Developing upstream solutions to social problems is more effective than scrambling to apply reactive remedies downstream. Whether you call it prevention or “nippin’ it in the bud,” looking upstream leads to more lasting impact for more people. That’s why changemakers in community health view policy, systems, and environmental change strategies as the most promising approaches to ensuring health and well-being for all.
Unfortunately, most of the American public embraces a long-enduring concept that makes these strategies harder to implement: individualism.
In a functioning democracy, the public drives decisions made by “gatekeepers” who have the power to rewrite policies; alter, create, or dismantle systems; and reshape natural, built, and social environments. In messaging briefs from the FrameWorks Institute, a leader in multi-disciplinary communications research, the organization highlights how the public’s individualistic reference frames can stall advocacy and communications efforts around a broad range of issues that affect health.
This recurring theme of individualism looks remarkably similar across a spectrum of health-impacting social issues. And to re-frame individualistic messages, we first need to know what they sound like. Consider these examples:
Although healthy aging is influenced by a range of social policies and environmental structures that affect entire communities, like income and tax policy, housing, street design, transportation patterns, and access to healthcare, the public believes that health and financial security in older age are the result of individuals’ choices and preparation.
Early childhood experiences help lay the foundation for good health later in life, and those experiences are shaped by complex social and cultural interactions. However, most narratives focus on parental responsibility, crime prevention, and safety. This emphasis on individuals increases the focus on parents’ mistakes and de-emphasizes communities’ influence on how children interact with the world.
High-quality education not only leads to better jobs, higher incomes, and longer, healthier lives, but educational settings also directly affect the health of children and young adults through policies that influence diet, exercise, discipline, and mental and physical health. The public, however, sees education in terms of three types of individuals: students, parents, and teachers. FrameWorks explains that this view “crowd[s] out their ability to consider the equally important roles that school boards, taxpayers, superintendents, principals and other policymakers play in creating, maintaining and reforming education.”
Although the public acknowledges that natural, built, and social environments affect our health in profound ways, environmental health is often conflated with healthcare. This causes people to focus on individual doctors’ and patients’ responsibility to reverse poor health outcomes that may be the result of the condition of our environments. This reduces appreciation and support for the work of organizations which ensure that our air, water, food, and buildings are free of contaminants that impact the health of entire communities.
The dominant narrative in America is that economic success and failure are tied to personal choice and determination. When thinking this way, people assume that the playing field is already level and that being poor is the result of bad choices. This view reduces public support to address economic policies, legal systems, institutional racism, and other factors that contribute to economic inequality and health disparities.
Diet is a leading contributor to chronic disease across the country, but the public still views this as an issue of personal choice rather than a public health problem. By viewing healthy food as a luxury consumer item rather than a human right, attempts to improve the food system are challenged by claims that the problem is a free market issue with no role for government or policy solutions.
Experts understand that access to nature is a boon to public health because it increases opportunities to be physically active, improves air quality, and can reduce stress, among other benefits. However, the public thinks about health outcomes primarily at the individual level. This means that people may not see a benefit to supporting parks for others in their community if that park is not close to them personally.
Even when it comes to race, the majority of Americans still do not see racism as a systemic or structural problem, but rather as something that lies within individual people. That view obstructs the implementation of effective reforms to address inequity.
People view the world through a multitude of frames, of which individualism is only one. The key to reframing messages is to tap in to alternative ways of thinking that are also widely held, and placing emphasis there.
While the “right” messaging frames will shift depending on our audience and the problem we’re trying to solve, it’s clear that focusing on individual behavior change—both in our messages and as a goal—is ineffective in the long run. It’s time to reframe our thinking. Our nation’s health depends on it.
For additional reading, FrameWorks Institute resources are linked for each issue area listed above. The resources outline research methods, key findings, and guidance for more effective messaging.