How opinion polling and framing research can work together
How opinion polling and framing research can work together
These two approaches can be used together to identify communications strategies to support social progress. A case study of research on health inequalities, written with Kate Stanley at FrameWorks UK.
The Fairness Foundation has just published some opinion polling on public attitudes to health inequalities. It shows that people do recognise the importance of strengthening the building blocks of health by tackling issues such as poverty, homes and pollution. But it also suggests that there is more work to do to build public understanding of them. And to answer these questions, we need to look beyond opinion polling to other approaches, such as framing research.
Sam Freedman argued in How not to use polling in July (paywall) that single-issue polls (as opposed to voting intention polls) are hard to get right: “We don’t know how much respondents know about the policy; or how strongly their opinion is held; or how important the issue is to them… Small changes in wording, which frame the issue in different ways, or add information, can dramatically alter responses”. So they can be difficult to interpret easy to skew. Moreover, they encourage politicians to “follow the electorate rather than lead it”. He makes the case for combining polling with other forms of research, such as citizens’ juries, to allow for more debate and consideration of the issues. This will allow policies to be designed based on a deep understanding of what the public think and why, and to be sold to the public in a way that will “persuade and lead” them, not just follow them.
FrameWorks UK published an article in July about the difference between framing research and opinion polling, which echoes Freedman. It argued that opinion polls help us understand what people think and believe (and how this varies over time), while framing research provides insights into how and why people think as they do, by examining the mindsets that lie behind people's attitudes, as well as whether and how those mindsets can be changed.
Understanding what people think about health inequalities and how to change this are distinct but complementary avenues of enquiry. On this topic, and on many other areas of public policy, we think that there is a compelling argument for opinion polling and framing research to be carried out in a joined-up way.
Let's examine this particular issue in more detail, as a case study.
A long read published by the Health Foundation in 2022 sets out the existing evidence base on public attitudes to health inequalities in the UK (citing two reports from FrameWorks UK: A matter of life and death, and How to talk about the building blocks of health). A key finding is that "there is a mismatch between the public’s perceptions of what influences health (namely individual behaviour and access to care) and the clear evidence base demonstrating the significance of wider determinants of health".
People tend to filter nuanced messages about health through either an individualistic or structural lens, depending on whether they think that individual factors (such as ‘lifestyle choices’) or structural factors (such as poverty or housing) have a greater influence on people's health outcomes. And because many people give more weight to individual factors, there is a widespread lack of understanding of the impact of structural factors on health. And these factors are hugely important; the evidence suggests that health inequalities are caused more by ‘social determinants’ of health, such as poverty, poor-quality housing, low-paid or unstable jobs, and pollution, than by unequal healthcare provision or factors like smoking, diet, or drinking.
However, it is possible to address this mismatch. FrameWorks UK has shown, in the work cited above, how to frame communications to tell a more powerful story about health that can increase understanding of the role that the wider determinants play in our health, and support for action to address them.
The Fairness Foundation’s polling built on the existing evidence base on attitudes to health inequalities in the UK, including the research carried out by FrameWorks UK. It aimed to find out whether, despite the prevalence of ‘individualist’ thinking, people recognise the impact of social factors on health outcomes when they are presented with specific case studies, and how they compare the impact of those factors to individual choices and healthcare services. It also investigated who people think should be responsible for addressing the issues, and whether they think that government should be doing (and spending) more to tackle health inequalities. And it looked at how attitudes vary based on people’s background and beliefs.
The polling results suggested that, when presented with case studies, people do recognise the impact of economic and environmental factors on poor health rather than simply blaming the state of the NHS or individuals. Attitudes did not differ widely between Labour and Conservative voters. However, individualistic thinking retains its power, especially around issues connected to food. An example around type two diabetes saw many more people blame the condition on individual decisions than on poverty or other structural factors, unlike in the examples that were focused on long covid, anxiety, cancer and asthma where people did see the structural factors.
The results give us a broad picture of how people think differently about different conditions and aspects of health, and of how attitudes vary (or not) between groups of respondents, but they don’t give us definitive answers about why they think like this, or how we might look to influence their underlying mindsets. This is where framing work adds real value.
We very much hope that the polling work published by the Fairness Foundation and the research from FrameWorks UK in partnership with the Health Foundation encourages other organisations to take up this research agenda, and that there is a broader move across all areas of social policy towards using polling alongside complementary research approaches.
Will Snell, Chief Executive, Fairness Foundation
Kate Stanley, Executive Director, FrameWorks UK
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