Health Care

health care

From 2002-2004, the FrameWorks Institute conducted an integrated series of research projects to determine how Americans think about health care and the problems facing the health care system. The goal of this research was to understand how the public thinks about health care and the larger context of the health care system. What, if anything, do they see as broken? And what would fix the problem?

Specifically, we investigated the following questions:

  • Are there dominant frames about health care that appear almost automatic?
  • Are there default frames that are routinely relied upon to make sense of unfamiliar situations or policies?
  • How do these frames affect the public’s policy preferences?
  • How are these frames reinforced by advocates, experts, and the media; in other words, what frames are available to people from media and the public debate?
  • How can the problems affecting health care and uninsured populations in be reframed to evoke a different way of thinking, one that makes appropriate policy choices salient and sensible?

Research was conducted in three states: Arizona, California and New Hampshire. While each state had a local perspective on the issue, residents of the three states shared many common perceptions of the American health care system that may be useful for other state and national advocates. Research reports and Message Memos can be found in the state-specific toolkits.

In 2008, FrameWorks completed research on how Americans think about Community Health, which may also be of interest to health care advocates. To access this research, click here.  

Our Funders

This project was generously funded by: The Endowment for Health and HNHfoundation in New Hampshire; the California Wellness Foundation and the California Endowment; and the St. Luke's Health Initiatives
 in Arizona.  

Research & Recommendations

Making the Public Case for Health Care Reform- A FrameWorks Message Brief . This Message Brief distills the research findings and framing strategies outlined in the state-based Toolkits, and offers some dos and don’ts for communicators on the issue.

Answering Tough Questions About Health Care Reform. This document examines some Frequently Asked Questions about health care reform, providing typical answers and reframed responses. Also included are three key cautions for health care reform communicators.

In Arizona, the following research was conducted:

  • 6 focus groups of engaged citizens in Prescott and Phoenix.
  • A statewide phone survey of voting age adults’ attitudes to health care, the health care system and health care reform.  The survey base included an oversample of Latinos and residents in rural parts of the state.
  • A statewide survey of 800 Arizonans conducted by phone November 12- December 4, 2003 to test priorities and preferences for health care reform in that state.

In New Hampshire, the following research was conducted:

  • A comprehensive review of existing public opinion research on attitudes to health care, both nationally and within New Hampshire.
  • 26 in-depth interviews conducted with ordinary citizens and individuals in positions of influence in various parts of the state.
  • 4 focus groups with engaged citizens (separated by gender) in Lebanon and Londonderry.
  • A content analysis of print media coverage nationally and in the selected state newspapers addressing health care and the uninsured over five months in 2002.
  • A statewide survey of 1002 New Hampshire residents to further test the recommendations emanating from the research

In California, the following research was conducted:

  • An updated meta-analysis of existing public opinion about health care among Californians, based on an exhaustive review of more than 50 reports, presentations, press releases and surveys from existing, publicly available opinion research.
  • 25 in-depth interviews conducted with ordinary citizens and individuals in positions of influence in various parts of California.
  • 9 focus groups conducted with engaged citizens, divided by location and race/ethnicity.
  • A statewide survey of 1211 Californians to further test the recommendations emanating from the research

Our Products and Tools


The research reports, summary finding and recommendations, as well as tools and applications can be found in the following three compendia:


Fairness is a value often used by health care reform advocates to appeal to broad audiences. Read FrameWorks’ FrameByte, The Challenge of Using Fairness to Advance Health Care Reform, to learn more about the unintentional consequences of using this value in your communications.

Related Reports

Invisible Structures of Opportunity: How Media Depictions of Race Trivialize Issues of Diversity and Disparity . This analysis was supported by the W. K. Kellogg Foundation to examine the various ways in which race is presented to readers, directly and indirectly, in the nation’s news media. More specifically, it analyzes media coverage of race over the course of one year in four issue areas: health, education, early child development and employment.  The report lays out the dominant frames that are applied to race in these areas and demonstrates how these frames constrain public solutions.

FrameWorks Institute

  Updated: 02/06/15