Despite extensive evidence for 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.
The FrameWorks Institute 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 Health Foundation is working with the FrameWorks Institute to develop a deeper appreciation of the ways in which people understand and think about health in order to develop more effective approaches to communicating evidence.

Read the full list of key points

This briefing presents the main findings from research commissioned by the Health Foundation and carried out by the FrameWorks Institute, analysing public understanding, expert opinion and media narrative around health. It also presents findings from questions sponsored by the Health Foundation in the 2017 British Social Attitudes survey.

Four key challenges are identified that communicators must tackle to achieve wider public acceptance of the evidence on the social determinants of health.

The briefing concludes by reiterating that by building wider understanding of the social determinants beyond those working in the field, we can build support for the policies and programmes needed to reduce health inequalities and improve health.

In phase two of this work we will be developing and testing new ways to communicate more effectively about health. To sign up for updates, email Rachel.Cresswell@health.org.uk

Cite this publication

Elwell-Sutton T, Marshall L, Bibby J, Volmert A, 'Reframing the conversation on the social determinants of health'. Health Foundation; 2019 (https://www.health.org.uk/publications/reports/reframing-the-conversation-on-the-social-determinants-of-health)

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