Holding Death at Bay vs. Prolonging Life: Indexing Fatalism and Optimism in the Ideology of Health, Genetics, and Family History in the U. S. and South Korean Media

Media discourse creates and shapes views of personhood, of possibilities, of wellness, and at the same time, these views and beliefs, in their turn, shape media discourse. Public health discourses across cultures shape audience understanding of health and disease and they employ different strategies that contribute to audiences' perceived risks and threats of health issues. Media discourses in health-related edutainment programs and advertisements can therefore be rich sources for the discovery of culturally divergent stances and ideologies of agency concerning health and illness. In the present study, we elucidate the various ways in which the respective ideologies of fatalism and optimism are indexed in the multiple instances of public health discourse. Specifically, from an indexicality-based perspective, we focus on public health discourse in U.S. and South Korean media and we identify the patterned ways in which ideologies of fatalism and optimism are indexed with regard to agency and stance. Literature Review Fatalism in the Health Context of the U.S. Since public health communication designedly aims to influence people's attitudes or behaviors, it runs the potential risk of interfering with personal freedom and thus violating respect for autonomy (Guttman, 2000). In terms of health beliefs affecting media health discourses, the influence of fatalistic beliefs should be considered significant in relation to audience autonomy and control. According to Lee, Niederdeppe, and Freres (2012), "Fatalism is an outlook that events are controlled by external forces and humans are powerless to influence them" (p. 486). In the context of cancer communication, Jensen et al. (2011) also define fatalism as an individual's thought that nothing can be done to influence the results of a situation. According to the literature, media coverage and framing (1) have contributed to fatalism toward health outlooks in U.S. society (see Angell & Kassirer, 1994; Jensen 2008; Jensen et al., 2011; Nelkin & Lindee, 1995; Parascandola, 2000). This tendency goes back to the 70s when Greenberg (1975) criticized optimism in cancer coverage. Greenberg (ibid) argued that the general public had developed exaggerated expectations about curing and surviving cancer due to unrealistically optimistic representations in the media: Despite two decades and several billion dollars expended on research for cancer cures, official figures on trends in five-year survival rates did not provide foundations for the degree of optimism that characterized media discourse. This skewed view of optimism in U.S. health discourse may have influenced the American media landscape in the later decades. In the context of health communication research, studies on fatalism have mostly focused on cancer. Cancer fatalism is a specific type of fatalism, essentially the belief that an individual can do nothing to prevent or treat the disease (Jensen et al., 2011; Powe & Finnie, 2003). Cancer fatalism is conceptually defined as "the belief that death is inevitable when cancer is present," (Powe & Finnie, 2003, p. 454). According to scholars, the characterization of these fatalistic beliefs can be better described by a sense of pessimism, helplessness, and confusion (Lee, Niederdeppe, & Freres, 2012; Niederdeppe & Gurmankin Levy, 2007). News coverage has also been linked to fatalistic reactions to reports on disease, primarily cancer. News coverage that includes qualifications and explicit limitations of scientific studies is referred to as hedged (Crismore & Vende Kopple, 1988; Jensen 2008; Jensen et al. 2011). Unqualified and unmitigated expressions of certainty in news coverage is referred to as streamlined (Jensen 2008, Jensen et al., 2011). The differences between hedged and streamlined media coverage have also been investigated in the context of fatalism as a reaction to cancer. Several scholars analyze news coverage in the US and found that the tendency of streamlined news coverage of cancer might cause reactions of fatalism (Brody, 1999; Russell, 1999; Slenker & Spreitzer, 1988). …