Political Perception in Health Disparity

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The Robert Wood Johnson Foundation launched a major bipartisan commission on the issue of health disparities. To overcome political gridlock, they needed a better understanding of how Democrats and Republicans viewed the issue.


We conducted ZMET® interviews with Democratic and Republican legislative staffers and health policy experts regarding "thoughts and feelings about the differences in health of Americans, and the sources of those differences."


Democrats believe poor levels of health arise from a complex system of social factors that trap low-income people in communities where it is impossible for them to achieve better health. This inequality is unjust, and the government should attempt to "level the playing field."

Republicans believe that health is a matter of making good life choices, but that in some communities inadequate resources make those choices very difficult. It's not inequality that matters, it's "raising the bottom" to make those choices easier.


To create messages that resonate across the political spectrum, RWJF stopped using the language of inequality in its communications. Instead, it began to frame health issues using the Deep Metaphor™ of Journey, which appeals to both Republicans and Democrats.

The tagline, "Health starts where we live, learn, work and play" has helped RWJF gain bipartisan support for initiatives in areas such as childhood obesity, access to health care, and healthy family eating, and the ZMET® study has become a landmark case in social policy circles.


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