Words Matter: What Public Health Can Learn from the Health Care Reform Debate Robert Crittenden, MD, MPH Francesca Holme, MPH

Objectivesuccessfully connect with the public, media, and/or legislators on public health goals Goala healthier next generation of Americans

Learn… Effective communications strategies for health reform Ways to apply these strategies to public health How to use health care reform as a springboard for public health

Communication strategies for health reform

Why Connect? Remember Harry and Louise? The public = legislators

The Need for an Opening Photo by Miuki: creativecommons.org/licenses/by-sa/3.0/

Tips for Connecting Know your audience Values + beliefs outweigh facts Anger motivates us—fear shuts us down Be proactive Use personal themes Know your opponents

Health Care as an Example Remember: 93% of voters (2008) have health insurance

Health Care is a Core Value Linked to:  The pursuit of the American Dream  Our country’s destiny  Our family’s well-being and future Voters talk about reform in moral terms yet reform as a moral issue is insufficient to move voters.

Photo by Azoreg: creativecommons.org/licenses/by-sa/3.0 It’s Personal Americans think about health care and reform through a very personal prism: Who will pay? What will I lose?

Poll: Choice and Control When it comes to health care reform, the top issue my friends need to be reassured about is A.Choice of plans they can afford B.Choice to keep their doctor C.Guaranteed coverage D.A plan (public or private) with standard comprehensive benefits

Security and Peace of Mind Voters (especially women) want care they can count on through life and economic transitions Birth of a child Job changes, part-time work Major illness Divorce Relocation Early retirement Layoffs

Example It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will slow the growth of health care costs for our families, our businesses, and our government. It’s a plan that asks everyone to take responsibility for meeting this challenge – not just government and insurance companies, but employers and individuals. Pres. Obama Sep. 9, 2009

Messaging Advice Start your message with a story Keep your message simple and personal—don’t get pulled into the weeds Focus on values

Start with a Story Start with solid form Problem, Tension, Resolution Protagonist, Antagonist, Motives Use powerful and understandable metaphors iPhone Show Americans solving problems

Example Story I became a public health nurse because I wanted to help people stay healthy. But our health care system doesn’t make it easy for me to do my job. Insurance companies motivated by profit – not health – call the shots while hard-working Americans suffer. protagonist antagonist motives problem tension motives

Example Story (cont.) It doesn’t have to stay this way. Our leaders have proposed a uniquely American approach to health reform that reflects what’s important to us: having health care our patients can afford, and giving public health nurses the tools we need to give the best care. resolution Americans solving problems

Then Frame the Issues Affordability Choices Control Peace of mind Responsibility/fairness

Application of values to public health

Poll: What Is Public Health Write two to three words that best describes what public health is or does. Enter your answer via text chat.

What About Public Health? The public thinks prevention is the most important health reform priority. But keep in mind: prevention public health personal institutional healthy kids government program personal prevention community prevention

Healthiest next generation Responsibility Peace of mind Choice Affordability Possible Crossover Values

Public Health Challenges Name an important challenge public health faces today, or a policy goal you would like public health to achieve. Enter your answer via text chat.

Childhood obesity epidemic Chronic illnesses Lack of stable funding for prevention Examples

Obesity Healthiest Next Generation

Chronic Illness Shared Responsibility Photo by Kilbosh: creativecommons.org/licenses/by-sa/3.0

Funding Peace of Mind Photo: Pediboi (creativecommons.org/licenses/by/3.0)

Possible Example: Peace of Mind When we invest in prevention, all of us can rest easier: we know that the food we eat is safe; that we’ll be protected if there is a disease outbreak; and that help will be there for us during an emergency. Preventing disease doesn’t cost as much as treating an illness. But the peace of mind that comes with knowing that we’re protected is priceless.

Using health care reform as a springboard for public health

Current Status of Reform: House HR 3200 Community prevention grants National prevention and wellness strategy Core public health infrastructure for state, local and tribal health departments Public health workforce training and funding Peace of Mind

Current Status of Reform: Senate Senate Finance Committee Bill Maternal, infant and early childhood visitation Healthy lifestyle programs for Medicare and Medicaid patients Childhood obesity demonstration project Healthiest next generation

A Historic Opportunity Remember: the public is with you… if you connect.

It’s Not Over When a Bill is Passed One of the great lessons I’ve learned from a life in politics is that no reform is ever truly complete. We must constantly keep moving forward. Senator Edward Kennedy

Further Resources Check for current and future research and messaging… New research on messaging prevention soon to come! Let us know if you have ideas.