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2022 Campaign Advertising Highlights: What Was and Wasn’t Featured in Issue Discussion on Television



And its implications for policy to promote population health

Campaign advertising – on television, online, through social media platforms, and even at the gas pump – remains a centrally important method through which candidates for office (and the groups that support them) convey to voters their policy accomplishments and priorities and those of their opponents.

Because advertising can influence public opinion and perceptions of issues that should be addressed through policy, understanding the issue discussion – both what is on politicians’ agendas and what is left out – in election advertising is important. Studies have shown that advertising on television features more substantive issue discussion than advertising online. Therefore, drawing on data released by the Wesleyan Media Project (WMP), we examine the issues discussed in federal advertising, focusing on what policies relevant to population health were discussed and what policies were left off the agenda.

As we discussed early on in the cycle, abortion rights featured prominently in the 2022 midterms, and during the fall general election portion of the campaign, abortion rights messaging came almost exclusively from pro-Democratic advertising, where it was featured as the top issue topic, followed closely by health care more broadly. By contrast, advertising by or on behalf of Republican candidates rarely mentioned abortion, although messaging in pro-Republican U.S. Senate advertising was higher (3.6 percent) than in pro-Republican U.S. House advertising, where it was featured in only one percent of airings. Notably, even health care, which was the central issue of the 2018 midterm elections, was absent from the top ten issues in pro-Republican federal advertising overall and in both U.S. Senate and U.S. House top ten issue lists individually.

Public safety featured prominently in messaging from both sides of the aisle, although ads supporting Republican candidates were much more likely to feature the topic, and when they did they were more likely to mention defunding the police as well. Pro-Republican messaging was also likely to feature discussion of immigration, border security, and the drug war, rounding out a large focus on safety-related fears, which may further increase worry about crime. When pro-Democratic ads mentioned public safety, they were more likely to talk about violence against women.

Another big theme in federal campaign ads from both sides of the aisle was costs consumers were facing, but the parties and their allies took different tactics in emphasizing what types of costs were of biggest concern. Over a fifth of pro-Democratic advertising in federal races discussed prescription drugs in their advertising (20 percent), and many of those ads explicitly discussed the cost of medications. In addition, Democratic ads also discussed Medicare (12 percent) and Social Security (11.3 percent), rounding out a big focus on concerns surrounding seniors, a theme that also featured prominently in President Biden’s State of the Union address. Pro-Republican advertising, by contrast, focused over a third of their advertising (over 37 percent) on rising costs due to inflation and over a quarter of their advertising (29 percent) on gas prices, which get captured under the broad label of energy/environment. Ads supporting Democrats didn’t ignore inflation to the same degree that Republican ads ignored abortion, but references to inflation fell outside of the top ten Democratic issues.

It is also worth mentioning what was left off the 2022 campaign agenda on both sides. For one, the discussion of climate change – although a large concern among half of the public and one of the top five single most important issues just prior to the election – was largely absent from the campaign agenda on both sides (the issue appeared in only 0.6 percent of federal airings during the fall general election period with roughly equal mentions in pro-Democratic and pro-Republican advertising; see here for further discussion with examples of how the few ads that did discuss the issue talked about it). Although references to guns in advertising have been rising in recent years, the issue was notably not in the top ten topics for either party, and made up less than 2 percent of airings.

And although costs consumers faced were raised by both parties, explicit attention to poverty and inequality or to policies to address these persistent equity issues remained extremely low. For instance, only 0.1% of airings in federal races made reference to the Medicaid program, the health insurance program for the poor. This is consistent with in-depth analyses of prior election cycles. For instance, discussion of the minimum wage (another program to address poverty among workers) was lower than prior estimates, at only one percent of airings compared to nearly five percent in the 2015-2016 cycle. As we described previously, references to the child tax credit, another program to provide income support for families, which has been popular on both sides of the aisle, were virtually nonexistent during the fall general election (see here for our prior analysis). 

As with prior in-depth work on political advertising, we see few signs that campaign communication that references the broader determinants of population health (such as employment, education, or costs of living) are explicitly tying these topics to health outcomes. It is difficult to know what these ads will ultimately mean for policymaking progress in the next few years. Both parties spent substantial sums of money to signal the issues that are important for their agendas, but both are also aware that they can’t always get what they want—the government is divided as are the parties, and there are current (and potentially future) conflicts between, and with, foreign powers that will have implications for political capital and will. All of these complex forces will come together to influence how much effort policymakers devote to our own health and national well-being, and to the well-being of the broader world.

Given the very different issue agendas of the two parties and the divided nature of U.S. politics both in the aggregate and in legislative control, it remains to be seen how and whether any of the top topics from the 2022 midterms will produce productive policy discussion. 

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The COMM team includes members of the Wesleyan Media Project (WMP). Since the 2010 election cycle, WMP has been providing real-time information on the extent of corporate and union spending in federal election campaigns across the country, who specifically is doing that spending and which candidates are benefiting. In the Fall of 2022 and following the conclusion of the 2022 midterms, the COMM team will be providing periodic commentaries about the ways in which discourse in political ads is relevant to health equity.

This post was funded by the Robert Wood Johnson Foundation (Grant no. 79754). The views expressed here do not necessarily reflect the views of the foundation.


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