The National Security Contagion: A Study of the Framing of Infectious Disease in the United States, 2000-2015

Abstract

The way American policymakers, government officials, and public intellectuals frame infectious disease influences not only opinions of the issue but also proposals to address it. By examining the widespread framing of infectious disease as national security threats, this thesis contributes to the burgeoning literature on priority setting, which addresses why some issues succeed in garnering political attention while others are overlooked. The literature on framing and health issues frequently posits that health issues like infectious disease are increasingly being characterized as national security threats. Yet the literature lacks first, evidence of the extent to which national security frames in fact dominate the evocation of other frames rooted in human rights or ethics and second, possible explanations for why American stakeholders are attracted to this specific message platform. This thesis seeks to address these gaps in the literature. A secondary research question addressed in this thesis examines how policymakers and thought leaders incorporate their opinions on emerging disease threats into the positions they take on existing policy issues. This thesis’ methodology applies the general frameworks on framing found in the literature to three case studies—the 2003 SARS epidemic, 2009 H1N1 pandemic, and 2014 Ebola outbreak. In so doing, it evaluates how elements of these theoretical frameworks unfolded over the past 15 years in the United States. This analysis is based on a comprehensive review of materials drawn from a representative sample of sources from different stakeholder groups across the three outbreaks periods. By presenting the case studies sequentially, this thesis also provides a recent history of Americans’ dynamic attitudes and policies toward infectious disease starting from the beginning of the twenty-first century. I show that the flexible interpretation afforded by national security framing partly explains its prevalence and endurance, as the frame can be applied to multiple policy issues and be mobilized by groups with differing—even conflicting—viewpoints and political agendas. The case studies illustrate how the political and policy climate surrounding emerging disease threats interacts with characteristics specific to the outbreaks themselves to influence American stakeholders’ framing of infectious disease. Lastly, examples found in the case studies demonstrate that the national security frame does not invariably lead to the aggressive and often isolationist policy outcomes often predicted of it. The implications of this thesis’ findings regarding the power of frames have relevance not only to the field of health but also to broader work on voter opinion and democratic choice.