Lessons in public health messaging: Q&A with Fernando Quintero

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PreventObesity.net Leader Fernando Quintero is a strategic communications specialist for Berkeley Media Studies Group and often blogs on issues that offer insightful lessons for those managing public health campaigns. Recently, Fernando wrote on how the frame of personal responsibility is damaging to public health campaigns. In short, an exclusive frame of personal responsibility lays the burden of the problem on individuals and their choices, and not on the environment in which they find themselves. But as the public health community seeks policies to change our surroundings so that they support, rather than undermine, health, we need the larger community to view public health issues, such as diet-related illnesses, as environmental and system-based challenges, not just personal shortcomings. Inside Track recently had a chance to ask Fernando some follow-up questions.

IT: What do you see as the biggest risks for allowing public health campaigns to be framed through the personal responsibility lens?

FQ: As I mentioned in my blog, the personal responsibility frame is the default frame. Our task is to show how our surroundings shape and impact health, making the invisible visible. In public health, we are used to producing messages designed to change individual behavior. What we are not used to is developing and supporting messages aimed at making changes to our environment that support health. Without that broader environmental frame, it can be harder for the public and policymakers to understand why solutions beyond behavior change are needed.

IT: In many ways the personal responsibility narrative has become part of the American culture. In what ways is this a barrier to our work?

FQ: When we’re asking for meaningful policy, systems and environmental change to improve community health — whether it involves something like removing sugary drinks from city property or advocating for a red light a dangerous crosswalk — the default personal responsibility frame says: Why don’t people simply make smarter decisions about what they drink, or why can’t parents watch what their kids eat and drink? It asks why people crossing the street aren’t more careful and staying off their cell phones and watching where they’re going. Parents should be watching what their kids eat and everyone should be careful crossing the street, but we also need the government to act when our environments don’t support health and well-being. Parents don’t decide which foods are marketed to kids or whether a stop light goes in — that’s something that, as a community, we decide together through our government.

IT: Can you provide a real-world example of framing and how it affects public perception?

FQ: There are abundant examples all around us. Consider the rise in diabetes and other nutrition-related diseases, especially in communities of color. People looking at this through the default personal responsibility frame are likely to see the issue as one of poor decision-making, lack of willpower and other character flaws. What people often fail to see is how the environment can undermine our efforts to be healthy. Things like a lack of grocery stores and other places to buy healthy food, aggressive marketing that saturates communities with advertising for unhealthy products, pricing strategies that make unhealthy food not only easier to get but also cheaper — all of these are examples of how our environment affects health. But because those things are regular parts of our world, they seem normal and regular, almost natural. That’s how the default frame can impact public perceptions.

IT: What are some of the steps campaign managers can take when they are developing a frame or messaging for a campaign?

FQ: They can reframe the conversation by making visible the many factors outside of a person's control that make us unhealthy. There are several resources available to help with this, including some guides on our website, such as "What Surrounds Us Shapes Us: Making the Case for Environmental Change" and "Making the Case for Prevention: Basic Messages for Health Departments." It is also important to remember that message strategy is part of a larger strategic framework that should be developed first. Click here for more on our "Layers of Strategy."

To read Fernando's full post, "How personal responsibility framing undermines efforts to improve public health," and more of the BSMG blog, visit http://www.bmsg.org/blog.

This post originally appeared in PreventObesity.net's Inside Track.

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