In a time when public health is facing budget cuts and deep systemic challenges, advocacy is the key to turning the tide. This post explores how organizations can assess their ability to advocate effectively, harness grassroots efforts, and build strong coalitions. It delves into the importance of crafting messages that resonate with different audiences and creating a counternarrative that pushes back against the status quo. Through collective action and celebrating even the small wins, organizations can sustain momentum and drive meaningful change in public health reform.
Written by: Destiny Gonzalez (she/her/ella)
In honor of National Public Health Week 2025
Public health is at a critical crossroads. After years of chronic underfunding, the sweeping cuts to both funding and programs in 2025 have pushed the sector into an even more precarious state. In this political climate, advocacy is more than a tool—it is an absolute necessity to sustain public health efforts. Advocacy goes beyond raising awareness or offering a superficial sense of “care” for the issues at hand. It is about demanding equitable access to health resources and driving change in a moment when the very systems that should support health are actively working against it.
Though the path forward will be uncertain and fraught with challenges, advocacy remains essential in combating the health inequities that continue to affect vulnerable communities. With a clear, strategic vision, advocacy can catalyze meaningful reforms, driving improvements in public health and fostering long-lasting social transformation.
Here are some key strategies for organizations to advocate for public health:
- Understand Your Organization’s Capacity
Begin by evaluating your organization’s capacity to engage in public health advocacy. Start with a broad understanding of your state’s public health landscape. Use resources like the 50-State Scan of Public Health Advocacy Capacity to analyze how public health is structured in your state. For example, in Massachusetts, public health is managed by municipalities, meaning your advocacy strategy will need to adapt to this decentralized approach.
To advocate successfully, solidify your internal structure by understanding what tools and resources your team needs to advocate effectively. Ensure that the team is aligned and prepared to focus on the collective mission, not just individual goals.
Strategies to assess internal capacity for organizational advocacy:
- Track staff wellbeing through data and evaluation.
- Ensure transparency through regular quarterly meetings with teams to celebrate wins, evaluate progress, and discuss metrics about organizational advocacy.
- Use resources like the Institute for Organizational Science and Mindfulness for staff mental health support.
- Leverage Grassroots Organizers
Policy change cannot succeed without grassroots organizing. Advocacy efforts must be grounded in a powerful grassroots movement that connects authentically with the communities you aim to serve, and where these communities lead the work. Unlike many organizations, grassroot organizers have deep relationships with community members and core stakeholders, and they understand the unique landscape of their community – allowing them to tailor their messaging effectively.
To ensure your advocacy efforts resonate, you must explicitly link four key elements:
- Your organization
- The issue at hand
- Grassroots organizers
- The community itself
To gauge your advocacy’s impact, ask yourself the following questions:
- Does your audience truly understand your mission and values?
- What issues are you aiming to solve?
- How does this issue align with your core mission and values?
- Why should your audience care?
- Why is this audience essential to the success of this work?
The power of grassroots organizers lies in their ability to amplify and mobilize communities, turning your mission into action. Additionally, it’s essential to recognize that the actions taken by policy decision-makers at the top are frequently in response to the shifts in power created by organizing efforts from below.
- Build a Counternarrative and Coalition
In advocacy, particularly in challenging political or social climates, it’s crucial to create and amplify a strong counternarrative. As shared at the 2025 TSNE conference, Equity Forward, “In a time of a witch-hunt, we should act like witches” — stand firm in your beliefs and principles, even when faced with resistance. Reach out to those already engaged in the work and build powerful coalitions. Be introspective: What are our strengths and expertise? Where do we have gaps? How can we collaborate with others who possess the knowledge or skills we lack? How can we partner with organizations that share a common mission to fill those gaps?
Storytelling is foundational to creating a counternarrative in public health. While how we tell these stories must evolve to the current climate, storytelling remains a powerful tool for driving action and shaping public perception. However, the way we craft and deliver messages will vary depending on the audience. You can’t communicate your advocacy efforts the same way to community members as you would to a small grassroots organization, a mid-sized nonprofit, or a large foundation.
This is why building a counternarrative begins with identifying and aligning with like-minded organizations. Collaborating with these groups enables you to tailor messages that resonate with different audiences, strengthening your coalition. A strong, unified coalition—starting from those directly involved on the ground and extending to aligned organizations—helps amplify your advocacy efforts and provides more substantial support for your cause.
- Never Underestimate the Power of Collective Action
The power of collective action is transformative, and its impact cannot be overstated. In public health advocacy, cross-sector coalitions are particularly vital. By collaborating with sectors such as education, housing, and the environment, you can amplify your advocacy efforts and create a stronger, more unified movement. While large-scale collective action is the goal, meaningful progress starts small. For example, members can start by building relationships with local elected officials; these connections can become the foundation for broader advocacy efforts, helping to magnify your voice in a larger cause.
Collective action has the unique ability to shift the political landscape. When public opinion is galvanized and organizations align behind a common cause, the political cost of opposing the movement becomes too great to ignore. As momentum grows, it becomes increasingly difficult for politicians and organizations to remain neutral — especially when public sentiment is clearly on the side of the counternarrative. History demonstrates the undeniable effectiveness of collective action — from the Civil Rights Movement to the fight for marriage equality. These movements were driven by powerful narratives and strategic pressure on political entities, forcing them to take a stand. Though these movements were long and challenging, their success was directly attributed to the collective will of people determined to push for change.
- Celebrate Your Small Wins
Advocacy work is a marathon, not a sprint. It requires unwavering commitment and a long-term perspective. In the fast-paced world of activism, it’s easy to fall into the trap of seeking instant gratification — the desire for quick wins or immediate results. However, true change rarely happens overnight. While it’s tempting to overestimate what can be accomplished in a single year, seasoned organizers understand that sustained, consistent effort over the course of five or more years often produces the most meaningful impact.
Small wins bolster morale, reinforce the belief in the movement, and remind everyone involved that their efforts are not in vain. Over time, these moments of success accumulate and create a sense of collective achievement, allowing you to keep your focus on the bigger picture and overcome the inevitable setbacks.
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Limitations of Lobbying
For many organizations, having a registered lobbyist is the easiest way to promote policy work. However, 501(c)(3) nonprofits face limitations on the lobbying activities they can engage in. It’s important to note that these limitations do not apply to advocacy, educational activities, and the production of white papers. With increasing pressure on private foundations, particularly as federal funding becomes less reliable, policy efforts may focus on changing the 5% mandated giving amount or making it easier to access funds by reinvesting in communities through “trust-based philanthropy.” For foundations that are interested in supporting projects involving lobbying, the Project Grant Rule Hub is an excellent resource.
Conclusion
The most important shift we must make is to reorient ourselves toward the why behind our work. Many of us have been trained to build careers within systems that perpetuate inequity and oppression. The ultimate goal is to work ourselves out of a job. Advocacy is part of embracing the calling of public health—envisioning a world where the field of public health is no longer needed, and health equity has been achieved for all.
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