A matter of life and death Explaining the wider determinants of health in the UK

March 2022

Emilie L’Hôte
Maria Castellina
Andrew Volmert
Lindsey Conklin
Patrick O’Shea
Report front cover

Key points

  • The Health Foundation is working with the FrameWorks Institute to design more effective ways of talking about the wider determinants of health. 
  • Framing –  the choices we make about what we say and how we say it – affects how people think, feel and act.
  • This report outlines an evidence-based framing strategy for shifting understanding and building greater support for action to address the wider determinants of health. The strategy centres on making the issue more tangible for people by using explanation.
  • Firstly, we need to start by explaining why the wider determinants of health matter. Right now, in the poorest parts of the UK, people are dying years earlier than people in wealthier areas. Quite simply – this is a matter of life and death. We need to say so.
  • Secondly, we need to ‘go deep’ in our explanation of the issue to show how and why our health is shaped by these wider determinants, and why experiences are unequal across the country.
  • Thirdly, we need to be solutions-focused in our communications and explain how these issues can, and should, be solved.

To address health inequalities, we need to change the way that we communicate about the wider determinants of health – to increase public understanding and to build space for policy change. Key to this change is harnessing the power of explanation.  

We can build support and action to address health inequalities by focusing on explaining the links between jobs, homes and education and our health.

The Health Foundation commissioned the FrameWorks Institute to examine how people think about their health, and the health of others, and based on this, recommend how we can frame health communications to tell a more powerful story.

Drawing on findings from the second phase of our research, this report outlines an evidence-based framing strategy for shifting understanding and building greater support for action to address the wider determinants of health. It is for anyone working and communicating in the field of public health, whether they are speaking to a public, political, or expert audience.

About the research

FrameWorks’ research was split into two phases.

The first examined how the public thinks about their health and the health of others, and how that differs to expert opinion and the current media narratives around health. The second, built on these findings to develop, then test, new ways to communicate about health. Ways that will increase understanding of the role of the wider determinants and build understanding and support for policies to improve health across the UK.  

To develop this evidence-based framing strategy, FrameWorks undertook both qualitative and quantitative research including on-the-street interviews, experimental surveys, and peer-discourse sessions (a particular type of focus group designed to evaluate which frames are most productive, most easily understood and were most easily used during conversation with peers). More than 7,000 people from across the UK were included in this research. 

A detailed research methods supplement is available to accompany this report and can be downloaded below. 

What's next?

This summer, we'll be sharing a communicators toolkit to support public health communicators to use the new framing strategies. Sign up to receive updates on this project, including future work and events.

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