Diverging governance of climate-related health risks in China and the United States: insights from mass media discourse

Climate change increasingly threatens human health, but national responses to the framing and governing these risks diverge sharply. As the world’s two largest emitters and influential policy actors, China and the United States provide critical cases for examining how climate–health linkages are communicated in ways that shape governance logics and public engagement. This study undertakes a cross-national media analysis, drawing on an expanded bilingual corpus of 865 news articles (China: 420; U.S.: 445) and applying an integrated methodology that combines sentiment analysis, keyword analysis, and Discursive News Values Analysis (DNVA) across textual and visual domains. The findings reveal that while both Chinese and U.S. media invoke the news values of Negativity, Impact and Eliteness, they assign different weight to these values, foreground additional ones, and thereby construct the climate–health nexus in distinct ways. Chinese media foreground extreme heat, institutional measures, and global collective responsibility, constructing Eliteness and Positivity through official statistics, systemic coordination, and symbolic caricatures of the Earth. U.S. media, in contrast, highlight a wider range of hazards–including wildfires, air pollution, and vector-borne diseases – and personalize risks through detailed accounts of climate-related damage to specific human organs (e.g. lungs, heart and skin), close-up images of affected individuals, and politicized portrayals of leaders, thereby amplifying Negativity, Personalization, and Proximity. These divergent patterns show that Chinese discourse tends to privilege universality and solidarity, while U.S. reporting dramatizes immediacy and contestation. Taken together, these results illuminate how media discourse mediates between governance structures and public perceptions of climate–health risks. For policy, the study suggests that strengthening localized resonance could enhance the effectiveness of Chinese communication, whereas in the U.S. context, bipartisan and less politicized framings are likely to foster greater public trust. Such insights underscore the importance of communication environments for adaptive climate–health governance. Media framing of climate-health risks reflects and reinforces diverging national climate governance structures, with Chinese media promoting state-led, international cooperation narratives and U.S. media emphasizing localized, politicized and individual-centered responses. In China, enhancing community-level narratives and showcasing vulnerable groups can complement centralized strategies, making climate–health risks more tangible and engaging for the public. In the U.S., bipartisan messaging that emphasizes shared risks and collaborative solutions could counter polarization, strengthen institutional credibility, and improve public uptake of adaptation measures. Cross-national learning suggests that balancing systemic coordination with localized engagement, and combining emotional resonance with cooperative governance, is key to building inclusive and context-sensitive climate–health governance.