When asked what influences their health, the British public consistently point to two things – their individual behaviour, and their ability to access health care. This has been shown time and again over the last 5 years, from British Social Attitudes polling in 2017, to Ipsos polling commissioned by the Health Foundation in late 2021. Yet for decades there has been clear evidence that the building blocks of health are wider ranging. Factors such as housing, education and employment are pivotal in shaping individual opportunities to be healthy and play a stronger role in maintaining good health than access to the NHS.

This mismatch between public perceptions and the evidence has consequences. Public opinion shapes political decision making. In the face of life expectancy stalling, and falling for some, a sustained focus on policies to enable people to stay healthy for longer is paramount. Our analysis finds that this will require greater public buy-in for policies that go beyond the role of the NHS. Which in turn, will require advocates to find more effective ways to communicate to the public.

This long read explores reasons behind current public attitudes towards health and inequalities in health outcomes, drawing on polling and public attitudes research by the Health Foundation and others. It considers the role of communication approaches in bringing closer alignment between public understanding and the evidence, referencing findings from the Health Foundation’s ‘Thinking differently about health’ project with the FrameWorks Institute.