Communicating About Health Equity Concepts (CHEC)

What we did

CDC’s Office of Health Equity (OHE) conducted message testing in 2022 to learn what diverse audiences think, understand, and feel about the concept of health equity. Findings helped to inform improved approaches for creating effective messages for specific audiences.

What we want to change

We need to reframe public health messages to communicate about health h equity instead of focusing on health disparities. Why? When you shift the focus to the systemic and structural issues, you show a pathway to address health disparities in a meaningful, non-stigmatizing, and sustainable way. This approach encourages strategies to address root causes and boosts broader systems-level changes that benefit us all.

How we move upstream

Results from OHE’s 2022 message testing helped develop three principles to improve communication about health equity concepts. The principles below help to change the conversation to addressing health equity instead of naming and quantifying health disparities.

Principle 1: Meet the audience where they are.

This means: Learn your audience's beliefs, attitudes, values, and biases towards health equity concepts.

Why it matters: Knowing how your audience understands these concepts, such as equity, equality, justice, fairness, and social determinants of health, and their potential resistance to certain words, can help tailor effective messages.

In practice:

• Take small steps with your audience. Use enabling language that promotes choices. Help the audience see concepts as their own ideas.
• Set the context. Explain how health disparities and inequities happen before mentioning which people and communities are most affected.
• Help the audience draw new conclusions. Help the audience transform or develop a different perspective to influence their actions and views.

Principle 2: Communicate health equity as a “we” issue.

This means: Build on society's shared values, interconnectedness, and empathy. Help your audience see themselves as impacted by inequities and prevent an "us versus them" mentality.

Why it matters: Messages framed in a negative way are ineffective to convey the importance of addressing health equity. These messages highlight disparities as the problem instead of showing the outcome of the problem. These messages may create fear in some audiences. Instead, write messages that lead the audience to focus on the systemic drivers (e.g., lack of transportation, etc.). This framing destigmatizes health disparities and enables audiences to see how inequities might impact them. This framing might help your audience understand how health equity efforts could potentially benefit them.

In practice:

• Use gain-framed messaging. Gain-framed messaging focuses on the positive outcome, encouraging disease prevention (e.g., eating healthy foods, exercising regularly, using sunscreen). With a health equity frame, gain-framed messaging should focus on making "the best possible health" accessible to everyone.
• Make clear that achieving health equity is not a "zero sum game." Explain that when an intervention helps one group of people, it does not mean that other people or communities have to lose something in return.
• To destigmatize health disparities, share examples of how equitable approaches can benefit everyone. Examples like the curb-cut effect (i.e., the ramps on sidewalks that were initially intended to help people with mobility disabilities but proved to be beneficial for far more people).

Principle 3: Frame health equity as achievable.

This means: Health equity can be broken down into more manageable concepts when solutions are offered across multiple levels. Provide examples of how individuals and communities can advance health equity, as well as public health agencies, healthcare delivery systems, and/or state, tribal, local, and territorial governments can help people to understand different points of view.

Why it matters: Messages that frame health disparities as caused by systems and structures (e.g., systemic racism as a root cause of racial and ethnic health inequities, rather than personal behaviors, may cause some audiences to believe they have limited control to change their health outcomes or advance health equity. This can prevent a person's efficacy, or motivation, to take action.

In practice:

• Use action terms. When educating audiences about situations, conditions, and policies that create inequities, show pathways to address disparities. That way, audiences can see that achieving health equity is feasible and within their control.
• Avoid language that speaks to previously defined assumptions. Fatalism, or the false belief that nothing can be done to change health outcomes prevents people from see policies and structural interventions as a way for meaningful change. Instead, include messages that help people identify social conditions as the cause of many health disparities. This makes it easier to see policies and structural interventions as a way for meaningful change.