The coronavirus (COVID-19) pandemic compels us all to think differently about what our society needs to be healthy. It is highlighting and heightening the inequalities that affect our health. And it’s shining fresh light on how our social, economic and environmental circumstances – the wider determinants of health – shape our health and wellbeing. COVID-19 is having an unacceptably uneven impact. For many in the public health community, it’s yet more compelling evidence of the need for a concerted focus on health inequalities and the wider determinants of health.

But this perspective is not easily accessible to those who are not specialists in this area. People in the UK tend to think about health in certain ways. It’s about how well we look after ourselves. It’s the presence – or absence – of illness. It’s the care we get from the NHS. Most people tend not to think about or understand the complex and important connections between our health and our social, economic and environmental circumstances.

This was one of the early findings of the Thinking differently about health project, a collaboration between the FrameWorks Institute and the Health Foundation. It aims to understand public perceptions of health and what influences health. The project also explores how we can broaden public understanding and support for change.

What is framing and why does it matter right now?

Framing refers to the choices we make about what we say and how we say it. These choices shape how people interpret information and ideas. They influence where responsibility is attributed, what actions are deemed necessary and how important issues like health are understood.

We all think in story. We rely on our existing beliefs and opinions to make sense of the world around us. We draw conclusions about data and experiences based on this. This means that the ways health experts and communicators talk about health matter a great deal.

COVID-19 has brought sizeable challenges, some of which have implications for framing: how to communicate epidemiological concepts so they are widely understood and acted on appropriately? How to frame the policy measures required to contain the virus and minimise its impact? But there is also a need to take a broader, longer term view on the factors that shape our health. How can we show that the pandemic’s impact has been shaped by the wider determinants of health? How can we help people see that we must continue to focus on and address these wider factors in order to address the impact of the pandemic?

Effective strategies during the pandemic

The pandemic could and should be a watershed moment for addressing health inequalities and promoting health as an asset, both for individuals and society, in the UK. And there are signs that the experience of the pandemic is altering public perceptions in important ways. More people are recognising the government’s responsibility for our health: 86% in a recent survey, compared with 61% in 2018.

But to catalyse and sustain a change of approach, experts need to frame the case for this effectively. This means carefully translating and bringing to life the concepts that experts take for granted. It means framing and explaining data, rather than expecting it to convey meaning and tell a story by itself. FrameWorks’ guidance on framing during the pandemic also highlights the need to:

  • avoid sounding opportunistic, out of touch or highly predictable when talking about longer term issues and solutions in the light of the pandemic
  • show that this is a moment when change is possible, necessary and desirable, rather than presenting a bleak status quo
  • be clear about the distinct role the government should play – and the way it differs from the actions that businesses, charities and individuals can take.

In experiencing the most immediate and direct challenge to our health in a century, we’re learning a lot about ourselves. We’re seeing how our values and social norms shape our behaviour and our collective societal responses. We need to come through this experience more able to inspire realistic, collective action to address the social, economic and environmental factors that shape our health and wellbeing. Through this, we can reduce inequalities and improve the health of the UK population.

Stay involved

Our Thinking differently about health research is ongoing, with some adjustments made in light of COVID-19. For regular updates on the project, please sign up here.  

Nicky Hawkins is Director of Impact at the FrameWorks Institute.

Further reading

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