Newspaper Coverage of Cancer Prevention: Multilevel Evidence for Knowledge-Gap Effects

Abstract

Prior research on knowledge gap effects, in health as well as in other domains, has focused largely on assessing individual-level differences in exposure to news based on self-report of media use. Inherent inferential limitations of this approach are addressed by testing the hypothesis that the relationship between education and cancer prevention knowledge will be moderated by regional differences in U.S. news coverage of cancer prevention. The study also tests, using these methods, findings by Kwak (1999) suggesting that the importance of attention to relevant news in predicting knowledge decreases as information available in the news increases. Using a representative national sample of newspaper coverage to assess regional differences in cancer prevention coverage, a representative national probability sample to assess respondent education and cancer prevention knowledge, and multilevel analyses of the relationship between regional coverage differences and knowledge of persons in those regions, support is found for both of these propositions.News coverage of health issues has been shown to predict associated knowledge, attitudes, and behavior in a variety of health domains, including substance use (Stryker, 2003) and cancer (Yanovitzky & Blitz, 2000). In particular, recent research has suggested the presence of knowledge gap effects in health domains-that is, the strength of the relationship between socio-economic status (SES) and health knowledge increases as the availability of relevant information in the social environment increases (Viswanath & Finnegan, 1996). In particular, one analysis has indicated that greater education predicts greater knowledge of the causes of cancer, as does attention to health news (Viswanath et al., 2006); another provides evidence that higher SES individuals are more likely to respond to media reports of celebrity diagnoses of cancer by seeking information than are lower SES individuals (Niederdeppe, 2008 (Lau, Hartman, & Ware, 1986;Slater & Flora, 1991) are probably more knowledgeable, more likely to adopt more healthy behaviors, and to report using more health-related media than are people less interested in health. These associations could generate spurious relationships, assuming that higher SES individuals may be less worried about paying rent and feeding family members and more able to give higher priority to health than lower SES individuals. In this case, one would expect higher SES individuals to have greater health knowledge and also report greater use of health-relevant media, for reasons having more to do with SES status than likely effects of greater media use.In this study, we use a unique, nationally representative data set of news coverage to identify regional differences in the amount of news coverage regarding cancer prevention and to assess the knowledge gap effect-i.e., whether a relationship between news coverage and health knowledge is contingent on people's level of education (Viswanath & Finnegan, 1996). In so doing, we provide a conservative tes...

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