Reporters are often encouraged to put a “face” on issues — to find individuals whose life stories illustrate the realities of corporate malfeasance, or some misguided policy. At one level, this editorial advice speaks to the desire for a more compelling article; following it might also garner a wider audience. But to what extent does telling representative stories — the essence of “narrative journalism” — also contribute to journalism’s civic mission of promoting deeper public understanding? What’s the precise difference between a “dry” policy story pitched at a general level and the textured narration of a particular source’s experience?

A 2012 study published in Journalism & Mass Communication Quarterly, “The Effect of Narrative News Format on Empathy for Stigmatized Groups,” was based on an experiment that tested responses to narrative and non-narrative stories on health care for the elderly, immigrants, and prisoners. The participants, 399 college-age adults, were given the same basic information in both story types, but the narrative stories framed the issues through the experiences of individuals, while non-narrative or “policy” stories framed issues around research findings. (See two contrasting examples of one story below.)

The study, from Penn State and Indiana University-Purdue University Fort Wayne, sought to test the “extent to which attitudes and beliefs are changed by information” in the two types of stories. After participants read the stories, they were also offered the chance to learn more about the groups spotlighted. The paper’s authors are Mary Beth Oliver, James Price Dillard, Keunmin Bae and Daniel J. Tamul.

The study’s findings include:

• “The data showed that narrative news stories produced changes in emotions, attitudes, intentions and behavior that were beneficial to members of stigmatized groups.” Overall, the “data clearly point to the potency of narrative formats for inducing compassionate affect.”
• The narrative stories make it more likely that readers would take the opportunity to learn more about the groups portrayed in the story, though the data were not overwhelming in terms of such further information-seeking.
• The results suggest that “variations in news format have the potential to promote favorable social and behavioral change toward stigmatized groups, though additional research is needed to examine how to increase the magnitude of these effects.”
• “Relative to non-narrative-formatted news stories, narratives instigate empathic processes that can substantially improve evaluations of stigmatized groups. Our data demonstrate the generality of these processes across three groups — immigrants, prisoners and the elderly — as well as illustrate the potential for behavior change. All told, the results point the way for members of the media to carry out their work in ways that lead to the betterment of society.”

The researchers note that the key to fostering better educational outcomes was the stories’ ability to evoke “compassion,” and the narrative stories presented did not seek to establish an ultimate cause for individuals’ health care-related problems. But not all news stories will necessarily work this way, and, as the study notes, on some occasions the cause of problems may be individuals: “Narrative format does not invariably create either favorable or unfavorable reactions in consumers. Rather, relative to non-narrative format, it amplifies various responses in ways that are consistent with the story line.”

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“Policy”-style story on immigrants and health care

Undocumented Workers in Health Jeopardy

Washington — Undocumented workers in the United States are receiving far less health care than their naturalized counterparts and full citizens, according to a Harvard University study published Thursday.

Undocumented workers are typically unable to afford health insurance or provide the necessary paperwork to receive coverage, said Professor Stacey Ward, who led the study. As a result, a large percentage of immigrants’ total interaction with a doctor begins and ends in the emergency room.

“When most people get sick or hurt they go to a doctor,” Ward said. “This is not always the case for people without health insurance.”

The study estimates that about 30% of the 9.3 million undocumented workers in this country have not seen a doctor in the last two years.

Many immigrants cannot apply for health insurance as they cannot afford it, Ward said. Since most employers who hire undocumented workers do not provide health insurance, workers often avoid medical treatment until an illness or an injury has become acute, at which point they are left with few other choices, she said.

“Many of the problems that will bring undocumented workers to the emergency room arise as a result of allowing a smaller and less serious problem to go untreated,” said Leonardo Cuello, director of the Washington, DC, Health and Law Project. This form of care is far more expensive than a routine visit to a primary care physician.

“Many times immigrants hurt the taxpayer more when they use emergency rooms for medical care than when they see a primary care physician,” said Cuello.

Medical problems can go undiagnosed for weeks or months at a time, often allowing for small health problems, like a few cuts on a finger, to fester and grow into much more debilitating conditions, said Ward.

Alejandro Martinez, 36, of Leesburg, Va., was working for Northern Apparel, a clothing manufacturer, when he cut two of his fingers while trimming fabric. He said because he did not have health insurance, he treated his injury at home. When his fingers later became infected, he had to have them amputated in a hospital emergency room.

The reliance of undocumented persons on emergency rooms can be traced to a 1986 federal law, requiring hospital emergency rooms to treat everyone regardless of their ability to pay or citizenship status. It makes hospital emergency rooms one of the few places that undocumented persons can receive care, no questions asked. The trouble, according to advocates, is that this care often comes at too high a price, both for the taxpayer and the patient.

According to Ward, having a portion of the population utilizing emergency rooms as primary care centers can also cause problems both for the uninsured and the rest of the population.

“If there is some emergency or natural disaster, emergency rooms need to be able to handle a large influx of patients all  at the same time,” said Ward. “You can’t have that if you have people in there that really should be seeing a general practitioner.”

Not all of the uninsured individuals in the country are immigrants. According to the non-partisan Kaiser foundation, about 46.3 million people that live in the United States are currently uninsured.

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“Narrative”-style story on immigrants and health care

Living Without Health Insurance

Washington — Alejandro Martinez, 36, of Leesburg, Va., fumbles with the buttons on his shirt, clumsily working around two missing fingers. Some mornings his heavily bandaged hand seems to have a will of its own.

“Let me get those,” his wife, Mariana, 35, told Martinez. “You’ll be late to drop the kids off.” She reaches up and deftly finishes off the last two buttons.

“It’s days like these when I miss my old life,” Martinez said. “Days when I can still feel those missing fingers are the hardest.”

Three weeks ago Martinez cut two of his fingers at work while trimming a roll of fabric as a floor worker at Northern Apparel, a large clothing manufacturer. He says he probably should have gotten stitches right then but small injuries are not uncommon and slow down the production line.

Last month Martinez had a well paying job at a clothing manufacturer and had recently been promoted to floor manager. The new position meant more time at home to spend with his wife and two children, Montoya, 5, and Isabel, 1, along with a much needed pay raise.

All of the things he once envisioned for himself and his family are no longer possible, Martinez said.

“When most people get sick or hurt they go to a doctor,” said Leonardo Cuello, Director of the Washington, DC, Health and Law Project. “This is not always the case for people without health insurance.”

Most employers who hire undocumented workers do not provide health insurance, and workers often avoid medical treatment until an illness or an injury has become acute, said Harvard University Professor Stacey Ward.

At this point they are left with few other choices.

A large percentage of immigrants’ total interactions with a doctor begin and end in the emergency room, Ward said. She said about 30% of the 9.3 million undocumented workers in this country have not seen a doctor in the last two years.

Instead of seeking immediate medical attention, Martinez treated the wound at home because he is an undocumented worker from Mexico and cannot afford health insurance.

“It was such a small cut, I thought I would be able to take care of it myself,” Martinez said.

His fingers became swollen and painful within a few days, looking more like fat sausages than human appendages. He realized that he needed to see a doctor and went to the emergency room for treatment. The news the doctors had for him was not good: It had been too long since the infection had set in and he would need an amputation.

“It was devastating,” Martinez said.

He said the knowledge that all of this could have been prevented is even more painful than the loss of his fingers. Because he could not see a doctor in time, he is now unable to help his son practice for the little league baseball team, carry his newborn daughter, or even dress himself in the morning.

“This whole thing has been such a heartbreaking experience. Alex used to love so much to play with our children when he got home from work,” Mariana Martinez said. “Now he can barely get himself dressed in the morning. It just breaks my heart.”

 

Tags: news, training, cognition