Strategies for and Barriers to Communicating About Health Equity in Challenging Times: Qualitative Interviews With Public Health Communicators

Abstract

Policy Points Public health communicators in practice discuss health equity issues in a competitive information environment. Through interviews with 36 communicators from diverse professional perspectives (i.e., journalists, advocates, public health leaders) in 2022–2023, we illuminated key challenges they face and strategies and resources that might mitigate these challenges. Findings can inform communication research priorities and investment in resources to help practitioners communicate about health equity amid a challenging political landscape. Context: Communicating about health equity is increasingly challenging in light of a changing information environment and the emergence of opposition to equity and equity-related concepts since 2020. Public health communicators often discuss health equity–related concepts, but it is not clear what strategies they use or what resources can support them to overcome challenges they face. Methods: We conducted qualitative interviews (N = 36) with communicators across four professional categories (public health leaders, journalists, thought leaders, and health advocates/organizers) from late 2022 to mid-2023 to discuss the strategies they employ; the challenges or barriers they face related to audiences, their institutions, or the broader communication landscape; and the resources they rely on, including their social networks, toolkits or guides, trainings, and research. Findings: Communicators use a range of strategies to explain health equity, the causes of disparities, and the imperative of solutions; data and stories were common approaches used, although these strategies were not considered a panacea. They also face consistent challenges, such as concerns about audience resistance, lack of public understanding of terminology, and a fragmented communication landscape—and for journalists in particular, institutional barriers and the challenge of identifying diverse sources. Communicators rely on a range of resources, though mainly colleagues and interpersonal support, with the use of research-based resources being relatively uncommon. Although there were commonalities among public health leaders’ and advocates’ approaches, journalists’ concerns and resources were often different. Conclusions: Communicators could benefit from more research to confirm or offset some of their concerns (such as the potential for resistance from the use of key phrases, like “systemic racism,” or unintended consequences of using disparities data); researchers must also disseminate this work to these practitioners, including journalists. Academic researchers, foundations, and nonprofit organizations all can play roles in building infrastructure for resource sharing, research dissemination, and convening communicators to build stronger connections and support.