainly women and workers78. The impact on the quality of life of these people and the repercussions they have on the world of work put mental disorders as a serious public health problem79,80.

The visibility of news about diseases and mental disorders can be central to the understanding and perception of them. However, the low scientific production does not give us many elements to establish a panorama regarding journalistic coverage, considering the diversity of existing disorders. Of the four manuscripts, we can point out a study, related to schizophrenia that found that the media investigated reinforced the stigma in relation to the disease37. This study also highlighted that the news did not give voice to the patient suffering schizophrenia. This finding is in line with a trend already demonstrated by several studies of the sociology of journalism: the media prioritize official sources(e) to the detriment of the voices of society. By using this strategy, the media tends to symbolically reproduce the existing power structure in the institutional order of society81. Regarding depression, there was a study that highlighted that the media investigated emphasized medicalization as the priority treatment, demonstrating that the conception of news coverage in relation to the disease was biomedical39.

The second most researched topic was the Brazilian National Health System (SUS) with nine articles (Chart 2). Result of long social struggles, the SUS was implemented during more than 20 years, through the Organic Law of Health, 1990, with the purpose of being a universal, free, decentralized and democratic public health system. Despite this trajectory, according to Paim82, politicians, health professionals, the media and the population know little about their health system and have different and distorted conceptions about it.

When analyzing the SUS category, we identified five subtopics, with the journalistic coverage of the Mais Médicos Program (Chart 4) leading this role. Its implementation took place in 2013 and is presented by the federal government as a strategy for the strengthening of Primary Care in the country.

Chart 4 Subtopics related to the Unified Health System 

Themes Authors N. %
More doctors program Morais et al.45; Scremin and Javorski46; Luz, Cambraia e Gontijo47 3 33,34
Health services Menegon42; Ortona and Fortes48 2 22,22
Management, health professionals and users Silva and Rasera43,44 2 22,22
Health Actions Silva, Pereira and Lopes Filho49 1 11,11
Mental health policy Machado41 1 11,11
Total 9 100

The articles analyzed showed the role that the media played in the repercussion of the Mais Médicos Program45, their interference in the public conception of foreign physicians and in the acceptance of them by the public45, identifying a gap from the coverage in relation to the objectives of the law that created the program47.

Regarding sub-themes 2 and 3 (Chart 4), the studies identified that journalistic coverage focused on crisis periods in the health services42,43, creating discredit of SUS managers and users44. These findings dialog with Oliveira83 considering that the main images and information divulged about the system use as a starting point a supposed inefficiency of the State, incompetence of the authorities or the professionals of the area, leading to the construction of a symbolic order that is scarcely reflexive regarding the field of health policy represented by SUS.

To Araújo84, however, it is important to take into account the different interests that are at stake, considering that both SUS and the media are not homogeneous: “society against the media”, “SUS against the media”, and that this polarization “harms a real understanding of the process of social production of the meanings […]”84 (p. 69).

Methodological approach: the predominance of qualitative studies

The methodological approach used in most studies was qualitative. There was only one quantitative study, as specified in Chart 5. Most of the studies were based on only one technique of data production: documentary research (texts, 93.85%, images, 6.15%). There were few who combined it with other techniques, such as interviews, focus groups and application of questionnaires (Chart 6). For Minayo85, the triangulation of the data collection technique is an important resource to give greater validity to the study, however the use or not of various techniques, or even of research methods, will depend on the objective of the investigation and the object investigated. These factors have the last word regarding choices to make.

Chart 5 Methodological approaches in the investigated studies 

Qualitative approach Authors N %
Diniz and Guedes11; Castro12; Jurberg e Macchiute13; Jurberg et al.15; Jurberg, Gouveia and Belisário16; Jurberg and Macchiute17; Bertol18; Silva, Bousfielde and Cardoso19; França, Abreu e Siqueira20; Ferraz and Gomes21; Villela and Natal22; Malinverni, Cuenca and Brigagão23; Lódola and Góis Júnior24; Maciel-Lima et al.25; Medeiros and Massarani26; Medeiros and Massarani27; Ferraz and Gomes28; Silva and Camargo29; Spink et al.30; Rangel-S31; Bevilacqua et al.32; Villela and Natal33; Schneider, Tavares and Musse34; Rangel-S35; Tomita and Padula36, Guarniero, Bellinghini and Gattaz37; Soares and Caponi38; Rios et al.39; Santos and Cardoso40, Machado41; Silva e Rasera43,44; Scremin and Javorski46; Luz, Cambraia and Gontijo47; Ortona and Fortes48; Silva, Pereira and Lopes Filho49; Romanini and Roso51; Conceição et al.52; Macedo, Roso and Lara53; Noto et al.54; Ronzani et al.55, Ortega et al.56; Nascimento57; Leandro and Santos59; Saraiva et al.60, Njaine61; Garbin e Fischer62; Campos, Vieira e Mota63; Saraiva e Coutinho64, Di Giulio et al.65; Di Giulio, Pereira and Figueiredo67; Cavaca, Gentilli and Marcolino69, Fontes70; Souza and Brandão71, Stacheski and Massi72, Oliveira et al.73, Côrtea, Khoury and Mussi74. 57 89,06
Qualitative-quantitative Cavaca et al.68, Menegon42, Morais et al.45, Lacerda, Mastroianni and Noto50, Diniz and Castro58, Spink, Medrado e Mello66. 6 9,38
Qualitative Jurberg e Verjovsky14. 1 1,56
Total 64 100

Chart 6 Identification and frequency of data production 

Production of data Authors N %
Documentary research Diniz and Guedes11; Jurberg et al.15; Jurberg, Gouveia amd Belisário16; Jurberg and Macchiute17; Bertol18; Silva, Bousfield and Cardoso19; França, Abreu and Siqueira20; Ferraz and Gomes21; Villela and Natal22,33; Malinverni, Cuenca and Brigagão23; Lódola and Góis Júnior24; Maciel-Lima et al.25; Medeiros and Massarani26,27; Ferraz and Gomes28; Leandro and Santos59; Silva and Camargo29; Bevilacqua et al.32; Schneider, Tavares and Musse34; Rangel-S35; Tomita and Padula36; Guarniero, Bellinghini e Gattaz39; Machado41; Soares and Caponi38; Rios et al.39; Menegon42; Silva and Rasera43,44; Morais et al.45; Scremin e Javorski46; Luz, Cambraia and Gontijo47; Lacerda, Mastroianni e Noto50; Romanini and Roso51; Conceição et al.52; Macedo, Roso and Lara53; Noto et al.54; Ronzani et al.55; Nascimento57; Diniz and Castro58; Leandro and Santos59; Saraiva et al.60; Garbin and Fischer62; Saraiva and Coutinho64; Spink, Medrado and Mello66; Cavaca et al.68; Cavaca, Gentilli and Marcolino69; Fontes70; Souza and Brandão72; Côrtea, Khoury and Mussi74; Oliveira et al.73; StacheskiI and Massi72. 51 79,69
Documentary research and other techniques Castro12; Jurberg and Macchiute17; Jurberg and Verjovsky14; Spink et al.30; Rangel-S31; Silva, Pereira and Lopes Filho49; Ortega et al.56; Campos, Vieira and Mota63; Di Giulio et al.65; Di Giulio, Pereira and Figueiredo67. 10 15,63
Interviews Santos and Cardoso40; Ortona and Fortes48. 2 3,12
Focus groups Njaine61 1 1,56
Total 64 100%

The observation was not used in any study, despite being a possible resource for analyzing journalistic routines and news production. In the field of journalism, the interactionist theory starts from the premise that news is a construction, resulting from complex processes of social interaction between social agents: journalists and sources of information; journalists and society; members of the professional community, inside and outside their organization. It is aimed at the production and the producers of the news, when studying the influence of the journalistic routine in the representation of the events. News production is thought as an industrial routine, and news is seen as the result of the various factors, i.e. personal, social, ideological, cultural, physical and historical86.

Studies known as newsmaking fit into this perspective and draw on participant observation. With tradition in American studies87, it is potent, especially if aligned with other data production techniques, to understand the internal processes of news production (meeting follow-up and discussion of schedules, monitoring of coverage and interviews with reporters and editors).

However, we can consider that there are difficulties and limitations to include observation in research in the field of communication and health, both for the feasibility of this type of study - which demands time and availability of the researcher - and for the difficulty of access to the media.

On the studies of newsworthiness, Ponte88 emphasizes the importance of articulating various data production strategies, including in the writing studies the participant observation and the analysis of the journalistic coverage for longer periods to give more attention to the routines than to specific events.

Another aspect verified is that the investigated studies focused on the analysis of the journalistic product (82.82%), meeting a trend already identified in research in the area of communication89. There were few investigations that included any dimension related to the journalistic production process (10.93%); or analyzing the public’s perception of the news stories, the so-called reception studies, “a receiving subject that re-signifies the media messages, identifying their negotiations and resistance to the logic of the media”90 (p. 22), representing 6.25% of the investigated studies. In a brief mapping on the publication of articles in scientific journals of communication and health, Lerner and Sacramento90 also arrived at the same finding about the timid presence of studies aimed at reception.

These findings refer to the repetition of methodological formulas commonly used in studies on the media and show us some difficulty in incorporating these approaches, considering the various processes that comprise journalistic coverage - in order to surround this phenomenon so complex by several prisms.

Absence of information on the methods of analysis employed

The most frequent methods of analysis - considering those that specified this information - were discourse and content analysis, a tendency also present in media studies89. In the first case, some studies were based on authors like Foucault, Orlandi, Charaudeau and Maingueneau (Chart 6). However, in some manuscripts, there was no direct reference to a certain school of discourse analysis or even which authors had based the theoretical-methodological choice. This information, however, is relevant if we consider that there are specificities and nuances between the various schools, such as the analysis of discourse, a French line, and critical analysis of the discourse, an Anglo-Saxon line.

In an article, the authors combined several methods of analysis: speech with agenda “setting and framing analysis”. Regarding content analysis, the main reference was that of Bardin. Other theoretical-methodological references used were “framing analysis” and Social Representations (SR). In the first case, not all articles made a reference to authors supporting this option, and those who did, resorted to Erving Goffman. However, there is a diversity of conceptual interpretations about framing analysis as well as its applicability91,92, Regarding the representations, the reference author was Serge Moscovici. In three cases, SRs were combined with other methods, such as content analysis and Collective Subject Discourse93. There was considerable number of articles where information on the method of analysis was not available. This information however, is important so that readers can evaluate the results presented in the publications. Methods that appeared only in one manuscript or were not combined with other methodologies were grouped into ‘Other’ (Chart 7).

Chart 7 Methods of analysis used 

Methods of analysis Authors Articles %
Discourse analysis (DA) Ferraz e Gomes23,28; Rangel-S31; Bevilacqua et al.32; Villela e Natal33; Schneider, Tavares e Musse34; Tomita e Padula36; Silva e Rasera44, Côrtea, Khoury e Mussi74; Macedo, Roso e Lara53; Nascimento57; Spink, Medrado e Mello66; Saraiva et al.60; Garbin e Fischer62; Stacheski e Massi72. 15 23,43
Content analysis Jurberg e Verjovsky14; Jurberg e Macchiute17; Maciel-Lima et al.25; Soares e Caponi38; Morais et al.45; Ortona e Fortes48; Lacerda, Mastroianni e Noto50; Romanini e Roso51; Conceição et al.52; Noto et al.54; Ronzani et al.55; Di Giulio et al.65; Di Giulio, Pereira e Figueiredo67; Cavaca et al.68; Cavaca, Gentilli e Marcolino69. 15 23,43
Information not available Diniz e Guedes11; Castro12; Jurberg e Macchiute13; Jurberg et al.15; Jurberg, Gouveia e Belisário16; França, Abreu e Siqueira20; Spink et al.30; Rios et al.39; Menegon42; Leandro e Santos59; Souza e Brandão72; Côrtea, Khoury e Mussi74; Oliveira et al.73. 13 20,31
Others Lódola e Góis Júnior24; Rangel-S35; Guarniero, Bellinghini e Gattaz37; Santos e Cardoso40; Luz, Cambraia e Gontijo47; Silva, Pereira e Lopes Filho49; Njaine61; Campos, Vieira e Mota63. 8 12,53
Framing analysis Bertol18; Medeiros e Massarani26,27; Scremin e Javorski46; Diniz e Castro58; Fontes70. 6 9,37
Social Representations (SR) Silva, Bousfield e Cardoso19; Silva e Camargo29; Saraiva e Coutinho64; Ortega et al.56. 4 6,25
SR and other methods Villela and Natal22; Machado41. 2 3,12
DA and other methods Malinverni, Cuenca and Brigagão23. 1 1,56
Total 64 100%

Newspaper: the means of communication most investigated

Regarding the means investigated, according to Chart 8, the predominance was the newspapers as also identified by Catalan-Matamoros and Peñafiel-Saiz94 and Terrón et al.5 There were only three that investigated television programs, all broadcasted by Rede Globo; one study analyzed the content published in a radio program and another investigated news sites, however, this manuscript did not specify in the methodology section, which were the sites investigated, being possible to detect such information during the presentation of the results.

Chart 8 List of the most investigated media 

Means Authors N %
Newnspapers Diniz e Guedes11; Jurberg et al.15; Jurberg, Gouveia e Belisário16; Bertol18; França, Abreu e Siqueira20; Ferraz e Gomes21; Malinverni, Cuenca e Brigagão23; Lódola e Góis Júnior24; Maciel-Lima et al.25; Spink et al.30; Rangel-S31,35; Bevilacqua et al.32; Villela e Natal33; Schneider, Tavares e Musse34; Tomita e Padula36; Machado41; Menegon42; Silva e Rasera43,44; Morais et al.45; Luz, Cambraia e Gontijo47; Silva, Pereira e Lopes Filho49; Romanini e Roso51; Leandro e Santos59; Garbin e Fischer62; Campos, Vieira e Mota63; Saraiva e Coutinho64; Di Giulio et al.65; Spink, Medrado e Mello66; Cavaca et al.68, Cavaca, Gentilli e Marcolino69; Souza e Brandão71; Stacheski e Massi72. 37 52,30
Newspapers and magazines Castro12; Villela e Natal22; Guarniero, Bellinghini e Gattaz37; Soares e Caponi38; Rios et al.39; Lacerda, Mastroianni e Noto50; Noto et al.54; Ortega et al.56; Nascimento57; Diniz e Castro58; Fontes70. 11 16,92
Magazines Jurberg e Macchiute17; Silva, Bousfield e Cardoso19; Ferraz e Gomes21; Silva e Camargo29; Conceição et al.52; Ronzani et al.55; Saraiva et al.60; Oliveira et al.73. 8 12,30
Television Jurberg and Verjovsky14; Medeiros and Massarani26,27; Scremin e Javorski46; Macedo, Roso and Lara53. 5 7,69
Radio Jurberg and Macchiute13. 1 1,53
Magazine and news websites Côrtea, Khoury and Mussi74. 1 1,53
TV and newspapers Di Giulio, Pereira and Figueiredo67. 1 1,53
Total 64 100%

It is also possible to infer that this tendency to choose the analysis of newspapers may be related to the ease of making this kind of study feasible: having access to the object (newspaper) is easier5 because in general and especially in national newspapers, content is available on the internet.

For analysis of other media, such as radio and television, it is necessary to record the content, regarding the current situation, or to use the database of the broadcasters, when referring to the previous periods, which in both cases may represent a hindrance. Another aspect is the short duration of studies that can restrict the researchers, limiting them to study media that require less availability and time89.

There was no analysis of social media networks, such as Facebook or Twitter, something that may have been interesting in order to reflect on the important role that these media are playing in today’s society, besides showing a possibility to access the various audiences in an investigation about their public.

An analysis that contemplates the diversity of the media could still offer us more elements to deepen our understanding related to journalistic coverage on Brazilian public health. The different media types can not be confused because they do not follow the same rules of operation: “No trabajan con el mismo material y no producen los mismos tipos de efecto sobre un público que además no es el mismo95” (They do not work with the same material and do not produce the same kind of effect on an audience that is not the same) (p. 321).

Among the most investigated newspapers were those related to the major press, such as Folha de São Paulo, Globo and Estado de São Paulo. There were, however, studies from regional journals, mainly those that included a larger number of publications in their sample. The reviews of magazines were less frequent, and the studies focused on the more traditional and national ones such as Veja, Isto É e Época. Most of the studies - which reviewed journals and journals concurrently - did not consider some of these differences during their analysis: newspapers are daily, tend to focus on factual news, and weekly magazines tend to bring in more in-depth reporting, elements that could have implications during the analysis of the results.

Regarding comparative studies, there were few who used this feature; even those who analyzed more than one vehicle did not analyzed them in most cases in a comparative perspective. There were two studies, for example, that compared coverage in Brazilian and American newspapers, both related to cancer15,18. This methodology has been used in other areas of knowledge, but in the Communication, although the volume of research is high in relation to the news, few are comparative, showing that the number of journalism studies with this profile is low86. In Collective Health, its use is relatively new96. According to Conill96, “Comparing is looking for similarities, differences or relationships between phenomena that may be contemporary or not, occurring in distinct spaces or not to better understand them” (p.564). For this reason, the use of this methodology is potent to identify differences or similarities in journalistic coverage considering the different social contexts of news production.

Final considerations

This review brought a broad landscape of the scientific production on issues of Brazilian collective health. However, it indicated several shortcomings: there were few studies on chronic diseases and neglected diseases, which have a significant impact on the health of the population. New studies could provide an overview of the frequency of these contents, the kind of approach used, if they bring some perspective on health promotion, if they focus on the discovery of new medicines, the quality of the information or even another theoretical-methodological approach, such as senses and discourses produced on these NCD in the media.

It is also possible to reflect on whether the media agenda itself may have guided the scientific production in the area, considering that epidemic diseases were one of the most investigated themes. Regarding the SUS category, the ‘More Doctors’ program - which received wide coverage of journalism - was also one of the topics that most aroused interest on the part of researchers.

Regarding the methodology, there was a low diversity of data production techniques, and observation was not observed in any study. Few works have contemplated other aspects that are also related to journalistic coverage, such as the production of news and the perception of the users about its contents. These findings lead us to reflect on the importance of further investigations that may encompass these other processes. Regarding the method of analysis, there were a considerable number of articles that did not specify this information. This methodological issue is a challenge to be faced by researchers in new studies in this field. It is also important to highlight the low diversity of media investigated.

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(e)()A source is a person who the journalist interviews and who provides information to compose the news

* This article is the result of the PhD thesis of the first author, with funding from the Coordination for the Improvement of Higher Education Personnel (Capes).

Received: March 02, 2018; Accepted: September 18, 2018

Translator: Félix Héctor Rigoli

Authors’ contributions

Andrea Langbecker, Marcelo Eduardo Pfeiffer Castellanos, Robson da Fonseca Neves and Daniel Catalan-Matamoros participated equally in the preparation of the article and approved the final version presented.

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