The role of the media in the health policymaking process: perspectives of key actors in Spain

Abstract

ABSTRACTHealth and political communication disciplines address the influences that mass media have on health policy processes such as agenda setting and framing. However, we have fewer insights into the direct interactions among interest groups, media, and decision-makers. We conducted a case study using semi-structured interviews with journalists (N = 7) and other key actors in Spanish health policy (N = 47). A purposive sample of interviewees sought to represent all sectors involved in health policymaking. All actors interviewed agreed on the key role played by media in shaping health policy. They described a wide range of actions from subtle to overt pressure. There was a consensus on the increasing vulnerability of the media to the influence of industry due to their financial dependence and lack of critical capacity. Through the capture of media, key actors considered that health-related corporations are able to frame health problems and their solutions according to their own interests. The actors interviewed described extreme strategies against uncollaborative political actors that went beyond framing health issues and bordered on the unethical. These results highlight how corporations condition the generation and dissemination of knowledge on health issues in order to influence first the media agenda and then the political agenda. The intellectual capture of policy through media, as part of a wider policy capture process, biases health policy towards biomedical and individual responses to public health issues. Moreover, it neglects social innovations, weakens public health advance, and favours disease-related industries to the detriment of the public interest.