Collaborative Research on Agenda-setting: Temporal, Institutional and Cross-Sectional Dynamics of Attention to Disease in the Public Arena

这一建议提供了一种完全不同的方法来研究如何以及为什么将注意力分配到问题上，这种方法克服了许多关于议程设置和社会问题构建的研究的局限性。它建立并标志着几十年来致力于以下问题的重要研究的进步：为什么一些社会问题引起了政府官员、公众和媒体的高度关注，而其他问题却鲜有人注意(Baumgartner and Jones 1993；Best 1990；Blumer 1971；Cobb and Ross 1997；Gusfield 1981；Hilgartner and Bosk 1988；Kingdon 1995；Schattschneider 1975；Schneider and Ingram 1993；Spector and Kitsuse 1973；Walker 1977)。一项工作强调问题本身的特点，将其作为注意力的重要决定因素。这项研究有助于强调社会中背负问题负担的群体和对问题感兴趣的有组织的倡导者如何影响这些问题受到的关注；问题是通过一个社会过程构建的。然而，关于议程设置的所有其他工作都侧重于有助于确定哪些问题受到关注的注意力分配过程的各个方面。这项研究展示了时间动态以及不同子议程(如国会、媒体)之间的相互作用如何影响哪些问题进入公共舞台。尽管有证据表明，过程和问题的各个方面都是注意力分配现象的组成部分，但研究人员往往只关注其中一个维度。因此，经验总结往往来自不完整或错误指定的模型。拟议的项目从理论上认为，将注意力分配给问题的现象是一个复杂的函数，既有问题特征(如问题负担、与问题相关的有组织社区的规模和性质，以及问题的文化价位)，也有面向过程的动态(如不同机构的议程之间存在的关系；议程设置的时间动态，以及不同问题之间争夺议程空间的关系)。在经验上，该项目建议比较不同领域随着时间推移对多个问题的关注，以区分注意力分配过程的过程导向型和问题导向型决定因素。这是通过研究媒体、政府和科学界25年来对37种不同疾病的关注来实现的。疾病提供了一个强大的视角来观察注意力产生过程中特定于问题和与过程相关的动态，因为疾病既是医学事实，也是社会结构，因为疾病具有明确的结果，如住院或死亡，因此其严重性可以用共同的衡量标准来衡量。这项针对议程设置的面向问题和过程的决定因素的研究提供了学术和实践两方面的回报。这项研究设计承诺推动对社会问题构建和议程设置的理论和实证理解。此外，由于对疾病的特别关注，研究结果将解决主要的政策问题：政府如何回应媒体和有组织的利益集团所反映的公共卫生优先事项；按种族/民族、性别和年龄划分的疾病负担差异如何影响优先事项；这些优先事项如何影响制药公司在新药研发和现有药物营销方面做出的复杂决定；以及政府预算决定如何反映(如果不是放大)这些优先事项。更广泛地说，拟议的项目谈到了如何在一个看似同样值得关注的社会问题领域有选择地分配社会资源。

This proposal offers a radically different approach to studying how and why attention is allocated to problems, an approach that overcomes the limitations of many studies of agenda setting and social problem construction. It both builds and marks an advance on decades of important study devoted to the question of why some social problems draw a great deal of attention from government officials, the public, and the media while other problems receive little notice (Baumgartner and Jones 1993; Best 1990; Blumer 1971; Cobb and Ross 1997; Gusfield 1981; Hilgartner and Bosk 1988; Kingdon 1995; Schattschneider 1975; Schneider and Ingram 1993; Spector and Kitsuse 1973; Walker 1977). One body of work emphasizes the characteristics of problems themselves as important determinants of attention. This research has helped to underscore how the groups in society who are burdened by problems and the organized advocates who take an interest in problems affect the attention those problems receive; problems are constructed through a ihsocial process.le Other work on agenda-setting, however, focuses on aspects of the attention allocation process that help determine which problems receive attention. This research has demonstrated how temporal dynamics as well as the interplay between various sub-agendas (e.g., Congress, the media) affect which problems make their way into the public arena. Despite the evidence that aspects of both process and problem are integral to the phenomenon of attention allocation, researchers have tended to focus solely on one of these dimensions. Thus, empirical generalizations tend to emerge from incomplete or misspecified models. The proposed project proceeds theoretically from the idea that the phenomenon of allocating attention to problems is a complex function both of problem characteristics (such as problem burden, the size and nature of organized communities associated with a problem, and a problem's cultural valence), and of process-oriented dynamics (such as the relationships that exist among the agendas of different institutions; the temporal dynamics of agenda setting, and the relationships between different problems jockeying for agenda space). Empirically, the project proposes to compare the attention given to multiple problems over time in different arenas in order to discriminate between the process-oriented and problem-oriented determinants of the attention allocation process. This is accomplished by studying attention to 37 different diseases by the media, by government, and by the scientific community across 25 years. Disease offers a powerful lens to view the problem-specific and process-related dynamics of the attention generating process because diseases are both medical facts and social constructions, and because diseases have clearly defined outcomes, like hospitalization or death, so that their severity can be gauged with a common metric.This study of the problem- and process-oriented determinants of agenda setting offers both scholarly and practical rewards. The research design promises to advance the theoretical and empirical understanding of both social problem construction and agenda setting. Moreover, because of the specific focus on disease, the findings will address major policy issues: how the government responds to public health priorities, as reflected in the media and via organized interest groups; how disparities in disease burden by race/ethnicity, sex and age shape priorities; how these priorities inform the complex decisions made by pharmaceutical companies, both in their research and development of new drugs and in their marketing of existing ones; and how government budgetary decisions might reflect (if not magnify) these priorities. More broadly, the proposed project speaks to how societal resources are selectively allocated across a field of seemingly equally attention-worthy social problems.