Change the Conversation

Change the Conversation
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How Can We Change the Conversation?

Change the conversation about what creates health equity within public health, across government, and in communities (Read actions you can take below)

Narratives are the values-based stories we tell about how and why the world works as it does, and they frame our response to the problems we see. Health departments must actively work within their departments and with community and government partners to change an entrenched narrative — around risk factors, behavior change, and the biomedical model — that impedes progress on health equity.

A new narrative would expand the understanding of what creates health — the social determinants and equity — and improves how we articulate our vision of social and health equity and a clear path forward that can inspire and encourage others to join us. Making a narrative shift requires understanding historical and political contexts, and the role of policy, systems, and environmental change in addressing or exacerbating inequities. It also includes expanding the definition of what public health can — and must — do.

Departments must harness the power of popular culture at one end and developing communications plans and messages at the other — all to clearly and consistently express and translate the concepts of health equity, target upstream policy change, and join social justice movements.

Actions to Advance Equity Using This Practice

Your leadership, staff, and department can take the following actions to change the conversation:

  • Use mission, vision, and values statements to communicate the priority of advancing health equity, as well as the health department’s role in addressing health equity
  • Work with communities experiencing inequities and others to develop, use, and promote a shared narrative around health that focuses on the social determinants of health, power, and oppression rather than individual responsibility and a biomedical model. Make sure to talk about the role of policy, systems, and environmental change in addressing inequities
  • Develop an agency-wide communication plan to disseminate clear and consistent messages about what creates health and equity
  • Leverage social media, agency-wide communications and newsletters, earned media, and public events to raise awareness of the conditions that create health and inequities
  • Normalize conversations about health equity in meetings, media presentations, and other forums by explicitly including equity data and terms that include: social justice, racism, oppression, and power
  • Leverage data to: 1) change the narrative of what creates health, 2) inform and inspire policy change, and 3) support partnerships and engagement
  • Use tools such as data collection, reports, presentations, assessment, and program evaluation to identify health inequities and demonstrate how they are connected to policy, system, and environmental conditions and opportunities
  • When developing agency publications, frame messaging in a way that:
    – Connects individual health outcomes to the social issues and inequities that drive those outcomes
    – Presents a solution to the problem
    – Assigns primary responsibility for who can fix the problem
    – Makes a practical policy appeal
    – Uses stories and images to humanize the impacts
    – Is tailored to various audiences, including communities experiencing inequities and decision makers
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