Framing the message of equity: What resonates with policy makers and public health professionals on the social determinants of health?

Disparities between and within nations and societies increasingly point to the “causes of the causes”---the various social, economic, political, and environmental factors that impact health--- otherwise known as the “social determinants of health” (SDH). However, the practical application of SDH at the state and community levels vary widely given differences in awareness, interest, understanding, and source of health data. The objective is to determine the: (1) level of SDH awareness, interest, and perspectives; (2) preferred format for health information; (3) SDH message framing that resonated best among local policy makers, state legislators, and public health professionals. A survey was given online via Qualtrics, by phone, and by mail. Public health professionals (78%) were most aware of the SDH message compared to state legislators (66%) and local policy makers (51%). In using data for policy and/or practice decisions, state legislators preferred consulting with the Office of Legislative Counsel & Research, other legislators, and constituents. Local policy makers consulted with other policy makers, constituents, and the internet. Public health professionals consulted with the community, policy makers, and state health department. SDH messages framed according to children's health needs resonated best among policy makers while a message emphasizing prevention was favored by public health professionals. Policy makers at all levels need to know more about the social determinants of health. SDH messages framed according to local community needs, using a format and language that people understand, are more likely to resonate across the political spectrum and the public health discipline.