Visibility of healthcare workers in the Covid-19 crisis: a study of sources and topics in television news broadcasts

Marta Rebolledo Hildegart González Inés Olza About the authors

Abstracts

Esta investigación analiza la cobertura mediática de la crisis del Covid-19 en España, y el papel que en ella ha tenido la comunicación sobre salud y sobre los profesionales sanitarios. Se estudia el tratamiento recibido por las fuentes y temas sanitarios en los informativos de Radiotelevisión Española (RTVE) emitidos entre el 31 diciembre 2019 y el 8 junio 2020. Para ello, se realiza un análisis de contenido cuantitativo de 452 noticias de 21 informativos. Los resultados muestran que los debates de política y los propios políticos ocupan más espacio como tema y fuentes, respectivamente, en los informativos analizados, por delante de la salud y de los profesionales sanitarios. El estudio confirma, por tanto, la falta de visibilidad de los profesionales de salud en la cobertura informativa televisiva en España sobre el Covid-19.

Palabras clave
Covid-19; Fuentes informativas; Cobertura mediática; España; Profesionales sanitarios


Esta pesquisa analisa a cobertura mediática da crise do Covid-19 na Espanha e o papel que a comunicação sobre a saúde e os profissionais de saúde nela tiveram. É estudado o tratamento recebido pelas fontes e questões de saúde nos telejornais da Radiotelevisión (RTVE) da Espanha, transmitidos entre 31 de dezembro de 2019 e 8 de junho de 2020. Para isso, é realizada uma análise quantitativa do conteúdo de 452 notícias de um total de 21 telejornais. Os resultados mostram que os debates sobre políticas e os próprios políticos ocupam mais espaço como tema e fontes, respectivamente, nos noticiários analisados, à frente dos profissionais de saúde e dos profissionais de saúde. O estudo, portanto, confirma a falta de visibilidade dos profissionais de saúde na cobertura noticiosa da televisão na Espanha sobre o Covid-19.

Palavras-chave
Covid-19; Fontes de informação; Cobertura da mídia; Espanha; Profissionais de saúde


This study is an analysis on the Spanish media coverage of the Covid-19 crisis and the role of information on health and healthcare professionals within it. We studied the treatment given to healthcare sources and topics in news broadcasts released by Radiotelevisión Española (RTVE) between December 31, 2019, and June 8, 2020. To this end, we conducted a quantitative content analysis on 452 news items from 21 news broadcasts. The results showed that debates on political issues were the main topics and politicians were the main sources, in the broadcasts analyzed, ahead of health issues and healthcare professionals. Our study thus confirms the lack of visibility of healthcare professionals in the television news coverage of the Covid-19 crisis in Spain.

Keywords
Covid-19; News sources; Media coverage; Spain; Healthcare professionals


Introduction

The Covid-19 pandemic has put health and management of healthcare services at the center of public debate. During this crisis, healthcare professionals have gained greater visibility. The importance and usefulness of their work, along with the need to invest in this work and in healthcare, have become central topics in public debate, to the point that healthcare workers have been rated as heroes worldwide. In the case of Spain, on June 3, 2020, the Princess of Asturias Foundation announced that the 2020 Concordia Prize would be awarded to the Spanish healthcare workers who were at the forefront of the fight against Covid-19(d (d) https://bit.ly/premiosanitarios ). Spanish society’s support for this professional sector has been expressed through various initiatives, as it also has been at global level. By way of example, applause at eight o’clock in the evening became standard practice in various countries.

Since the beginning of this global health emergency, each country has tried to take the measures and actions that it has valued as most appropriate. Indeed, disparity of actions between governments has been the common tone. These actions have ranged from drastic measures of total lockdown of society in countries such as Spain, Italy or France to recommendations to stay at home and maintain prevention and hygiene indications in Belgium or Canada. Decisions made on the basis of the recommendations of health experts have been intended to control infection, prevent the collapse of healthcare systems and address the lack of materials: in short, to try to reduce the numbers of cases of infection and death due to this pandemic.

In crisis situations, communication becomes the central element that contributes to their management. This is not only a question of providing information on the events that have occurred, but also one of responding to the concerns of the different audiences affected at different stages of the crisis, with the aim of providing security and, as far as possible, minimizing the uncertainty that has arisen. As indicated in the literature, different phases of crises can be distinguished and communication needs will vary according to each phase11 Fink S. Crisis management. New York: American Management Association; 1986.

2 Coombs WT. Ongoing crisis communication: planning, managing and responding. 4th ed. London: SAGE Publications; 2014.
-33 Reynolds B, Seeger MW. Crisis and emergency risk communication as an integrative model. J Health Commun. 2005; 10(1):43-55. Doi: https://doi.org/10.1080/10810730590904571.
https://doi.org/10.1080/1081073059090457...
. Given that the present situation is a health crisis, the relationship of interdependence between communication and health becomes, if anything, even more evident, since communication not only explains to the public the risks to which they are exposed, but also aspires to involve them in the solution44 Costa-Sánchez C, López-García X. Comunicación y crisis del coronavirus en España. Primeras lecciones. Prof Inform. 2020; 29(3):e290304. Doi: https://doi.org/10.3145/epi.2020.may.04.
https://doi.org/10.3145/epi.2020.may.04...
.

The key point in crisis communication is the choice of spokesperson. To this end, the credibility and trust that it conveys should be taken into account. In the case of Spain, one of the strands of the Government’s communication work has been to put an expert spokesperson in the field of healthcare on the front line55 Rebolledo M. El desarrollo de la crisis del Covid-19 en España: gestión de la crisis y percepción de la opinión pública. In: Gutiérrez-Rubi A, Pont-Sorribes C, coordinadores. Comunicación política en tiempos de coronavirus. Barcelona: Caátedra Ideograma-UPF de Comunicación Política y Democracia; 2020. p. 39-44.. Fernando Simón, director of the Alert and Emergency Coordination Center of the Ministry of Health, has been in charge of presenting the latest news as the virus has spread, from the beginning of the crisis in Spain. His work as a technical spokesperson has been complemented by a political spokesperson, mainly by Salvador Illa, Minister of Health (until January 26, 2021), and by Pedro Sánchez, Prime Minister, as well as by other ministers who have been interspersed in a string of press conferences.

Theoretical framework

The Covid-19 pandemic has helped to give visibility to the professional work carried out in Spain by healthcare workers, along with their role as experts in addressing crisis situations within public health. In fact, according to an Ipsos poll66 Ipsos. Estudio de la opinión pública sobre la crisis del coronavirus [Internet]. Paris: Ipsos; 2020 [citado 29 Jun 2020]. Disponible en: https://www.ipsos.com/sites/default/files/ct/news/documents/2020-03/estudio_de_la_opinion_publica_sobre_la_crisis_del_coronavirus.pdf
https://www.ipsos.com/sites/default/file...
conducted before the state of emergency started, Spanish citizens held healthcare workers in high esteem with regard to the pandemic and placed them in the top position (35.3% of the sample considered that these workers were highly prepared to face the threat of coronavirus), followed by hospitals and the healthcare system. This trend has been maintained throughout the crisis, as shown by different surveys conducted by various media: healthcare workers are in top position, in the citizens’ view77 López-García G. Vigilar y castigar: el papel de militares, policías y guardias civiles en la comunicación de la crisis del Covid-19 en España. Prof Inform. 2020; 29(3):e290311. Doi: https://doi.org/10.3145/epi.2020.may.11.
https://doi.org/10.3145/epi.2020.may.11...
.

However, healthcare is not a field of activity to which national and regional media devote much space88 Costa-Sánchez C. Medicina y salud en la prensa. Las noticias de salud en los principales diarios de Galicia. Rev Lat Comun Soc. 2008; 63:15-21. Doi: https://doi.org/10.4185/RLCS-63-2008-750-015-021.
https://doi.org/10.4185/RLCS-63-2008-750...

9 Revuelta G. Salud en España durante el período 2000-2009: aproximación a través del análisis de la prensa. Med Clin. 2011; 138(14):622-6. Doi: https://doi.org/10.1016/j.medcli.2011.03.011.
https://doi.org/10.1016/j.medcli.2011.03...
-1010 Carrasco JM, García M, Navas A, Olza I, Gómez Baceiredo B, Pujol F, et al. What does the media say about palliative care? A descriptive study of news coverage in written media in Spain. PLoS One. 2017; 12(10):e0184806. Doi: https://doi.org/10.1371/journal.pone.0184806.
https://doi.org/10.1371/journal.pone.018...
. In fact, there is widespread demand from the healthcare sector for health issues to have greater visibility in the news. In general, healthcare workers have low presence in the media and are only rarely used as information sources by journalists. In the case of nurses, their presence is negligible1111 Mason D, Nixon L, Glickstein B, Han S, Westphaln K, Carter L. The woodhull study revisited: nurses’ representation in health news media 20 years later. J Nurs Scholarsh. 2018; 50(6):695-704. Doi: https://doi.org/10.1111/jnu.12429.
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,1212 Bennett CL, James AH, Kelly D. Beyond tropes: towards a new image of nursing in the wake of Covid-19. J Clin Nurs. 2020; 29(15-16):2753-5. Doi: https://doi.org/10.1111/jocn.15346.
https://doi.org/10.1111/jocn.15346...
. A study analyzing the coverage of health matters in the Spanish press from 1997 to 2004 showed that 49% of the sources of information used in articles about health were people in political-technical positions, while only 26% came from the health-scientific sector1313 Revuelta G. Salud y medios de comunicación en España. Gac Sanit. 2006; 20 Suppl 1:203-8. Doi: https://doi.org/10.1157/13086045.
https://doi.org/10.1157/13086045...
. Information on health matters often comes from administrative and management-related sources and, only to a lesser extent, from specialized sources. In this regard, in a study on information sources conducted by surveying newspaper directors, Mayo-Cubero1414 Mayo-Cubero M. News sections, journalists and information sources in the journalistic coverage of crises and emergencies in Spain. Prof Inform. 2020; 29(2):e290211. Doi: https://doi.org/10.3145/epi.2020.mar.11.
https://doi.org/10.3145/epi.2020.mar.11...
concluded that there was no journalistic specialization relating to covering crises, disasters and emergencies, and that use of unofficial sources (victims and other people affected) was prioritized ahead of official government sources.

Selection of sources is also, precisely, a central element in constructing the information story. Specialized sources are needed in order to transmit health information in a responsible and reliable manner, and to avoid transmitting erroneous or superficial information1515 Muñoz-Maldonado H. Sensacionalismo en la información periodística sobre el hospital Carlos Haya de Málaga: un riesgo evitable. Rev Esp Comun Salud. 2012; 3(1):88-93.. Despite this, healthcare sources have not commonly been the subject of studies in Spain.

How the media develops coverage of a crisis has a clear impact on citizens’ perceptions. Not only does the media influence the selection of topics that are considered news (agenda-setting)1616 McCombs M, Shaw D. The agenda-setting function of the mass media. Public Opin Q. 1972; 36(2):176-87. Doi: https://doi.org/10.2307/2747787.
https://doi.org/10.2307/2747787...
, but also it does so through the approach taken (how the topic is framed)1717 Entman R. Framing: toward clarification of a fractured paradigm. J Commun. 1993; 43(4):51-8. Doi: https://doi.org/10.1111/j.1460-2466.1993.tb01304.x.
https://doi.org/10.1111/j.1460-2466.1993...
. Several studies published in international journals have highlighted the importance of enabling greater media visibility for the healthcare sector with regard to information on health matters that is disseminated1818 Girvin J, Jackson D, Hutchinson M. Contemporary public perceptions of nursing: a systematic review and narrative synthesis of the international research evidence. J Nurs Manag. 2016; 24(8):994-1006.,1919 Summers S, Jacobs H. Saving lives: why the media’s portrayal of nurse puts us all at risk. London: Kaplan Publishing; 2009.. It has been noted that healthcare workers only receive attention as information sources at very specific times, such as during epidemics2020 McGillis Hall L, Kashin J. Public understanding of the role of nurses during ebola. J Nurs Scholarsh. 2015; 4(1):91-7. Doi: https://doi.org/10.1111/jnu.12182.
https://doi.org/10.1111/jnu.12182...
,2121 McGillis Hall L, Angus J, Peter E, O’Brien-Pallas L, Wynn F, Donner G. World health. Media portrayal of nurses’ perspectives and concerns in the SARS crisis in Toronto. J Nurs Scholarsh. 2003; 35(3):211-6. Doi: https://doi.org/10.1111/j.1547-5069.2003.00211.x.
https://doi.org/10.1111/j.1547-5069.2003...
or in situations of medical negligence2222 Forte ECN, Pires DEP, Martins MMFPS, Padilha MICS, Schneider DG, Trindade LL. Nursing errors in the media: patient safety in the window. Rev Bras Enferm. 2019; 72 Suppl 1:189-96. Doi: https://doi.org/10.1590/0034-7167-2018-0113.
https://doi.org/10.1590/0034-7167-2018-0...
, or when they are demanding pay rises2323 Urban AM. Textually mediated discourses in Canadian news stories: situating nurses’ salaries as the problem. Nurs Inq. 2018; 25(3):e12233. Doi: https://doi.org/10.1111/nin.12233.
https://doi.org/10.1111/nin.12233...
.

Given that Covid-19 is a health crisis without precedents within the last century, communicating reliable technical data on this disease is essential, both for managing the crisis itself and for involving society in finding solutions for this situation. Our article is a contribution that follows the line of previous studies and enriches the existing limited investigations around communication and health.

Methodology

Hypothesis

The aim of this investigation was to analyze what the media coverage of the Covid-19 crisis has been like. The treatment of sources and health issues in the information that Radiotelevisión Española (RTVE) broadcast during the period from December 31, 2019, to June 8, 2020, was examined. The information output by this public corporation was taken as a unique case of analysis, given that RTVE 1 is the channel that is regarded as having content of greatest credibility2424 Personality Media. Análisis de imagen de cadenas de televisión–2019 [Internet]. Madrid; 2019 [citado 24 Jun 2020]. Disponible en: https://drive.google.com/file/d/1f4fRtt5Bmo43HKM_mTK0VTW4ayrENbZI/view/
https://drive.google.com/file/d/1f4fRtt5...
.

The two hypotheses that gave rise to the design of this study were:

The Covid-19 pandemic is a health crisis, but despite this, the issue of health has not been the priority in its media coverage. (H1)

Although healthcare professionals are the group of workers most affected and most responsible for operational management of the pandemic, they have not been the main source of information used by journalists. (H2)

In relation to these hypotheses, the following research questions arise:

What have been the main topics in Spanish television news coverage during the pandemic? (Q1)

What have been the main sources used by Spanish television journalists in reporting on the pandemic? (Q2)

To answer these questions, the topics presented in RTVE news broadcasts during the Covid-19 pandemic were identified. It was then examined whether there had been any evolution of the issues addressed between the time when the virus first appeared and the date of June 8, 2020. In addition, the information sources that RTVE journalists used in reporting on the pandemic were identified and the hierarchy among these was defined.

Sample selection

The sample analyzed was compiled in accordance with the following criteria.

  1. In order to obtain a representative corpus of RTVE’s coverage of the crisis, it was decided to collect data from the news program of channel 1 at 3 pm. This is the corporation’s news program with the largest audience, according to data provided by Barlovento Comunicación2525 Barlovento Comunicación. Análisis televisivo 2019 [Internet]. Madrid: Barlovento; 2020 [citado 24 Jun 2020]. Disponible en: https://www.barloventocomunicacion.es/wp-content/uploads/2019/12/analisis-televisivo-2019-BarloventoComunicacion-1.pdf
    https://www.barloventocomunicacion.es/wp...
    and by RTVE itself2626 RTVE. Los Informativos de TVE, los que más crecen en número de espectadores en el mes de marzo [Internet]. Madrid: RTVE; 2020 [citado 24 Jun 2020]. Disponible en: https://www.rtve.es/rtve/20200401/informativos-tve-mas-crecen-numero-espectadores-marzo/2011218.shtml
    https://www.rtve.es/rtve/20200401/inform...
    .

  2. The date of the first news broadcast analyzed (December 31, 2019) was the day on which the Wuhan Health Commission reported a series of cases of pneumonia to the World Health Organization2727 Organización Mundial de la Salud. Covid-19: cronología de la actuación de la OMS [Internet]. Ginebra: OMS; 2020[citado 24 Jul 2020]. Disponible en: https://www.who.int/es/news-room/detail/27-04-2020-who-timeline---covid-19.
    https://www.who.int/es/news-room/detail/...
    . The end date of the sample (June 8, 2020) corresponded to the official start of phase 3 of the de-escalation of crisis measures in Spain (Spanish Official Gazette, BOE, No. 384 of June 2, 2020), which included substantial changes to crisis management (increased powers for regional governments and permission for mobility between provinces and communities). It preceded the completion of the state of emergency (June 21, 2020) and the arrival of the New Normality.

  3. The dates of the news broadcasts finally selected were obtained through a constructed week scheme, which made it possible to have adequate random sampling without the need to select all the days of the total sample2828 Riffe D, Aust CF, Lacy SR. The effectiveness of random, consecutive day and constructed week sampling in newspaper content analysis. Journal Q. 1993; 70(1):133-9. Doi: https://doi.org/10.1177/107769909307000115.
    https://doi.org/10.1177/1077699093070001...
    . Specifically, the timeframe analyzed in this study covered 22 weeks and 6 days, i.e. a total of 160 news broadcasts in the initial sample. Table 1 provides data from the final sample (n = 21 news broadcasts; 3 full constructed weeks) obtained from application of the constructed-week method to the aforementioned time interval.

Table 1
Final sample of news broadcasts (n = 21) obtained using the constructed-week method.

The full viewing of the final sample of news broadcasts was done through RTVE’s(e (e) https://www.rtve.es/alacarta/videos/telediario/ ) news web file. The result from this initial viewing was a database constructed in accordance with the following parameters:

Parameter 1: Selection of study units according to topic. News relating to Covid-19 was selected, following the criterion that one or more of the following terms should be mentioned, clearly referring to the spread of the SARS-CoV-2 virus: “coronavirus”, “virus”, “Covid or Covid-19”, “pandemic”, “epidemic”, “positive”, “infected and lockdown”.

Parameter 2: Classification of the news items according to structure, as follows:

  1. 2.1. Composed of a lead-in by the main presenter (announcer) of the news broadcast and a body of news of varying content.

  2. 2.2. Composed only of an intervention by the main presenter of the news broadcast.

  3. 2.3. Composed of a body of varying content (as in 2.1) but without a lead-in by the announcer.

Parameter 3: Position of the study units. The units were classified according to their position within or outside the initial battery of news headlines (first six minutes of the broadcast).

The complete corpus of the sample consisted of 452 study units.

Content analysis

The methodology used was quantitative content analysis. An ad hoc code for this study was designed in order to obtain relevant data to be able to answer the two research questions posed. The code included nine variables with their respective categories. Two of them provided information on the temporal dissemination of the news (date and phase of the crisis). To this end, the analysis period referred to in the sample was divided into three stages: precrisis, from December 31 to March 14, when the state of emergency started; crisis, including the weeks of lockdown; and post-crisis, which began with the de-escalation, which was decreed on May 4.

The third variable referred to geolocation of the news; the fourth, to the priority topic; three others, to identifying the main sources of information that the journalists used; and the last two, to analysis on constitutive issues regarding the study unit within the information (location and elements that formed it).

The researchers designed an initial analysis code that was applied to 10% of the sample with the aims of improving its effectiveness, resolving interpretation doubts and generating a coding guide to ensure maximum objectivity during the analysis process. After enriching this first code, the final code was applied by the three members of the research team to 20% of the sample. Despite obtaining a very high level of matching, it was decided that in order to ensure maximum objectivity, the entire sample should be encoded by two researchers independently, with subsequent sharing of the results obtained in order to evaluate the level of match in the analysis on each study unit. The analysis on the data obtained through encoding was carried out using the Stata IC-15.1 software. The frequencies and contingency tables obtained in this analysis gave rise to the results described below.

Results

Evolution and areas of coverage

The results showed that the amount of news about Covid-19 increased as the weeks passed by, after the first cases were detected in China. As shown in Figure 1, the amount of news progressively increased over the course of the pre-crisis phase, reaching a climax at the start of the state of emergency in Spain, i.e. at the beginning of the second phase analyzed (crisis phase), with 40 units per news program. This volume of news can be explained by the moment of uncertainty that Spain was experiencing. The number of news items during this second phase was maintained, reaching its maximum (43 units, accounting for the entirety of the news program) almost at the end of this phase, on April 21, 2020. The move to the de-escalation phase was approaching and the uncertainty surrounding this, along with interest in knowing what plans were to be put in place by the Government, promoted increased numbers of news items. The third phase (post-crisis) showed a gradual decrease in the number of news items relating to the virus, until May 23 (end of stage 1 of the de-escalation), when news reduced sharply. From then on, information on Covid-19 rebounded progressively.

Graphic 1
Evolution of the number of news items according to phases of the crisis

Another noteworthy aspect of the news items related to their scope. The following categories were identified for this variable: Spanish, regional, Madrid (this included all the news that focused on the capital), European, American (both South American and North American), Asian, African and oceanic. Nearly three-quarters of the news items focused on the Spanish context, reaching exactly 73.9% if national, regional and Madrid news were summed. This was followed by 11.5% at European level, which related mostly to countries close to Spain such as France, Italy and Germany. Lastly, there were news items at the global level and others focusing on the Americas, where the presence of the United States stood out from other parts of this region such as South America. News from the Asian continent referred, above all, to China.

Graphic 2
Scope of news items in percentages.

A statistically significant relationship was detected between the number of news items and their scope (chi-square test; p = 0.004). The analysis period covered by the sample, as already noted, was divided into three phases (precrisis, crisis and post-crisis). Analysis on the evolution of each phase showed that, during the precrisis phase, the news focused mainly on Spain and, to a lesser extent, on its regions. This dynamic was maintained at the beginning of the state of emergency: the difference in the number of news items between the two areas was large, with 55% of news items dedicated to the national level. In the post-crisis period, there was a change in trend. Nationally focused news continued to take precedence, but news dedicated to Europe began to take center stage. European measures under negotiation between member states and ongoing discussions on the economy and the opening of borders may explain this increase in the European presence in news items in this de-escalation phase.

Table 2
Scope of news items according to the phase of the crisis, in percentages.

Topics

The issue on which the greatest amount of news was disseminated was the legal measures of various kinds taken by the Spanish government: more than 20%. These ranged from measures to restrict mobility to regulations for the end of closure of business activities. The second most present topic was the monitoring of the numbers of deaths and cases of infection, accounting for 13.5% of the news items. The economy also occupied an important place, with almost 12%. Most of this news related to the economic consequences at the general level of the country’s economy, along with the obstacles faced by entrepreneurs and self-employed people in carrying out their projects.

As shown in Figure 3, health issues did not fall within the main topics: only just over 9% dealt with health issues. This confirms the first hypothesis of the present investigation: the topic of healthcare has not been the priority within media coverage, even though the Covid-19 pandemic is eminently a health crisis. It is striking that issues linked to political debates and disagreements (government versus opposition and central government versus regional governments) were more present than health issues, i.e. resources and supplies, attention, planning, medical protection, etc.).

Graphic 3
News topics in percentages.

Looking at the topics covered during the different phases of the crisis, it can be seen that in the first stage, during the period before the state of emergency, the main topic consisted of monitoring the numbers of deaths and cases of infection, which accounted for more than 32% of the news items. Afterwards, this was followed by political topics and, very closely but curiously, by sport (with 13.2% and 12%, respectively). During this period, healthcare issue appeared in sixth place. The low media visibility of this field can be explained by the remoteness of the source of the virus from the environment of Spain and Europe. The first cases in Spain and Europe were not detected until February and thus were not discerned as a real threat at the time of this first phase.

Once the state of emergency had been declared, the trend changed. The change in the citizens’ way of life constituted a radical break in social dynamics, which would explain the presence of this topic. The predominant issue was the legislation that was being brought in, to regulate the weeks of lockdown, rather than deaths and cases of infection. This was followed, albeit with a much smaller percentage, by news on healthcare issues and, at almost the same level, by news on the economy, both with just over 12% of the news items. It was striking that economic and healthcare issues attracted almost the same level of media interest. The fact that the space granted to healthcare issues only reached 12% reaffirms that these were not one of the main issues, even at the height of the crisis, when healthcare services were overwhelmed. This dynamic became accentuated upon moving to the post-crisis phase, in which healthcare news barely reached 4% of the total disseminated. In fact, in this last phase, news on politics was also more important than news on health matters. The legislation relating to the de-escalation at its various stages was the main issue, followed by political issues and then news relating to the economy.

Table 3
News topics according to the phase of the crisis, in percentages.

Information sources

Analysis on the direct sources used in Covid-19 news formed another strand of the present research. Any testimony provided by any social agent (including journalists and correspondents at street level) that was given an audiovisual or sound presence in the broadcast content was considered to be a direct source.

To code the information sources, the following categories were distinguished, based on the study by Casero-Ripollés and López-Rabadán2929 Casero-Ripollés A, López Rabadán P. La evolución del uso de fuentes informativas en el periodismo español. In: Comunicació i risc: 3o Congrés Internacional Associació Espanyola d’Investigació de la Comunicació; 2012; Tarragona. Tarragona: Universitat Rovira i Virgili; 2012. p. 95-106.: “only the presenter of the news”, when the presenter told the news story in its entirety; “no sources appeared”, when the body of the news consisted of images and a voiceover by the announcer; “journalists”, including those who reported from the ground, correspondents and reporters; “citizens”, both Spanish and those of other countries; “political sources”, including the Government as a whole, the opposition, regional politicians and international leaders; “entrepreneurs”, ranging from business owners to representatives of business associations; “experts”, such as epidemiologists, psychologists and statisticians, among others; “sport practitioners”, i.e. active professionals and people in sports-related management positions; “hybrid source”, i.e. people in technical positions that are between political and health-related, such as Fernando Simón; “healthcare sources”, ranging from doctors and nurses to representatives of healthcare entities; and “others”, which included artists and people involved in cultural activities, along with other sources that did not correspond to any of the above categories. See the full breakdown in Table 4.

The data obtained showed that the main voices that narrated the pandemic in the RTVE news broadcasts were those of communication professionals. In fact, in 33.6% of the news items, journalists or correspondents in the street were the first direct source of information to support the broadcast content. In addition, in almost 24% of the news items, there was no source of information and the item was narrated in full by the presenter or by a voiceover. It is also important to mention that in more than half of the news items, there was no second source of information, and in more than 66% of them, there was no support from a third source.

Table 4
Overview of sources used in the news, broken down into the 1st, 2nd and 3rd sources used.

Testimonies from citizens of both Spain and other countries have been one of the most recurrent information resources of journalists. Their voices were used as the first source in almost 8.4% of the news items analyzed here; as a second, in 11%; and as a third source, in 10.1%, thus surpassing the voices of representatives of political entities and public institutions as second and third sources, by several percentage points. A detailed analysis of the latter source category showed that government citations reached the highest percentage of media visibility as the first and second official sources in this group, followed by regional leaders. The hybrid spokesman – Fernando Simón, halfway between politicians and healthcare workers – achieved a significant percentage of prominence (2.6% as the first source), although he did not reach the media visibility that all government representatives received in the coverage of Covid-19.

However, healthcare workers only appeared as the main source in 2.4% of the news items. They were significantly surpassed by the testimonies of entrepreneurs (5.9%), sports practitioners (4.6%), experts (4.2%) or people in other professions such as the police, military or the arts (5%). While healthcare workers’ presence as a second source of information brought their rate up to 4.8%, the data presented confirm the second hypothesis of this study: although healthcare professionals were the professional group most affected by Covid-19 and were the ones responsible for its operational management, they were not the main source of information for journalists during Covid-19 coverage. Within this category, it is worth noting that nursing professionals experienced media invisibility, despite accounting for the largest proportion of the healthcare workforce (70%). It is also worth noting the sparse media presence of healthcare associations.

Graphic 4
First sources used in news items, in percentages.

Discussion and conclusions

This investigation analyzed the media visibility of the healthcare sector within the coverage of RTVE’s news broadcasts. On the one hand, we focused on seeing the extent to which the issue of health during the Covid-19 crisis was present in the news; on the other hand, whether healthcare sources were used by journalists to construct news items.

Our first starting hypothesis established that, although the Covid-19 pandemic is a health crisis, the issue of health was not the priority within media coverage. The study showed that health was not the main topic within the coverage, nor was it among the main topics covered in the news. In this way, we also answered our first research question: what were the main topics in the coverage of Spanish television news during the pandemic? Through content analysis, we found that the main topics were the legal measures taken progressively by the Government and monitoring of the numbers of deaths and cases of infection, which was present mainly in the second and third phases. In contrast, health and the healthcare consequences of the pandemic had limited space within the coverage. Indeed, political issues had more presence than healthcare issues (except in the crisis phase), along with economic issues. It was striking that, in the post-crisis phase, healthcare information was one of the least addressed topics. After the peak of the pandemic had passed, it was seen that the interest in the de-escalation process lay in the return to economic activity and freedom of movement of citizens. One of the debates regarding management of this crisis has focused precisely on whether experts should have a greater role than policy makers in official communications from institutions. Although the Government had intended to balance these two profiles by putting Fernando Simón on the front line (with his hybrid profile between the healthcare and political spheres), the coverage showed that greater prominence was given to people with a purely political profile.

This study also confirmed our second hypothesis: healthcare professionals were not the main source of information used by journalists, despite effectively being responsible for management of the pandemic. Thus, we also answered our second research question: what were the main sources that Spanish television journalists used when reporting on the pandemic? The main sources were the media professionals themselves, such as journalists, correspondents and reporters. In addition, we saw that a high percentage of news items did not use external sources, i.e. they were compiled by the editorial personnel. Here too, it could be seen how politics took up more space in terms of sources than healthcare: during the crisis, journalists turned more to politicians and public representatives than to specialized healthcare voices. Among the first sources for news items, politicians accounted for 8.8%, while healthcare workers only accounted for 2.3%, while hybrid sources accounted for more than healthcare workers, at 3.1%.

These findings are not strange, given that they confirm results from previous studies on the media-healthcare binomial. It therefore seems necessary to implement measures to make the media and healthcare sources work together better. Ways to ensure that health information is more present and is more appropriately transmitted in a specialized manner by the media need to be sought. We even saw in our study how citizens were preferred as sources, rather than specialized testimonies. The frequent demand from within the field of healthcare for ties with the media to be strengthened in order to work together better is not a trivial matter. Communication committees may be the key to improving this situation, as some authors have pointed out3030 González H. Estrategias de comunicación en las ONG de desarrollo: departamentos, funciones e impacto en los medios. Madrid: CIDEAL; 2006.,3131 Almansa A. Del gabinete de prensa al gabinete de comunicación: la dirección de la comunicación en la actualidad. Salamanca: Comunicación Social; 2011..

This research makes a general contribution to the field of studies on communication and health. Specifically, it provides systematic data on the media visibility of the healthcare sector. This is an area of research that remains underdeveloped, with only some studies focusing on epidemics. Nonetheless, the contributions from our research are not exempt from some limitations. Firstly, a single news program from a single public television network was analyzed. In future studies, it would be interesting to enrich this research by comparing information of different kinds, such as from private networks. In this way, it may be possible to see differences in how health-related issues are covered, thus adding to the findings from our study. Secondly, the time period chosen, although justified, did not cover the total duration of the pandemic, given that it is still continuing on its course. In this regard, an extension of the sample could be presented in another study. Along these lines, a comparison of the media coverage of this health pandemic with past pandemics would also help in gaining better understanding of the dynamics of the media and journalists in situations in which they need to communicate about issues for which specialized information becomes essential.

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Publication Dates

  • Publication in this collection
    19 Apr 2021
  • Date of issue
    2021

History

  • Received
    15 Sept 2020
  • Accepted
    31 Jan 2021
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