A New (more effective!) Way to Talk About the Social Determinants of Health

The Robert Wood Johnson Foundation has produced a very interesting document that reports on its effort to translate the science of "social determinants of health" into messages that resonate with all Americans, across the political spectrum. The full report is really worth looking at. (click on the title above to go to page and report)

Here is a small excerpt.

" Below you’ll find one long-form message that was developed, revised,
tested and revised again based on what the research showed us.
It was consistently the most persuasive message among all groups,
regardless of their political perspective. While we are not necessarily
recommending that you use this in its entirety, it is helpful to understand
why the phrase worked."

America leads the world in medical research and
medical care, and for all we spend on health
care, we should be the healthiest people on Earth.
Yet on some of the most important indicators,
like how long we live, we’re not even in the top 25,
behind countries like Bosnia and Jordan. It’s time
for America to lead again on health, and that
means taking three steps. The first is to ensure
that everyone can afford to see a doctor when
they’re sick. The second is to build preventive
care like screening for cancer and heart disease
into every health care plan and make it available
to people who otherwise won’t or can’t go in for
it, in malls and other public places, where it’s easy
to stop for a test. The third is to stop thinking
of health as something we get at the doctor’s
office but instead as something that starts in our
families, in our schools and workplaces, in our
playgrounds and parks, and in the air we breathe
and the water we drink. The more you see the
problem of health this way, the more opportunities
you have to improve it. Scientists have found that
the conditions in which we live and work have an
enormous impact on our health, long before we
ever see a doctor. It’s time we expand the way
we think about health to include how to keep it,
not just how to get it back.

WHY THIS WORKED:

• Audiences flat out didn’t believe the
statement, “America is not among the top
25 countries in life expectancy,” and they
responded negatively to any message
that led with that statement. However,
when we start off with something most
Americans already believe, “Americans
lead the world in medical research and
medical care,” they are more likely to
believe everything that follows.

• Words like “insured or “uninsured” are
politically loaded. But the phrase “ensure
everyone can afford to see a doctor when
they are sick” doesn’t touch existing
political hot buttons.

• Framing our message in the context of
accepted beliefs like the importance
of access to care or prevention helps our
message fit into the broader thinking of
what it takes to be healthy.

• The inclusion of specific solutions increased
acceptance of the core message.

• Illustrating with examples like “playgrounds
and parks” and “in the air we breathe and
water we drink,” makes the concept of
social factors more tangible.

• In the statement, “Scientists have found,”
other options were tested with more
specificity, such as “Scientists at the
Centers for Disease Control and at
universities around the country have
shown that the conditions in which
people live and work have more than
five times the effect on our health
than all the errors doctors and hospitals
make combined.” Presenting the fact
in a more colloquial, relatable way,
stripped of the academic support, is
more effective than a longer statement.