Messaging Research: Effective Public Health Communication Strategies for a Divisive Political Climate

Posted on September 14, 2023 by Big Cities Health Coalition

This entry is part 17 of 17 in the series Big Cities Health Coalition

Between March and May 2023, the Big Cities Health Coalition (BCHC) polled key audiences in its member jurisdictions (35 big cities).* The goal was to better understand how individuals who are skeptical of public health interventions could be moved to better support the important role governmental public health departments and leaders play in their communities. This post outlines the top strategies BCHC research supports.

Overview

Between March and May 2023, the Big Cities Health Coalition polled key audiences in its member jurisdictions (35 big cities). The goal was to better understand how individuals who are skeptical of public health interventions could be moved to better support the important role governmental public health departments and leaders play in their communities.

Continue reading for our top-level findings and messaging recommendations. Download the messaging guide to save these recommendations in a convenient one-pager. Download the full slide deck to review more detailed findings from our research.

Project details

In collaboration with Hart Research, we conducted two focus groups with 8 white centrists and 8 Black residents in Philadelphia; then QualBoards with 20 white center-right and 19 Black and Hispanic residents; and finally, an online survey of 1,006 similar “policy influencers” in 35 BCHC jurisdictions with an oversample of Black and Hispanic residents.

The project was primarily supported by the CDC Foundation.

Map showing BCHC’s 35 member cities, whose residents were the focus of this study

Research-supported strategies

Our messaging research supports the following communication strategies.

Explain the direct connections between public health and health issues people care about most. Respondents ranked reducing crime, addressing homelessness, improving education, and increasing access to affordable housing and quality medical care as even higher priorities in their city than public health. (See Graph 1 below.)

GRAPH 1. Respondents consider public health important – but rank other city needs as having a higher priority.

Illustrate how health departments fight for policies that make it easier for all people to live their healthiest lives: livable wages, safe and affordable housing, healthy food.
When relevant, account for regional and political variation: respondents in western states and conservative residents were the most concerned about homelessness and substance use disorder, while respondents in southern states (incl. Texas) prioritized obesity and diabetes instead. Concern about mental health issues was highest in the northeast and the Midwest and among Black residents.
Describe how meaningful investments in public health save money by preventing disease and supporting a better quality of life for all communities (see Persuasive Messages section below).
Show how your city supports opportunities for health and empowers residents to make healthy choices. In our study, using empowerment and opportunity language aligned with respondents’ values and made them more likely to see their local health department as a valued community partner. (See Graph 2 below.)

GRAPH 2. Respondents support city government giving residents opportunities to be healthy.

Emphasize that people have the power to address and even solve their community’s challenges. Respondents often resisted explicit language about racial justice, but most (57%) supported this framing: “Racial health inequities are a result of social and economic systems that have been made by people, and therefore can be changed by people as well. Addressing racial health inequities will require examining and addressing the root causes of these disparities, including unequal access to healthcare and distribution of resources. But by acknowledging that these inequities are manmade and fixable, we can begin to take the necessary steps to create a more fair and just society.” (See Graph 3 below.)

GRAPH 3. Discussions of racial inequity gain more traction when framed as a human-made problem we can fix.

Percent of respondents who said messaging about racial health inequities being human-made and thus fixable was a major reason for their city to focus on the health of Black and Hispanic residents.

Persuasive messages

The audiences we polled found these to be the most convincing messages about why city leaders should invest in public health:

Fiscal responsibility & prevention

“One reason the United States spends so much on healthcare is that we spend so little on preventing health problems before they start. We have one of the lowest life expectancies in the world and huge disparities across race, ethnicity, and income. We can reduce healthcare costs by investing in things like livable wages, healthy food access, and other things that will help prevent many health problems from occurring in the first place.”

Quality of life

“Everyone wants their city to be a healthy, thriving city. We don’t want to have to choose between clean air, good education, affordable housing, and access to quality food and we shouldn’t have to choose. We need all these things in order to have the best possible quality of life for our families and our neighbors, and everyone in the city needs and deserves them. The city must make investments to ensure we have them.”

Download the Messaging Guide or the Full Slide Deck.

This post originally appeared on the Big Cities Health Coalition website and is republished here with permission.

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