Global health journalism, a beat in flux
Filed under: Europe, Health journalism, Hot Health Headline, Studies
If it’s 32 pages on the present and future of journalism and major global health issues you seek, look no further than the Kaiser Family Foundation’s Taking the Temperature: The Future of Global Health Journalism (PDF). The paper’s authors, Nellie Bristol and John Donnelly, interviewed 51 reporters, editors, freelancers and producers from across the media landscape and assembled their findings into a sort of “state of the industry” report.
Their report opens with a bit of a paradox. At the very moment that the news industry in general and global health coverage in particular is on the decline worldwide, overall funding for global health has surged, thanks in large part to the American federal government and high-profile private organizations like the Gates Foundation. That isn’t to say, of course, that those organizations have been absent from the media arena either.
In fact, throughout the course of the report, you can’t help but notice just how many global health reporting efforts are funded by public media or Gates and company. Thanks to these funds and the evolution of media in the United States, the global health reporting landscape seems to be shifting as more journalists exit the discipline and more purpose-driven organizations slide in to take their places. Furthermore, these new pressures, both positive and negative, have arrived alongside a shift in the focus of the beat itself.
Many interviewees noted that increasingly, stories they covered tended towards infectious disease outbreaks, like influenza, and disaster related health issues. This was not only a resource issue, but what some saw as story fatigue or lack of fresh angles on health stories in developing countries, especially related to HIV/AIDS. Many, though not all, found policy angles, such as U.S. government efforts to improve global health, difficult to incorporate into their stories, much less serve as a focal point.
Major news organizations like The Associated Press and New York Times have shuttered foreign bureaus and tightened their travel budgets, and the funds allocated for freelancers are falling across the board.
The current financial reality for many global health freelancers, whose work is viewed as filling the gap created by media staff reductions, is pretty grim. Samuel Loewenberg who has written on global health issues for publications ranging from The New York Times to The Lancet, said freelance rates for many publications have fallen. Arthur Allen, a former AP staff writer and now an author and freelancer, said a prominent online publication recently dropped its rate from $1,000 to $500 a story. Another pays $300 a story. “I asked why they are decreasing payment and they say, ‘Some people are writing for nothing,’” Allen said. “It’s a hobby for people who have other gigs. …Certainly doctors and lawyers have a lot to say about things, but it’s difficult for people like me who are journalists.”
As an interesting aside, The Boston Globe has replaced those traditional coverage extenders, travel and freelance, with something more direct: Skype and the cell phones that are now commonplace in even the more remote bits of the planet.
Amid the tales of industry-wide retreat that fill the report, there’s one clear bright spot: academic and professional journals. The authors found journal staffers to be particularly optimistic about their profession and optimistic about the future.
Medical, science and health policy journals have expanded their global health reach, supported both by grants and a larger global health professional audience. While the journals’ primary purpose is to publish research, several also now offer news columns or field-based reporting that focus on global health.
The health highlights of two years of Guardian data
Filed under: Europe, Health data, Health journalism, Public health, Public records, Tools
In two years, the Guardian’s data blog has published more than 600 data sets. I know this because, thanks to their nifty summary post, I just browsed the full list. In addition to more than a few UK analogues to the sort of stuff we see from AHRQ and NCHS, such as UK life expectancy, birth rates and aging populations and public spending, they’ve also got the sort of global health stuff that any journalist or blogger could pull out and use in a post tomorrow. I’ve collected some of my favorites and tried to strike a good balance between unique stuff and broad-spectrum, widely available global health data.
- Cancer rates: see how countries compare worldwide
- Assisted suicide statistics: the numbers Dignitas helps to die, by country
- What’s happened to measles immunisation - and how do we compare to the rest of the world?
- There’s more to life than GDP
- Hunger by numbers: How we are losing the battle against worldwide malnutrition
- The world in drugs use
- Condom use around the world
- Obesity around the world
And finally, for no particular reason, here’s the outcome of every freedom of information request ever filed by the BBC. Also in the category of “data for curious journalists/insiders”? Several years of UK libel cases.
Rather on drug resistance, psychology and Norwegian fish farms
Filed under: Europe, Hot Health Headline, Pharmaceuticals, Public health
Dan Rather Reports, HDnet’s investigative series, has devoted its latest episode to antibiotic overuse and the resistance it has created. A transcript of the hourlong program is available in PDF format. Rather focuses first on primary care physicians and upon understanding the psychological and economic pressure they’re under when they choose to prescribe antibiotics that might not be strictly necessary. When he talked to Dr. Rita Mangione-Smith of Seattle Children’s Hospital, she illustrated that those forces can and have overcome clinical good sense.
In the 1990s, it was really bad. Okay, there are a couple of studies that were done – that were published in the Journal of American Medical Association, in JAMA, that showed that if you looked at national level data, we were, you know, prescribing antibiotics in greater than 50 percent of outpatient visits for most children with colds. And antibiotics do nothing for colds.
Rather extends this focus on psychology to his investigation of antibiotic-averse Norway as well. Norway, as you have likely heard, has kept antibiotic use and resistance so low that even good old penicillin can be relied upon there to fight many bacterial infections. While others have focused on Norwegian central policy, Rather also considers how Norwegian mores and attitudes toward medical intervention have helped that country’s physicians resist the temptation to overprescribe antibiotics.
As Gunnar Simonsen, head of that country’s microbial resistance surveillance system, told Rather, “Many Norwegians will not like to take drugs unless strictly necessary. That’s not a kind of an official policy. That’s how we were brought up.” Simonson said the other pillar of his anti-resistance campaign was simply infection control – fewer bacterial infections means fewer opportunities to use antibiotics.
In addition to primary care physicians, Rather looks at that other great breeder of resistance: large-scale livestock feeding operations. Here, he contrasts the well-known American story to that of Norway, where antibiotic use in industrial fish farming was slashed 97 percent from 1994 to 2008. Over that same time, farmers say they actually increased fish survival rates by replacing the antibiotics with vaccines. Prevention instead of cure.
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International cooperative to share health data
Filed under: Europe, Health data, Health policy, Hot Health Headline, Public health, Public records, Tools
Writing that “the importance of data sharing in advancing health is becoming increasingly widely recognised,” 17 major public health players entities, from the CDC and AHRQ to the Bill and Melinda Gates foundation and the World Bank, have banded together to form a sort of data cooperative around the Wellcome Trust and the Hewlett foundation. In a Lancet commentary announcing the initiative, Wellcome director Mark Walport and Hewlett president Paul Brest write that, while fields such as genetics and molecular biology, a mature data-sharing system has sped up discoveries and increased efficiency, public health is lagging behind.
Much of the infrastructures, technical standards, and incentives that are needed to support data sharing are lacking, and these data can hold particular sensitivities. And some researchers are reluctant to share data. Too often, data are treated as the private property of investigators who aim to maximise their publication record at the expense of the widest possible use of the data. This situation threatens to limit both the progress of this research and its application for public health benefit.
Each organization will work within its own structure and their initial goals include the creation of data standards to facilitate sharing as well as increasing the prestige of creating public data sets. They acknowledge there will be some bumps along the way, but call on other organizations to join the initiative and to pursue the long-term goal of the widespread, fair and privacy-respecting sharing of public health data.
Researchers examine long-term effects of vitamins, vaccines on children’s immune systems
Filed under: Children, Europe, Hot Health Headline, Public health
For a 40-minute documentary broadcast on BBC Radio 4 and produced by Anthony Baxter, reporter Richard Phinney visited a small, long-running public health outpost in Guinea Bissau where a team of Danish and African researchers has studied the long-term effects of vaccines and vitamin supplements on the immune systems of children. The team has published reams of research and influenced WHO policy, but Phinney focuses on what he calls their most “explosive” findings.
They show that the world’s most commonly used vaccines can strengthen - or weaken - a child’s immune system in the long term, and affect their ability to fight off disease. The results directly challenge the WHO’s global health advice, followed by most countries in the developing world, and could mean that thousands of young lives, in Africa and beyond, are needlessly at risk.
Programming note: The program will only be available to download worldwide for a few more days.
Update: The audio is no longer available at the earlier link but it is available, in two parts, on this page. Search the page or scroll down for “Vaccine Detectives.”
BMJ: Wakefield’s vaccine-autism study fraudulent
Filed under: Children, Europe, Health journalism, Pharmaceuticals, Public health
The Internet and other media are abuzz with the news, published by BMJ yesterday, that the study published in The Lancet in 1998 by Dr. Andrew Wakefield linking autism to the MMR vaccine was fraudulent. The study of 12 children is frequently cited as proof that vaccines cause autism or play a part in the disorder, despite the fact that it was retracted. The BMJ calls the study “fatally flawed both scientifically and ethically” in a new editorial.
Covering Health has compiled some links to interesting reading on this subject, much of it specifically for journalists.
Ivan Oransky, on Embargo Watch, looks at an entirely different facet of the news with “Does a tweet break an embargo? A case study involving the BMJ, autism, vaccines, and an alleged hoax.”
Meanwhile, Gary Schwitzer, publisher of HealthNewsReview.org, writes that the Wakefield MMR/autism dismantling demonstrates what a difference one journalist can make.
CNN’s Anderson Cooper interviewed Andrew Wakefield last night about the charges that his study was flawed. And Brian Deer, the investigative journalist who reported the BMJ story, was interviewed on CNN’s World Report.
Update: Seth Mnookin, who has spent two years looking into vaccine scares, has written an interesting post about the topic, including his view that BMJ over-hyped its story, which almost certainly helped drive media coverage. Mnookin also appeared on CNN.
By sending out breathless press releases and prepping the worldwide media for a series of bombshell stories, the BMJ created the impression that this was fundamentally new news – and it wasn’t. We knew that Wakefield’s work wasn’t reliable or accurate on January 3 – and we still know that today. The stories that are currently running are not really all that different in tone or content than the stories that ran almost exactly a year ago, when a UK medical panel found there was sufficient evidence to justify stripping Wakefield of his right to practice medicine.
Covering Health posts
- Parikh examines media’s role in vaccine-autism link
- CDC: Nearly 1 percent of U.S. kids have autism
- Autism and vaccines: A failure to communicate
- Tribune: Lupron to treat autism is ‘junk science’
- Anger at radio host shapes autism performance
- CDC working to uncover cause of autism
- Newspaper: Landmark autism study used fixed data
- Review finds no link between vaccines, autism
Tip sheets
- Background on autism from Pauline A. Filipek M.D., director of the Autism Program for OC Kids Neurodevelopmental Center and associate professor of clinical pediatrics and neurology at the University of California, Irvine, School of Medicine.
- Investigating alternative treatments for autism: Trish Callahan & Trine Tsouderos, of the Chicago Tribune, wrote “Dubious Medicine,” a look at the world of alternative treatments for autism, treatments that are often risky and unproven.
Contest entries
- Dubious Medicine, Trine Tsouderos and Patricia Callahan, Chicago Tribune
- The Truth About Autism: Scientists Reconsider What They Think They Know, David Wolman, Wired
- Is it Autism?, Norine Dworkin-McDaniel, American Baby
Covering Medical Research
Learn how to analyze and write about health and medical research studies with AHCJ’s latest slim guide. It offers advice on recognizing and reporting the problems, limitations and backstory of a study, as well as publication biases in medical journals and it includes 10 questions you should answer to produce a meaningful and appropriately skeptical report. This guide, supported by the Robert Wood Johnson Foundation, will be a road map to help you do a better job of explaining research results for your audience.
UK’s Dartmouth-esque atlas yields familiar results
Filed under: Europe, Health data, Hot Health Headline, Tools
Writing for NPR’s health blog, Christopher Weaver looks at the NHS Atlas of Variation in Healthcare, which is similar to our Dartmouth Atlas. While they don’t have an interactive map up yet (they promise one will come next year), it has generous helpings of maps and graphs. The full PDF comes out to 100 pages and 19mb.
The most and least surprising thing about the NHS atlas? That, despite vastly different health care systems, it yields much the same results as the American version. I’ll let Weaver explain:
Before you blame … inconsistencies on America’s money-driven health system, take a look at Britain’s effort to anglicize the Dartmouth work: Doctors in some areas such as the college town of Oxford do one type of hip replacement at rates up to 16 times greater than in places like London, according to a November atlas by the National Health Service.
The British atlas is surprising because “doctors are not by and large paid on a fee for service basis in the NHS,” Angela Coulter, director of global initiatives for the Dartmouth Atlas-associated Foundation for Informed Medical Decision Making, said at a Salzburg Global Seminar session this week. “It illustrates the fact… that doctors tend to favor the treatments they’re trained to provide,” even when money isn’t a factor. Most British doctors get salaries rather than payments for each procedure like their American colleagues.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
Lack of vaccination, awareness worsen UK flu season
Filed under: Europe, Government, Hot Health Headline, Public health
The Guardian’s Denis Campbell and Sarah Boseley report that a drop in vaccination rates and a lack of public awareness has made this flu season worse than it should have been, and that there is potential for the NHS to be “inundated” with flu cases. The story has spread quickly in the UK, and may be providing just the sort of public awareness campaign that the reporters found was previously lacking.
Professor Steve Field, who until last month was the chairman of the Royal College of General Practitioners, spoke out as the Department of Health revealed there are more than 300 people in critical care beds with flu and 17 people have died.
Field said the decision not to encourage the public to have a jab to protect themselves was “ill-advised” and needed to be urgently reversed.
The NHS should have acted more decisively to encourage people to have the jab because it was known that H1N1 swine flu was still circulating and that few NHS staff had the swine flu vaccine when it was offered to them late last year.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
EU reviewing limits to physician work weeks
Filed under: Europe, Government, Hot Health Headline
The Telegraph’s Andy Bloxham writes that the European Union’s 48-hour-a-week average working time limit is under review, at least as far as doctors are concerned.
Photo by dimnikolov via FlickrThe limit has been in place since August, 2009, and doctors have a limited opt-out clause. According to Bloxham, European health providers have been hit hard by the rule, which cut back their hours “drastically.” Critics have said that “junior doctors, who used to work very long hours, were being stopped from learning or building up experience as quickly as in the past.”
The EU has committed to either reviewing or overhauling the law, and Bloxham lists a few possible modifications.
One way of altering the rules could see doctors’ hours spent on call at hospital rather than on duty counted differently to the hours spent treating patients.
It might also permit them to return from their breaks sooner than the law currently allows in cases where staff shortages are more severe.
The weekly average for American doctors is around 51, which is down from 55 in 1996.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
Report: Kosovo crime ring executed prisoners, harvested their organs
According to a draft report from the Council of Europe, a criminal network in Kosovo executed prisoners and sold their organs on the black market within the past decade. The network is linked to Kosovo’s current prime minister and victims likely included Kosovo Serb civilians. We learned about the story through Michael Montgomery and Altin Raxhimi of the Center for Investigative Reporting.
The report alleges the organ trafficking was part of a broader web of organized criminal activity including assassinations and drug dealing. The “boss” of the criminal network, according to the report, was Hashim Thaci, Kosovo’s current prime minister and the former political director of the Kosovo Liberation Army.
…
The recent case of illegal transplants conducted at the Medicus clinic in Pristina is not an isolated episode. “We believe that there are sufficiently serious and substantial indications to demonstrate that this form of trafficking long pre-dates the Medicus case, and that certain KLA leaders and affiliates have been implicated in it previously,” the report states.
According to a former U.N. war crimes prosecutor interviewed by CIR, an international investigation will be needed because of the breadth and complexity of the case.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
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