New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants

Background: Public stigma surrounding alcohol use disorder (AUD) negatively impacts people with alcohol-related liver disease (ALD) in need of liver transplants (LT). Representations of LT for ALD are socially constructed in part through media, but media on this topic has been underexplored in curre...

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Main Authors: Whitney Langlee, Divya Kalluri, Rivka Abedon, Aura T. Teles, Janetta Brundage, Po-Hung Chen, Andrew M. Cameron, Hannah C. Sung, Olivia S. Kates
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:SSM: Qualitative Research in Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667321525000459
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author Whitney Langlee
Divya Kalluri
Rivka Abedon
Aura T. Teles
Janetta Brundage
Po-Hung Chen
Andrew M. Cameron
Hannah C. Sung
Olivia S. Kates
author_facet Whitney Langlee
Divya Kalluri
Rivka Abedon
Aura T. Teles
Janetta Brundage
Po-Hung Chen
Andrew M. Cameron
Hannah C. Sung
Olivia S. Kates
author_sort Whitney Langlee
collection DOAJ
description Background: Public stigma surrounding alcohol use disorder (AUD) negatively impacts people with alcohol-related liver disease (ALD) in need of liver transplants (LT). Representations of LT for ALD are socially constructed in part through media, but media on this topic has been underexplored in current research. Methods: Research team members conducted systematic searches during 7/2022-5/2024 for online, publicly available articles about LT for ALD within leading English-language news sites in the US by monthly visits (n = 24). Using inductive framing analysis, we coded and identified patterns in news articles (n = 42) from 1990 to 2021 to generate frames. Findings: Our inductive analysis generated 4 main frames: (a) making individual exceptions: good people in a bad group, (b) appealing to societal costs: individual actions putting a strain on society, (c) questioning professionals' judgements: doctors’ discretionary power, and (d) portraying healthcare as a competition: unfair play in a zero-sum game. Media characterized people with ALD as less deserving of liver transplant, but with individual exceptions. Articles described people with “self-induced” illnesses as irresponsible towards themselves, other LT candidates, and society; doctors as “gatekeepers” with discretionary power over how to apply criteria or rules; and the liver transplant waitlist as a competitive zero-sum game in which people with ALD are or should be deprioritized. Discussion: News articles reflect our society's stigmatization of alcohol-related conditions as well as misconceptions about transplant listing and allocation. Such mischaracterizations can further marginalize stigmatized patients with alcohol-related conditions in need of LTs. We offer recommendations for public communications, including avoiding representations of patients with ALD as exceptions to the norm and contextualizing LT for ALD within the context of public health and social and systemic factors.
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spelling doaj-art-300a676b9a7145aa8bb2e29d274df24e2025-08-20T02:28:41ZengElsevierSSM: Qualitative Research in Health2667-32152025-06-01710056710.1016/j.ssmqr.2025.100567New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplantsWhitney Langlee0Divya Kalluri1Rivka Abedon2Aura T. Teles3Janetta Brundage4Po-Hung Chen5Andrew M. Cameron6Hannah C. Sung7Olivia S. Kates8Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Gastroenterology & Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Addiction Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Medicine, Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA; Corresponding author. Johns Hopkins University, 601 N Wolfe Street Baltimore, MD, 21205, USA.Background: Public stigma surrounding alcohol use disorder (AUD) negatively impacts people with alcohol-related liver disease (ALD) in need of liver transplants (LT). Representations of LT for ALD are socially constructed in part through media, but media on this topic has been underexplored in current research. Methods: Research team members conducted systematic searches during 7/2022-5/2024 for online, publicly available articles about LT for ALD within leading English-language news sites in the US by monthly visits (n = 24). Using inductive framing analysis, we coded and identified patterns in news articles (n = 42) from 1990 to 2021 to generate frames. Findings: Our inductive analysis generated 4 main frames: (a) making individual exceptions: good people in a bad group, (b) appealing to societal costs: individual actions putting a strain on society, (c) questioning professionals' judgements: doctors’ discretionary power, and (d) portraying healthcare as a competition: unfair play in a zero-sum game. Media characterized people with ALD as less deserving of liver transplant, but with individual exceptions. Articles described people with “self-induced” illnesses as irresponsible towards themselves, other LT candidates, and society; doctors as “gatekeepers” with discretionary power over how to apply criteria or rules; and the liver transplant waitlist as a competitive zero-sum game in which people with ALD are or should be deprioritized. Discussion: News articles reflect our society's stigmatization of alcohol-related conditions as well as misconceptions about transplant listing and allocation. Such mischaracterizations can further marginalize stigmatized patients with alcohol-related conditions in need of LTs. We offer recommendations for public communications, including avoiding representations of patients with ALD as exceptions to the norm and contextualizing LT for ALD within the context of public health and social and systemic factors.http://www.sciencedirect.com/science/article/pii/S2667321525000459Alcohol useNews mediaQualitativeFraming analysisLiver transplantationAlcohol-related liver disease
spellingShingle Whitney Langlee
Divya Kalluri
Rivka Abedon
Aura T. Teles
Janetta Brundage
Po-Hung Chen
Andrew M. Cameron
Hannah C. Sung
Olivia S. Kates
New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants
SSM: Qualitative Research in Health
Alcohol use
News media
Qualitative
Framing analysis
Liver transplantation
Alcohol-related liver disease
title New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants
title_full New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants
title_fullStr New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants
title_full_unstemmed New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants
title_short New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants
title_sort new stories same stigma framing analysis of news articles about people with alcohol related conditions needing liver transplants
topic Alcohol use
News media
Qualitative
Framing analysis
Liver transplantation
Alcohol-related liver disease
url http://www.sciencedirect.com/science/article/pii/S2667321525000459
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