From Barriers to Breakthroughs: Communicating About Public Health with Policymakers

Public health professionals have always been charged with uplifting the voices of communities. At its core, public health work is about doing right by the people we serve and by the communities we belong to. We listen, we translate, and we advocate for conditions that allow people to live their healthiest lives. Today, public health leaders are being asked to do something additional and often uncomfortable: to elevate their own voices and needs to policymakers. For many, this audience feels intimidating. Policymakers often control budgets, set priorities, and shape the conditions under which public health agencies operate. And still, engaging them can feel risky, political, or outside the traditional understanding of public health practice and expertise. Yet, there is an opportunity to shift policymaking from something that happens to public health agencies to something that is shaped with them. That shift requires 2 things: policymakers stepping into their role as partners and public health leaders showing up prepared, strategic, and clear about what they need. Of course, this is easier said than done. Public health often competes for attention with sectors that may have more political capital, more consistent access to policymakers, and louder voices. Opportunities to communicate with policymakers may be infrequent or uneven. Thus, when we do get time with a policymaker, we need to be ready to meet the moment- aware of common pitfalls, equipped to avoid them, and able to turn challenges into opportunities for connection and influence. To understand how to do this, the de Beaumont Foundation conducted focus groups with 20 former elected officials and senior legislative staff from politically competitive states (MN, MI, NC, PA, and WI). We intentionally included policymakers with a wide ideological range, from Democrats to moderate Republicans to conservative, MAGA-aligned Republicans. ​Across these discussions, we explored how participants view public health, where their frustrations come from, and what makes conversations with public health professionals more productive. ​We also tested messages to pinpoint which frames and phrases resonate most, and why. Here is what we learned: In many cases, policymakers do not see public health professionals as trusted partners. Three core perceptions fuel this distrust: Zero Sum: Many policymakers see public health recommendations as a zero-sum game, creating difficult or unrealistic tradeoffs in budgeting, policy, or lifestyle choices. As a result, public health can feel like a constant source of problems rather than a partner offering achievable, aspirational solutions. Ideological: Some policymakers assume public health professionals are motivated more by political ideology than by real-world feasibility. They expect public health professionals to push the most restrictive or far-reaching policies, even if the evidence does not fully justify it. As a result, policymakers automatically dismiss recommendations as “extreme” before fully considering their merits. Ignores Individual Agency: Finally, some policymakers believe public health undervalues personal responsibility. They see the field as favoring mandates and regulations over equipping people with information and tools to make their own decisions. This perception reinforces the belief that public health is misaligned with many policymakers' core values, such as individual freedom and personal choice. These perceptions create real barriers to effectively communicating about public health with policymakers, but they are not immovable. For each of these barriers, there's a communication strategy that opens doors instead of closing them: Address the zero-sum mindset by showing aspirational impact. Rather than positioning public health as a set of difficult tradeoffs, frame it as a force that strengthens both community well-being and economic vitality. This approach helps policymakers move beyond the idea that public health is simply a cost center. Instead, it highlights how public health investments contribute to shared goals, such as stronger workforces, safer neighborhoods, and more resilient local economies. Counter ideological assumptions by emphasizing a local, listening-based approach. Make it clear that public health recommendations stem from listening to communities, not in advancing an ideological agenda. This reframing challenges the perception that public health professionals are bureaucrats imposing. It also reinforces that public health leaders are members of the communities they serve—experts, with their own lived experiences, who are listening to what their neighbors wants and developing practical solutions to real problems. Reframe constraints on individual agency by showing how community health enables personal choice. Emphasize that strong public health systems expand, rather than limit, individual agency. People are better able to make healthy choices when they have healthy, accessible options. This framing helps policymakers see that they do not have to choose between supporting public health action and valuing personal responsibility. Taken together, these strategies offer a roadmap for repositioning public health as a practical, collaborative problem solver. ​ In addition to these strategies, several practical considerations can help public health leaders make the most of their interactions with policymakers: Learn how the process works. Effective engagement requires understanding the political environment. Be prepared to negotiate, and know in advance where you can be flexible and where you cannot. Make the “what is in it for me” case. Align requests with policymakers' existing priorities and initiatives. Frame public health actions as opportunities to deliver visible results, build a legacy, or work across political lines. Learn how to identify policy windows. Sometimes “no,” simply means “not now.” Policy windows open and close. A rejection today does not mean the conversation is over. Even though the answer may be not right now, the work continues. If there is one thing public health professionals know how to do, it is to meet difficult moments head-on. The field has never shied away from complex challenges, unfamiliar terrain, or high-stakes decisions. Communicating effectively with policymakers is another version of this work—and one where public health leaders now have clear, practical guidance to help them move forward with confidence.