Framing Strategies to Avoid Mother-Blame in Communicating the Origins of Chronic Disease

Abstract

Evolving research in epigenetics and the developmental origins of health and disease offers tremendous promise in explaining how the social environment, place, and resources available to us have enduring effects on our health. Troubling from a communications perspective, however, is the tendency in framing the science to hold mothers almost uniquely culpable for their offspring's later disease risk. The purpose of this article is to add to the conversation about avoiding this unintended outcome by (1) discussing the importance of cognitive processing and issue frames, (2) describing framing challenges associated with communicating about developmental origins of health and disease and offering principles to address them, and (3) providing examples of conceptual metaphors that may be helpful in telling this complex and contextual story for public health.

A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease

“…Those seeking to bridge DOHaD research and practice encounter a communication task fraught with difficulty [24]. First, having emerged over the past three decades, this is a relatively new body of science that is undergoing constant clarification and is marked by great complexity.…”

“…For many, it represents a very different way of conceptualizing the onset of disease risk. Second, the specific vocabulary that animates this science (e.g., “programming,” “wiring,” “embedding,” “imprinting,” “poor control”) and the range of language used to describe the “quality” of a person’s physical constitution can prove problematic when used in non-scientific arenas [24]. …”

“…As we and others have noted, there is a tendency in communicating DOHaD to frame it disproportionately around the biology, behaviors, and life circumstances of the most proximal link in the gestational chain: the mother [24, 34–36]. Common experimental designs evident within the field of DOHaD may contribute to this frame, as they typically compare health outcomes across proximal exposures -- the mother’s constitution, her pregnancy experience, and her actions during or prior to it.…”

“…We have identified three additional potential contributors to the tendency toward mother-blame in DOHaD communications [24]. First, cognitive linguistics explains that people’s minds create unavoidable associations, or “cognitive maps,” between concepts nested within categories.…”

Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective

“…Upstream discourse is necessary because communication surrounding DOHaD runs the risk of holding an individual woman as the sole proprietor of responsibility (and therefore, subject of “mother-blame”) concerning fetal and early-life health [49]. Moreover, this risk in communication can extended to inferences that entire disadvantaged communities are not doing enough—i.e., “community blame” [50]; meanwhile, the more powerful forces—e.g., profits, elitism, neoliberal ideology—[51,52,53] that actually push against individual and community-level lifestyle (e.g., diet) are left out of the discourse.…”