News Media Coverage of Childcare: How U.S. Local TV News Framed the Problem Before and During the Early Stage of the COVID-19 Pandemic.

Early care and education (ECE), or the care young children receive before entering formal schooling, can take multiple forms and is delivered in different settings, such as a center, church, or public school. Federal and state governments regularly fund ECE programs and policies through the Child Care and Development Block Grant Act (CCDBG). Many families, however, face significant challenges in access, cost, and quality of ECE programs, and ECE professionals report substantial challenges in the workplace (e.g., inadequate training) and beyond (e.g., low wages). Policies addressing issues related to ECE were proposed in 2021, but stalled on the U.S. federal policy agenda. In this study, we examine the ECE content of local television news coverage both for its representations of and for its potential influences on ECE policy agendas. We use data from local stations affiliated with the major networks (ABC, NBC, CBS, and FOX) in media markets across the U.S., airing before and during the pandemic. We analyze elements of coverage that could affect public recognition of ECE-related issues, including how problems were framed (e.g., news coverage highlighting scandals or adverse events at ECE facilities) and solutions identified (e.g., public policy). We find that during 2018 and 2019, more coverage highlighted scandalous activity than public policy. The reverse was true, however, during the early period of the pandemic (from mid-March through June of 2020). Researchers and health professionals were seldom included in stories in either sample, and very few stories offered context about the benefits of ECE for health and well-being. These coverage patterns have implications for the public's understanding of ECE policy and the perceived need for reform. Policymakers, advocates, and researchers looking to advance support for ECE should consider ways to use local television news to present health and policy-relevant information to broad segments of the public.

Local TV News Coverage of Racial Disparities in COVID-19 During the First Wave of the Pandemic, March-June 2020.

The COVID-19 pandemic has disproportionately impacted health and social outcomes for people of color in the United States. This study examined how local TV news stories attributed causes and solutions for COVID-19-related racial health and social disparities, and whether coverage of such disparities changed after George Floyd's murder, during the first wave of the COVID-19 pandemic. We systematically validated keywords to extract relevant news content and conducted a content analysis of 169 discrete local TV news stories aired between March and June 2020 from 80 broadcast networks within 22 purposefully selected media markets. We found that social determinants of COVID-19 related racial disparities have been part of the discussion in local TV news, but racism as a public health crisis was rarely mentioned. Coverage of racial disparities focused far more attention on physical health outcomes than broader social impacts. Stories cited more structural factors than individual factors, as causes of these disparities. After the murder of George Floyd, stories were more likely to mention Black and Latinx people than other populations impacted by COVID-19. Only 9% of local news stories referenced racism, and stories referenced politicians more frequently than public health experts.

Who does COVID-19 hurt most? Perceptions of unequal impact and political implications.

While the overall impact of the COVID-19 pandemic on U.S. population health has been devastating, it has not affected everyone equally. The risks of hospitalization and death from the disease are relatively low for the population as a whole, but much higher for specific subpopulations defined by age, health status, and race or ethnicity. The extent to which Americans perceive these disparities is an open question, with potentially important political implications. Recognition of unequal impacts may prime concerns about justice and fairness, making Americans more concerned and willing to support government intervention. On the other hand, belief that the pandemic primarily threatens "other people" or out-groups may reduce, rather than increase, a person's concern. Partisanship and media consumption habits are also likely to play a role in these perceptions, as they do in most issues related to COVID-19. In this paper, we use original survey data from the Cooperative Election Study (N = 1000) to explore Americans' perceptions of which groups are most harmed by the pandemic, the demographic and political determinants of these perceptions, and the relationship of these perceptions with their opinions about COVID-related mitigation policy. We find that, on average, people perceived accurately that certain groups (e.g., Black Americans, older people) were more affected, but these group perceptions varied by demographic and political characteristics of respondents. We find, in contrast with recent experimental evidence, that the perception that populations of color were harmed was associated with more support for pandemic mitigation strategies. More research should investigate the relationships among pandemic politics and the racial dynamics of the target populations most affected.

Television airings of U.S. federal COVID-19 public service announcements in 2020 were associated with market-level political orientation, not COVID-19 rates.

Televised public service announcements were one of the ways that the U.S. federal government distributed health information about the COVID-19 pandemic to Americans in 2020. However, little is known about the reach of these campaigns or the populations who might have been exposed to the information these ads conveyed. We conducted a descriptive analysis of federally-affiliated public service announcement airings to assess where they were aired and the market-level social and demographic characteristics associated with the airings. We found no correspondence between airings and COVID-19 incidence rates from March to December 2020, but we found a positive association between airings and the Democratic vote share of the market, adjusting for other market demographic characteristics. Our results suggest that PSAs may have contributed to divergent exposure to health information among the U.S. public during the first year of the COVID-19 pandemic.

Serving the public? A content analysis of COVID-19 public service announcements airing from March - December of 2020 in the U.S.

The objective of this research was to examine the health messages conveyed in public service announcements (PSAs) affiliated with the U.S. federal government response to the COVID-19 pandemic in 2020. To do so, we conducted a content analysis of 132 federally-affiliated PSAs that were aired 170,820 times between March 12 and December 16, 2020. Using a quantitative coding instrument, we analyzed health behavioral guidance, messages about groups, people depicted, and other PSA features. We calculated frequencies of exposure to messages at the airing-level to account for the varying number of times each PSA was aired. Far more PSAs aired between March and June than between July and December. The most common health guidance was to stay at home (80.7%), practice social distancing (61.9%), and wash hands (54.5%); 36.1% of airings included guidance to wear masks. Few PSAs referenced group differences in risk of infection or transmission, nor did they reference scientific evidence or the future availability of vaccines. PSAs aired in 2020 missed opportunities to convey important information to the public and to center health equity in public communication.

Americans' perceptions of health disparities over the first year of the COVID-19 pandemic: Results from three nationally-representative surveys.

COVID-19 has illuminated health inequity in the United States. The burdens of disease are much higher among Black and Indigenous people and other people of color. Disparities by income are also profound, as lower-wage workers were less able to adopt mitigating behaviors compared to higher-income counterparts. These disparities became part of public health discourse in 2020, with commentators frequently highlighting the connection between racism, socioeconomic position, and COVID-19. But what proportion of the public-and among key subgroups-recognized these social group disparities, relative to disparities associated with age and chronic illness, and did public recognition change over the first year of the pandemic? To address these questions, we analyzed data from three nationally-representative cross-sectional public opinion surveys, collected using the NORC AmeriSpeak panel in April 2020 (N = 1007), August 2020 (N = 2716), and April 2021 (N = 1020). The key outcomes were respondents' agreement with statements about disparities in COVID-19 mortality by age, chronic illness, income, and race. We found little change from 2020 to 2021 in Americans' recognition of disparities. At all three time points, most respondents acknowledged age and chronic illness disparities, while no more than half at any time point recognized income- and race-based disparities. Political party affiliation was not statistically associated with agreement with age or illness-related disparities, but was strongly associated with views about income- and race-based disparities. Efforts to promote recognition of racial and socioeconomic health disparities in the United States need to be mindful of the ways in which public understanding of health inequities is linked to partisanship.

Effects of politicized media coverage: Experimental evidence from the HPV vaccine and COVID-19.

Although concerns about politicization of health and science are not new, the COVID-19 pandemic has amplified attention to how political disagreement over scientific guidelines and recommendations might influence attitudes and behaviors about the health topics in question and might even spill or carry over to affect other attitudes important to public health. The literature employs differing definitions of politicization-at times referring to controversy in the public sphere, at others referring to the exploitation of the uncertainty inherent in science, and at still others referring to whether the issue enters political discourse-all of which are viewed as distinct dimensions by the public. What is not known is how these different aspects of politicization influence public attitudes about the health topics and or broader attitudes about scientific guidelines, and-assuming adverse effects-what strategies might be effective at mitigating the consequences. This paper draws on a survey experiment of 3012U.S. respondents fielded in summer 2020 that was designed as a pilot study to assess the effects of different dimensions of politicization. Findings do not suggest that one type of politicization is necessarily more pernicious than the others. In fact, all types of politicization increased negative emotional responses and confusion, both with respect to the health topic in question (HPV vaccine and COVID-19) but also on other domains, although opinions about policy were unaffected. The findings also suggest that inoculation may have potential as a messaging strategy for blunting the adverse effects of exposure to politicization.

The Emergence of COVID-19 in the US: A Public Health and Political Communication Crisis.

The coronavirus public health crisis is also a political-communication and health-communication crisis. In this article, the authors describe the key communication-related phenomena and evidence of concerning effects manifested in the United States during the initial response to the pandemic. The authors outline the conditions of communication about coronavirus that contribute to deleterious outcomes, including partisan cueing, conflicting science, downplayed threats, emotional arousal, fragmented media, and Trump's messaging. The authors suggest these have contributed to divergent responses by media sources, partisan leaders, and the public alike, leading to different attitudes and beliefs as well as varying protective actions taken by members of the public to reduce their risk. In turn, these divergent communication phenomena will likely amplify geographic variation in and inequities with COVID-19 disease outcomes. The authors conclude with some suggestions for future research, particularly surrounding communication about health inequity and strategies for reducing partisan divergence in views of public health issues in the future.

Public perceptions of conflicting information surrounding COVID-19: Results from a nationally representative survey of U.S. adults.

Conflicting information surrounding COVID-19 abounds, from disagreement over the effectiveness of face masks in preventing viral transmission to competing claims about the promise of certain treatments. Despite the potential for conflicting information about COVID-19 to produce adverse public health effects, little is known about whether the U.S. public notices this information, and whether certain population subgroups are particularly likely to do so. To address these questions, we fielded a nationally representative survey of U.S. adults in late April 2020 (N = 1,007). Results showed substantial self-reported exposure to conflicting information about COVID-19, with nearly 75% of participants reporting having recently heard such information from health experts, politicians, and/or others. Participants perceived disagreement across a range of COVID-19-related issues, though from politicians more than health experts. Factors including political affiliation, information source use, and personal experience with COVID-19 were associated with perceptions of disagreement. Future research should consider potential cognitive and behavioral consequences of such perceptions.

Access and enrollment in safety net programs in the wake of COVID-19: A national cross-sectional survey.

The global COVID-19 pandemic is causing unprecedented job loss and financial strain. It is unclear how those most directly experiencing economic impacts may seek assistance from disparate safety net programs. To identify self-reported economic hardship and enrollment in major safety net programs before and early in the COVID-19 pandemic, we compared individuals with COVID-19 related employment or earnings reduction with other individuals. We created a set of questions related to COVID-19 economic impact that was added to a cross-sectional, nationally representative online survey of American adults (age ≥18, English-speaking) in the AmeriSpeak panel fielded from April 23-27, 2020. All analyses were weighted to account for survey non-response and known oversampling probabilities. We calculated unadjusted bivariate differences, comparing people with and without COVID-19 employment and earnings reductions with other individuals. Our study looked primarily at awareness and enrollment in seven major safety net programs before and since the pandemic (Medicaid, health insurance marketplaces/exchanges, unemployment insurance, food pantries/free meals, housing/renters assistance, SNAP, and TANF). Overall, 28.1% of all individuals experienced an employment reduction (job loss or reduced earnings). Prior to the pandemic, 39.0% of the sample was enrolled in ≥1 safety net program, and 50.0% of individuals who subsequently experienced COVID-19 employment reduction were enrolled in at least one safety net program. Those who experienced COVID-19 employment reduction versus those who did not were significantly more likely to have applied or enrolled in ≥1 program (45.9% versus 11.7%, p<0.001) and also significantly more likely to specifically have enrolled in unemployment insurance (29.4% versus 5.4%, p < .001) and SNAP (16.8% versus 2.8%, p = 0.028). The economic devastation from COVID-19 increases the importance of a robust safety net.

Americans' perceptions of disparities in COVID-19 mortality: Results from a nationally-representative survey.

As with many other infectious and chronic conditions, the COVID-19 crisis in the United States (U.S.) reveals severe inequities in health. The objective of this study was to describe public perceptions of disparities in mortality from COVID-19 and examine correlates of those perceptions. We fielded a nationally-representative survey in late April 2020, asking participants how much they agreed with four statements describing group-level COVID-19 disparities: older people compared to younger, people with chronic health conditions compared to those without, poorer people compared to wealthier, and Black people compared to white people. We also measured personal characteristics, experience with COVID-19, and information sources. Overall agreement with age- and health condition-related disparities was high (>80%) while agreement with socioeconomic (SES) and racial disparities was lower (52%). Higher education and income were generally associated with greater agreement with disparities. Partisanship and information sources used were associated with perceptions of SES- and racial-disparities, with Democrats and those attune to national news-but not Fox cable news-more likely to perceive these disparities. As of April 2020, information about age- and health condition-related disparities in COVID-19 was well known by the U.S. public, while information about social disparities was less recognized and varied along socioeconomic and partisan lines.