Improving Population Health in a Politicized
World: Understanding and Overcoming
Communication Barriers
Sarah Gollust, Ph.D.
Associate Professor, University of Minnesota
@sarahgollust
How We Can Improve Health Science Communication
University of Michigan
June 17-18, 2016
#HScomm #scicomm
America Today
Pew Research Center, April 2016
Brookings data, NYTimes graphic, Feb 2016
Improving Population Health
See also: Jim House,
Beyond Obamacare,
Life Death and Social
Policy (2015)
Public Understanding of Factors that
“Very Strongly” Influence Health
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Personal
Health
practices
Affordable
Health Care
Has Health
Insurance
Income
Education
Where a Race/ethnicity
Person Lives
Source: Robert & Booske (2011) American Journal of Public Health
Traditional news
Source: Gollust and Lantz 2009
Traditional news
 Growing capacity
Traditional news
 Growing capacity
 But still relatively uncommon
2016
2010
Barriers to Communication
 Group-related beliefs
 Values / symbolic politics
 Motivated reasoning
 Politicization
Group Beliefs
April 20, 2016
May 8, 2016
Values and Symbolic Politics
 Responsibility judgments and deservingness are central
themes in public health policy
Health education campaigns
…As is true in social policy
more generally, i.e., Cook &
Barrett (1992), Support for the
American Welfare State; Gilens
(1999) Why Americans Hate
Welfare; Iyengar (1991) Is
Anyone Responsible
Values and Symbolic Politics
 Responsibility judgments and deservingness are central
themes in public health policy
 And in health message response
Source: Gollust and Cappella (2014) in Journal of Health Communication
Motivated Reasoning
20.0%
15.0%
Soda tax support
15.0%
10.2%
10.0%
5.0%
0.0%
-5.0%
-10.0%
Republicans
-8.4%
Refuting Big Soda
Democrats
Independents
% difference from a control group; *<0.05, **p<0.01
Source: Gollust, Barry & Niederdeppe (2015) APSA paper
Motivated Reasoning is Enhanced in
Politically Polarized Environments
 When members of the public are told that politicians
have polarized stances on a policy issue (energy /
immigration) they are
 More likely to follow partisan cues
 Less likely to follow stronger (vs. weaker) arguments
“In a polarized partisan environment, partisan
motivated reasoning overwhelms substance.” (p. 68)
Druckman et al., (2013) “How elite polarization affects public opinion
formation” American Political Science Review 107(1): 57-79
Opportunities for More Effective
Communication
 Use of alternative values
 Values affirmation
 Finding the right villain
 Using the right messenger
Alternative Values
Source: Gollust, Niederdeppe, Barry (2013) American Journal of Public Health
Values Affirmation
 Evidence suggests self-affirmation (of values, identity) is a
way to mitigate the motivated reasoning of information
designed to persuade
 Explicit in some RWJF communications and
recommendations
RWJF language, Commission to Build a Healthier America (2008)
 Supported by my work which shows that including
personal responsibility explicitly in messaging can reduce
reactance responses (and see Niederdeppe et al.)
Finding the Right Villain
Novel messengers
“When it comes to children’s health and our
national security, retreat is not an option.”
“Retreat is Not an Option: Healthier School
Meals Protect Our Children and Country”
Military
leaders
speaking to
policymakers
and the public
Conclusion
 All health and science communication issues confront
 Public understanding of science
 Credibility of science and scientists
 Counter-arguing and motivated reasoning
 Communication with the goal of increasing public and
policymaker support to improve population health has
additional challenges
 Multidisciplinary empirical research agendas can help
illuminate a path toward building public and political
will
Acknowledgements
• Colleen Barry (Johns Hopkins), Jeff Niederdeppe (Cornell)
• Erika Franklin Fowler (Wesleyan), Julie Lynch (Penn), Rebekah
Nagler (Minnesota), Joe Cappella (Penn)
• Paula Lantz (Michigan), Peter Ubel (Duke), Nick Valentino
(Michigan)
• Funding
▫ Robert Wood Johnson Foundation (Health & Society Scholars Program,
Healthy Eating Research, State Health Access Reform Evaluation
Program)
▫ McKnight Land-Grant Professorship, UMN
▫ American Cancer Society Research Scholar Grant (RSG-14-166-01-CPPB)
Thank You