What Does Intentional Equity Mean in Public Health Campaigns?

When creating public health campaigns, it’s more important than ever to focus on making programs intentionally equitable, or ensuring that those who need our help the most are the ones getting the majority of our support. While many programs strive to be equitable, they often fail to reach the most vulnerable audiences, putting too much emphasis on trying to reach everyone. In this article, we’ll explain why programs that aren’t intentionally equitable actually end up becoming unintentionally inequitable and provide some strategies for creating truly equitable public health campaigns.

Our Audiences Face Different Inequities

Each of our audiences is impacted differently by environmental and personal inequities, and programs that focus on equality over equity tend to over deliver to lower-risk audiences and under deliver to higher-risk audiences. In the graphic below, the grass represents environmental inequities and the heights of the women represent personal inequities. The little boxes underneath them represent our programs and investments in people.

READ MORE: Learn how our internal team of PhDs and MPHs use research to better understand the needs of our audiences.

Even When Striving for Equality, Many Programs End Up Inequitable

When we try to create messages that “speak to everybody,” we're producing “lowest common denominator creative,” trying to find the simplest message that everyone can hear and understand so no one feels left out. The problem is those who have the means, time and resources—represented by the lady on the left in the graphic below—can take advantage of that simple message. Audiences with more obstacles and challenges, like the lady depicted on the right, need more support to take advantage of that message.

Even the media channels used to disseminate our messages disproportionately cater to lower-risk individuals. The vast majority of media channels have been structured to reach those who are in purchasing audiences, which are most often the lower-risk individuals. We end up with disproportionate distribution and impact, which widens disparities, as seen in the graphic below.

READ MORE: Learn how we helped increase quitline enrollments among priority populations.

Equity Must Be Intentionally Inserted at Every Phase of Program Development and Dissemination

For a program to actually be equitable, we have to strive for equity throughout research, strategy, message development, and implementation prioritizing those at greatest risk and understanding their challenges. This approach ends up benefiting everyone. Messages that show a higher-risk person overcoming their adversity can help empower lower-risk audiences, as well. They see someone with more barriers than them engaging in healthy behavior and realize the behavior is attainable for them, too.

Media also must be disproportionately delivered to those at greatest risk. We have to work against algorithms designed to deliver messages to lower-risk audiences who are already interested in the message. We need to ensure that those who need the message most get a higher dosage of it. Only when we intentionally infuse equity into every phase of our campaign development can we truly ensure that our program is equitable.

If you’d like to learn more about creating intentionally equitable campaigns, please contact us.