What surrounds us shapes us: Making the case for environmental change

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May 1, 2009

Creating healthy environments starts with knowing what you want to change. Then you have to find the right language to talk about it effectively. Language is important because how an issue is described, or framed, can affect whether it has popular or political support.

Linguists say that framing is how our minds recognize patterns of ideas, categorize them, and derive meaning from them. Framing is the translation process between incoming information—things we see, read, or hear—and the ideas already in our heads. Frames are important to advocates because they influence how people react to ideas.1
Consider one example from Kraft Foods. When Kraft reframed recipes as "solutions" rather than as"cooking,"more people requested the company's recipes. Mary BethWest,Kraft's Chief Marketing Officer, explained that communicating this idea in the recipe's title could bump it to the top of Kraft's request list: "'Learn to cook stir-fry' is fast to the bottom; 'Easy stir-fry in 15 minutes' is at the top. Framing it more as a food solution and an idea of getting dinner on the table is what it's all about."2
Language can create a "frame of mind" that makes some ideas attractive and others not. Whether promoting recipes or promoting policy, the frame matters.

This framing brief suggests how to create frames that can help people see that environments affect health. When people understand that idea, they are more likely to support policies that improve those environments.

Shifting from portrait to landscape

Research shows that in the U.S., most of the time most people think that individuals are masters of their own destiny. People believe that hard work, discipline, and self-determination will outweigh other factors such as the conditions in which they live. These values extend to people's perceptions about health as well: their gut-level assumption—what we call the default frame—is that individuals can control their own health outcomes if they make the right choices.

The problem with the default frame is that it hides the influence of the places where people live, work,and play. The default frame is like a portrait,focused narrowly on the details of a single person. Advocates need to evoke frames that are more like landscapes—frames that include people, but also the context that surrounds them.

Advocates slip into the default frame when they encourage people to eat more fruits and vegetables and fewer fatty foods, without mentioning the need for all neighborhoods to have stores that sell healthy foods at affordable prices; or when they tell parents to make sure their children get enough exercise, but don't make the case for neighborhoods and schools that offer safe places for children to play, free of violence and crime.

Advocates need to broaden the default frame from its exclusive focus on the individual—or portrait—to a landscape perspective that makes visible the external factors in the environment. By painting a broader picture, advocates can help people see that neighborhoods, schools, and workplaces influence health. Only then will policies that improve places make sense to people.

To do this, advocates need to think about what they say and ask themselves: What assumptions does our language trigger? What pictures are we bringing to mind? Do they lead to support for our policy and reinforce our values? Advocates have to start with a frame that brings to mind place. Then they can talk about the people in those places.

Triggering an environmental frame

How can advocates trigger the idea that contexts affect individuals? Research from the FrameWorks Institute suggests reminding people that where we live, work, or play (including homes, schools, offices, businesses, stores, parks, and any other physical spaces), affects our daily lives, including our health. When we improve and maintain these environments, the health of the people who live and work there improves as well.

Advocates can trigger an environmental frame by starting their communications with a vivid description of the environment that contributes to poor health, as well as the kind of place that supports health. Then, advocates can state the value that motivates them to make the change they seek. To that they can add a clear, simple description of their policy. The task is to create an image of the world that, linked to the advocates' values, accommodates their policy solutions and creates the desired place-based frame.

Below is an equation that incorporates each of the variables needed to create the desired frame:

graphic 1

For example, community members advocating for the city to work with businesses to promote corner stores that sell healthier food could combine their policy goal with the value of fairness and say something like this:

"Children are healthier when their communities provide healthy food. But when neighborhood stores don't have a selection of healthy food, people simply can't feed their families the way they want to, and their health suffers. It's not fair that the people in our neighborhood have plenty of access to liquor stores and junk food, but have to take two buses to get to a grocery store that sells fresh produce. That's why we need the city council to work with us to attract a new market to our community."

The order of the statement matters because audiences will be able to understand the relevance of the policy only if they understand that environments matter when it comes to health. You may arrive at different ways to trigger that idea but the important thing is that you do it first. Usually there's more to say about the environment than time to say it; emphasize those parts of the environment that link logically to the policy solutions you seek.

Incorporating values

FrameWorks research tested three commonly shared values—fairness, ingenuity, and prevention—with good results. Linking any of the three values to environmental triggers inspired positive responses to public policy among different audiences. Here are some ways to use these values to create environmental frames:

  • Use fairness to show that certain communities do not have a fair chance to live healthy lives, and that policy change will help even the playing field so all communities have access to health.
  • Ingenuity, or "can-do spirit"—the idea that communities can and do work together to create lasting and meaningful change—can help people see that it is possible to establish policies that benefit the common good, even though it might be difficult.
  • If you begin with statements that trigger context, you can talk about our responsibility as a community to prevent health problems by creating the environments in which all people can enjoy long-term good health.

Below are three examples of how these values could be applied when advocating for joint use, the movement to open school facilities or community center grounds to the public to promote greater opportunities for physical activity.3 Notice that each statement describes what joint use means and why it matters without using the technical term itself.

  • An environmental trigger with the fairness value:
    Children are healthier when they have safe places to play with well-maintained playgrounds. It's not fair that some children in our city have this while others don't. If we keep schoolyards open after hours, all children can have safe places to play.
  • An environmental trigger with the ingenuity value:
    Children are healthier when they have safe places to play. Fortunately, we already have those places: schoolyards. The smart solution is to keep schoolyards open after hours so all children can be more active.
  • An environmental trigger with the prevention value:
    Children are healthier when they have safe places to play. When schoolyards are closed after hours, some children can't play outdoors, which means they don't get the exercise they need to be healthy. We can prevent poor health now and in the future if we keep schoolyards open after hours.

Message strategies need to be considered in the context of your overall objective. A frame that fits well with one objective may not fit with another. Or you may want to frame your argument differently depending on your target. For example, if your goal is to have government provide incentives for neighborhood convenience stores to carry more fresh produce, you might talk about the can-do spirit of business owners working with government to broaden their inventories with healthy food. But if your plan is to require that all convenience stores in certain neighborhoods carry fresh produce, you may make the case that it is our responsibility as a community to ensure access to healthy food for all. Experiment with language you feel comfortable using in connection with the goals you seek.

The downfall of "choice" — a common trap

Advocates want to expand the conversation about health from a narrow focus on personal responsibility to include the environmental landscape. Reporters and policy makers, however, will often draw the conversation back to individuals by talking about "choice." The danger is that the more you talk about choice—even when you're talking about the absence of choice—the more you reinforce the dominant frame of individualism. Choice is important, but the idea itself triggers an individualistic understanding of the world that distracts from the environment in which the choices are made.

So, when reporters or others ask about choice, use it as an opportunity to move the conversation toward the environment, to the policy solution you seek, and the values you hold. Here are some examples of statements you could use to pivot away from choice to an environmental frame using our commonly held values.

  • Fairness: "Sure, parents want to make good nutrition choices for their children, but parents don't choose what is stocked in grocery stores or whether a grocery store with healthy food is even located in their neighborhood. It's simply not fair that some families have easy access to healthy food and others don't. That's why we need to [add your policy action here]."
  • Ingenuity or "can-do" spirit: "Choice is important, but good choices are not possible in our environment.This is a big problem since we know that environments can determine whether people will be healthy. But we've tackled big problems before, and we can tackle this one. Let's find the innovative ways companies and business owners can do the most good for the communities they serve. We can start by [add your policy action here]."
  • Prevention: "All parents want to make the best choices for their families. But everyone's decisions are made in a context and right now our situation doesn't promote health. People are healthy when their communities provide healthy food and safe places to play.We can prevent future problems by creating environments that foster health for everyone.That's why we are asking for [add your policy action here]."

Interview gone wrong

Once we have figured out what has to be done, who has to do it, and how to frame the issue, then we have to talk about it, in public and on the record. Talking with journalists is especially important since policy makers pay close attention to the news. Whenever we talk with reporters we have the opportunity to educate them about the problems we see and what to do about them. But talking with reporters can be intimidating. Sometimes it's hard to stay focused on our message, including the policy goal. Let's use the example of a moratorium on fast food outlets and see what can happen under the pressure of an interview.

    Reporter: What should we do about childhood obesity?
    Answer:We need to make healthier food more widely available in our communities. One way to do this is to stop building fast-food outlets, so neighborhoods can attract a bigger variety of food options.

    So far so good. Let's keep going

    Reporter: But no one forces people to go into a McDonald's. What does the number of fast food restaurants have to do with obesity?
    Answer: Of course we can't guarantee that people will buy fruit instead of french fries or chips, but at least if people have healthy food available instead of junk food, we are headed in the right direction. For example, making produce avail- able in corner stores would make it easier for families to buy healthy food.

    Reporter: If people in the neighborhood wanted to purchase that sort of food, wouldn't it already be in the stores? And why should small businesses take the risk of putting expensive, perishable produce on their shelves? Their concern is business, not health.
    Answer: People in this neighborhood already purchase that sort of food, but not as often as they want to because they have to travel so far to do it. We want to encourage business owners here to promote health. They should be held accountable for the unhealthy food they carry in their stores and restaurants. Corner stores can start by carrying small quantities of healthy food, and increase the supply once demand increases.

    Now you are off track. These are good points, but you wanted to focus on the specific policy goal of supporting the fast food moratorium in your city. Instead, you find yourself talking about the importance of convenience stores carrying produce--not a bad idea, but not where you wanted to end up, given your policy goal. Let's try the interview again.

    Reporter: What should we do about childhood obesity?
    Answer: We need to make healthier food more widely available in our communities. One way to do this is to stop building fast-food outlets so neighborhoods can attract a bigger variety of food options.

    Reporter: But no one forces people to go into a McDonald's. What does the number of fast food restaurants have to do with obesity?
    Answer: Policymakers can help ensure that communities are given a fair chance for health if they pay attention to the environment that affects health. Right now we have plenty of fast food outlets in our neighborhood.What is lacking are places that offer healthier menus with fresh food.

    Reporter: Why should government interfere with where businesses locate? Isn't this a free market issue? If there were a demand for other sorts of restaurants, wouldn't businesses like that locate here?
    Answer: We have a responsibility, and our policy makers have a responsibility, to be sure neighborhoods don't stack the deck against their residents' health.That's why the moratorium makes sense.We need a breather from fast food to attract other healthier businesses into the neighborhood.

    Now you're on the right track. The reporter may follow up with questions about how the fast food moratorium will work, what you hope the outcome will be, or next steps. Or the reporter may ask another distracting question. But by staying on track, you will have the discussion you want to have, focused on your priority policy goal.

Conclusion

Most of the time in policy battles, advocates are trying to energize and activate their supporters. They can do so when they state their solutions clearly, use frames that help people understand that environments make a difference in health, and express their values about why the solution matters.

This Framing Brief was written by Berkeley Media Studies Group for the Strategic Alliance's Rapid Response Media Network and The California Endowment’s Healthy Eating, Active Communities program. Both Strategic Alliance and the Rapid Response Media Network are funded by The California Endowment. For more information about this piece or the Rapid Response Network, contact Sana Chehimi, sana@preventioninstitute.org or 510-444-7738.

1 There is a growing literature on framing. For research and examples of framing applied to health, see FrameWorks Institute, www.frameworksinstitute.org and Berkeley Media Studies Group, www.bmsg.org.

2 York, Emily Bryson. Kraft tests recipe for selling in a recession. Advertising Age, November 10, 2008, page 20.

3 See www.jointuse.org for background, examples, and connections to those working to establish joint use.

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