Structuration Theory and Health and Risk Messaging

2017 ◽  
Author(s):  
Joel Iverson ◽  
Tomeka Robinson ◽  
Steven J. Venette
Keyword(s):  
United States ◽  
Health Care ◽  
Media Coverage ◽  
Health Care Organizations ◽  
Essential Element ◽  
Structuration Theory ◽  
The United States ◽  
The Public ◽  
Communicative Constitution ◽  
Institutional Positioning

Risk can be defined using a mathematical formula—probability multiplied by consequences. An essential element of risk communication is a focus on messages within organizations. However, many health-related risks such as Ebola extend beyond an individual organization and risk is better understood as a social construction cogenerated within and between systems. Therefore, the process is influenced by systemic and supra-systemic values and predilections. Risk from a structurational perspective allows an understanding of the public as well as organizational responses to risk. Structuration theory provides a useful lens to move beyond seeing organizations as something that flows within an organization to understanding how organizations are enacted through communication. Structuration theory articulates the connections between systems and structures through the action of agents, whose practices produce and reproduce the rules and resources of social life. Within the structuration tradition, organizational communication scholars have shifted to an understanding of the communicative constitution of organizations (CCO). Specifically, one of the theories of CCO is the Four Flows Model. The four flows highlight the ways people enact organizations and provide a means to analyze the various ways communication constitutes organizations. The four flows are membership negotiation, activity coordination, reflexive self-structuring, and institutional positioning. Membership negotiation enacts the inner members and outsiders at a basic level including socialization, identity, and assimilation. Activity coordination produces collective action around a specific goal. Reflexive self-structuring is the decentralized enactment of structures for the organization through the communication of policies. Institutional positioning covers the macro-level actions where people in the organization act as an entity within the environment. When considering the public reaction to Ebola, a simple way to evaluate risk perception is the intersection of dread and control. The U.S. public considered Ebola a serious risk. From a structuration perspective, the viral nature of twitter, media coverage, and public discussion generated resources for fear to be exacerbated. Structuration theory allows us to position the risk beliefs as rules and resources that are reproduced through discourse. The organizational implications fall primarily into the two flows of institutional positioning and reflexive self-structuring. For institutional positioning, U.S. healthcare organizations faced general public dread and perceived lack of control. Within the United States multiple policies and procedures were changed, thus fulfilling the second flow of organizational self-structuring. The Ebola risk had a significant impact on the communicative constitution of health-care organizations in the United States and beyond. Overall, risk is communicatively constituted, as are organizations. The interplay between risk and health-care organizations is evident through the analysis of American cases of Ebola. Structuration theory provides a means for exploring and understanding the communicative nature of risk and situates that risk within the larger systems of organizations.

Current Issues in Health Care Technology Assessment

1989 ◽  
Vol 5 (1) ◽  
pp. 123-136 ◽  
Author(s):  
Frederick Mosteller ◽  
Elisabeth Burdick
Keyword(s):  
United States ◽  
Health Care ◽  
Technology Assessment ◽  
The United States ◽  
Health Care Technology ◽  
The Public ◽  
National System ◽  
Care Technology

This article presents an overview of technology assessment in the United States. The authors argue that while there are numerous institutions carrying out assessments, the United States requires an overall plan that would provide a national system for technology assessment. If technology assessment were more organized and systematized, the authors argue, it would be more efficient and would reach the public and the medical world effectively.

scholarly journals 2018: A watershed year for psychedelic science

2019 ◽  
Vol 5 ◽  
pp. 205032451987228 ◽  
Author(s):  
Jacob S Aday ◽  
Christopher C Davoli ◽  
Emily K Bloesch
Keyword(s):  
United States ◽  
Media Coverage ◽  
The United States ◽  
Ballot Initiatives ◽  
The Public ◽  
Psychedelic Drugs ◽  
The Status ◽  
Regulatory Bodies ◽  
The Public Sphere

While interest in the study of psychedelic drugs has increased over much of the last decade, in this article, we argue that 2018 marked the true turning point for the field. Substantive advances in the scientific, public, and regulatory communities in 2018 significantly elevated the status and long-term outlook of psychedelic science, particularly in the United States. Advances in the scientific community can be attributed to impactful research applications of psychedelics as well as acknowledgement in preeminent journals. In the public sphere, Michael Pollan’s book How to Change Your Mind was a commercial hit and spurred thought-provoking, positive media coverage on psychedelics. Unprecedented psychedelic ballot initiatives in the United States were representative of changes in public interest. Finally, regulatory bodies began to acknowledge psychedelic science in earnest in 2018, as evidenced by the designation of psilocybin-assisted psychotherapy to “breakthrough therapy” status for treatment-resistant depression by the U.S. Food and Drug Administration (FDA). In short, 2018 was a seminal year for psychedelic science.

scholarly journals To market, to market: Corporatisation, privatisation and hospital costs

1997 ◽  
Vol 20 (2) ◽  
pp. 13 ◽  
Author(s):  
Kevin White ◽  
Fran Collyer
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Services ◽  
Hospital Costs ◽  
The United States ◽  
Political Arena ◽  
The Public ◽  
Care Services ◽  
Health Strategy ◽  
Australian Hospital

The Australian political arena echoes with calls for the privatisation of health careinstitutions, the contracting-out of health care services and the introduction of variousmarketing strategies into hospital management. These calls are justified by assertingthat the market, rather than the public sector, can provide better services, greaterproductivity and increased efficiency. The National Health Strategy (1991, p 17)provides a good example. Noting that Australia is copying American investment trendsfor hospital ?chains? rather than for independent small establishments, the strategydismisses any concern over changes in ownership, pointing instead to a ?process ofrationalisation? that is to be ?welcomed?. Using evidence from the United States,United Kingdom and Australian hospital sectors, this paper examines claims for thegreater efficiency of market processes.

scholarly journals It Takes Three: How Mass Media Coverage Conditions Public Responsiveness to Policy Outputs in the United States

2017 ◽  
Author(s):  
Christopher Williams ◽  
Martijn Schoonvelde
Keyword(s):  
United States ◽  
Media Coverage ◽  
Public Attitudes ◽  
Empirical Support ◽  
The United States ◽  
Policy Outcomes ◽  
Policy Area ◽  
The Public ◽  
Media Attention ◽  
Public Demand

Democratic governance requires that policy outcomes and public demand for policy be linked. While studies have shown empirical support for such a relationship in various policy domains, empirical evidence also indicates that the public is relatively unaware of policy outputs. This raises a puzzle: Why do policy outputs influence public attitudes if the public knows little about them?MethodsThis study seeks to address this paradox by examining the conditioning role of media coverage. We rely on data derived from the Policy Agendas Project in the United States, allowing us to analyze the relationship between policy outcomes, public preferences, and newspaper content across a long span of time (1972–2007).ResultsOur results indicate that public policy preferences respond to policy outputs, and that this relationship is strengthened by greater media attention to a policy area. Importantly, our findings also indicate that without media attention to a policy area, there is no direct effect of policy outputs on public demand for policy.ConclusionsMedia coverage appears to be a key factor for public responsiveness to occur. In the absence of policy coverage by the media, public responsiveness to policy outputs is greatly reduced.

Government Intervention in Health Care Markets is Practical, Necessary, and Morally Sound

2012 ◽  
Vol 40 (3) ◽  
pp. 547-557 ◽  
Author(s):  
Len M. Nichols
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Health Reform ◽  
The United States ◽  
Evidence Based ◽  
Health Care Markets ◽  
Health Care Market ◽  
The Public ◽  
Patient Protection

The intensity of the opposition to health reform in the United States continues to shock and perplex proponents of the Patient Protection and Affordable Care Act (PPACA). The emotion (“Abort Obama”) and the apocalyptic rhetoric (“Save our Country, Protect our Liberty, Repeal Obamacare”), render civil and evidence-based debate over the implications and alternatives to specific provisions in the law difficult if not problematic. The public debate has largely barreled down two non-parallel yet non-intersecting paths: opponents focus on their fear of government expansion in the future if PPACA is implemented now, while proponents focus on the urgency and specifics of our health care market problems and the limited number of tools we have to address them. Frustration on both sides has led opponents to deny the seriousness of our health system’s problems and proponents to ignore the risk of governmental overreach. These non-intersecting lines of argument are not moving us closer to a desired and necessary resolution.

Myths as Barriers to Health Care Reform in the United States

2003 ◽  
Vol 33 (2) ◽  
pp. 315-329 ◽  
Author(s):  
John P. Geyman
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Public Interest ◽  
Free Market ◽  
The United States ◽  
The Public ◽  
Incremental Change ◽  
The U.S ◽  
Care System

The U.S. health care system is deteriorating in terms of decreasing access, increased costs, unacceptable quality, and poor system performance compared with health care systems in many other industrialized Western countries. Reform efforts to establish universal insurance coverage have been defeated on five occasions over the last century, largely through successful opposition by pro-market stakeholders in the status quo. Reform attempts have repeatedly been thwarted by myths perpetuated by stakeholders without regard for the public interest. Six myths are identified here and defused by evidence: (1) “Everyone gets care anyhow;” (2) “We don't ration care in the United States”; (3) “The free market can resolve our problems in health care”; (4) “The U.S. health care system is basically healthy, so incremental change will address its problems;” (5) “The United States has the best health care system in the world”; and (6) “National health insurance is so unfeasible for political reasons that it should not be given serious consideration as a policy alternative.” Incremental changes of the existing health care system have failed to resolve its underlying problems. Pressure is building again for system reform, which may become more feasible if a national debate can be focused on the public interest without distortion by myths and disinformation fueled by defending stakeholders.

Health

2010 ◽  
Author(s):  
Richard Freeman ◽  
Heinz Rothgang
Keyword(s):  
United States ◽  
Health Care ◽  
International Health ◽  
The United States ◽  
Modern State ◽  
Health Issues ◽  
Health It ◽  
Industrial Countries ◽  
The Public ◽  
The United Kingdom

This article focuses on the public aspects of health systems, on the ways in which concerns for health and health care are expressed in politics and policy. It first reviews the origins and development of health policy in the modern state, pointing to the different ways that development has been understood by welfare state scholars. It then discusses the different standard forms of health system, describing the ways health care is paid for, provided, and regulated in advanced industrial countries, and comments on the emergence of a new domain of international and global health. It takes the United Kingdom, Germany, and the United States as archetypes of respective systems in regulation patterns. International health issues are interesting not least because they cut across the logic of comparison.

Currents in Contemporary Ethics

2006 ◽  
Vol 34 (3) ◽  
pp. 620-623 ◽  
Author(s):  
Barry DeCoster
Keyword(s):  
United States ◽  
Health Care ◽  
Avian Influenza ◽  
Influenza Vaccine ◽  
Influenza Pandemic ◽  
The United States ◽  
Health Care Rationing ◽  
The Public ◽  
Care Rationing

The flu has an interesting history with respect to health care rationing in the United States. Consider that just about two years ago, the American public faced a shortage of influenza vaccine. Dire predictions were made about how many people might perish, and rationing protocols were created. However, many of the rationing protocols were ignored. Luckily, that flu season did not result in the horrible fatalities that were predicted. For these reasons, problems of health care rationing around issues of the flu were postponed, rather than resolved.Over the last year, the public has focused its anxious attention on the possible avian influenza pandemic. Last week I noticed that at least once each day I heard mention in some discussion or another of the threat of this disease becoming easily transmissible from human to human.

The Public Agenda

2019 ◽  
pp. 219-242
Author(s):  
Shaun Bevan ◽  
Will Jennings
Keyword(s):  
United States ◽  
Public Policy ◽  
Public Opinion ◽  
Media Coverage ◽  
The United States ◽  
Survey Question ◽  
Policy Issues ◽  
The Public ◽  
The United Kingdom ◽  
Public Agenda

This chapter considers the question of what shapes the public agenda and how, in turn, the public agenda influences public policy. It introduces the survey question about the most important problem as a measure of the public agenda—comparing evidence on the policy issues attended to by publics in the United States, the United Kingdom, and Spain, and also the degree to which public opinion itself is subject to “punctuations.” The analysis shows how the public agenda reflects both the problem status and level of media coverage of certain issues (specifically crime and the economy). Lastly, it presents evidence on the correspondence between the priorities of citizens and those of policymakers.

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