Karen Goldstein & Melissa ZuckermanKaren Goldstein and Melissa Zuckerman co-authored this article.

The White House Conference on Hunger, Nutrition and Health created quite the buzz in the JPA Health offices. The meeting was designed to spark discussion on the dire needs of millions of Americans experiencing food insecurity and related diseases, including heart disease, obesity and Type 2 diabetes. As the conference website aptly declared, “Lack of access to healthy, safe and affordable food and to safe outdoor spaces contributes to hunger, [related] diseases and health disparities.”

This statement says it all and was the reason we were so excited. While many in the public health and healthcare sector will read that sentence and not blink twice, the national spotlight on the connection between non-health factors in a person’s life—such as access to healthy, affordable food—and health outcomes is significant, as is the elevation of the disproportionate impact food insecurity has on underserved communities.

Due in large part to the racial and economic biases revealed in our health system during the COVID-19 pandemic, the movement to frame health in this macro way, beyond the traditional healthcare model, has finally become more mainstream. By bringing together the public and private sector to coordinate action to end hunger, to improve nutrition and physical activity and to address related disparities, the White House Conference demonstrates how the major players are increasing conversations and commitments on social, economic and other Drivers Of Health when addressing public health challenges.

DOH, commonly referred to as social determinants of health, recognize that the conditions in which people are born, grow, work and live influence a person’s health. DOH often manifest themselves in things like lack of access to safe housing, nutritious food and transportation.

This article is featured in O'Dwyer's Oct. '22 Healthcare & Medical PR Magazine
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People frequently aren’t able to follow through with their treatment for disease or even get to medical appointments, despite their desire to. How can we expect a person with diabetes to take their insulin if they don’t have electricity to keep it refrigerated? Or what about the person in kidney failure dependent on safe, reliable transportation to get to their life-saving dialysis care three days a week? For health-related communications, this context requires more holistic thinking about our audiences and what they are experiencing, as well as how we can best support their needs through our efforts.

One example of this approach is exemplified by The Physicians Foundation, an organization actively crafting solutions and policies to advance how we pay for and deliver care to improve health. Like the White House Conference, this changed from understanding to action earlier this year when the Centers for Medicare and Medicaid Services adopted the first-ever DOH measures in a federal quality or payment program. This milestone comes as a result of a proposal that the Physicians Foundation submitted to CMS last year on screening rate and screen-positive rate measures.

The public relations industry is part of the solution. As PR professionals, we play a significant part in promoting education and awareness in this broader health context. It is even more critical for us to take an audience-centric, person-first approach. In the same way that public health professionals consider behavior change theories, public relations professionals must think about a person’s universe—the systems, organizations and individuals with which they engage, as well as an individual’s knowledge, attitudes, behaviors and barriers. To ensure equity, we have a responsibility to consider such factors as cultural appropriateness, digital access and language barriers, among many other elements.

One organization that exemplifies the power of audience-centric communications is Community Catalyst, whom we have been collaborating with to increase equitable access to COVID-19 and influenza vaccines. For this effort, Community Catalyst recognized that different communities would require different approaches because the beliefs and barriers for community members would be distinct from those of others. Guided by this insight, Community Catalyst implemented a strategy to support 90 community-based organizations across the country to engage community members with trust and cultural competency.

Within the communities, CBOs recruited and trained an assortment of individuals to serve as influential messengers to share vaccine information. These local influencers—including barbers, drag queens, faith leaders, local television personalities and many others—were unique to each community and contributed to authenticity and building trust among distinct audiences.

Together, we created a vast communications toolkit with messaging and materials that addressed a range of barriers to vaccination—access barriers like transportation, singular concern barriers such as immigration status, faith- and culture-based barriers and high levels of misinformation and disinformation—that the CBOs and trusted messengers could have at their disposal. Across the country, CBOs effectively increased accurate and relevant vaccination messages in the community and vaccination opportunities, helping improve the health and well-being of others.

Such success is a reminder that the U.S. can’t effectively improve health outcomes or health equity without addressing DOH. General awareness and understanding of DOH is important, but it must be built upon with action. Whether increasing vaccine confidence or embarking on a long-term strategy to improve access to nutritional foods, the context of health is appropriately expanding to encompass social, economic and physical conditions. To truly improve health equity in our country, we all must work to incorporate DOH into our strategies to improve health outcomes. As a nation, we’re trending in this direction. With this “health is bigger than healthcare” approach, we have reason to be hopeful that we are headed toward a more equitable and healthier future.


Karen Goldstein, MPH, is Senior Vice President at JPA Health. Melissa Zuckerman is Senior Vice President at JPA Health.