Key points

  • Despite extensive evidence of the impact of social determinants on people’s health, public discourse and policy action is limited in acknowledging the role that societal factors such as housing, education, welfare and work play in shaping people’s long-term health.
  • There are many reasons for this, but one factor that merits greater attention is the way in which the evidence is communicated to and understood by the public. Building public awareness and understanding is a necessary foundation for securing social change.
  • The Health Foundation is working with the FrameWorks Institute to develop a deeper appreciation of the ways in which people understand and think about their health in order to develop more effective approaches to communicating evidence.
  • Surveys of public attitudes suggest that the public consider individual behaviours and access to health care to have the greatest effects on health.
  • FrameWorks has identified a range of ‘cultural models’– common but implicit assumptions and patterns of thinking – that give deeper insight into how people think about what makes them healthy.
  • Understanding which cultural models promote – or obscure – people’s awareness of the importance of social determinants is an important first step in developing effective ways of framing the evidence.
  • The media can reflect and shape public thinking. Analysis of media narratives about health by FrameWorks showed that they tended to reinforce individualistic ways of thinking about health.
  • This briefing presents the main findings of research commissioned by the Health Foundation and carried out by FrameWorks. It also presents findings from questions sponsored by the Health Foundation in the 2017 British Social Attitudes survey.