Abstract

Introduction

Journalism shows a growing interest in the delivery of health content¹1. Oliveira VC. Os sentidos da saúde nas mídias jornalísticas impressas. RECIIS, Rev Eletronica Comum, Inf Inov Saude. 2013; 6(4):1-14.^-22. Silva MAR. Além do newsmaking: um olhar panorâmico para as pesquisas em jornalismo. In: Lerner K, Sacramento I. Saúde e jornalismo: interfaces contemporâneas. Rio de Janeiro: Fiocruz; 2014.. Most of the newspapers with the largest circulation in the country (both printed and digital) have spaces dedicated to the theme. In the case of the Folha de São Paulo, there is the daily “Health + Science” and the weekly Equilíbrio and Saúde. Globo also publishes health, science and technology news in the Society section. The Estadão has a daily health magazine and the southern Zero Hour, the weekly supplement Caderno Vida³3. Langbecker A, Catalan-Matamoros D. Las secciones de salud en los periódicos brasileños: el caso del diario Folha de São Paulo. In: Terrón JL, Peñafiel C, Catalan-Matamoros D. Avances en investigación y buenas prácticas en comunicación y salud. Cuadernos Artesanos de Comunicación. Tenerife: Latina; 2017..

This theme may still be present in several daily newspaper editorials, such as in Cidade when addressing issues related to the emergency service units; in Police, when portraying the aggression to health professionals in public hospitals; in the section of Politics, when bringing the speech of authorities on the financing of the public health system, as well as in Sports, when it publishes some news on diets for runners²2. Silva MAR. Além do newsmaking: um olhar panorâmico para as pesquisas em jornalismo. In: Lerner K, Sacramento I. Saúde e jornalismo: interfaces contemporâneas. Rio de Janeiro: Fiocruz; 2014..

This subject also regularly receives the pages of magazines Veja, Isto É, Época and television programs³3. Langbecker A, Catalan-Matamoros D. Las secciones de salud en los periódicos brasileños: el caso del diario Folha de São Paulo. In: Terrón JL, Peñafiel C, Catalan-Matamoros D. Avances en investigación y buenas prácticas en comunicación y salud. Cuadernos Artesanos de Comunicación. Tenerife: Latina; 2017., in addition to its presence in news sites and social networks, expanding the possibilities of content delivery on health.

How is journalistic coverage when it comes to topics of interest to Brazilian collective health? In this paper it is understood as an interdisciplinary field, aimed to the understanding of health and the explanation of the social determinants of the health-disease process. Its aim is not only for the individual, but also for the community, with a priority focus on health promotion, contemplating likewise the prevention and care of diseases and diseases⁴4. Silva LMV, Paim JS, Scharaiber LB. O que é saúde coletiva? In: Paim JS, Almeida-Filho N. Saúde coletiva: teoria e prática. Rio de Janeiro: Med Book; 2014..

Despite the relevance of this question, there are few review studies in health and communication that contribute to illuminate this issue. According to Terrón et al.⁵5. Terrón JL, Leyva FMR, Fernández SV, Jacobetty P. La comunicación en las revistas de salud pública de la biblioteca virtual Scielo. Rev Española Comun Salud. 2017; 8(2):165-83., analyzing the publications on communication in the public health journals available in the Scielo database, covering eleven countries including Brazil, the number of articles published on this subject for a period of ten years was inexpressive.

With the purpose of painting a broad outline, as well as identifying gaps, the present study sought to characterize the profile of scientific production in the health area - from 2000 to 2015 - that analyzed journalistic coverage on topics pertinent to this field.

Methodological strategy

The scoping review - methodological option of the present work - aims to map the main concepts on a given theme. It is characterized by avoiding starting from a specific question and, as it proposes to bring a general overview, it does not make a qualitative analysis of the material. It allows including studies with different designs and methodologies. It also has as main function to point the gaps in the knowledge of the object in question⁶6. Arksey H, O’malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8(1):19-32.. In North America, specifically Canada, the tradition of developing scoping review is strong; in Brazil however, the use of this method is still scarce.

A systematic search was carried out in the databases of the Virtual Health Library (VHL), which brings together national and international databases of articles in Portuguese, English and Spanish (Chart 1), with success on the bases described in Figure 1. The period investigated was from 2000 to 2015 because it is more representative of the scientific production of the field of communication and health in Brazil, due to its recent structuring, and the beginning of more significant initiatives date from the end of the 90s⁷7. Araújo IS, Cardoso JM. Comunicação e saúde. Rio de Janeiro: Fiocruz; 2007.. The first scientific journal in Brazil and Latin America with this focus, the magazine Interface - Communication, Health, Education, for example, was released in 1997⁸8. Cyrino AP, Lima EA, Garcia VL, Teixeira RR, Foresti MCPP, Schraiber LB. Um espaço interdisciplinar de comunicação científica na Saúde Coletiva: a revista Interface - Comunicação, Saúde, Educação. Cienc Saude Colet. 2015; 20(7):2059-68..

We understand journalistic coverage not only as the act of covering a series of facts, which result in the news being conveyed, but also as a “verification and angulation strategy”⁹9. Silva G, Soares RL. O método análise de cobertura jornalística e o acontecimento noticioso da doença do ex-presidente Lula. Rumores. 2013; 7(14):80-7. doi: 10.11606/issn.1982-677X.rum.2013.69431.
https://doi.org/10.11606/issn.1982-677X.... (p. 1), which includes the news production process. We still consider the public’s perspective regarding the coverage of the issue.

The following inclusion criteria were adopted: empirical studies whose objective was to investigate the Brazilian journalistic coverage on issues, problems or themes pertinent to Brazilian Collective Health; studies that analyzed the generalist media, except the studies that analyzed concomitantly generalist and specialized media.

Were excluded: articles in which the focus of journalistic coverage on individual health did not establish any connection with a collective perspective; empirical studies that referred to the media without presenting data related to the media; studies that analyzed the specialized media.

The steps of the process of obtaining the selected articles were guided by the “Guidance for conducting systematic scoping reviews”¹⁰10. Peters MD, Godfrey CM, Khalil H, Mclnerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015; 13(3):141-6.. In this proposal, the first author and the third author made the initial selection of articles and the fourth author made the final review, expressing any doubts. In order to expand the search, the articles obtained from the cross-references were included. Those articles are the references captured from articles included in the review (Figure 1).

Results and discussion

A total of 64 articles were selected for analysis (Figure 1). These manuscripts were organized in the following categories: themes, data production, methods of analysis and media investigated. Some subcategories were created from these, taking as reference the frequency of appearance within the investigated studies. They also fulfilled the function of grouping elements that were repeated infrequently among the included articles.

We categorized 11 themes in which the scientific production focused mainly on the journalistic coverage of “physical and mental diseases”, as specified in Chart 2. It is important to note however, that no databases of the field of communication were included, and that that inclusion may have resulted in another configuration to these results, as warned by Terrón et al.⁵5. Terrón JL, Leyva FMR, Fernández SV, Jacobetty P. La comunicación en las revistas de salud pública de la biblioteca virtual Scielo. Rev Española Comun Salud. 2017; 8(2):165-83.

Among those of physical origin, research on infectious diseases (Chart 3), such as: H1N1 influenza (28.57%), dengue (21.43%), AIDS (14.28%), yellow fever (14.28%), encephalitis (7.14%), meningitis (7.14%) and visceral leishmaniasis (7.14%). Of the most investigated, the studies found that the focus of coverage on the H1N1 flu epidemic was centered on panic, risk, and fear related to the disease. In the case of dengue, the research pointed to accountability and culpability of the population on its occurrence.

To Waisbord⁷⁵75. Waisbord S. Cuando la salud es titular: dengue, gripe A H1N1 y ciclos ‘mediáticos-epidémicos’. In: Petracci M, Waisbord S. Comunicación y salud en la Argentina. Buenos Aires: La Crujia; 2011. p. 93-103., these two diseases have priority in the Latin American media agenda, composing what are known as “epidemic media” cycles (related to the dynamics of topics in the journalistic agenda). Some factors that, according to the author⁷⁵75. Waisbord S. Cuando la salud es titular: dengue, gripe A H1N1 y ciclos ‘mediáticos-epidémicos’. In: Petracci M, Waisbord S. Comunicación y salud en la Argentina. Buenos Aires: La Crujia; 2011. p. 93-103., contribute putting the H1N1 flu and dengue fever in the information cycle are, among others, oriented: because the speed and expansion of cases fit the journalistic requirement to convey updated information daily; and the two diseases extrapolate the social and geographical divisions of other diseases by being transmitted with high effectiveness between different groups. As they do not focus only on low-resource populations, as they do with other diseases, they impact where the media and its audiences live and work, thus counting on greater journalistic value.

These findings make us reflect how diseases tend to be shown by the media in isolation, without considering the social determinants, and can change the focus of the population’s perception of the origin of the problem, as well as legitimize the State’s lack of responsibility in this regard⁷⁶76. Fleury-Teixeira P, Bronzo C. Determinação social da saúde e política. In: Nogueira RP. Determinação social da saúde e reforma sanitária. Rio de Janeiro: Cebes; 2010.. It is not in question the perspective of adopting a paternalistic attitude towards the population and a criminalist towards the State, but rather of offering an opportunity for a more comprehensive critique to be made through what is published by the press.

Non-communicable chronic diseases (NCDs) - which significantly impact the population and the health system itself - accounted for about 70% of deaths in 2007, becoming a priority health demand in the country⁷⁷77. Schmidt MI, Duncan BB, Silva GA, Menezes AM, Monteiro CA, Barreto SM, et al. Doenças crônicas não transmissíveis no Brasil: carga e desafios atuais. In: Victora CG, Leal MC, Barreto ML, Schmidt MI, Monteiro CA. Saúde no Brasil: a série The Lancet. Rio de Janeiro: Fiocruz; 2011. p. 61-74.. Part of this group are those related to the circulatory system, the number one cause of death, followed by cancer, which occupies second place in the ranking. In this review, we did not find studies on journalistic coverage for circulatory diseases.

Regarding cancer, the most investigated chronic disease, we found seven studies¹²12. Castro C. Câncer na mídia: uma questão de saúde pública. Rev Bras Cancerol. 2009; 55(1):41-8.

13. Jurberg C, Macchiute B. Câncer nas ondas do rádio. Rev Bras Cancerol. 2007; 53(3):291-6.

14. Jurberg C, Verjovsky M. Nunca aos domingos: um estudo sobre a temática do câncer nas emissoras de TV Brasileiras. Hist Cienc Saude Manguinhos. 2010; 17 Supl 1:149-63.

15. Jurberg C, Verjovsky M, Pereira G, Teixeira LA. Perfis das notícias sobre o câncer no correio da manhã e no The New York times nos anos 1931-1932 e 1948-1949. Rev Bras Cancerol. 2012; 58(2):143-52.

16. Jurberg C, Gouveia ME, Belisário C. Na mira do câncer: o papel da mídia brasileira. Rev Bras Cancerol. 2006; 52(2):139-46.

17. Jurberg C, Macchiute B. Um olhar sobre as revistas: o caso da divulgação em câncer. Intercom. 2006; 29(2):119-32.^-1818. Bertol S. Comunicação da saúde: um estudo comparado sobre a divulgação do câncer de mama Brasil-EUA. Rev FAMECOS. 2009; 39:105-11., whose majority was conducted by the same researcher¹³13. Jurberg C, Macchiute B. Câncer nas ondas do rádio. Rev Bras Cancerol. 2007; 53(3):291-6.

14. Jurberg C, Verjovsky M. Nunca aos domingos: um estudo sobre a temática do câncer nas emissoras de TV Brasileiras. Hist Cienc Saude Manguinhos. 2010; 17 Supl 1:149-63.

15. Jurberg C, Verjovsky M, Pereira G, Teixeira LA. Perfis das notícias sobre o câncer no correio da manhã e no The New York times nos anos 1931-1932 e 1948-1949. Rev Bras Cancerol. 2012; 58(2):143-52.

16. Jurberg C, Gouveia ME, Belisário C. Na mira do câncer: o papel da mídia brasileira. Rev Bras Cancerol. 2006; 52(2):139-46.^-1717. Jurberg C, Macchiute B. Um olhar sobre as revistas: o caso da divulgação em câncer. Intercom. 2006; 29(2):119-32.. Part of them showed that the media gave more space to news about prevention¹²12. Castro C. Câncer na mídia: uma questão de saúde pública. Rev Bras Cancerol. 2009; 55(1):41-8.

13. Jurberg C, Macchiute B. Câncer nas ondas do rádio. Rev Bras Cancerol. 2007; 53(3):291-6.^-1414. Jurberg C, Verjovsky M. Nunca aos domingos: um estudo sobre a temática do câncer nas emissoras de TV Brasileiras. Hist Cienc Saude Manguinhos. 2010; 17 Supl 1:149-63.^,1616. Jurberg C, Gouveia ME, Belisário C. Na mira do câncer: o papel da mídia brasileira. Rev Bras Cancerol. 2006; 52(2):139-46., although the focus on the coverage of scientific research was also present¹²12. Castro C. Câncer na mídia: uma questão de saúde pública. Rev Bras Cancerol. 2009; 55(1):41-8.^,1717. Jurberg C, Macchiute B. Um olhar sobre as revistas: o caso da divulgação em câncer. Intercom. 2006; 29(2):119-32.^,1818. Bertol S. Comunicação da saúde: um estudo comparado sobre a divulgação do câncer de mama Brasil-EUA. Rev FAMECOS. 2009; 39:105-11.. We found only one study on hypertension¹⁹19. Silva JP, Bousfield ABS, Cardoso LH. A hipertensão arterial na mídia impressa: análise da revista Veja. Psicol Saber Soc. 2013; 2(2):191-203.. However, no studies on diabetes have been found, despite the increase in the prevalence of this disease in the country⁷⁷77. Schmidt MI, Duncan BB, Silva GA, Menezes AM, Monteiro CA, Barreto SM, et al. Doenças crônicas não transmissíveis no Brasil: carga e desafios atuais. In: Victora CG, Leal MC, Barreto ML, Schmidt MI, Monteiro CA. Saúde no Brasil: a série The Lancet. Rio de Janeiro: Fiocruz; 2011. p. 61-74..

There was a low number of researches that looked at mental illnesses and disorders³⁷37. Guarniero FB, Bellinghini RH, Gattaz WF. O estigma da esquizofrenia na mídia: um levantamento de notícias publicadas em veículos brasileiros de grande circulação. Rev Psiquiatr Clin. 2012; 39(3):80-4.^,3939. Rios C, Ortega F, Zorzabelli R, Nascimento LF. Da invisibilidade à epidemia: a construção narrativa do autismo na mídia impressa brasileira. Interface (Botucatu). 2015; 19(53):325-35.

40. <underline>Santos JE, Cardoso CMS</underline>. Narrativas e experiências acerca da loucura: uma reflexão de profissionais de comunicação. Interface (Botucatu). 2011; 15(38):727-40. doi: 10.1590/S1414-32832011000300009.
https://doi.org/10.1590/S1414-3283201100... ^-4141. Machado AL. Reforma psiquiátrica e mídia: representações sociais na Folha de São Paulo. Cienc Saude Colet. 2004; 9(2):483-91., despite its expressive prevalence, reaching between 20% and 56% of the Brazilian adult population, mainly women and workers⁷⁸78. Santos EG, Siqueira MM. Prevalência dos transtornos mentais na população adulta brasileira: uma revisão sistemática de 1997 a 2009. J Bras Psiquiatr. 2010; 59(3):238-46.. The impact on the quality of life of these people and the repercussions they have on the world of work put mental disorders as a serious public health problem⁷⁹79. Gonçalves DM, Kapczinski F. Prevalência de transtornos mentais em indivíduos de uma unidade de referência para Programa Saúde da Família em Santa Cruz do Sul, Rio Grande do Sul, Brasil. Cad Saude Publica. 2008; 24(9):2043-53.^,8080. Neves RF, Nunes MO, Magalhães L. As interações entre os atores no retorno ao trabalho após afastamento por transtorno mental: uma meta etnografia. Cad Saude Publica. 2015; 31(11):2275-90..

The visibility of news about diseases and mental disorders can be central to the understanding and perception of them. However, the low scientific production does not give us many elements to establish a panorama regarding journalistic coverage, considering the diversity of existing disorders. Of the four manuscripts, we can point out a study, related to schizophrenia that found that the media investigated reinforced the stigma in relation to the disease³⁷37. Guarniero FB, Bellinghini RH, Gattaz WF. O estigma da esquizofrenia na mídia: um levantamento de notícias publicadas em veículos brasileiros de grande circulação. Rev Psiquiatr Clin. 2012; 39(3):80-4.. This study also highlighted that the news did not give voice to the patient suffering schizophrenia. This finding is in line with a trend already demonstrated by several studies of the sociology of journalism: the media prioritize official sources^(e(e)()A source is a person who the journalist interviews and who provides information to compose the news⁾ to the detriment of the voices of society. By using this strategy, the media tends to symbolically reproduce the existing power structure in the institutional order of society⁸¹81. Hall S. The narrative construction of reality: an interview with Stuart Hall. Sout Rev. 1984; 17(1):3-17.. Regarding depression, there was a study that highlighted that the media investigated emphasized medicalization as the priority treatment, demonstrating that the conception of news coverage in relation to the disease was biomedical³⁹39. Rios C, Ortega F, Zorzabelli R, Nascimento LF. Da invisibilidade à epidemia: a construção narrativa do autismo na mídia impressa brasileira. Interface (Botucatu). 2015; 19(53):325-35..

The second most researched topic was the Brazilian National Health System (SUS) with nine articles (Chart 2). Result of long social struggles, the SUS was implemented during more than 20 years, through the Organic Law of Health, 1990, with the purpose of being a universal, free, decentralized and democratic public health system. Despite this trajectory, according to Paim⁸²82. Paim JS. O que é o SUS. Rio de Janeiro: Fiocruz; 2009., politicians, health professionals, the media and the population know little about their health system and have different and distorted conceptions about it.

When analyzing the SUS category, we identified five subtopics, with the journalistic coverage of the Mais Médicos Program (Chart 4) leading this role. Its implementation took place in 2013 and is presented by the federal government as a strategy for the strengthening of Primary Care in the country.

The articles analyzed showed the role that the media played in the repercussion of the Mais Médicos Program⁴⁵45. Morais I, Alkiman D, Lopes J, Santos M, Leonel M, Santos R, et al. Jornais Folha de São Paulo e Correio Braziliense: o que dizem sobre o programa mais médicos? Rev Esc Enferm USP. 2014; 48 esp 2:112-20., their interference in the public conception of foreign physicians and in the acceptance of them by the public⁴⁵45. Morais I, Alkiman D, Lopes J, Santos M, Leonel M, Santos R, et al. Jornais Folha de São Paulo e Correio Braziliense: o que dizem sobre o programa mais médicos? Rev Esc Enferm USP. 2014; 48 esp 2:112-20., identifying a gap from the coverage in relation to the objectives of the law that created the program⁴⁷47. Luz C, Cambraia CN, Gontijo ED. Monitoramento de terminologia na mídia: o Programa Mais Médicos. Tradterm. 2015; 25:199-233..

Regarding sub-themes 2 and 3 (Chart 4), the studies identified that journalistic coverage focused on crisis periods in the health services⁴²42. Menegon VSM. Crise dos serviços de saúde no cotidiano da mídia impressa. Psicol Soc. 2008; 20 esp:32-40.^,4343. Silva GM, Rasera EF. A construção do SUS: problema no jornal Folha de S. Paulo. Hist Cienc Saude Manguinhos. 2014; 21(1):61-76., creating discredit of SUS managers and users⁴⁴44. Silva GM, Rasera EF. Desqualificação do SUS na Folha de São Paulo: construção discursiva de gestores e usuários. Psico. 2013; 44(1):82-91.. These findings dialog with Oliveira⁸³83. Oliveira VC. A comunicação midiática e o Sistema Único de Saúde. Interface (Botucatu). 2000; 4(7):71-80. considering that the main images and information divulged about the system use as a starting point a supposed inefficiency of the State, incompetence of the authorities or the professionals of the area, leading to the construction of a symbolic order that is scarcely reflexive regarding the field of health policy represented by SUS.

To Araújo⁸⁴84. Araújo IS. Um olhar sobre as relações entre o SUS e a mídia. In: Seminário SUS 20 anos: desafios para a informação e comunicação em saúde. Rio de Janeiro: Fiocruz, ICICT; 2009. p. 62-9., however, it is important to take into account the different interests that are at stake, considering that both SUS and the media are not homogeneous: “society against the media”, “SUS against the media”, and that this polarization “harms a real understanding of the process of social production of the meanings […]”⁸⁴84. Araújo IS. Um olhar sobre as relações entre o SUS e a mídia. In: Seminário SUS 20 anos: desafios para a informação e comunicação em saúde. Rio de Janeiro: Fiocruz, ICICT; 2009. p. 62-9. (p. 69).

Methodological approach: the predominance of qualitative studies

The methodological approach used in most studies was qualitative. There was only one quantitative study, as specified in Chart 5. Most of the studies were based on only one technique of data production: documentary research (texts, 93.85%, images, 6.15%). There were few who combined it with other techniques, such as interviews, focus groups and application of questionnaires (Chart 6). For Minayo⁸⁵85. Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. São Paulo: Hucitec; 1992., the triangulation of the data collection technique is an important resource to give greater validity to the study, however the use or not of various techniques, or even of research methods, will depend on the objective of the investigation and the object investigated. These factors have the last word regarding choices to make.

The observation was not used in any study, despite being a possible resource for analyzing journalistic routines and news production. In the field of journalism, the interactionist theory starts from the premise that news is a construction, resulting from complex processes of social interaction between social agents: journalists and sources of information; journalists and society; members of the professional community, inside and outside their organization. It is aimed at the production and the producers of the news, when studying the influence of the journalistic routine in the representation of the events. News production is thought as an industrial routine, and news is seen as the result of the various factors, i.e. personal, social, ideological, cultural, physical and historical⁸⁶86. Traquina N. Teorias do jornalismo: porque as notícias são como são. Florianópolis: Insular; 2012. v. 1..

Studies known as newsmaking fit into this perspective and draw on participant observation. With tradition in American studies⁸⁷87. Tuchman G. Making news: a study in the construction of the reality. New York: The Free Press, London: Collier Macmillan Publishers; 1978., it is potent, especially if aligned with other data production techniques, to understand the internal processes of news production (meeting follow-up and discussion of schedules, monitoring of coverage and interviews with reporters and editors).

However, we can consider that there are difficulties and limitations to include observation in research in the field of communication and health, both for the feasibility of this type of study - which demands time and availability of the researcher - and for the difficulty of access to the media.

On the studies of newsworthiness, Ponte⁸⁸88. Ponte C. Para entender as notícias: linhas de análise do discurso jornalístico. Florianópolis: Insular; 2005. emphasizes the importance of articulating various data production strategies, including in the writing studies the participant observation and the analysis of the journalistic coverage for longer periods to give more attention to the routines than to specific events.

Another aspect verified is that the investigated studies focused on the analysis of the journalistic product (82.82%), meeting a trend already identified in research in the area of communication⁸⁹89. Silva G, Maia FD. Análise de cobertura jornalística: um protocolo metodológico. Rumores. 2011; 10(5):18-6. doi: 10.11606/issn.1982-677X.rum.2011.51250.
https://doi.org/10.11606/issn.1982-677X.... . There were few investigations that included any dimension related to the journalistic production process (10.93%); or analyzing the public’s perception of the news stories, the so-called reception studies, “a receiving subject that re-signifies the media messages, identifying their negotiations and resistance to the logic of the media”⁹⁰90. Lerner K, Sacramento I. Saúde e jornalismo: interfaces contemporâneas. Rio de Janeiro: Fiocruz; 2014. (p. 22), representing 6.25% of the investigated studies. In a brief mapping on the publication of articles in scientific journals of communication and health, Lerner and Sacramento⁹⁰90. Lerner K, Sacramento I. Saúde e jornalismo: interfaces contemporâneas. Rio de Janeiro: Fiocruz; 2014. also arrived at the same finding about the timid presence of studies aimed at reception.

These findings refer to the repetition of methodological formulas commonly used in studies on the media and show us some difficulty in incorporating these approaches, considering the various processes that comprise journalistic coverage - in order to surround this phenomenon so complex by several prisms.

Absence of information on the methods of analysis employed

The most frequent methods of analysis - considering those that specified this information - were discourse and content analysis, a tendency also present in media studies⁸⁹89. Silva G, Maia FD. Análise de cobertura jornalística: um protocolo metodológico. Rumores. 2011; 10(5):18-6. doi: 10.11606/issn.1982-677X.rum.2011.51250.
https://doi.org/10.11606/issn.1982-677X.... . In the first case, some studies were based on authors like Foucault, Orlandi, Charaudeau and Maingueneau (Chart 6). However, in some manuscripts, there was no direct reference to a certain school of discourse analysis or even which authors had based the theoretical-methodological choice. This information, however, is relevant if we consider that there are specificities and nuances between the various schools, such as the analysis of discourse, a French line, and critical analysis of the discourse, an Anglo-Saxon line.

In an article, the authors combined several methods of analysis: speech with agenda “setting and framing analysis”. Regarding content analysis, the main reference was that of Bardin. Other theoretical-methodological references used were “framing analysis” and Social Representations (SR). In the first case, not all articles made a reference to authors supporting this option, and those who did, resorted to Erving Goffman. However, there is a diversity of conceptual interpretations about framing analysis as well as its applicability⁹¹91. Gutmann JF. Quadros narrativos pautados pela mídia: framing como segundo nível do agenda-setting? Contemporanea. 2006; 4(1):25-50.^,9292. Rosseto GPN, Silva AM. Agenda-setting e framing: detalhes de uma mesma teoria? Intexto (Porto Alegre). 2012; 26:98-114., Regarding the representations, the reference author was Serge Moscovici. In three cases, SRs were combined with other methods, such as content analysis and Collective Subject Discourse⁹³93. Deslandes SF, Iriart JAB. Usos teórico-metodológicos das pesquisas na área de Ciências Sociais e Humanas em Saúde. Cad Saude Publica. 2012; 28(12):2380-6.. There was considerable number of articles where information on the method of analysis was not available. This information however, is important so that readers can evaluate the results presented in the publications. Methods that appeared only in one manuscript or were not combined with other methodologies were grouped into ‘Other’ (Chart 7).

Newspaper: the means of communication most investigated

Regarding the means investigated, according to Chart 8, the predominance was the newspapers as also identified by Catalan-Matamoros and Peñafiel-Saiz⁹⁴94. Catalan-Matamoros D, Peñafiel-Saiz C. The use of traditional media for public communication about medicines: a systematic review of characteristics and outcomes. Health Commun. Forthcoming 2018 [citado 22 Dez 2017]. Disponível em: https://www.tandfonline.com/doi/full/10.1080/10410236.2017.1405485. doi: 10.1080/10410236.2017.1405485.
https://www.tandfonline.com/doi/full/10.... and Terrón et al.⁵5. Terrón JL, Leyva FMR, Fernández SV, Jacobetty P. La comunicación en las revistas de salud pública de la biblioteca virtual Scielo. Rev Española Comun Salud. 2017; 8(2):165-83. There were only three that investigated television programs, all broadcasted by Rede Globo; one study analyzed the content published in a radio program and another investigated news sites, however, this manuscript did not specify in the methodology section, which were the sites investigated, being possible to detect such information during the presentation of the results.

It is also possible to infer that this tendency to choose the analysis of newspapers may be related to the ease of making this kind of study feasible: having access to the object (newspaper) is easier⁵5. Terrón JL, Leyva FMR, Fernández SV, Jacobetty P. La comunicación en las revistas de salud pública de la biblioteca virtual Scielo. Rev Española Comun Salud. 2017; 8(2):165-83. because in general and especially in national newspapers, content is available on the internet.

For analysis of other media, such as radio and television, it is necessary to record the content, regarding the current situation, or to use the database of the broadcasters, when referring to the previous periods, which in both cases may represent a hindrance. Another aspect is the short duration of studies that can restrict the researchers, limiting them to study media that require less availability and time⁸⁹89. Silva G, Maia FD. Análise de cobertura jornalística: um protocolo metodológico. Rumores. 2011; 10(5):18-6. doi: 10.11606/issn.1982-677X.rum.2011.51250.
https://doi.org/10.11606/issn.1982-677X.... .

There was no analysis of social media networks, such as Facebook or Twitter, something that may have been interesting in order to reflect on the important role that these media are playing in today’s society, besides showing a possibility to access the various audiences in an investigation about their public.

An analysis that contemplates the diversity of the media could still offer us more elements to deepen our understanding related to journalistic coverage on Brazilian public health. The different media types can not be confused because they do not follow the same rules of operation: “No trabajan con el mismo material y no producen los mismos tipos de efecto sobre un público que además no es el mismo⁹⁵95. Charaudeau P. ¿Nos manipulan los medios? Cuad Inf Comun. 2005; (10):319-30.” (They do not work with the same material and do not produce the same kind of effect on an audience that is not the same) (p. 321).

Among the most investigated newspapers were those related to the major press, such as Folha de São Paulo, Globo and Estado de São Paulo. There were, however, studies from regional journals, mainly those that included a larger number of publications in their sample. The reviews of magazines were less frequent, and the studies focused on the more traditional and national ones such as Veja, Isto É e Época. Most of the studies - which reviewed journals and journals concurrently - did not consider some of these differences during their analysis: newspapers are daily, tend to focus on factual news, and weekly magazines tend to bring in more in-depth reporting, elements that could have implications during the analysis of the results.

Regarding comparative studies, there were few who used this feature; even those who analyzed more than one vehicle did not analyzed them in most cases in a comparative perspective. There were two studies, for example, that compared coverage in Brazilian and American newspapers, both related to cancer¹⁵15. Jurberg C, Verjovsky M, Pereira G, Teixeira LA. Perfis das notícias sobre o câncer no correio da manhã e no The New York times nos anos 1931-1932 e 1948-1949. Rev Bras Cancerol. 2012; 58(2):143-52.^,1818. Bertol S. Comunicação da saúde: um estudo comparado sobre a divulgação do câncer de mama Brasil-EUA. Rev FAMECOS. 2009; 39:105-11.. This methodology has been used in other areas of knowledge, but in the Communication, although the volume of research is high in relation to the news, few are comparative, showing that the number of journalism studies with this profile is low⁸⁶86. Traquina N. Teorias do jornalismo: porque as notícias são como são. Florianópolis: Insular; 2012. v. 1.. In Collective Health, its use is relatively new⁹⁶96. Conill EM, Mendonça MH, Silva RAPR, Gawryszewski V. Organização dos serviços de saúde: a comparação como contribuição. Cad Saude Publica. 1991; 7(3):328-46.. According to Conill⁹⁶96. Conill EM, Mendonça MH, Silva RAPR, Gawryszewski V. Organização dos serviços de saúde: a comparação como contribuição. Cad Saude Publica. 1991; 7(3):328-46., “Comparing is looking for similarities, differences or relationships between phenomena that may be contemporary or not, occurring in distinct spaces or not to better understand them” (p.564). For this reason, the use of this methodology is potent to identify differences or similarities in journalistic coverage considering the different social contexts of news production.

Final considerations

This review brought a broad landscape of the scientific production on issues of Brazilian collective health. However, it indicated several shortcomings: there were few studies on chronic diseases and neglected diseases, which have a significant impact on the health of the population. New studies could provide an overview of the frequency of these contents, the kind of approach used, if they bring some perspective on health promotion, if they focus on the discovery of new medicines, the quality of the information or even another theoretical-methodological approach, such as senses and discourses produced on these NCD in the media.

It is also possible to reflect on whether the media agenda itself may have guided the scientific production in the area, considering that epidemic diseases were one of the most investigated themes. Regarding the SUS category, the ‘More Doctors’ program - which received wide coverage of journalism - was also one of the topics that most aroused interest on the part of researchers.

Regarding the methodology, there was a low diversity of data production techniques, and observation was not observed in any study. Few works have contemplated other aspects that are also related to journalistic coverage, such as the production of news and the perception of the users about its contents. These findings lead us to reflect on the importance of further investigations that may encompass these other processes. Regarding the method of analysis, there were a considerable number of articles that did not specify this information. This methodological issue is a challenge to be faced by researchers in new studies in this field. It is also important to highlight the low diversity of media investigated.

References

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