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The Health-Care Frame Game

Sunday, October 18, 2009

Now you don't have to take Frank Luntz's word for it.

The GOP pollster and message maven circulated a 28-page memo in the spring, coaching Republicans on how to talk about the "Washington takeover" of health care. New public health research confirms what Luntz has known all along: Framing matters.

A study that will appear in the December issue of the American Journal of Public Health tracked the ways in which party affiliation related to people's responses to identical information on diabetes.

Participants in the study read a mock news article on the American Diabetes Association lobbying Congress for greater attention to Type 2 diabetes, the sixth-leading cause of death in the United States. Some people read a straight news report, with minimal mention of what causes diabetes. Others read one of three versions of the story: one that pegged the disease primarily to genetic factors; one that emphasized personal choices; and one that focused on social and environmental factors, such as access to safe places to exercise and affordable, healthy food.

The study's authors, University of Pennsylvania researcher Sarah E. Gollust, along with the University of Michigan's Paula M. Lantz and Peter A. Ubel, were most interested in how people responded to the notion that "social determinants" -- how easy it is to buy fresh vegetables or exercise, among other things -- are underlying causes of disease. Public health advocates have been promoting the importance of these factors, believing that the more people know about these circumstances, the more likely they are to want to help.

But that assumption doesn't hold up. When people who identified themselves as Democrats read specifically about the social factors that can lead to Type 2 diabetes, they expressed greater backing for public health policies aimed at addressing those factors; Republicans, by contrast, registered much lower levels of support.

"The take-home message is that people can walk away from the same information with different attitudes," Gollust says.

She began this research in 2007, well before the current health-care debate was underway, but she is familiar with Luntz's work and how it overlaps with her study's findings about the power of a message to affect people's views.

She's not about to write her own strategy memo, though.

"We have different goals," she says. "I'm a researcher first."

-- Rachel Dry

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