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2007 84: 777Journalism & Mass Communication QuarterlyTeresa Mastin, Jounghwa Choi, Gia Elise Barboza and Lori Post

Newspapers' Framing of Elder Abuse: It's Not a Family Affair  

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NEWSPAPERS’ FRAMING OF ELDER ABUSE: IT’S NOT A FAMILY AFFAIR

By Tevesa Mastin, Jounghwa Choi, Gia Elise Barboza, and Lori Post

This article describes media coverage of elder abuse from 2003 to 2005. Guided by media typification and framing literatures, eight newspapers‘ elder abuse coverage was content analyzed. The newspapers’ coverage usually typified and framed elder abuse in a criminal justice context. The stories covered most often featured episodic frames, 57.170, while a majority, 65.20/0, of the coverage framed elder abuse as an individual- as opposed to a societal-level problem. Most elder abuse occurs in domestic settings, yet the newspapers’ coverage most often focused on elder abuse in long-term care settings.

The level of public attention, both social and political, given to elder abuse has increased steadily during the past two decades. This increasing attention is well warranted since it is estimated that the pop- ulation aged 65 years or greater will double by the year 2030.’ The fail- ure to adequately address elder abuse now could pose a serious future threat to older individuals and social welfare systems.

As defined by a group of experts convened by the U.S. National Academy of Sciences, elder abuse is ”(a) intentional actions that cause harm or create a serious risk of harm (whether or not harm is intended), to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder, or (b) failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.”2 Most clinical reports and international legal statutes recognize five types of elder abuse: physical abuse; psychological abuse; sexual assault; material exploitation, which involves the misappropriation of money or property; and negle~t .~

It is estimated that every year, 2.1 million older Americans are vic- tims of physical, psychological, or other forms of abuse and neglect. Moreover, experts maintain that for every case of elder abuse and neg- lect that is reported there may be as many as five that go unreported: The nationwide 2004 Survey of State Adult Protective Services (APS)5 reported a 19.770 increase in the total combined reports of elder and vul- nerable adult abuse and neglect. Thirty-two states reported 253,426 elder

Teresa Mastin is associate professor in advertising, public relations, and retailing at Michigan State University, where Iounghwa Choi completed her Ph.D. and Lori Post is assistant professor of telecommunications, information studies, and media. Gia Elise Barboza is assistant professor at American University. This research was supported in part by a grantfrom the U S . Department of Health and Human Services, CFDA 93.778, to the state of Michigan and Michigan State University.

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abuse cases, which represented 8.3 reports of abuse per 1,000 older Americans. In 2003, APS investigated 192,243 cases of alleged elder abuse in twenty-nine states. In twenty-four states, 46.7% of the cases were sub- stantiated. 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/ inti- mate partners (11.3%)?

Although media coverage of elder abuse has grown recently, there has been little academic attention directed at empirically analyzing how the media portray elder Numerous research studies have docu- mented crime-related news reporting problems, such as distortion, mis- representation, and oversimplification.R According to st even^,^ journal- ists typically report violence from a criminal justice perspective, with an emphasis on isolated and unusual episodes rather than on providing a comprehensive picture of violence as an epidemic. Pointing out the limi- tations of a criminal justice perspective, Stevenslo suggested taking a pub- lic health approach that focuses on thematic reporting of violent events and provides causal and contextual details to aid audiences' understand- ing of what occurred. While public health experts, scientists, and epi- demiologists already have taken a public health approach to crime, the media have failed to join this movement." When the media take a public health approach, the context within which a crime occurs and the conse- quences of the crime are addressed. Such coverage is more likely to leave readers and viewers with a better understanding of the status of crime in their communities and how they can work toward preventing violent incidents.'*

Given the increasing significance of elder abuse, exploring the ways in which the media typify and frame elder abuse could provide insight concerning the media's overall approach to the issue. This is an important undertaking because media coverage has the potential to influence the general public's and policymakers' elder abuse perceptions. Therefore, this study explores (1) how selected major newspapers typify elder abuse, and (2) the frames that emerge from the newspapers' elder abuse cover- age.

Literature Review

Elder Abuse as a Public Health Issue. A traditional approach to vio- lence has been one of criminal justice, which focuses on incarcerating vio- lent offenders and /or providing medical treatment for victims.I3 This approach has been criticized as being reactive rather than proactive, while public health officials have argued that violence should be treated the same as other social diseasest4 During the 1970s, a public health perspec- tive of violence and crime emergedls positioning violence as a topic for academic public health research.Ih Advantages of the public health approach include emphasis on prevention, integration of diverse scien- tific disciplines and organizations, and development of prevention pro- grams based on empirical res~l ts . '~ However, violence has received lim- ited attention from health communication scholars until recently.'R

Elder abuse has characteristics that are distinct from other types of public health issues. Specifically, there is evidence that a substantial num-

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ber of elder abuse incidents go unreported and are not included in offi- cial statistics for various reasons, including, for example, victims’ inabil- ity to report abuse, the fact that abuse often occurs in the family unit and hence remains ”hidden,” and victims’ lack of awareness that they are being abused.” The hidden nature of elder abuse suggests that the gen- eral public’s and policymakers’ understanding of the issue is more like- ly to be influenced by media portrayals.

The Mass Media and Public Health. Elder abuse and neglect has received increasing attention during the past several decades in both social science and media venues. The media play a critical role in shap- ing public attitudes and behaviors regarding public health issueszo and crime.*’ The manner in which the media present a health issue defines the problem, and in turn, influences individuals’ and societies’ decisions in regard to adopting one solution among several alternatives. This process is often achieved through the mechanism of typification and framing of an issue.

Media Typification. Typification is how something is represented as a type or as a symbol. Media typification refers to media practices that characterize and illustrate a view about a social problem. The concept of typification is based on the constructionist perspective of understand- ing 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, the constructionist approach defines problems without reference to the conditions themselves.zz The latter perceives that social problems are constructed by claimsmakers based on cultural, political, or historical contexts. Claimsmakers are those who assert and promote a definition for a social pr0blem,2~ and typify it by emphasizing certain aspects of the The media are deemed to play a critical role in typification and construction of social problems by serving as primary ~laimsmakers.~~ The way the media typify a certain issue often gener- ates related public outcries and policy responses.z6

Health and risk issues including crime are also socially construct- ed and are brought to public attention through claimsmaking by activists, policymakers, and/or the media.z7 For example, JohnsonzR ad- dressed the media’s manner of portraying child abuse, which played ”a prominent role in the political, social, and institutional success of the child maltreatment mo~ernent .”~~ Similarly, Lowney and BesPO ex- plained how media claimsmaking influenced the construction of stalk- ing as a social problem.

Analysis of the media’s coverage of elder abuse in terms of typifi- cation may provide insight regarding how the issue has been socially constructed. It is possible that media typification of elder abuse may not accurately reflect the nature of elder abuse because certain aspects of elder abuse are often not readily apparent. For example, although a majority of elder abuse cases occurred in domestic settings, such cases have tended to be under-reported. Thus, if the media rely on the police as a source of information, rather than academic communities of public health and welfare, their typification of elder abuse may depart from this reality.

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Discussing the social construction of crimes, Lowney and BesP sug- gested that ”claimsmakers typify the timing, location, interaction pat- terns, and consequences of crimes.” Claims on crimes tend to ”define types of crime in terms of both their actors and the nature of the activi- ty.”32 Therefore, our typification research questions focus on characteris- tics of actors, interactions, and broader social settings:

RQ1: How did the newspapers typify elder abuse?

RQla: How was the gender of the abuser and the abused typified in the newspapers’ elder abuse coverage?

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

RQlc: In the newspapers‘ elder abuse coverage, in what settings did abuse occur?

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

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

RQlf: What causes of elder abuse were featured most often in the newspapers‘ elder abuse coverage?

Media Framing. Framing is one of the techniques through which social problems are constructed. Frames define problems, identify causes, or suggest solutions for social issues.33 Through the framing process, cer- tain aspects of issues may be left out while others are amplified. Existing studies indicate that how an issue is framed greatly influences public atti- tudes toward that issue.34 By framing social issues in a certain way, the media influence how the public thinks about an issue by invoking certain interpretive ~chemas.3~ The way an issue is framed helps create the basis for public policy. Scholars have suggested that framing has a great impact on public health in the domain of health policy formation36 and “the media may affect the nature of regulation, the course of litigation, or the direction of research and de~elopment .”~~ Acknowledging the critical role of media framing, many scholars have studied media framing of various public health issues, such as breast cancer and

I ~ e n g a r ’ s ~ ~ distinction of thematic and episodic frames reflects opposing framing positions. News reports that adopt episodic frames tend to focus on specific and concrete events or individuals, while themat- ic frames are more issue-oriented. Episodic frames illustrate social prob- lems with individual-level examples and attribute cause responsibility to individuals while thematic frames tend to describe the issue in a more complicated social context and present collective cases of an issue.

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In addition to 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 either individuals’ or society’s responsibility. Wallack et al.40 argued that ”the view that social and health problems are individual problems pervades the society and is reinforced through framing in the mass media.” They suggested that, in America, the mass media tend to frame social and health problems based on individualism, and as a result, audiences tend 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 behavior~.~’ As a result, primary strate- gies for many health promotions focus on individual-level solutions, often presenting them as the entire solution to the problem.

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 then either focus on the individual moral issue, and warn about personal caution; or focus on the lack of regula- tory systems to protect the elderly, and propose new legislation. It is important to examine elder abuse within a conceptual framework that grounds the health issue as a societal problem because elder abuse and neglect costs occur at both the individual and societal level. Societal level costs include increasing levels of government health care spend- ing, higher hospitalization rates, and insufficient dependency The following research questions distinguish between thematic/episod- ic framing and problem/ solution framing:

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 cover- age?

RQ2c: Were individual- or societal-level solutions more often featured in the newspapers’ elder abuse cover- age?

Sample. Content analysis was used to examine selected Method newspapers from 2003 through 2005. This timeframe was selected because of the convenience of archives stored by the American Society of Adult Abuse Professionals and Survivors (ASAAPS), an advocacy group that works with elder abuse issues. During 2003-2005, ASAAPS used Google to gather elder abuse articles featured in U.S. newspapers. The newsfeed database served as the study’s sample frame and article titles served as keywords.

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TABLE 1 Newspapers‘ Elder Abuse Coverage as a Function of Word Count

NEWSPAPER” Circulationh N Mean‘ sd F-statistic

NEWSPAPER Sun Francisco Chronicle USA Today Boston Globe Houston Chronicle Washington Post New York Times Chicago Sun Times New York Daily News

505,202 2,220,863

451,471 554,783 707,690

1,121,057 600,988 715,052

161 27 14 22 18 20 10 18 32

6.38 6.91 6.51 6.33 6.68 6.08 6.05 6.08

3.87 (.001) ,875 ,935 .419 ,445 ,581 1.01 ,567 .466

a http:/ /www.freep.com/legacy/jobspage/links/toplOO.htm. Of the 15 largest circulation newspa- pers, 7 did not address elder abuse during the period examined. Those newspapers were: Wall Street lournal, Los Angeles Times, New York Post, Chicago Tribune, Dallas Morning News, Nemsday, and Arizona Republic. hCirculation numbers, 100 largest U.S. Newspapers, 2004, retrieved May 18, 2006, from http:/ / www.freep.com/legacy /jobspage/links/ top100.htm

Article length was calculated based on logarithm transformation of the number of words in each article.

Using ASAAPS’s news article titles, we searched articles printed in the fifteen largest US. newspapers based on circulation size, as of March 31, 2005. Examining these newspapers allowed us to work with articles presumably read by the largest number of people and therefore more like- ly to have the greatest potential to influence elder abuse perceptions and policies (see Table 1).

A total of 237 articles were collected, but 76 were discarded because they were not directly related to elder abuse, leaving a final sample of 161 articles. Although there were no duplicate articles, 5 were followups on previous articles, meaning the total unique sample was 156 articles (see Figure 1).

The unit of analysis was a newspaper article. Articles were coded to determine (1) gender of the abused; (2) gender of the abusers; (3) relation- ship between abused and abuser; (4) environment/location of abuse; (5) elder abuse defined; (6) abuse type; (7) abuse cause; (8) frame type; (9) frame problem; and 10) frame solution.

The gender of the abused and abusers and the relationship between the abused and the abuser were examined to gain a sense of the newspapers‘ gender- and relationship-related portrayals.

Elder abuse defined was operationalized as either commission (active) or omission (passive) and defined as: Commission-something done to cause harm to another person; or Omission-as not doing something neces- sary for another’s survival and/or health.43

The environment in which the abuse occurred was recorded to deter- mine if some locations were portrayed as being more prone to elder abuse.

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FIGURE 1 Nirmber of Elder Abuse Articles by Year, 2003-2005

Type of elder abuse included: material exploitation; psychological abuse/ neglect; physical abuse; and sexual abuse.

Cause of abuse included: abuser has mental illness; fraud /easy tar- get; substance abuse; abused has mental illness; and negligence.

Frame types were examined using Iyengar’? episodic and themat- ic frame categories as defined above. Also examined was whether the newspapers‘ elder abuse coverage framed the issue as an individual or societal problem and the extent to which the coverage presented indiuid- ual versus societal level solutions.

Finally, article word count was recorded to show the importance the newspapers placed on the issue as article length can influence pub- lic attitudes.45

An inter-coder reliability test for simple agreement and agreement by chance (Scott’s pi) was conducted with the second and third authors. Thirty-eight articles, 24% of the total sample, were used to establish inter-coder reliability. After establishing inter-coder reliability, the sec- ond and third authors divided the remaining articles and coded them separately. Coder simple agreement for the variables ranged from .74 to .92; Scott’s pi ranged from .68 to .90 with an average of .78. The simple agreement measures were all .70 or higher and therefore deemed accept- able.

To analyze the relationship between characteristics of elder abuse and news coverage, chi-square tests and univariate analyses of variance were conducted. The chi-square statistic estimation technique was used to test if certain characteristics of elder abuse were more frequently por- trayed in the newspapers. We performed a univariate analysis of vari- ance procedure to estimate the effect of each independent variable on word count, i.e., article length. Because the dependent variable, the number of words in each article, was judged to be non-normal, a loga-

Analysis and Results

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TABLE 2 Key Variable Differences and Elder Abuse as a Function of Word Count

Independent Variables N % X' Mean" (sd) F-Statistic (p-value)

GENDER OF ABUSED 79 13.79, 2.31 (.13) Female 56 70.9 df=l, 6.51 ( 3 8 ) Male 23 29.1 p<.OOl 6.24 (.66)

GENDER OF ABUSER 54 18.96, 2.20 (.14) Female 11 20.4 df=l, 5.97 (.40) Male 43 79.6 p<.001 6.29 (.69)

RELATIONSHIP TO ABUSED 119 56.34, 2.36 (.06) Fiduciary 12 10.1 df=4, 6.46 (.83) Family /Friends 18 15.1 p<.OOI 6.00 (.48) Employee / Employer 56 47.1 6.39 (.70) Neighbor / Co-resident 13 10.9 6.69 (.64) Other 20 16.8 6.20 (.72)

ABUSE LOCATION 105 10.37, 4.99 (.03) Long-term Care 69 65.7 df=l, 6.15 (.60) Home 36 34.3 p=.OOl 6.45 (.69)

ABUSE DEFINED 120 .53, 1.04 (.31) Commission (Active) 64 53.3 df=l, 6.30 (.69) Omission (Passive) 56 46.7 p=.47 6.44 (.75)

ABUSE TYPE 122 23.77, 1.00 (.46) Material Exploitation 43 35.2 df=3, 6.30 (.63) Psychological Abuse/ Neglect 38 31.1 p<.OOl 6.47 (.74) Physical Abuse 33 27.0 6.27 (.76) Sexual Assault 8 6.6 6.59 (.76)

ABUSE CAUSE 96 37.02, 1.21 (.31) Abuser has mental illness 9 9.4 df=4, 6.86 (.65) Fraud/Easy Target 38 39.6 p<.OOI 6.30 (.72) Substance Abuse 7 7.3 6.59 (.96) Abused has mental illness 14 14.6 6.47 (.51) Negligence 28 29.2 6.42 (.78)

a Word count was calculated based on logarithmic transformation of the number of words in each article.

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TABLE 3 Newspapers’ Framing of Elder Abuse

Independent Variables N % X’ Mean (sd) F-Statistic (p-value)

FRAME TYPE Thematic Episodic

FRAME PROBLEM Individual Societal

FRAME SOLUTION Individual-level Societal-level

161 69 42.9 92 57.1

161 105 65.2 56 34.8

105 56 53.3 49 46.7

3.29, df=l, p=.07

14.91, df=l, p<.oo1

.47, df=l, p=.50

16.14 (.001) 6.60 (.77) 6.18 (.58)

12.12 (.001) 6.22 (.64) 6.61 (.73)

2.05 (.16) 6.34 (.67) 6.53 (.68)

rithmic transformation of the data was performed to impose normality and to stabilize variance.

Overall Trends in Newspaper Coverage of Elder Abuse. Each newspaper portrayed elder abuse as gaining increasing importance over time in terms of word count, with the exception of the Washington Post. Table 1 ANOVA results suggested significant differences in the length of coverage across the newspapers ( F = 3.87, df = 7, p = .001). Pairwise comparisons using Bonferroni adjusted p-values indicate that, on average, U S A Today, which has the largest daily circulation (2.2 mil- lion), provided the most extensive coverage.

Newspapers’ Typification of Elder Abuse. To answer the first set of research questions that explored newspapers’ typification of elder abuse, we examined whether certain characteristics of elder abuse occurred more frequently than others.

Table 2 provides information about frequency and average word count of news articles that contained key variables. The frequen- cy of news articles differed by gender of abused, gender of abuser, relationship to abused, abuse location, type of abuse, and cause of abuse. Differences in article length were found only for abuse loca- tion.

Abused and Abusers. RQla considered the gender of those abused and their abusers. Of the articles that identified the gender of those abused, a majority, n=56 or 70.9%, covered abuse directed toward wo- men, while abuse directed toward men was addressed in 23 (29.1%) articles, xz (1) = 13.79, p < .001. Of the articles that identified abusers’ gender, almost 80% (n=43) were male; women were abusers in slightly more than 2070 of the articles (n=ll), xz (1) = 18.96, p < .001. Mean article length, based on word count, did not differ significantly by gender of abused or abuser.

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FIGURE 2 Elder Abuse by Year and Sclccted Frarrie Typcs,

iri P e r c o z t a p

100.

8 0 .

60

40.

20.

0 -

.

2003 2004 2005 2003 2004 2005 2003 2004 2005

Material Exploitation Psychological Abuse Physical Abuse and Neglect

Episodic Thematic

Relatioizslziy bctwccw Abused arid Abuser. R Q l b queried the rela- tionship between the abused and the abuser. There was a significant difference in the number of articles across newspapers, ~ ~ ( 4 ) = 56.34, 17 < ,001, in regard to relationship type. For articles that provided relation- ship information, most abuse occurred in the employer / employee rela- tionship (e.g., paid caregiver), or in 56 (47.1%)) of the 119 articles, followed by family and friends ( w = 18, 15.1%~). Mean word count differences approached significance for relatioriship to abused, F (4, 114) = 2.36, [ J = .06. Pairwise comparisons using Bonferroni adjusted p-values revealed that elder abuse committed by a family/friends (M = 6.00) was given less cov- erage than abuse committed by a neighbor/co-resident (M = 6.69), M,l,,, =

.69, p = .06. Abuse Envirorznzent. R Q l c examined the location where elder abuse

occurred. More than half, 65.7‘%, or 69 of 105 articles, of the abuse cases took place in either nursing homes or assisted living facilities, followed by individuals’ homes, 34.3%) (11 = 36), x2(1) = 10.37, y = .001. On the other hand, abuse cases occurring in individuals’ homes received more cover- age in average word count (M = 6.45) compared with abuse cases occur- ring in long-term care settings (M = 6.15), M,,,,, = .30, F (1, 103) = 4.99, y < .05.

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Commission versus Omission. R Q l d addressed acts of commission and omission. More than half of the elder abuse coverage featured acts done to cause harm-commission, 53.3% (64 of 120 articles); while 46.7% (n=56) of the abuse cases represented acts of omission. However, neither the frequency nor average word count of articles was significantly different between the categories.

Types of Elder Abuse. R Q l e examined types of elder abuse. Each type of abuse appeared in the newspapers with different frequency, x2(3) = 23.77, p < .001. Material exploitation was addressed most often, in 35.2% (n = 43) of 122 articles. Physical abuse was addressed second most often, in 31.3% (n = 38). Sexual assault was addressed least often, in eight articles (6.6%). Word count did not differ significantly by abuse type.

Cause of Abuse. RQlf examined the causes of elder abuse. The frequency of types of elder abuse causes reported in the newspapers was significantly different, x2(4) = 37.02, p < .001. Thirty eight (39.6%), of the 96 articles that provided a cause named fraud/easy target. Ne- gligence was the cause addressed second most often, in 28 articles (29.2%), as shown in Table 2. The newspapers rarely mentioned either mental illness or substance abuse as the cause of abuse. No difference was found in terms of article length as a function of abuse type.

Media Framing of Elder Abuse. The second set of research ques- tions addressed how the newspapers framed elder abuse. Although there were fewer articles that (1) addressed elder abuse in a thematic frame, (2) framed the problem as a societal issue, and (3) called for soci- etal-level solutions, when the issue was addressed from these perspec- tives, the articles were longer (see Table 3).

Thematic vs. Episodic, The newspapers‘ elder abuse coverage more often featured episodic frames (n = 92) than thematic frames (n = 69), x2(1) = 3.29, p = .07. Figure 2 shows that this result held regardless of year or type of abuse. Thematically framed articles did increase during the time frame examined, although the increase was not statistically significant, ~ ~ ( 2 ) = 4.69, p = .lo. For example, in 2003 the newspapers fea- tured 16 episodic and 5 thematic articles; during 2005 the articles were more evenly distributed among episodic (n = 29) and thematic (n = 30) frames, regardless of the abuse type featured (see Table 4).

Problem Framing. RQ2b considered whether elder abuse was more often framed as an individual- or societal-level problem. Individual- level framing was more prevalent than societal-level framing, ~’(1) = 14.91, p < .001; when elder abuse was described as a societal problem, it received more coverage, F(l, 159) = 12.12, p i .001. A majority (65.2% or 105 of 161 articles) of the newspapers’ elder abuse coverage framed the issue as an individual problem. Of articles that adopted an individ- ual-level problem frame, most (53.3%) described elder abuse as individ- uals’ misbehaviors, such as fraud, neglect, or violence. Acquaintanceship- related abuse was mostly attributed to rogue individuals and not dis- cussed in the context of the larger social system. Eight articles attributed elder abuse to the mental disabilities of the abused. Finally, 17 articles named management issues at care facilities as the main problem causing

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TABLE 4 Episodic and Thematic Frame in Newspapers' Coverage

Frame Type 2003 2004 2005 Total

Episodic 76.19% 58.23% 49.15% 91 N = 1 6 n = 46 n = 29

Thematic 23.81% 41.77% 50.85% 68 n = 5 n = 33 n =30

Total

x2= 4.69, df=2, p=.10

100% 100% 100% N = 2 1 n = 79 n = 59

the elder abuse. In particular, individual care facility mistakes in terms of management, employee training, and employees' skills were discussed. U S A Today was the only newspaper that focused more often on elder abuse as a societal issue. Eleven of 14 USA Today articles framed elder abuse in a societal context.

Of 56 articles that adopted a societal-level problem frame, more than half ( n = 30) framed elder abuse as a problem of social systems, such as lack of governmental regulation and oversight of care facilities; social workers' case loads; absence of emergency evacuation systems, etc. Twelve articles focused on elder care facilities' management issues, e.g., inadequate staff training and incomplete employee background checks.

Solution Framing. RQ2c examined whether the newspapers pre- sented solutions for elder abuse at the individual or societal level. More than a third of the elder abuse articles (34.8% or 56 of 161 articles) did not specify a solution. Of 105 articles that mentioned a solution, 56 (53.3%) suggested solutions at the individual level while the remaining articles offered societal-level solutions, ~ ~ ( 1 ) = .47, p = n. s.

Articles that featured individual-level solutions named either legal litigation or investigation against the abuser or care facility as the actions taken by the abused and their families. These articles did not mention solutions for preventing elder abuse. In contrast, 10 articles provided individual-level protection suggestions/ how to tips regarding: (1) select- ing financial representatives, (2) financial scams, (3) identifying signs of abuse, and (4) reporting abuse.

All articles that adopted a societal-level solution frame called for governmental measures in the form of regulation, legislation, or interven- tion. Several articles called for stronger governmental regulations, in terms of licensing, financial penalties, staffing and resident screening, and governmental oversight. Of the newspapers that proposed solu-

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tions, a majority of four newspapers’ articles placed the solutions in a societal context: Houston Chronicle (6 of 7); USA Today (6 of 8); Washington Post (6 of 9); and Boston Globe (11 of 21).

Discussion This study examined three years, 2003 to 2005, of selected news-

papers’ coverage of elder abuse to determine what elder abuse percep- tions the media are most likely imparting to the general public and pol- icymakers.

Typifying Elder Abuse. When the newspapers addressed elder abuse, acts of commission (i.e., active) as compared with acts of omis- sion (i.e., passive) were more often featured; women compared with men were more likely to be abused; men compared with women were more likely to be abusers; and caregivers in an employee/employer role were more often the abusers. Several of the images portrayed in the newspapers’ elder abuse coverage did not reflect the realities of elder abuse. In particular, and in direct contrast to our findings, existing research strongly indicates that acts of omission and abuse within domestic settings are far more common than the newspapers’ coverage ind i~a ted .~~

It is important that the media provide the general public with elder abuse images that reflect reality because media portrayals often encourage the public to become social change agents, primarily through pressuring public officials responsible for shaping public policy. Misleading representations could have a negative impact both on the quality of life of elders in abusive situations and on legislation devel- oped to curtail elder abuse.

Framing Elder Abuse. The results of this study support existing framing research.47 The newspapers provided a consistent frame that portrays elder abuse as an individual problem with an individual solu- tion. The nature (e.g., space limitations) of news cycles encourages the media to cover issues in an episodic fashion. This practice means that coverage favors newsroom protocol potentially at the expense of por- traying the realities of a pressing societal issue. Only USA Today’s elder abuse coverage deviated from the norm. The newspaper‘s elder abuse coverage provided readers with a broad view of the issue. Although the newspaper printed only 14 elder abuse articles during the timeframe examined, the articles consistently provided extensive coverage that framed the issue thematically and addressed both problem and solution at the societal level.

Overall, however, as a group the newspapers framed elder abuse as an individual problem with an individual solution. This finding is particularly troubling because the manner in which issues are framed in the media partially determines whether they are perceived to be legiti- mate social problems.4x Portraying elder abuse as an individual issue provides an “out” for societal intervention.

For example, if the media frame elder abuse in the context of a rogue child, a rogue nursing home, or a rogue business person taking

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advantage of an elderly person, there is neither incentive nor pres- sure to establish policies designed to prevent such abuses. In contrast, if abuse cases are discussed in the context of systemic problems, the issue will more likely generate public pressure to mandate policy changes.

On a positive note, over time there was an increase (although not a statistically significant different one) in the percentage of articles that addressed elder abuse in a thematic frame. This is most likely a result of an increasing mobilization of elder abuse advocacy groups, emerging from an aging population that includes a large number of highly educat- ed and politically active individuals.

Zmplications for Advocates. Our results indicate a need for elder abuse advocates and the media to work together to ensure more bal- anced elder abuse coverage. More specifically, elder abuse advocates can use the media’s insufficient coverage as an opportunity to introduce themselves to media representatives and to provide them with materials that will allow them to better inform the general public and policymak- ers about the broad range of elder abuse. Simply, advocates can use media advocacy tools to guide and direct the media, overtly and covert- ly, to ensure that various publics have the knowledge needed to devel- op informed elder abuse opinions.

Limitations. The small sample size and less-than-optimal reliabil- ity scores for some variables should be addressed in future studies. This study examined only one medium; future studies should examine how other media frame elder abuse. Future research should include in-depth interviews and focus groups with media audiences for the purpose of obtaining a better understanding of the media‘s role in shaping their elder abuse attitudes, opinions, and policy formation.

In sum, our study supports the typification process of social prob- lems by claimsmakers. In particular, the fact that abuse occurring in institutional settings was more prominent in the newspapers’ coverage than was abuse occurring in domestic settings suggests that social serv- ices and law enforcement agencies played a critical role as claimsmakers and the media followed them. Media should make efforts to provide a comprehensive picture of elder abuse based on the public health approach in order for the general public and policymakers to form a more realistic perspective of elder abuse.

NOTES

1. CEDDS, “CEDDS 2004: Complete Economic and Demograph- ic Data Source” (Washington, DC: Woods and Poole Economics, Inc., 2004).

2. Mark S. Lachs and Karl Pillemer, ”Elder Abuse,” The Lancet 364 (October 2-8, 2004): 1263-72, 1264.

3. Lachs and Pillemer, “Elder Abuse.” 4. American Psychological Association, Elder Abuse and Neglect: In

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Search of Solutions, http: / /www.apa.org/pi/aging/elderabuse.html (May 2007).

5. National Center on Elder Abuse, Fact Sheet, http:/ /www.aarp- foundation.org / Thursday / Preconference / ElderAbuse / Handout3.pdf (May 20,2007).

6. National Center on Elder Abuse, Fact Sheet. 7. Holly Beard and Brian K. Payne, ”The Portrayal of Elder Abuse

in the National Media,” American Journal of Criminal Justice 29 (spring

8. See, for example, Melissa Hickman Barlow, David E. Barlow, and Theodore T. Chiricos, ”Economic Conditions and Ideologies of Crime in the Media: A Content Analysis of Crime News,” Crime and Delinquency 41 (January 1995): 3-19; Jason Ditton and James Duffy, ”Bias in the Newspaper Reporting of Crime News,” British Journal of Criminology 23 (April 1983): 159-65; Jane E. Stevens, Reporting on Violence: A Handbook for Journalists (Berkeley, CA: Media Studies Group, 1997).

9. Jane E. Stevens, ”Integrating the Public Health Perspective into Reporting on Violence,” Nieman Reports (December 1998): 38-41.

10. Stevens, ”Integrating the Public Health Perspective into Reporting on Violence.”

11. Stevens, ”Integrating the Public Health Perspective into Reporting on Violence.’‘

12. Stevens, “Integrating the Public Health Perspective into Reporting on Violence.”

13. W. Rodney Hammond, Daniel J. Whitaker, John R. Lutzker, James Mercy, and Pamela M. Chin, “Setting a Violence Prevention Agenda at the Centers for Disease Control and Prevention,” Aggression and Violent Behavior 11 (March-April 2006): 112-19; James A. Mercy, Mark L. Rosenberg, Kenneth E. Powell, Claire V. Broome, and William L. Roper, “Public Health Policy for Preventing Violence,” Health Affair 12 (4,1993):

14. Renita Coleman and Esther Thorson, ”The Effects of News Stories That Put Crime and Violence into Context: Testing the Public Health Model of Reporting,” Journal of Health Communication 7 (October 2002): 401-25; Lori Dorfman, Katie Woodruff, Vivian Chavez, and Lawrence Wallack, ”Youth and Violence on Local Television News in California,” American Journal of Public Health 87 (8, 1997): 1311-16.

15. Etienne G. Krug, Linda L. Dahlberg, James A. Mercy, Anthony B. Zwi, and Rafael Lozano, ”The World Report on Violence and Health,” The Lancet 360 (October 5,2002): 1083-88.

16. Liana B. Winett, “Constructing Violence as a Public Health Problem,” Public Health Reports 113 (November-December 1998): 498- 507.

17. Mercy et al., “Public Health Policy for Preventing Violence.’’ 18. See, for example, Coleman and Thorson, “The Effects of News

Stories That Put Crime and Violence into Context: Testing the Public Health Model of Reporting”; Lori Dorfman, Esther Thorson, and Jane Ellen Stevens, “Reporting on Violence: Bringing a Public Health Perspective into the Newsroom,” Health Education G. Behavior 28 (August

2005): 269-84.

7-29.

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2001): 402-19; Gary Meyer, Anthony J. Roberto, Franklin J. Boster, and Heather L. Roberto, ”Assessing the Get Real About Violence(R) Curriculum: Process and Outcome Evaluation Results and Im- plications,” Health Communication 16 (4, 2004): 451-74; Robin L. Nabi, Brian Southwell, and Robert Hornik, ”Predicting Intentions vs. Predicting Behaviors: A Look at Actions to Prevent Domestic Violence,” Health Communication 14 (4, 2002): 429-49; Shelly Rodgers and Esther Thorson, “The Reporting of Crime and Violence in the Los Angeles Times: Is There a Public Health Perspective?” Journal of Health Communication 6 (April 2001): 169-82; Esther Thorson, ”Print News and Health Psychology,” Journal of Health Psychology 11 (2, 2006): 175-82.

19. American Psychological Association, Elder Abuse and Neglect. 20. Stephen Klaidman, Health in the Headlines: The Stories Behind the

Stories (New York Oxford University Press, 1991); Lawrence Wallack, Lori Dorfman, David Jernigan, and Makani Themba, Media Advocacy and Public Health: Power for Prevention (Newbury Park, CA: Sage, 1993).

21. Dorfman, Thorson, and Stevens, ”Reporting on Violence: Bringing a Public Health Perspective into the Newsroom”; John M. Johnson, ”Horror Stories and the Construction of Child Abuse,” in Images of Issues: Typifying Contemporary Social Problems, ed. Joel Best (New York Walter De Gruyter, 1989): 5-19; Stevens, Reporting on Violence: A Handbook for Journalists.

22. W. Lawrence Neuman, “Negotiated Meanings and State Transfor- mation: The Trust Issue in the Progressive Era,” Social Problems 45

23. Malcolm Spector and John I. Kitsuse, Constructing Social Prob7ems (Menlo Park, CA: Cummings, 1977).

24. Joel Best, ed., Images of Issues: Typifying Contemporary Social Problems (New York Aldine de Gruyter, 1989).

25. Kathleen S. Lowney and Joel Best, “Stalking Strangers and Lovers: Changing Media Typifications of a New Crime Problem,” in Images of Issues: Typifying Contemporary Social Problems, 2d ed., ed. Joel Best (New York Walter de Gruyter, Inc., 1995), 33-57.

26. Johnson, ”Horror Stories and the Construction of Child Abuse”; Lowney and Best, “Stalking Strangers and Lovers: Changing Media Typifications of a New Crime Problem.”

(August 1998): 315-35.

27. Spector and Kitsuse, Constructing Social Problems. 28. Johnson, ”Horror Stories and the Construction of Child Abuse.” 29. Johnson, ”Horror Stories and the Construction of Child Abuse,”

30. Lowney and Best, “Stalking Strangers and Lovers: Changing

31. Lowney and Best, “Stalking Strangers and Lovers: Changing

32. Lowney and Best, “Stalking Strangers and Lovers: Changing

33. Robert M. Entman, ”Framing: Toward Clarification of a Fractured

19.

Media Typifications of a New Crime Problem.”

Media Typifications of a New Crime Problem,” 33.

Media Typifications of a New Crime Problem,” 33.

Paradigm,” Journal of Communication 43 (autumn 1993): 51-58.

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34. Erving Goffman, Frame Analysis: A n Essay on the Organization of Experience (Cambridge, MA: Harvard University Press, 1974); Muzafer Sherif, Social Interaction: Process and Products (Chicago: Aldine, 1967).

35. Dietram A. Scheufele, ”Agenda-Setting, Priming, and Framing Revisited: Another Look at Cognitive Effects of Political Commu- nication,” Mass Communication 6 Society 3 (spring/summer 2000): 297- 316.

36. Lori Dorfman, Lawrence Wallack, and Katie Woodruff, ”More Than a Message: Framing Public Health Advocacy to Change Corporate Practices,” Health Education 6 Behavior 32 (June 2005): 320-36; Wallack et al., Media Advocacy and Public Health: Power for Prevention; Kim Walsh- Childers, ”Newspaper Influence on Health Policy Development,” Newspaper Research Journal 15 (summer 1994): 89-104.

37. Dorothy Nelkin, Selling Science: How the Press Covers Science and Technology (New York Freeman, 1987), 54.

38. Julie L. Andsager and Angela Powers, “Framing Women’s Health with a Sense-Making Approach: Magazine Coverage of Breast Cancer and Implants,” Health Communication 13 (2, 2001): 163-85; Regina G. Lawrence, “Framing Obesity: The Evolution of News Discourse on a Public Health Issue,” PresslPolitics 9 (3, 2004): 56-75.

39. Shanto Iyengar, Is Anyone Responsible? How Television Frames Political Issues (Chicago: University of Chicago Press, 1991).

40. Wallack et al., Media Advocacy and Public Health: Powerfor Pre- vention.

41. Shelly Campo and Teresa Mastin, “Placing the Burden on the In- dividual: Overweight and Obesity in African-American and Main- stream Women‘s Magazines,” Health Communication 22 (3, 2007): 229-40; Teresa Mastin and Shelly Campo, ”Conflicting Messages: Overweight and Obesity Advertisements and Articles in Black Magazines,” The Howard Journal of Communications 17 (December 2006); 265-85; Wallack et al., Media Advocacy and Public Health: Power for Prevention.

42. Lori A. Post, Gia E. Barboza, Artem B.Prokhorov, Michael G. Hogberg, James F. Oehmke,and Sarah J. Swierenga, “Public Policy Im- plications of an Aging Population for the Prevention of Abuse, Neglect, and Exploitation of the Elderly” (unpublished manuscript, 2006).

43. Lachs and Pillemer, ”Elder Abuse.” 44. Iyengar, Is Anyone Responsible? How Television Frames Political

Issues. 45. Felicia Mebane, ”Want to Understand How Americans Viewed

Long-Term Care in 1998? Start with Media Coverage,” The Gerontologist 41 (February 2001): 24-33.

46. Jan R. Greenberg and Martha McKibben, “Dependent Adult Children and Elder Abuse,” Journal of Elder Abuse Neglect 2 (June 1990): 73-86; Lachs and Pillemer, ”Elder Abuse”; Melissa Muehlbauer and Patricia A. Crane, “Elder Abuse and Neglect,” Journal of Psychological Nursing and Mental Health Services 44 (November 2006): 43-48; Karl Pillemer and David Finkelhor, ”Causes of Elder Abuse: Caregiver Stress Versus Problem Relatives,” American Journal of Orthopsychiatry 59 (April 1989): 179-87; Karl Pillemer and J. Jill Suitor, ”Violence and Violent

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Feelings: What Causes Them among Family Givers?” Journal of Gerontology 47 (July 1992): S165-S72.

47. Campo and Mastin, ” Placing the Burden on the Individual: Overweight and Obesity in African-American and Mainstream Wo- men’s Magazines”; Mastin and Campo, “Conflicting Messages: Over- weight and Obesity Advertisements and Articles in Black Magazines”; Wallack et al., Media Advocacy and Public Health: Power for Prevention.

48. Johnson, ”Horror Stories and the Construction of Child Abuse”; Lowney and Best, “Stalking Strangers and Lovers: Changing Media Typi- fications of a New Crime Problem.”

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