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Newspapers’ Framing of Elder Abuse

NEWSPAPERS’ Framing of Elder Abuse: It’s NOT A FAMILY AFFAIR

ABSTRACT

This article describes media coverage of elder abuse from 2003-2005. Guided by agenda setting and framing literatures, eight newspapers’ elder abuse coverage (N = 161) was content analyzed. The stories covered most often featured episodic frames, 57.1%, while a majority, 65.2%, of the coverage framed elder abuse as an individual- as opposed to a societal-level problem. The coverage did not reflect findings of empirical research. Most elder abuse occurs in domestic settings; yet, the newspapers’ coverage most often focused on elder abuse in long-term caresettings. Elder abuse advocates are encouraged to use media advocacy to work with the media for a purpose of encouraging more balanced elder abuse coverage.

Key Words: elder abuse, framing, agenda setting

NEWSPAPERS’ Framing of Elder Abuse: It’s NOT A FAMILY AFFAIR

The 2004 Survey of State Adult Protective Services (APS) (Fact Sheet, 2006) reported a 19.7% increase in the total combined reports of elder and vulnerable adult abuse[1] and neglect. Thirty two states separated out elder abuse, reporting 253,426 elder abuse cases, which represents 8.3 reports of abuse per 1,000 older Americans. In 2003, APS investigated 192,243 cases of alleged elder abuse in 29 states. In 24 states, 46.7% of the cases were substantiated. A majority of the cases, 89.3%, occurred in domestic settings, and most of the alleged elder abuse perpetrators were adult children, 32.6%; followed by other family members, 21.5%; and spouses/intimate partners, 11.3% (Fact Sheet, National Center on Elder Abuse, 2006).

Various official reports suggest thatmistreatment of the elderly is an increasingly important public health topic(Payne, 2005).It is estimated that every year 2.1 million older Americans are victims of physical, psychological, or other forms of abuse and neglect. Furthermore, experts maintain that for every case of elder abuse and neglect that is reported there may be as many as five that go unreported (American Psychological Association, 2007).

Furthermore, given that the population aged 65 years or greater is estimated to double by the year 2030(CEDDS, 2004), elder abuse poses a serious threat to social welfare systems as well as to individuals. In addition, although media coverage of elder abuse has grown recently, there has been little academic attention directed at empirically analyzing how the media portray elder abuse(Beard Payne, 2005).

Numerousstudies have suggested problems in crime related news reporting, such as distortion, misrepresentation, and oversimplification (e.g., Stevens & Dorfman, 1997; Ditton & Duffy, 1983; Barlow, Barlow, & Chiricos, 1995). According to Stevens (1998), journalists report violence from a criminal justice perspective, with an emphasis on isolated episodes rather than providing a comprehensive picture of violence as an epidemic. More specifically, the media typically report crime as an individual problem rather than as a societal problem. Stevens (1998) suggested an alternative reporting practice that focuses on thematic reporting of violent events and provides causal and contextual details to aid audiences’ understanding.

While public health experts, scientists, and epidemiologists already have taken a public health approach to crime, the media have failed to join this movement (Stevens, 1998). Because the media play a critical role in shaping public attitudes and behaviors regarding public health issues (Wallack, Dorfman, Jernigan, & Themba, 1993), it is important to explore how the media portray elder abuse, especially whether they take a public health approach or a criminal justice approach in dealing with the issue.

Literature on media coverage and health issues have shown that media frames of public health issues and the way the media typify them has significant influence on public attitudes and policies (Klaidman, 1991; Wallack, Dorfman, Jernigan, & Themba, 1993). Therefore, this study quantitatively and qualitatively explores:(1) howselected major newspapers’typifyelder abuse,and (2) theframesthat emerge from the newspapers’elder abuse coverage. Study results will provide insight into elder abuse perceptions held by the general public and the political community based on information printed in national newspapers.

LITERATURE REVIEW

Elder AbuseHistory

Elder abuse emerged as an issue during the late 1970s on the heels of child abuse and what was then known as spouse abuse. In the 1980s the issue was defined as a social problem similar to child abuse. By the end of the 1980s, a conceptual shift occurred in which experts began characterizing elder abuse as being more similar to spouse abuse than child abuse.

State laws with little to no coordination were quickly passed to address elder abuse, which resulted in a range of differences in key areas: how elderly was defined; how elder abuse was defined; classification of elder abuse as criminal or civil; reporting standards; investigation standards, and sanctions recommended for elder abuse (Beard & Payne, 2005). These differences also had a tremendous impact on how researchers studied elder abuse. In particular, it was virtually impossible to compare elder abuse issues across states. Furthermore, the nature of elder abuse made it extremely difficult to obtain representative samples of individuals who had been abused for three primary reasons: 1) elder abuse often occurs in domestic setting, which can result in abuse not being report,2) in some instances those abused are not capable of reporting the abuse, or 3) they choose not to report the abuse for fear of retribution.

Further complicating research in this area, by the 1990s elder abuse had been redefined as a criminal problem rather than a social problem. This shift resulted in the police and other social service agencies taking the lead in addressing the issue. Law enforcement agencies developed special units to deal with older victims, Medicaid Fraud Control Units expanded their efforts to detect patient abuse in nursing homes, and legislatures increased penalties for offenses involving older victims (Beard & Payne, 2005).

Elder Abuse as a Public Health Issue

A traditional approach to violence has been a criminal justice approach, which has a focus on incarcerating violent offenders or providing medical treatment for victims (Hammond et al., 2006; Mercy et al., 1993). This approach discourages development and implementation of strategies aimed at preventing violence (Hammond et al., 2006). Thus, the criminal justice approach has been criticized as being reactive rather than proactive. Acknowledging the limitations,scholars have argued that violence should be treated the same as other social diseases (Dorfman et al., 1997).During the 1970s,a public health perspective of violence and crime emerged (Krug, Mercy, Dahlberg, & Zwi, 2002). As a result, violence became a legitimate topic for academic public health research (Winett, 1998). Advantages of the public health approach include an emphasison prevention, an integration of diverse scientific disciplines and organizations, anda development of prevention programs based on empirical results(Mercy et al., 1993). However, violence has received limited attention from health communication scholars until recently (e.g., Coleman & Thorson, 2002; Rodgers & Thorson, 2001; Thorson, 2006; Dorfman, Thorson, Stevens, 2001; Meyer, Roberto, Boster, & Roberto, 2004; Nabi & Southwell, & Hornik, 2002).

Elder abuse and neglect is a major health issue that has received increasing attention during the past decade in both social science and media venues. The consequences of elder abuse and neglect affect not only the individuals involved, but also society at large. In particular, quality of life for neglected and abused individuals is severely jeopardized due to lower levels of functioning, progressive dependency, poorly rated self-health, feelings of helplessness, social isolation, stress, and further psychological decline (Dong, 2005; Muehlbauer & Crane, 2006). From a societal perspective, the costs of abuse and neglect include increasing levels of government health care spending, higher hospitalization rates, and insufficient dependency ratios (Post et al., 2006). Therefore, it is important that elder abuse be examined within a conceptual framework that grounds the health issue as a societal problem, which foretells the need to establish solutions and interventions generated within governmental, public health, and community sectors.

Elder abuse has characteristics that are distinct from other types of public health issues. Specifically, there is evidence that a substantial number of elder abuse incidents go unreported or are not known as they are not included in official statistics for various reasons, for example, victims’ inability to report the abuse, the abuse often occurs in the family and hence remains “hidden”, and victims’ lack of awareness that they are being abused (American Psychological Association, 2007;Payne, 2005).Also, although psychological abuse and neglect, as distinct forms of elder abuse, are the most prevalent, they are the least understood components of elder mistreatment (Fulmer, Paveza, Abraham, & Fairchild, 2000). Previous research has identified a broad array of risk factors, such as caregivers’ mental health, substance abuse, dependence on the care recipient, and depression.

Because there are various types of elder abuse and it is often complicated with other types of abuse, crime, or social issue, the definition of elder abuse has changed over time. Since the media have significant influence in regard to defining the characteristics, problems, or solutions of public health issues, it is important to explore their elder abuse coverage. The following section describes the theoretical framework used in this study to understand one medium’s elder abuse coverage.

The Mass Media and Public Health

The mass media play a critical role in shaping public opinion and public policy formation for various social issues. By bringing attention to specific issues through their agenda setting function(McCombs & Shaw, 1972), the media set agendas for policymakers and the public. In addition, the manner in which the media present a healthissue defines the problem, and in turn, influences individuals’ and societies’ decisionsin regard to adopting one solution among several alternatives.That is, by emphasizingone particular aspect of the health issue over another, news coverage provides a lens by which the public views health issues and associated outcomes. In examining newspapers’ coverage of elder abuse, this study focuses on selectednewspapers’ typification and framing of the issuefor the purpose of providing a better understanding of how elder abuse is defined and the solutions offered to counter elder abuse.

Media Typification of Public Health Issues.Media typification refers to media practices that characterize and illustrate a view on a social problem. The concept of typification is based on the constructionist perspective ofunderstanding social problems. While the objectivist approach focuses on the nature and cause of the condition in which an event or issue becomes a social problem, in the constructionist approach, problems are defined without reference to the conditions themselves (Neuman, 1998). Rather, the latter sees that social problems are constructed based on cultural, political, or historical context by claimsmakers. Claimsmakers are those who assert and promote a definition for a given situation as a problem (Spector & Kituse, 1977), and they typify a problem by emphasizing certain aspects of the problem (Best, 1989). The media are deemed to play a critical role in typification and construction of social problems by serving as primary claimsmakers (Lowney & Best, 1995). Furthermore, the way they typify a certain issue could generate public outcry and policy responses to it (Lowney & Best, 1995; Johnson, 1989).

Health and risk issues including crimes are also socially constructed and they are brought to public attention through claimsmaking by activists, policymakers and/or the media (Spector & Kitsuse, 1977). For example, Johnson (1989) addressed how perceptions of child abuse changed as a result of the media’s portrayal of the issue.The media’s manner of portraying child abuse has played “a prominent role in the political, social, and institutional success of the child maltreatment movement” (Johnson, 1989, p. 19). Similarly, Lowney and Best (1995) explained how media claimsmaking influenced the construction of stalking as a social problem.

Analysis of the media’s coverage of elder abuse in regard to typification may provide insight regarding how the issue has been socially constructed. Discussing the social construction of crimes, Lowney and Best (1995) suggested that “claimsmakers typify the timing, location, interaction patterns, and consequences of crimes” (p.33). Claims on crimes tend to “define types of crime in terms of both their actors and the nature of the activity” (p. 33). Exploring the interaction between criminal actors and the nature of their criminal activity is important for understanding the complexity of elder abuse because an overwhelming majority of elder abuse and neglect incidents are committed by known perpetrators, such as an adult child or spouse[2]. However, it is an empirical question whether these characteristics of elder abuse are reflected in the media’s portrait of elder abuse. Therefore, in examining elder abuse typification, we focus on characteristics of actors, interactions, and broader social settings. Based on this conception, the following research questions are posed:

RQ1: How did the newspapers(under consideration) typify elder abuse?

RQ1a:How was male to female victimization characterized in the newspapers’ elder abuse coverage?

RQ1b: How was the relationship between abused and abuser characterized in the newspapers’ elder abuse coverage?

RQ1c: In the newspapers’ elder abuse coverage, in what settings did abuse typically occur?

RQ1d: In the newspapers’ coverage of elder abuse, were the abuse cases more often acts of commission (i.e., active) or acts of omission (i.e., passive)?

RQ1e: What types of elder abuse were featured most often in the newspapers’ elder abuse coverage?

RQ1f: What causes of elder abuse were featured most often in the newspapers’ elder abuse coverage?

Media Framing and Public Health Issues. Framing is one of the techniques through which social problems are constructed. Frames define problems, identify causes, or suggest solutions for social issues (Entman, 1993). Through the framing process, certain aspects of issues may be left out while others are amplified. Existing studies indicate that how an issue is framed greatly influences public attitudes toward that issue (Goffman, 1974; Sherif, 1967). By framing social issues in a certain way, the media not only tell the public what to think about but also how to think about an issue (Cohen, 1963). Subsequently, the way an issue is framed helps create the basis for public policy.

Scholarshave suggested that framing has a great impact on public health in the domain of health policy formation (Dorfman et al., 2005; Wallack et al., 1993; Walsh-Childers, 1994) and “the media may affect the nature of regulation, the course of litigation, or the direction of research and development” (Nelkin, 1989, p. 54).Acknowledging the critical role of media framing, many scholars have studied media framing of various public health issues, such as breast cancer and obesity (e.g., Andsager & Powers, 2001; Lawrence, 2004).

In general,there are two perspectives on framing: an exceptionalistic perspective and a universalistic perspective (Wallack et al., 1993).An exceptionalistic perspective views social problems as individual problems, whereas those who espouse a universalistic perspective maintain that “problems are rooted in the nature of social arrangements and are predictable rather than accidental events” (Wallack et al., 1993, p. 11).Iyengar’s (1991) distinction of thematic and episodic framesreflects these opposing positions. News reports that adopt episodic frames tend to focus on specific and concrete events or individuals, while thematic frames are more issue oriented. Episodic frames illustrate social problems with individual-level examples and attribute cause responsibility to individuals. On the other hand, thematic frames tend to describe the issue in a more complicated social context and present the collective cases of an issue.

In addition to the type of framing, it is also important to explore how the problems and solutions to the problem are presented in the media. A social problem can be presented as individuals being responsible for the problem or as society being responsible for the problem. Wallack et al. (1993) argue that “the view that social and health problems are individual problems pervades the society and is reinforced through framing in the mass media” (p. 69). They suggested that, in America, the mass media tend to frame social and health problems based on individualism, and, as a result, audiences tends to see these issues as individual issues, disassociated from broader social systems. For example, many health stories focus on lifestyles and provide tips and solutions based on personal behaviors (Campo & Mastin, forthcoming; Mastin & Campo, 2006; Wallack et al., 1993). As a result, primary strategies for many health promotions focus on individual-level solutions and uphold them as the entire solution.

It is possible that a news report adopts a thematic frame but defines the problem and solution at either an individual or societal level. For instance, a news report may describe financial exploitation targeting elders as a social issue, but either: focus on the individual moral issue and warn personal caution; or focus on the lack of regulatory systems to protect the elderly and proposenew legislation. While examining thematic/episodic framing tends to focus on the overall style of discourse articulated by news coverage, exploration of the framing of level of solution and problem is concerned with whether media coverage attributes the elder abuse causes and solutions to either individual behaviors or to social systems. Therefore, in what follows we distinguish the framing of problem and solution separately from thematic/episodic framing. With this rationale, the following research questions are put forth:

RQ2: How did the newspapers frame elder abuse?

RQ2a: Was the newspapers’elder abuse coverage more often framed in an episodic or a thematic frame?

RQ2b: Were individual- or societal-level problems more often featured in the newspapers’ elder abuse coverage?

RQ2c: Wereindividual- or societal-level solutions more often featured in the newspapers’ elder abuse coverage?

METHOD

Sample

Content analysis was used to examine selected newspapers for a three year period, 2003-2005. This timeframe was selected because of the convenience of archives stored by the American Society of Adult Abuse Professionals and Survivors (ASAAPS)[3].In addition, using the ASAAPS archive made it possible for us to examine 2003–2005, which represents the last year and the two subsequent years examined in the Beard and Payne (2005) study.During 2003-2005, ASAAPS used Google to gather elder abuse articles featured in newspapers across the country. The newsfeed database served as a sample frame for this study and the article titles were used as key words.