Deep Metaphors in Health

Last week, I tuned into an interesting Robert Wood Johnson Foundation webinar on communicating about health. We in public health often talk about the “social determinants” of health. When this term is used without explanation, I’m relatively certain it means very little to the average person. However, translated, this means that health outcome is largely predicted by the physical, economic, and social environment in which one lives.

According to research cited during the webinar, Democrats support the notion that societal factors influence health. For Democrats, for instance, poverty is a hole created by systems imbalances that trap individuals and puts them at risk for poor health. On the other hand, Republicans tend to view health metaphorically as an individual journey in which people have an opportunity to make choices. Poor choices result in roadblocks to good health.

Now, this research is not about whether Democrats or Republicans are correct about the real factors behind poor health. The value of generating deep metaphors is to gain a better understanding of the frames people use to view the world. In other words, for those of us who often communicate about health matters, it’s not about who is right or wrong, it’s about finding a common language that speaks persuasively to multiple viewpoints. I would urge you to explore the RWJF website for further information.


-Doug Hirano, MPH, APCA Executive Director