Collaborative Research on Agenda-Setting: Temporal, Institutional, and Cross-Sectional Dynamics of Attention to Disease in the Public Arena

This proposal offers a radically different approach to studying how and why attention is allocated to problems, an approach that overcomes the limitations of many studies of agenda setting and social problem construction. It both builds and marks an advance on decades of important study devoted to the question of why some social problems draw a great deal of attention from government officials, the public, and the media while other problems receive little notice (Baumgartner and Jones 1993; Best 1990; Blumer 1971; Cobb and Ross 1997; Gusfield 1981; Hilgartner and Bosk 1988; Kingdon 1995; Schattschneider 1975; Schneider and Ingram 1993; Spector and Kitsuse 1973; Walker 1977). One body of work emphasizes the characteristics of problems themselves as important determinants of attention.

This research has helped to underscore how the groups in society who are burdened by problems and the organized advocates who take an interest in problems affect the attention those problems receive; problems are constructed through a ihsocial process.le Other work on agenda-setting, however, focuses on aspects of the attention allocation process that help determine which problems receive attention. This research has demonstrated how temporal dynamics as well as the interplay between various sub-agendas (e.g., Congress, the media) affect which problems make their way into the public arena. Despite the evidence that aspects of both process and problem are integral to the phenomenon of attention allocation, researchers have tended to focus solely on one of these dimensions. Thus, empirical generalizations tend to emerge from incomplete or misspecified models.

The proposed project proceeds theoretically from the idea that the phenomenon of allocating attention to problems is a complex function both of problem characteristics (such as problem burden, the size and nature of organized communities associated with a problem, and a problem's cultural valence), and of process-oriented dynamics (such as the relationships that exist among the agendas of different institutions; the temporal dynamics of agenda setting, and the relationships between different problems jockeying for agenda space). Empirically, the project proposes to compare the attention given to multiple problems over time in different arenas in order to discriminate between the process-oriented and problem-oriented determinants of the attention allocation process.

This is accomplished by studying attention to 37 different diseases by the media, by government, and by the scientific community across 25 years. Disease offers a powerful lens to view the problem-specific and process-related dynamics of the attention generating process because diseases are both medical facts and social constructions, and because diseases have clearly defined outcomes, like hospitalization or death, so that their severity can be gauged with a common metric.

This study of the problem- and process-oriented determinants of agenda setting offers both scholarly and practical rewards. The research design promises to advance the theoretical and empirical understanding of both social problem construction and agenda setting. Moreover, because of the specific focus on disease, the findings will address major policy issues: how the government responds to public health priorities, as reflected in the media and via organized interest groups; how disparities in disease burden by race/ethnicity, sex and age shape priorities; how these priorities inform the complex decisions made by pharmaceutical companies, both in their research and development of new drugs and in their marketing of existing ones; and how government budgetary decisions might reflect (if not magnify) these priorities. More broadly, the proposed project speaks to how societal resources are selectively allocated across a field of seemingly equally attention-worthy social problems.