Using a Health Equity Lens

Health equity lens

It means intentionally looking at the potential positive and negative impacts of proposed messages. Use a health equity lens in communication planning, development, and dissemination, to be inclusive, avoid bias and stigmatization, and effectively reach intended audiences. This approach includes getting input from the intended audiences. Consider the following key health equity concepts when framing health disparities and discussing public health implications.

Systemic inequities

Long-standing systemic social and health inequities, including some that have been introduced or exacerbated by federal, state, and local policies, have put some population groups at increased risk of getting sick, having overall poor health, and having worse outcomes when they do get sick. Avoid perpetuating these inequities in communication:

• Consider how racism and other forms of discrimination unfairly disadvantage people and lead to social and health inequities.
• Explain that policies, programs, practices, services, and environments that support health can reduce health inequity.
• Recognize that access to information is not enough; people need information that they can understand, use, and that is culturally and linguistically appropriate.
• Avoid implying that a person/community/population is responsible for increased risk of adverse outcomes.
• Recognize that some members of disproportionately affected groups cannot follow public health recommendations. This may be due to inequitable resource allocation or a lack of inclusive infrastructure.
• Consider ways to improve the accessibility of content, such as using alternative communication formats and offering materials in other languages.

Diversity

Public health programs, policies, and practices are more likely to succeed when they recognize and reflect the diversity of the community they are trying to reach.

• Use language that is accessible and meaningful to your audience of focus.
• Tailor interventions and communications based on the unique circumstances of different populations.
• Emphasize positive actions to be taken and ensure that community strengths and solutions are highlighted and drive local public health efforts.
• Recognize that some members of your audience of focus may not be able to follow public health recommendations due to their cultural norms, beliefs, or practices.
• Analyze structural barriers (present and historical) that need to be addressed to best serve different populations at different levels and within different contexts.

Community engagement

Community engagement should be a foundational part of the process to develop culturally relevant, unbiased communication for health promotion, research, or policy making. Community engagement can have varying levels of community involvement, from outreach to consultation, involvement, collaboration, and shared leadership.

Be clear about the populations and/or communities you want to engage and the purposes and goals of the engagement effort. Remember that successful community engagement is a continuous process that builds trust and relationships through a two-way communication process. This starts with mindfulness and listening and continues with joint decision making and shared responsibility for outcomes.

Aim for co-developed, co-curated, and co-produced community content whenever possible. Engage organizations, agencies, and people who represent the community throughout the stages of communication development:

• Perform formative research to understand community health status, needs, priorities, assets, and key influences. Listen to and learn from intended audiences before creating information products.
• Consult community members on concept and message development in order to best understand what messages resonate and do not resonate with the intended audiences.
• Invite people who represent your intended audiences to review materials before finalizing and disseminating.
• Enhance reach of the message through use of effective channels and formats that are appropriate for the intended audiences.
• Learn what strategies and language were most effective for this audience and apply that knowledge to future communication plans.

The engagement must be responsive to the needs, culture, and norms of that community as defined by the community itself. Critically assess how your priorities and needs align with those of the community.

Intersectionality

Health equity is intersectional. This means that individuals belong to more than one group and, therefore, may have overlapping health and social inequities, as well as overlapping strengths and assets.

• The way people's social identities overlap should be considered to better understand, interpret, and communicate health outcomes.
• Members of population groups are not all the same in their health and living circumstances. Understanding and accurately articulating the particular needs and experiences of your audience of focus can determine the level of impact, success, or failure of an intervention.
• Diversity exists within and across communities, with variations in history, culture, norms, attitudes, behaviors, lived experience, and many other factors. Be cautious in generalizing about a community.
• Race/ethnicity should not serve as a proxy for socioeconomic status, and vice versa.

Literacy

Not all members of your audience of focus may have the same level of literacy. This includes both the ability to read and the ability to understand the content.

• Use active verbs and plain language so that all members of your audience can understand the information.
• Recognize that while some people may not be literate, they possess other life skills that enable them to lead meaningful lives and contribute positively to society.
• Acknowledge that many people with English as a secondary language are highly literate in a non-English language.
• Similarly, recognize that people may not be literate in their primary language, and avoid assuming that people with English as a secondary language will understand written information when it's translated into their primary language.
• Consider lack of digital access and literacy. Some people may not have access to technology, and others may not know how to use it.