Active framing of health communication to and about individuals with non-communicable diseases

To systematically document how individuals in vulnerable positions with diabetes or other non-communicable diseases (NCD) are portrayed in texts from Danish health care institutions.

Our dataset consists of texts from Steno Diabetes Center Sjælland (SDCS) and 10 other Danish institutions related to diabetes and/or health care. We searched for text excerpts that referred to NCD and contained words with the meaning 'vulnerable'/'vulnerability'. Through semantic analysis, we systematically categorised the semantic roles of referents in the texts, e.g. whether a person was framed as performing an action (having an ACTOR role) or as undergoing an action (having a role as UNDERGOER).

We found 1645 examples where persons were referred to as vulnerable (e.g. 'vulnerable families' or 'men in vulnerable positions'). The semantic text analysis of these examples showed that Danish health care institutions consistently portray these individuals as UNDERGOERS, who are passive participants in their own lives and treatment. They are rarely portrayed as making positive differences or being part of positive relations.

There is a discrepancy between the goal that individuals with diabetes and NCD are motivated to take action, and the low-agency language that the investigated Danish health care institutions use in relation to individuals in vulnerable positions with NCD including diabetes. We recommend strategically replacing low-agency predicates with words that position individuals with diabetes as acting intentionally and being capable of self-care.