The Evolving Field of Health Equity and Health Communication

By the Health Communication Working Group

Forty years ago, the U.S. Secretary of Health and Human Services released a comprehensive report documenting the negative outcomes attributed to health disparities among racialized minorities (1). The report set off a cascade of policies, initiatives, and programs aimed at understanding the social determinants of health and eliminating health disparities, thereby paving the way for adoption of language and practices to bolster health equity in all sectors of public health, including health communication.  

​Yet, in merely months, we have witnessed swift and disturbing moves at federal, state, and organizational levels to end the decades-long progress that public health practitioners in the U.S. have achieved

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Health equity—in fact, all concepts associated with equity—have come under scrutiny— resulting in critical initiatives and funding being dismantled, dissolved, or eliminated altogether (2). 

But why is health equity suddenly a taboo concept in the U.S.? What does health equity really mean, and what does it look like? 

Ultimately, the concept of health equity boils down to ensuring that all individuals have the opportunity to achieve the best possible state of health. As it relates to health communication, it is the naming of discrimination in its many forms, including racism, as a public health issue, building social norms about understanding why that is true, and developing means to tackle it. Concrete examples include breast cancer education materials being offered in Braille, Spanish, and Haitian Creole at a health clinic in Miami, Florida; improving access to safe, affordable, pest-free housing in historically disinvested-in (redlined) neighborhoods, and ensuring that all pregnant people receive respectful pregnancy, labor, and delivery care. It’s about advocating for coverage of HIV-prevention medication, PrEP, to be covered under health insurance policies since HIV disproportionately impacts certain populations more than others, or raising awareness about the risks of abortion not being legally accessible to all people across the entire country. It is about a myriad of disparities that have arisen and been maintained by structural discrimination, both intentional and unintentional. 


The term “health equity” asks us to confront uncomfortable truths about structural racism, discrimination, and unfair systems. But there’s another dynamic at play, which Lett et al. (2022) call health equity tourism. In recent years, especially during the COVID-19 pandemic and racial justice uprisings, many institutions and researchers suddenly pivoted into equity work without deep grounding in the field (3). This surface-level engagement can dilute “equity” into a buzzword rather than a transformative practice. When equity is used superficially, it becomes easier for critics to dismiss it as ideological rather than essential to justice.

Those of us who focus on health communication and health equity have been engaged in determining how we continue to center health equity in our work, given the current political landscape. Despite the challenges to be able to name equity in our endeavors, many of us have found innovative ways to discuss, educate on, and carry out this integral work. While health inequity has often been used as shorthand for an umbrella “lack of access to a variety of needs,” we can shift towards being explicit and specific about the needs, root causes, and issues that fuel health inequities. The language we use matters in upholding dignity for all, creating clarity, and effecting change. For instance, instead of saying, “unhoused individuals experience health inequities,” we could consider, “people without safe and reliable housing often lack access to healthy foods” — and then proceed to explain why that is and what we can do to address it. 

Though our present context gives us an opportunity to be more specific and arguably more intentional about how we address the root causes of disparities to achieve health equity, it is important to note that the fight we currently face isn’t against health equity: it is against the principle of equity. No matter our framing, our challenge is at the systemic level, where there is an attack on the concept of equity itself. Those in power appear to be seeking to deepen and harden the lines of disparity rather than helping to reduce barriers and increase access. 

Our mission, particularly as communicators, is to find ways to enhance opportunities for all and to find ways to center the ideas of fairness and collective benefit, rather than allowing the narrative of disparity and difference to permeate and take hold. When polled, 8 in 10 Americans believe in the concepts and values behind the ideas of diversity, equity, and inclusion (4).  On both sides of the aisle, agreement includes increasing access to Medicaid services and making prescription drugs more affordable (5). If diversity, equity, and inclusion terms are prohibited, we must find terms that demonstrate the concepts that these ideals embody and center them as our focus. While those in power may believe that these concepts are “radical leftist” or “woke” — we must work so that people, particularly the most marginalized, can see through these inaccurate and nonfactual statements. Most Americans of all political persuasions agree that health insurance companies have too much power (6) and that more people in this country should have access to quality, affordable health care. Many even believe it should be organized by the government, so that it isn’t a for-profit endeavor. However, when called “Medicare for All,”  some deem it “socialist” and “woke”. Therefore, we must focus on the values, ideas, and benefits that unite us and discourage incendiary, polarizing language.

We can continue to center health equity, from writing commitments into formal organizational strategy, listening to and elevating community voices, or aligning resources to address structural drivers of inequity. Importantly, this work cannot be done alone. Health equity requires collective action, and that means forging new partnerships and inviting stakeholders who may not have had a seat and/or voice at the table. 
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The fight continues. If you have suggestions and ideas for how to continue this fight in your community, discipline, or field, please share with us at the Health Communication Working Group of the American Public Health Association, and consider joining our group to make good trouble.

References

1. Heckler M. Report of the Secretary’s Task Force on Black and Minority Health. Washington, DC: US Department of Health and Human Services; 1985.
2. Hill, L., Artiga, S., Pillai, A., & Rao, A. (2025, March 21). Elimination of Federal Diversity Initiatives: Implications for Racial Health Equity. KFF. Retrieved September 4, 2025, from https://www.kff.org/racial-equity-and-health-policy/elimination-of-federal-diversity-initiatives-implications-for-racial-health-equity/
3. Lett, E., Adekunle, D., McMurray, P., Asabor, E. N., Irie, W., Simon, M. A., Hardeman, R., & McLemore, M. R. (2022). Health Equity Tourism: Ravaging the Justice Landscape. Journal of medical systems, 46(3), 17. https://doi.org/10.1007/s10916-022-01803-5
4. Brodbeck, T., Hannahs, L., Kennedy, S., Kromrey, C., & Levy, D. (2025, March 20). Beyond DEI: Understanding Public Opinion on Diversity, Equity, & Inclusion. American Association For Public Opinion Research. Retrieved September 4, 2025, from https://aapor.org/newsletters/beyond-dei-understanding-public-opinion-on-diversity-equity-inclusion/
5. Kirzinger, A., Montalvo, J., III, Kearney, A., Sparks, G., Valdes, I., & Hamel, L. (2025, January 17). KFF Health Tracking Poll: Public Weighs Health Care Spending and Other Priorities for Incoming Administration. KFF. Retrieved September 4, 2025, from https://www.kff.org/health-costs/kff-health-tracking-poll-public-weighs-health-care-spending-and-other-priorities-for-incoming-administration/ 
6. Giancarlo Pasquini and Eileen Yam. (2025, July 10). Americans’ Views on Who Influences Health Policy and Which Health Issues To Prioritize. Pew Research Center, Retrieved Sept 17, 2025, from //www.pewresearch.org/science/2025/07/10/americans-views-on-who-influences-health-policy-and-which-health-issues-to-prioritize/

Image Credit: Courtesy of the Health Communication Working Group
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The Health Communication Working Group is a 2024-2025 grantee partner of Health Equity Initiative, which also includes unrestricted funding for this blog post.

Author’s Bio
The Health Communication Working Group (HCWG) is part of the American Public Health Association's Public Health Education and Health Promotion section, and serves as the leading advocate for, and authority on, the use of communication and marketing approaches to improve the public's health. HCWG includes nearly 500 public health and health communication professionals from a variety of disciplines. 

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