Implications for communicators

To build support for the policies and programmes that are needed to improve health and reduce health inequalities, there needs to be a wider awareness and understanding of the social determinants of health. The research outlined in this briefing illustrates some of the challenges that exist in communicating these issues.

Although the research found that the way the members of the public involved think about health is multi-faceted, the dominant individualistic strain undermines support for policies and initiatives that focus on social determinants. However, this strain of thought sits alongside cultural models that are more productive, as people do recognise a role for social and environmental factors. The challenge for advocates of a social-determinants approach is to find ways to build on this ecological strain to create a more expansive way of thinking about health.

The next stage of this work is to develop and test detailed strategies to address the communication challenges outlined in this briefing. However, based on the work done so far, and previous work done by FrameWorks, we can outline some preliminary implications for those wanting to communicate more effectively on these issues:

  • Beware of gesturing towards the importance of individual choice or responsibility. Communicators may be tempted to open discussions by acknowledging the role of the individual and then pivoting to their message. Communications research has found gesturing in this way toward an unproductive understanding to be unhelpful in most situations – it reinforces existing ways of thinking, rather than challenging them.
  • Avoid ‘crisis messaging’. Rising rates of chronic disease are often described as ‘epidemics’ and the strains on the NHS as a ‘crisis’. While this is intended to increase people’s sense of urgency and motivation, research shows that crisis messaging frequently backfires by reinforcing people’s sense of fatalism. The result is often less support for solutions and rapid disengagement from the issue.
  • Use step-by-step, causal explanations of how social determinants affect health. Outlining the causal links between different social and environmental factors and health outcomes is critical to deepening the public’s understanding of how these factors shape health.
  • Provide concrete examples of how the social determinants influence people’s health to expand the public’s awareness of possible solutions. This is essential to cultivate an understanding of how health can be built at the societal level.
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