The polarizing effect of news media messages about the social determinants of health

Abstract

Framing health problems in terms of the social determinants of health aims to shift policy attention to nonmedical strategies to improve population health, yet little is known about how the public responds to these messages. We conducted an experiment to test the effect of a news article describing the social determinants of type 2 diabetes on the public's support for diabetes prevention strategies. We found that exposure to the social determinants message led to a divergence between Republicans' and Democrats' opinions, relative to their opinions after viewing an article with no message about the causes of diabetes. These results signify that increasing public awareness of the social determinants of health may not uniformly increase public support for policy action.

FIGURE 1

Probability of agreeing with the statement that “People with diabetes got their illness because of the social or economic circumstances in which they live,” by causal frame viewed and political party of viewer: United States, 2007. Note. Error bars represent 95% confidence intervals around the proportion who agreed with the statement.

FIGURE 2

Degree of support for public health policies after exposure to a news media article about type 2 diabetes, by causal frame viewed and political party of viewer: United States, 2007. Note. Participant opinion for each public health policy based on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree), averaged across 7 policies. Error bars represent 95% confidence intervals around the predicted mean support for public health policies (where higher values indicate more support). Difference between Democrats and Republicans in social determinants condition relative to control condition is statistically significant (b of interaction term from ordinary least squares regression = −0.45; P = .005). The ordinary least squares regression model included controls for study participants' age, gender, race (White, Black, other), ideological self-identification (liberal, conservative, middle), income, educational attainment, and diabetes status of self and family or friends.