Health Information to Citizens: a Content Analysis of Italian Websites Dealing with the Theme of “Waste and Healthâ€
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Abstract
Background
In the field of health communication a particularly critical issue is communication to the public of environmental risks, especially regarding topics for which it is difficult to obtain scientific evidence of risk estimates, and there is still a high degree of uncertainty. One of these topics is undoubtedly the impact of waste on people’s health, although little research has been conducted in this area. This theme is particular hot in Italy, where the global media have recently put out a message about the fact that the city of Naples and the surrounding area have reached such a high level of pollution, due to irresponsible waste disposal behavior, that the health of the people who live there has been put at serious risk. Information on the presumed environmental and health risks is transmitted via numerous channels, ranging from media reports to public meetings with institutional representatives. With the dissemination and increase of Internet use, websites have become a convenient and quick method of research, often replacing paper-based literature research. Hence, the Internet is likely to help shape risk perception, which is a complex process that can lead to conclusions often very far from the scientific evidence characterized by a quantitative approach. The aim of the study was to evaluate the presence of websites in Italian dealing with the theme "Waste and Health" using three search engines, and then analyze them. In addition, we assessed the visibility of institutional websites, which are committed to ensuring the accuracy and the reliability of the topics dealt with, in respect to their position on the first pages of the search engines.
Methods
The keywords "Waste and Health" (“Rifiuti e Saluteâ€) were entered in the most commonly used search engines, Google©, Yahoo© and Bing©, and the first 50 references were analyzed, giving a total of 150 occurrences. The websites were then coded according to the content analysis method, using a codebook regarding general information, technical information, information about the contents and information regarding access to Web 2.0. For websites of interest we also evaluated the "page rank", namely the position of the page itself in the search results, in order to assess user visibility of these websites.
Results
From the 150 occurrences analyzed, the number of websites found to deal with this subject was only 19, the most numerous being environmental associations (9, 47%), institutional entities (4, 21%) and private companies (2, 11%). The most frequent geographical location (21%) was the Campania region, where Naples is situated. The majority of websites gave a message of increased health risk associated with the three types of waste disposal tackled: rubbish piles (72%), rubbish dumps (87%), and incinerators (89%). Only institutional websites gave a message of “zero risk†for each of the three types of waste disposal. A minority of the websites used Web 2.0 tools, such as FEED RSS (7, 37%) and an Area Forum/Blog (4, 21%). As regards visibility, only one of the four institutional websites maintained its position on the first page of the three search engines.
Conclusions
In a situation such as that in Italy, where there is huge media exposure on the theme of waste and health due to the Naples case, which was debated globally, we obtained very interesting results when studying online information on the issue. Firstly, we saw that the majority of our sample of websites dealing with this subject put over a message of increased risk associated with the three types of waste disposal. This is only one of the channels that can be used to gain information on this topic, but it has the unique characteristic of being an active search, and very easy to access, whereas information gained from the mass media is often passive, not actively searched for by people. We can therefore expect online information to play a crucial role in building perceived risks. Secondly, the visibility of institutional websites appeared to be very low: if someone in Italy built up his knowledge on this theme using the Internet as his only source of information, he would mainly log on to non-governmental websites, whereas governmental websites are meant to be committed to ensuring the accuracy and the reliability of the topics dealt with. We could reflect about where the public health stakeholders are in this context, and whether these results could indicate a substantial immaturity of their web strategies in terms of meeting citizens’ health information needs. One important consequence of not meeting these needs is that this will strengthen rival health information providers and fuel distrust on the part of professional and regulatory bodies, as reported in the literature. These results provide evidence which is known to but often forgotten by our institutions: in a public health perspective it is not enough to manage a situation efficiently, it is necessary to communicate clearly how it has been handled to meet people’s needs. Taking communication aspects into consideration, especially in a society that increasingly uses the Internet for communication purposes, is no longer an option: communication is part of management, but achievement of this milestone still appears to be a long way off, even in a developed country such as Italy.
In the field of health communication a particularly critical issue is communication to the public of environmental risks, especially regarding topics for which it is difficult to obtain scientific evidence of risk estimates, and there is still a high degree of uncertainty. One of these topics is undoubtedly the impact of waste on people’s health, although little research has been conducted in this area. This theme is particular hot in Italy, where the global media have recently put out a message about the fact that the city of Naples and the surrounding area have reached such a high level of pollution, due to irresponsible waste disposal behavior, that the health of the people who live there has been put at serious risk. Information on the presumed environmental and health risks is transmitted via numerous channels, ranging from media reports to public meetings with institutional representatives. With the dissemination and increase of Internet use, websites have become a convenient and quick method of research, often replacing paper-based literature research. Hence, the Internet is likely to help shape risk perception, which is a complex process that can lead to conclusions often very far from the scientific evidence characterized by a quantitative approach. The aim of the study was to evaluate the presence of websites in Italian dealing with the theme "Waste and Health" using three search engines, and then analyze them. In addition, we assessed the visibility of institutional websites, which are committed to ensuring the accuracy and the reliability of the topics dealt with, in respect to their position on the first pages of the search engines.
Methods
The keywords "Waste and Health" (“Rifiuti e Saluteâ€) were entered in the most commonly used search engines, Google©, Yahoo© and Bing©, and the first 50 references were analyzed, giving a total of 150 occurrences. The websites were then coded according to the content analysis method, using a codebook regarding general information, technical information, information about the contents and information regarding access to Web 2.0. For websites of interest we also evaluated the "page rank", namely the position of the page itself in the search results, in order to assess user visibility of these websites.
Results
From the 150 occurrences analyzed, the number of websites found to deal with this subject was only 19, the most numerous being environmental associations (9, 47%), institutional entities (4, 21%) and private companies (2, 11%). The most frequent geographical location (21%) was the Campania region, where Naples is situated. The majority of websites gave a message of increased health risk associated with the three types of waste disposal tackled: rubbish piles (72%), rubbish dumps (87%), and incinerators (89%). Only institutional websites gave a message of “zero risk†for each of the three types of waste disposal. A minority of the websites used Web 2.0 tools, such as FEED RSS (7, 37%) and an Area Forum/Blog (4, 21%). As regards visibility, only one of the four institutional websites maintained its position on the first page of the three search engines.
Conclusions
In a situation such as that in Italy, where there is huge media exposure on the theme of waste and health due to the Naples case, which was debated globally, we obtained very interesting results when studying online information on the issue. Firstly, we saw that the majority of our sample of websites dealing with this subject put over a message of increased risk associated with the three types of waste disposal. This is only one of the channels that can be used to gain information on this topic, but it has the unique characteristic of being an active search, and very easy to access, whereas information gained from the mass media is often passive, not actively searched for by people. We can therefore expect online information to play a crucial role in building perceived risks. Secondly, the visibility of institutional websites appeared to be very low: if someone in Italy built up his knowledge on this theme using the Internet as his only source of information, he would mainly log on to non-governmental websites, whereas governmental websites are meant to be committed to ensuring the accuracy and the reliability of the topics dealt with. We could reflect about where the public health stakeholders are in this context, and whether these results could indicate a substantial immaturity of their web strategies in terms of meeting citizens’ health information needs. One important consequence of not meeting these needs is that this will strengthen rival health information providers and fuel distrust on the part of professional and regulatory bodies, as reported in the literature. These results provide evidence which is known to but often forgotten by our institutions: in a public health perspective it is not enough to manage a situation efficiently, it is necessary to communicate clearly how it has been handled to meet people’s needs. Taking communication aspects into consideration, especially in a society that increasingly uses the Internet for communication purposes, is no longer an option: communication is part of management, but achievement of this milestone still appears to be a long way off, even in a developed country such as Italy.
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