HEALTHY LIVING

How to talk about it...

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Communicating Health

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Index

What we leave unsaid

How we explain an issue

What we emphasise

• Framing is about making choices around what we say and how we say it
• This will change how people think, feel and act
• Can be adapted and used in a variety of contexts
• Helps us to tailor communications for different audiences and channels but still talk about our issue in a consistent way

Framing

Recommendations for boosting actions for health

The power of explanation

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Use data to strengthen the story, not tell it

Use certain arguments with caution

Show change is possible

Show why it matters

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• add complexity with concepts like ‘disability-free life expectancy’ or ‘ healthy life expectancy’
• leave people feeling that nothing can be done,

• Lead with the fact that lives are being cut short to establish why health inequalities matter.

• Then explain the causes of health inequalities.

example

To increase support for policies and action on the wider determinants of health we need to start by showing why this is important. To do that, be clear that this is a matter of life and death. Presenting the wider determinants of health as a matter of life and death conveys a stronger sense of urgency and importance than focusing on health and wellbeing in general. Wellbeing is always a matter of degree – life and death aren’t. When we make the issueabout inequalities in life expectancy and the fact that lives are being cut short, people take notice.

Show why it matters

There are lots of different ways we can flex this frame when we are speaking to different audiences and according to our own communication style.When we’re speaking to the media, we might want to dial up our tone and be more emotive. When we’re speaking to a commissioner, we might want to dialdown the tone and be more measured. The frame provides a scaffolding that we can flex up and down:

Different audiences

Harness the power of explanation

deep dive explanations

metaphor

People’s ability to understand why and how the world around us affects our health are two of the biggest challenges for communicators. Without this understanding, people default to the idea that ‘It’s just the way things are.’ Or that problems are too big and complex to be tackled. And when we don’t provide enough explanation, people fill in the gaps with narratives that already feel familiar to them – like ‘It’s up to individuals to make better choices.’ Explanation is a powerful way of bringing people with us – it increases understanding, and that helps to increase support for change.

Harness the power of explanation

How to do it: • Compare building a healthy society with that of constructing a sturdy building.• A thriving community needs all the right building blocks in place: jobs, pay, housing, education.• Explain health inequalities by talking about building blocks that are missing, or weak, and need replacing.

Use a ‘building blocks’ metaphor to explain the role of the wider determinants of health.

harness the power of explanation

when people have insecure or irregular work

Cause

Poorer health

consequence

Constantly worrying about having enough money to pay the rent can also lead to chronic stress, anxiety and depression.

Living in cold, damp homes can result in respiratory problems and other health issues.

Deep-dive explanations help point towards your solutions. When writing one, start by thinkingof the solution you want, and then explicitly building steps that link to your solution.

Improve job security

solution

...It means that it is harder to afford decent housing.

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Deep-dive explanations help point towards your solutions. When writing one, start by thinking of the solution you want, and then explicitly building steps that link to your solution.

Harness the power of explanation

Show change is possible

1. Talk explicitly about the fact that we can change this.
2. Show the urgency of the situation but don’t leave people at the crisis – show it can be improved, and how.
3. Talk about solutions often and build them into communications early.

Sometimes what we leave unsaid is just as (or even more) important than what we do say. There are ways of talking about an issue that can decrease support for what we’re trying to achieve. When it comes to talking about health there are three ways of talking about the issue to avoid where possible:1. economic cost of the wider determinants of health2. arguing that we should act on the wider determinants of health to protect the NHS3. focusing on the COVID-19 pandemic. Where these arguments can’t be avoided, there are ways of using them that will help to minimise the risk of decreasing support for action.

Use certain arguments with caution

Economic cost

use certain arguments with caution

+ info

Research shows that making an economic argument for why people should support action to address the wider determinants of health can backfire. Describing the issues in terms of their effect on the economy, or cost to the NHS, risks triggering blame towards people experiencing poor health, and taps into individualist thinking.If you need to provide economic evidence in your work, here is a way to do that.

What does it look like?

Use certain arguments with caution

Example - the nhs

Avoid making the NHS a central part of your messaging...

Remind people that the NHS was never meant to go it alone and it was always intended to be partof a broader system of support.

Explicitly mention people’s attachment to the NHS. Talk about ‘the NHS we all value and rely on’ -it’s there for us ‘from cradle to grave’..

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Messages that focused on the NHS as a reason to address the wider determinants of health are, at best, unpersuasive, and can even backfire – making people less likely to support policies and action addressing the wider determinants of health.Where possible, avoid making the NHS a central part of your argument about why we should act on the wider determinants of health.

Example - covid19

Explain how the pandemic has increased existing inequalities. In other words, use COVID-19 as a way to further emphasise your main point rather than as your main point.

Avoid leading with the effects of COVID-19 on health andlife expectancy.

Acknowledge that inequalities in health and life expectancy are a long-standing issue.

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Many people have ‘COVID fatigue’ that makes themtune out of what you have to say when you mention the pandemic. Avoid leading with the pandemic in discussions on the wider determinants of health. Instead, only mention the pandemic when it is specific to your argument.

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Statistics don’t speak for themselves. We can help people make sense of facts and figures by putting them in context; with metaphor, explanation and by signalling why they matter.

• Lead with why this matters: lives are being cut short.
• Explain the causes: you can do this through using the building blocks metaphor or by using words that link cause and effect (because, this leads to, this results in, this means etc).
• Make numbers easier to understand: place them in a familiar or relatable context. For example, you might compare numbers of people to populations of a city: ‘that’s the same number of people as live in Greater Manchester’.

Use data to strengthen your story, not to tell it

We can do this when we don’t have much space – like in a tweet:

Persuasive stories have three key ingredients. They need to:

STEP 03

show we can change it.

STEP 02

explain what it’s about

STEP 01

show why the issue matters

Putting it all together

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Thankyou!

AFTER ‘The NHS we all value and rely on was never meant to go it alone. It was supposed to be part of a wider system supporting people from cradle to grave; with decent jobs, pay, homes and education. To make sure the NHS can keep helping us in the way it was intended to, we need a broader system of support that can help all of us to thrive.’

BEFORE ‘The NHS today is under tremendous pressure to continue to deliver a service that is effective, accessible, equitable and sustainable. Improvements in life expectancy at birth might be stalling for the first time since the introduction of the NHS in 1948.’

When you do need to talk about the NHS, explain how it should fit within a broader system of support.

AFTER ‘The NHS we all value and rely on was never meant to go it alone. It was supposed to be part of a wider system supporting people from cradle to grave; with decent jobs, pay, homes and education. To make sure the NHS can keep helping us in the way it was intended to, we need a broader system of support that can help all of us to thrive.’

BEFORE ‘The NHS today is under tremendous pressure to continue to deliver a service that is effective, accessible, equitable and sustainable. Improvements in life expectancy at birth might be stalling for the first time since the introduction of the NHS in 1948.’

When you do need to talk about the NHS, explain how it should fit within a broader system of support.

You don’t have to include every way the wider determinant affects health – just pick out a couple of key points.

Explain it step-by-step using language that signals cause and effect: because, this leads to, this results in, this means.

Explain how and why the issue happens.

Use a deep-dive to explain the role of the wider determinants of health. In a deep-dive explanation, we need to focus on just one of the wider determinants and explain fully how and why it affects our health.

‘By increasing the minimum wage, we can prevent lives from being cut short. ‘higher income means that we have what we need to heat our homes, eat well & don’t have to constantly worry about bills. ‘As a result our bodies produce less stress hormones, meaning lower blood pressure & stronger immune system.’

‘In our least well-off neighbourhoods, people are dying a decade earlier than their peers.’

'Some people are dying earlier because...‘Life expectancy isn’t the same across the UK. ‘In some areas people are dying earlier.’ ‘To address gaps in life expectancy and prevent lives from getting shorter, we need to …’

Measured

Emotive

‘Right now, lives are being cut short.’ ‘Too many people are dying too young, because of …’‘Some people are dying a decade younger than they should.’

AFTER ‘Right now, people in our poorest neighbourhoods are dying a decade earlier than people in the wealthiest areas. When we don’t have what we need to heat our homes, buy healthy food and are constantly worrying about making ends meet, it can lead to chronic stress, poor health and lives being cut short.’

BEFORE ‘Life expectancy for females is 10.2 years longer in the least deprived areas compared with the most deprived areas in Scotland. For males that difference increased to 13.5 years.’

• First, lead with the impact on people. Messages that focus on the economy can be seen as commodifying human beings, which makes them immediately unpalatable.

• Lead with why the issue matters (lives are being cut short) and then expand people’s understanding of what health is and the factors that shape it before adding your economic evidence. Without this explanation, economic arguments are likely to just fuel individualistic thinking.

‘ Right now, in parts of the UK, people are dying years earlier than they should. When we don’t have the things we need, like warm homes and healthy food, and are constantly worrying about making ends meet, it puts a strain on our bodies. This results in increased stress, high blood pressure, and a weaker immune system.’

‘ The wider determinants of health have an important influence on health inequities. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.’

After

Before