Working up a lather: the rise (and fall?) of hand hygiene in Canadian newspapers, 1986–2015

Abstract

Hand hygiene is a long-standing concern in the health sciences literature, but its emergence as a public health issue in the news is a more recent development. Drawing on Alan Hunt’s work on moral regulation and responsibilization, this article analyses 30 years of Canadian newspaper coverage of hand hygiene. Concerns associated with hand hygiene and trends in coverage were identified in a sample of 518 articles, published between 1986 and 2015. Although the Severe Acute Respiratory Syndrome (SARS) and H1N1 influenza epidemics emerged as important triggers, healthcare-associated infection (HAI) was the dominant trigger for hand hygiene coverage. The articles tend to present hand hygiene as a unidimensional approach to infection control. They tend to responsibilize individuals–first members of the general public, then healthcare providers and increasingly patients–for managing the risk of infection, rather than focus upon social, cultural, political and economic factors that would promote a more broad-based and structural response to HAI.

Keywords:

• Hand hygiene
• Canada
• news
• infectious diseases
• healthcare-associated infection
• responsibilization

Acknowledgments

The author thanks Susan Haydt for assistance in the initial phases of the research, and Howard Ramos, the editors, and two anonymous reviewers for their helpful suggestions.

Notes

1. While the World Health Organization uses the abbreviation HCAI, the most common abbreviation for healthcare-associated infection in Canada is HAI (see http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2013/infections-eng.php).

2. The Globe & Mail (published in Toronto) ranked first, The Toronto Star second and The Ottawa Citizen fifth. The Major Newspapers search function is unavailable in the version of LexisNexis to which the author’s university now subscribes. However, in a Major World Publications search conducted in June 2017, The Globe & Mail and The Toronto Star ranked fifth and sixth, while British papers occupied the top four positions. It appears that hand hygiene peaked in British papers some years after American, Australian and Canadian coverage peaked.

3. Health is primarily under provincial jurisdiction in Canada; while other federalist countries such as the US and Australia have similarly distributed jurisdiction over health, they have more prominent federal public health agencies than Canada (National Advisory Committee on SARS & Public Health, 2003).