Despite its high incidence, SUID was far less commonly mentioned in the news media, with only 1.9% mentioned, as compared to 8.1% of drownings, 11.4% of MVC’s, 14.7% of homicides between the ages of 1–18, 20% of fire-related deaths and 25% of homicides under age one. When compared to SUID, these other deaths were mentioned in the news media between 4 and 13 times more. MVCs caused the largest number of injury deaths in the 0–18 year-old range from 2014 to 2018 in Georgia. However, SUID was almost as common and affected a much smaller age range, creating a proportionally larger population impact.
Racial discrepancies
This study is the first to examine racial discrepancies in the news media reporting of SUID. In addition, it corroborates that there is a mismatch between news media reporting of SUID and incidence. In Chicago between 2011 and 2015, news media reported 42 (59.2%) of the MVC deaths, 17 (37.8%) of the fire-related deaths, and 0 (0%) of the SUID deaths. Despite there being more than twice the SUID deaths than the number of MVC and fire-related deaths combined, there was a lack of news media coverage, which may lead to lower risk perception (Roehler et al. 2018). News media reporting also infrequently provides prevention messaging, which may be a missed opportunity for education and outreach (Faulkenberry and Schaechter 2015; Leavy et al. 2019). It is unclear why SUID is so infrequently mentioned in the news media.
Social media and mobile health intervention are being utilized increasingly to educate parents about safe sleep and other injury prevention topics. In a recent study, mothers who received safe sleep videos via text message or email were more likely to both place their infant supine to sleep and to room share. Although this study did not look at racial disparities in depth, they did state that “baseline levels of nonadherence [to safe sleep practices] were lower in African Americans…the SS [safe sleep] mHealth intervention improved these rates to levels comparable to those of other groups” (Moon et al. 2019). As parents of all backgrounds become more dependent on social media platforms and mobile health information to learn about health topics, it is important that we provide accurate information and prevention recommendations, specifically regarding safe sleep (Huo et al. 2019).
Both SUID and infant homicide disproportionately affected Black infants, with 58% (297/512) of SUID deaths and 71% (41/58) of infant homicide affecting Black infants (Table 3). We specifically focused on infant homicide due to finding during our research that many deaths that were originally thought to be SUID after further investigation were actually classified as infant homicide. By separating infant homicide from homicide in ages 1–18, we were able to directly compare infant homicides to SUID and analyze race data in the under 1-year age group.
White infant deaths were reported in the news media at 2.5 times the rate of Black infant deaths, controlling for whether they died of SUID or homicide. The disproportionately lower news media reporting of these deaths may give parents and communities the false impression that these deaths do not occur or do not have as much of an impact. If communities are unaware of an issue, they are less likely to be mobilized to address the issue and it also reduces the ability to add prevention messaging.
Studies suggest that social inequalities, not individual behaviors, are the main reason for health disparities, including discrepancies in social, environmental, physical, and economic conditions (Link and Phelan 1995; Kindig 2007; Berkman and Kawachi 2000). Previous studies have shown that the coverage of racial and ethnic health disparities has decreased since 1998. It is believed that the declining coverage of racial and ethnic health disparities may explain why the public is not aware of these health disparities (Kim et al. 2010). At least one previous network television producer has stated that bias is often present in local television newsrooms, and it is difficult to study the degree to which minorities are omitted from local news coverage (Lipschultz and Race 2003). Lack of communication and transparency may contribute to health disparities (Viswanath et al. 2006; Wallington et al. 2010; Nagler et al. 2016). By omitting those who are affected most by SUID, we are missing an important opportunity for education and prevention.
Limitations
During the evaluation of our news media reports, we had to rely on visual representation of race as compared to self-description, making us unable to determine ethnicity. Death records were not individually queried to determine the correlation of news media reports to the death record. News media reports were not linked to death records and all calculations were made using the separate news media report counts collected here and deaths as reported by OASIS. For SUID, OASIS counts only use the ICD-10 code R95 (SIDS) but exclude the related codes R99 (undetermined) and W75 (accidental suffocation and strangulation in bed) used to identify SUID cases. Because of this, the rates for news media reporting of SIDS may be overestimated here and the true disparities between the reporting of sleep related deaths and other injury related causes of death may be even greater. For homicides, many news media reports were not reported until someone was charged.
Race values were not available consistently in four out of our six categories (MVC, drowning, fire-related, and homicide between ages 1–18), as they were only reliably found for homicide under age one and SUID, so could only reliably be calculated for these two causes of death. Based on the significant number of small news media networks not affiliated with major cities and the countless ways that news is disseminated, our study was limited to local news networks and did not include print or social media. Despite limitations, this study provides an initial look at disparities in media reporting of injury deaths, particularly SUID. Future work will further evaluate racial disparities in news media reporting by linking individual news media reports to death records and evaluating findings in additional geographic areas.