A qualitative exploration of cardiovascular health and disease messages surrounding Canadian and U.S. campaigns through Facebook and Twitter

Abstract

Cardiovascular disease (CVD) is the leading cause of death and disability among Canadian and U.S. women. A majority of Canadian and U.S. women are unaware of their CVD risk profiles, symptoms of acute cardiac events, and take inadequate action to lower their risk. There is limited understanding regarding the meanings associated with Canadian and U.S. cardiovascular health campaign messages and user interactivity with these messages on social media. Filling in this knowledge gap contributes to understanding how women’s beliefs and behaviours are shaped by prevalent mass media forums, which construct certain portrayals of women’s disease, risk, and health-related identities. Within this doctoral dissertation, four studies were conducted in order to explore the media’s role in the social construction of CVD meanings. In the first study, a metasynthesis was conducted of primary research findings regarding qualitative analyses of mass media narratives surrounding women’s CVD in Canada and the U.S. Key findings included two critical, transcendental themes: 1) the medicalized culture of women’s CVD risk, and 2) the feminization of cardiovascular healthism. The second study was an ethnographic content analysis of the portrayals of women’s cardiovascular risk and health identities on Facebook page narratives of the Heart and Stroke Foundation of Canada (HSFC). An overarching theme of philanthropy as an act of women’s health promotion was identified and three sub-themes: 1) a culture of consumerism for women’s health promotion, 2) the cardiovascular systems of women as sites of fear and dependence, and 3) women’s CVD risk, acute events, and treatment as shared, community experiences. The third study used critical discourse analysis to explore the Facebook page of U.S. women’s cardiovascular health promotion agency Women’s Heart Alliance to investigate the discourses through which women’s CVD was portrayed, and the implications of these discourses on the construction of subject positions for related social agents. iv Women’s CVD was constructed within two central discourses: a discourse of achieving health equity and a discourse of healthism. These discourses intersected to construct the subject positions of altruistic fighters, health activists, and compliant patients and consumerists. The fourth study comprised a critical discourse analysis of the HSFC More Moments campaign meanings on Twitter for men and women. CVD risk was portrayed through a discourse of tragedy and loss, and a discourse of life and health, which constructed the subject positions of visionary leaders, selfless humanitarians, and successful survivors. Collectively, the findings of these four studies build upon understandings of the media’s nuanced contributions to gendered constructions of CVD meanings and risk.