WEBVTT

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Gnora Mahs: Are Connecting Connecting the value of public health to Civic Participation. We will be getting started soon.

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Gnora Mahs: Kayla E: Hi, everyone. We're just waiting for a few people to enter the space, get settled in, and feel free to introduce yourself in the chat. We'll be starting soon.

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Gnora Mahs: Great. Welcome to your midday or early morning conversation break with public health peers.

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Gnora Mahs: Public Health Communications Collaborative's webinars bring you closer to inspiring voices from across fields and backgrounds.

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Gnora Mahs: Today's conversation comes at a critical moment.

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Gnora Mahs: Just weeks away from consequential midterm elections. But we know that Civic Participation doesn't begin and end with elections.

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Gnora Mahs: Sarah Horn, We're going to explore how public health communicators can build bridges for their communities by showing how participating in local, state, and national government directly impacts the programs and initiatives people use every day.

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Gnora Mahs: Expect a candid, practical conversation on building community trust that drives greater civic participation. And, in turn, healthier community outcomes.

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Gnora Mahs: If you're new to the Public Health Communications Collaborative, also known as PHCC, welcome! PHCC is a learning and information hub for professionals who communicate about public health.

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Gnora Mahs: Samantha Bromberg, This community is always seeking opportunities to learn, connect, and grow together, and that's why we're here together today.

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Gnora Mahs: Next slide.

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Gnora Mahs: The speakers will spend some time introducing themselves during our conversation, but I'll share a little bit about each expert to help set the stage.

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Gnora Mahs: Katie Knapp, First, we'll be joined by Ben Ruxin, who is Chief Executive Officer of A Healthier Democracy, a national nonprofit built on the idea that trusted healthcare relationships can improve health beyond medical care.

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Gnora Mahs: A Healthier Democracy runs two programs. Vote ER, which gives healthcare professionals nonpartisan tools to help patients register and vote.

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Gnora Mahs: And Link Health, which connects patients to public health benefits through trained patient navigators. Ben lives in Minneapolis with his wife and two young children, and serves on the board of People Serving People, Hennepin County's largest family shelter.

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Gnora Mahs: Then we'll be joined by Aisha Pamukka Pamukku, sorry about that, who is a policy strategist, public interest lawyer, and coalition builder, whose work supports thriving, connected neighborhoods where opportunity is within reach for everyone.

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Gnora Mahs: Aysha leads the San Francisco Foundation's Policy Fund, partnering with local government and community organizations to pursue housing solutions that address the affordability crisis, expand economic opportunity, and strengthen long-term resilience. Aysha is a nationally recognized author, having recently co-written the book Advancing Equity and Justice.

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Gnora Mahs: And co-created the Civil Rights of Health Framework.

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Gnora Mahs: Finally, we'll be joined by David Hayne-Menendez

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Gnora Mahs: Who is a senior communications, public affairs, and strategy leader with more than 15 years of experience helping mission-driven organizations and civic coalitions connect public policy to people's everyday lives.

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Gnora Mahs: He serves as Mental Health Campaign Senior Advisor for Communications at Children's First, where he leads communication strategy for Strong Minds, Bright Futures, a statewide coalition advancing reforms to Pennsylvania's children's mental health system.

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Gnora Mahs: David also serves as Borough Councilman in Lewisburg, Pennsylvania, bringing a practical local government perspective on how public decisions shape health, trust, and civic participation.

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Gnora Mahs: He is a 2026 Public Health Communications Collaborative Ambassador. I'm eager to start the conversation, but first, some reminders for today's event.

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Gnora Mahs: Closed captioning is available via Zoom. If you'd like to use closed captions, click on the More button located on the Zoom toolbar, and select Show Captions. ASL interpretation is being provided by Keystone Interpreting Solutions, with interpreters Sage and Patty.

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Gnora Mahs: Please ask questions throughout today's event by using the Q&A or chat. We will do our best to get to all of your questions during the Q&A portions of today's conversation.

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Gnora Mahs: Samantha Bromberg, And a friendly reminder, today's event is being recorded. The recording will be available on the Public Health Communications Collaborative website by the end of the week. Samantha Bromberg, I am serving as a moderator-presenter role today, and I'm excited to kick things off with my personal story and some data.

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Gnora Mahs: Slide. So, I'm here to share some evidence on how health and democracy are related. Next slide.

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Gnora Mahs: Katie Knapp, But before we dive into the data and research, I want to share a personal story. So, my background is both in public health and as a community organizer. And when I was a young community organizer working in my home state of Oregon.

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Gnora Mahs: I was working to advance reproductive health equity across the state.

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Gnora Mahs: Sarah Horn, And many people think of Oregon as very blue and very, you know, proactive when it comes to reproductive health, but there was a school board just outside of the Portland metro area that had… their district had the highest teen pregnancy rate, and the school board was determining

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Gnora Mahs: Kim Williams, what services would be allowed in their school-based health center. And really, frankly, they were deciding to ban family planning services for their student health center.

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Gnora Mahs: Kara A. And this student health center was connected to a community health center, and their nurse practitioners had the full scope of practice, and were totally trained to provide these services in an age-appropriate way.

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Gnora Mahs: And so, when public comment opportunities came up, we filled the room.

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Gnora Mahs: K. with community members, with students, with alumni, with parents, all telling story after story after story about why this decision would harm the community that these elected representatives were tasked with serving.

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Gnora Mahs: And I would love to say that, you know, that story ended right then and there, that our voices were heard and they didn't change the contract language for the school-based health center. But that's not what happened.

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Gnora Mahs: When the vote finally came.

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Gnora Mahs: Six members voted in the majority to ban family planning services for students in that school district.

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Gnora Mahs: Speaker 1 And I remember feeling incredibly disappointed. My hands balled up in a fist of rage, and I could feel tears swelling up in my eyes. And my first thought was.

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Gnora Mahs: Kayla E: This didn't even matter. Why did we show up? Why did we tell our stories? No one was going to listen.

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Gnora Mahs: Kayla E: And I remember shuffling out of that room, it was a school cafeteria, shuffling out into the hallway, and everyone felt defeated. Kayla E: But together, we decided that that wouldn't be the end. Immediately, people took out their cell phones, knowing that the next school board election was just 9 months away.

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Gnora Mahs: Katie Knapp, So, who out of those 6 would be up for re-election? We realized 5 were.

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Gnora Mahs: Kayla E: And that started a 9-month campaign to recruit new school board members to run against those members, and knock every single door in that district, telling the story of what happened during that community input process.

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Gnora Mahs: Sarah Horn, And to me I'm I'm an optimist. I would love to say that.

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Gnora Mahs: You know, I would have been happy, it would have been enough if we had just replaced even one of those seats.

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Gnora Mahs: Kayla E: But that's not what happened. We didn't just replace one seat, or two seats, or three seats, we replaced all five of those school board seats that were up for re-election that year.

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Gnora Mahs: Sarah Horn, And that drastically changed the context for students to be seeking health services in their school-based health center moving forward. And so when people ask me.

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Gnora Mahs: you know, Nora, how is health related to democracy? Those two things seem incredibly different from each other. Well, I have to say, like, on my next slide.

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Gnora Mahs: Health is always on the ballot. It's on the ballot when we see it really clearly in health

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Gnora Mahs: you know, health initiatives that are, like, funding for Medicaid, funding for public safety and violence preventions, or drug prevention programs, right? That's really clear when it's on the ballot on an initiative. But it's also on the ballot in every other place where you might fill in a bubble.

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Gnora Mahs: Sarah Horn, It's on the ballot when we elect our school boards, our sheriffs, our judges, our state representatives, and even our national representatives. And so I really want to urge all of you to see our ballot as part of public health and part of advancing health equity. Next slide.

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Gnora Mahs: This work really began in earnest in 2020, when the Healthy Democracy Healthy People Coalition formed, which is now Health and Democracy Partners. We came together recognizing that the election was drawing near, and the COVID pandemic was spreading

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Gnora Mahs: further and faster.

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Gnora Mahs: And we had to have a unified voice. We had to step out and say.

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Gnora Mahs: Yes, the pandemic is scary. There are ways to keep yourself, your family, and your community safe.

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Gnora Mahs: But health and democracy are interconnected, so we need to participate. Next slide.

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Gnora Mahs: Sarah Horn, And since that time, we have been unified under this idea that health and democracy are interconnected. And we know that because, first, public health is what we do collectively to assure the conditions in which all people can be healthy. And so, who has a say and who doesn't have a say in that process?

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Gnora Mahs: Kara A. can really determine the conditions where communities can thrive or communities can't thrive. Next slide.

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Gnora Mahs: We use this framework.

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Gnora Mahs: Sarah Horn, under the understanding that this is a cyclical relationship, that civic participation leads to power to influence policy. That influence over policy creates the conditions that fuel health outcomes.

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Gnora Mahs: Samantha Bromberg, And then health outcomes also reinforce civic and voter participation. So on the positive side of the story, communities that have more… that have higher rates of civic and voter participation have greater power to influence policy, which leads to those community conditions reflecting their needs and improving health outcomes. And we also know that healthier people

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Gnora Mahs: Are more likely to be engaged and participate.

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Gnora Mahs: Kelly Crosbie, But also the opposite is true. When folks have lower rates of civic and voter participation, oftentimes due to barriers to that participation, we have less power to influence those policy conditions, worse health outcomes, and then worse health outcomes reinforces lower participation. Next slide.

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Gnora Mahs: Sarah Horn, Also sharing a framework that folks may be familiar with from County Health Rankings and Roadmaps, which really shows a model for health, where, you know, population health and well-being, only 20% of that is determined by our clinical care. The majority of our well-being is determined by community conditions.

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Gnora Mahs: But those community conditions are determined by societal rules. Written rules and unwritten rules, which include laws and policies, budgets, and governance.

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Gnora Mahs: But who gets to write those societal rules is really about who has power. And democracy is really formative in determining who has power in this country and in our society. Next slide.

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Gnora Mahs: Kelly Garner, So to share some really recent evidence, or historical evidence, showing this relationship.

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Gnora Mahs: We know from historical examples that

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Gnora Mahs: Kathy Sweedler, when we have expanded the electorate, health has improved. And it's not that when you get the right to vote, all of a sudden your, you know, preeclampsia is cured, or your heart condition is cured, but what happens is when folks get the right to vote.

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Gnora Mahs: legislative bodies and policymakers become more responsive to that community's concerns, and oftentimes write policies that are reflective of the things that those folks are asking for. For example, women's suffrage. When women gained the right to vote, we saw child mortality rates decline.

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Gnora Mahs: And the article written by Miller in 2008 shows that it wasn't magical overnight cure of child mortality issues causing child mortality.

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Gnora Mahs: Legislative bodies became responsive to women's concerns and made investments in things like hygiene and healthcare, and that helped improve child mortality rates. Next slide.

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Gnora Mahs: Katie Reilly, We looked at that historical evidence, and we thought, well, what is happening now? How is this related to our current context? And so, in 2021, we launched the Health and Democracy Index, which compares 12 public health indicators to the restrictiveness of voting policies in each state.

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Gnora Mahs: And the findings were incredibly clear.

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Gnora Mahs: States with more voter access and greater civic participation have better health outcomes. Next slide.

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Gnora Mahs: And you can see our main findings on this slide, where on the x-axis, we have states ranked based off of the cost of voting index, which is a measure of the ease or restrictiveness of voting policies in each state.

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Gnora Mahs: Where on the right side, we have the least restrictive state of Oregon, and on the left side, we have the most restrictive state, which was Texas.

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Gnora Mahs: Kara A. Then, if we move on the Y-axis, or up and down, we can see states ranked based off of America's health rankings from better health to worsening health.

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Gnora Mahs: Sarah Horn, And this shows a really clear relationship, and it is a simple correlation, so for statistical folks, there's not much control here, but we can see a really clear pattern, that when states have more flexible voting policies, more inclusive rules, we have better health outcomes, and as states become more restrictive, we have worsening health outcomes. Next slide.

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Gnora Mahs: Kayla E: So researchers are really interested in how do these policies impact folks who we know are disproportionately impacted by stringent voting policies. And so, in Social Science Quarterly, there was an article published in 2025 showing just that.

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Gnora Mahs: where we looked at self-reported health for Black and non-Black Americans.

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Gnora Mahs: And found that in states with a lower cost of voting index score, so a less restrictive environment, we saw health outcomes, self-reported health outcomes almost completely overlap.

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Gnora Mahs: Stephanie Landrum, And health outcomes were better in those states than in states where we had more restrictive environments, or a higher cost of voting.

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Gnora Mahs: Katie Knapp, What's more is that it wasn't just that everyone got worse, but that Black American self-reported health got worse faster in those states, and so a much steeper decrease in health outcomes, or quality of health outcomes.

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Gnora Mahs: for Black Americans who are oftentimes targeted by these disproportionate voting practices.

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Gnora Mahs: Next slide.

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Gnora Mahs: And there has been a plethora of peer-reviewed research that

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Gnora Mahs: reconfirms these findings. We know that states where it is easier to vote are more likely to have better rates of self-reported health across time, across a 25-year time period. Those states are likely to have lower uninsured rates.

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Gnora Mahs: Sarah Horn, Counties in those States had lower pre-vaccine Covid case and mortality rates and lower working age mortality rates.

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Gnora Mahs: Samantha Bromberg, And a longitudinal study showed that civic engagement, which includes voting, but also includes volunteering, activism, and other things among adolescents and young adults, was positively associated with better future income, education levels, and mental health compared to non-voters in that same age group.

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Gnora Mahs: Next slide.

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Gnora Mahs: Katie Reilly, And then for folks curious about how is democracy related to health policy, last summer, we put out a report showing that states with stronger democracies, based on the State Democracy Index.

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Gnora Mahs: Sarah Horn, were 3.7 times more likely to have expanded Medicaid eligibility, regardless of partisan lean, median household income, and educational attainment. And the State Democracy Index is a 54-measure tool that

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Gnora Mahs: Kristen D'is used across all 50 states from 2000 to 2023.

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Gnora Mahs: Katie Knapp, It includes variables like absentee voting, same-day registration, felon disenfranchisement, and partisan gerrymandering. Really, it's a measure of how free, fair, and acceptable electoral institutions are in a given state.

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Gnora Mahs: Katie Reilly, And just to give a flavor of who's in the top and who's in the bottom of that Democracy Index, we have states, like, in the top 10, Nevada, California, North Dakota, New Mexico, Iowa, Montana, Oregon, and Maine.

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Gnora Mahs: And in the bottom ten, we have states like Tennessee, Georgia, Alabama, South Carolina, Michigan, Indiana and Ohio. And so this is not this is clearly a nonpartisan tool and really spans across all of the states.

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Gnora Mahs: to show… but still, the pattern is clear. And now, I'm going to pass it over to Ben Ruxin to share a little bit more.

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Ben Ruxin - A Healthier Democracy: Thanks so much, Nora. And I am a proud resident of Minneapolis, and Minnesota is pretty far to the top and right of the Health and Democracy Index, which is something, you know, we take a lot of pride in.

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Ben Ruxin - A Healthier Democracy: here in Minnesota. Also, you're going to hear a lot of similar themes in this presentation as what Nora just shared, and that's not an accident. So much of our

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Ben Ruxin - A Healthier Democracy: work is built upon the foundation of your research and the work that you have done, so thank you for that. I'm here today to talk about trust and a couple of the ways that we use that point of trust to have really powerful conversations in healthcare settings. If we go to the next slide.

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Ben Ruxin - A Healthier Democracy: So institutions have lost trust. Everyone knows this. I don't need to spend too much time on this point. A Gallup survey this year reported an average of 27% trust across 14 major U.S. institutions, which is a historically low level.

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Ben Ruxin - A Healthier Democracy: At the same time, people still deeply trust their own healthcare provider. 86% of people trust their own healthcare provider, and people see their healthcare providers regularly. 83% of people saw a healthcare professional in the last year. So what this shows is that healthcare professionals have this unique opportunity where they are interacting with people, and those people are coming into those interactions with a sense of trust that is

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Ben Ruxin - A Healthier Democracy: not seen in other contexts across our society. Typically, those conversations are focused on medicine, are focused on health, and we want to extend those conversations to other topics.

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Ben Ruxin - A Healthier Democracy: If we go to the next slide, we can talk about, some of the ways that people… that we leverage that, today. So our Link Health program is really focused on meeting people's needs today. There are currently $142 billion in federal benefits that go unclaimed every year. This is…

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Ben Ruxin - A Healthier Democracy: Largely because enrollment is hard to navigate, not because people don't qualify. And, for those who are, in the weeds on, HR1 and the implementation of that, which I imagine many of y'all in this room are, you're well aware that that is

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Ben Ruxin - A Healthier Democracy: Essentially, the design of that program is to make it

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Ben Ruxin - A Healthier Democracy: even more red tape, even more barriers to people enrolling, and so we expect this problem to only grow in scale in 2027. Our approach to this is we put trained patient navigators to go on-site into community health clinics, again, leveraging the trust that people have in those spaces, and they connect patients to food assistance, childcare, utilities.

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Ben Ruxin - A Healthier Democracy: internet access healthcare coverage, and we train our staff to stay with people through that entire enrollment process, instead of

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Ben Ruxin - A Healthier Democracy: Passing them off, giving them another phone number to call, putting more barriers and more steps, in front of them.

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Ben Ruxin - A Healthier Democracy: We've screened about 30,000 patients through our work in Boston and Houston, and have secured about $5 million in benefits for those patients. There's one impact story on the bottom. I actually want to share another example from this work from just a couple of days ago.

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Ben Ruxin - A Healthier Democracy: We had a navigator named Ashley who was talking with a mother at a clinic in Houston, and

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Ben Ruxin - A Healthier Democracy: she identified that that person was receiving $20 a month in SNAP benefits, and something struck her as off. That struck her as too low a number. She felt like this person probably should be receiving more. They ended up going through the application again, contacting the SNAP office.

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Ben Ruxin - A Healthier Democracy: And it turned out, through a clerical error, this person, was receiving, should have been receiving $134 a month.

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Ben Ruxin - A Healthier Democracy: And so this person ended up walking out of that interaction with $134 a month instead of $20 and back pay. Again, not because anything about her income changed, not because anything about her situation changed, but because there are barriers in place that prevented her from getting access to all those services.

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Ben Ruxin - A Healthier Democracy: Healthcare settings can be such a powerful setting to have those trusted conversations that lead to outcomes like that. And if we go to the next slide.

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Ben Ruxin - A Healthier Democracy: I'll talk a little bit about our VoteER program, which is really focused, kind of building on the themes that Nora shared, on giving people a voice in what comes next. So there are 60 million unregistered eligible voters in the US, and most of those people have never even been asked to register to vote.

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Ben Ruxin - A Healthier Democracy: So we find it very powerful to have a trusted person, with a badge and a QR code asking a simple question, potentially during social history, or at any given time in that, doctor-patient interaction. Are you registered to vote?

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Ben Ruxin - A Healthier Democracy: It's an optional question, it's nonpartisan, it's really, really minimal in terms of adding to anyone's workload. And we're doing this work all across the country with 80,000 healthcare professionals, 2,100 plus participating sites, and we've registered.

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Ben Ruxin - A Healthier Democracy: tens of thousands of people through this work.

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Ben Ruxin - A Healthier Democracy: One part of this that I really like to take a pause and highlight, is that this work benefits our clinicians as well.

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Ben Ruxin - A Healthier Democracy: There is, again, to speak to a theme that I'm sure resonates with y'all in the room, so much burnout in health-related fields. And we surveyed our participating clinicians, and 79% of them reported a greater sense of agency from using our tools, and 50% of them said it helped protect them against burnout, again, because it felt like they were being given a tool.

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Ben Ruxin - A Healthier Democracy: To have conversations with patients about topics that, were important to them.

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Ben Ruxin - A Healthier Democracy: Participation also changes who gets listened to, so this is what gets at some of the work that Nora was sharing, too. When people don't vote, they're labeled as unlikely voters. Campaigns don't contact them, they're essentially invisible. Their priorities are not, in the agenda of elected officials. Things don't change, and that gives people even less of a reason to vote next time.

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Ben Ruxin - A Healthier Democracy: When they do participate, now they're labeled as likely voters. Campaigns start contacting… start contacting them, and their priorities enter the conversation, and it runs that loop the other way. You saw the graphic from Nora that lays out, that positive feedback loop, and we find that a very, very powerful thing.

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Ben Ruxin - A Healthier Democracy: The way that our tools work in practice is, number one, it starts from someone that they already trust. So, we, again, train our healthcare professionals to work this question in naturally into the social history, or into another, kind of natural part of the interaction with the patient. Number two, we don't expect.

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Ben Ruxin - A Healthier Democracy: a doctor, or a nurse, or a community health worker to be an expert in election law, or in how to vote, or even when the voter registration deadlines are, or early vote deadlines, or any of that.

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Ben Ruxin - A Healthier Democracy: All we all we ask for is that they ask the patient to scan a QR code or go to a website, and the website and the patient do the rest of the work from there. We've spent a lot of time developing tools that are easy to use and intuitive and available in multiple languages for patients to be able to get the data that they need to empower themselves to participate. And then number three is staying neutral. So we always focus on

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Ben Ruxin - A Healthier Democracy: handing the decision back to the patient, and I'm putting the power in their hands as opposed to telling them what to do. And before I move off of this page, the point I want to underscore here is

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Ben Ruxin - A Healthier Democracy: we do a lot of our work with healthcare professionals, but it really can be broader than that. You can imagine a WIC counselor, a home visitor, a public health professional, kind of anyone that has this kind of position of

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Ben Ruxin - A Healthier Democracy: trust with the person they're interacting with, having a similar type of interaction, and leading to more voter registration and participation.

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Ben Ruxin - A Healthier Democracy: This is a little bit more just to double-click on the script that we train people on. This, again, is built for a 30-second encounter. We don't want to add time to that interaction. We start by asking.

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Ben Ruxin - A Healthier Democracy: So before I… before I go, I'd like to check whether you're registered to vote. Then we try to tie it to something that people already care about, and keeping it local is something that we find really helpful here, because.

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Ben Ruxin - A Healthier Democracy: health often is, so local, and local elections are often decided by a small number of votes. So that can be a very powerful hook, for people.

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Ben Ruxin - A Healthier Democracy: And then finally, we have just one small action step that we ask people to do, and that's pointing their camera at the QR code, and assuring people that the rest of, the rest of the way, they will be in good hands, with that website walking them through every step.

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Ben Ruxin - A Healthier Democracy: And I do want to highlight the importance of nonpartisanship. There is an inherent power relationship between a healthcare professional and their patient. That power relationship is part of why there's trust. People trust that they're getting credible health advice from their healthcare professional.

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Ben Ruxin - A Healthier Democracy: We don't want to break that trust or exploit it by having people tell other people how they should vote, which way they should lean, any of that. We want to use that trust to put the decision in the hands of the patient and underscore the importance of participation, of participating in our democracy as a powerful tool in itself.

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Ben Ruxin - A Healthier Democracy: This virtuous cycle is very similar to what Nora laid out, but I will highlight how we view both of our programs playing a part in it. So we start with, Link Health connecting patients to the benefits and resources, that can, give them that critical support to improve health and provide financial stability.

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Ben Ruxin - A Healthier Democracy: This gives people a real experience of the system working for them, however imperfect that system may be.

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Ben Ruxin - A Healthier Democracy: And that then, we hope, leads patients to use their voice, and we use VOTER to encourage patients to use their voice, to then shape those systems to become even more accountable and responsive over time. So cutting down on some of the red tape and barriers over time that prevent people from accessing these benefits. That leads people to then access more of that support they need, and the cycle perpetuates itself, again.

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Ben Ruxin - A Healthier Democracy: So now I want to pause here and ask you all to, take a step. We are, just over a month out from Election Day. I'd imagine, given the folks that are in this room, most of y'all are already registered to vote, but if you scan this QR code, you can see the backend that any patient would see when they scan our… when they use our tools, and get a… get a chance to see, like, what the workflow looks like behind the scenes.

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Ben Ruxin - A Healthier Democracy: So, scan that QR code, I'll also paste that link in the, you know, we can paste that link in the chat.

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Ben Ruxin - A Healthier Democracy: That is, The first and most important step any of us can take.

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Ben Ruxin - A Healthier Democracy: And if we go to the next slide, as folks are doing that, if people are interested in going a little bit deeper with us, anyone can order a free badge and materials. Like I said, just because a lot of our work is with healthcare professionals doesn't mean that you have to be a clinician in order to use our tools. Anyone that has trusted interactions with people in the community are a great fit to use our tools. So you can go and get a free badge, and

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Ben Ruxin - A Healthier Democracy: training materials for yourself.

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Ben Ruxin - A Healthier Democracy: If you represent an organization, you can join as a partner, get your own branded landing page, you can actually track how much progress you're making in terms of voter registration as an organization.

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Ben Ruxin - A Healthier Democracy: And then if you're interested in learning more about our Link Health work, especially if you're in Massachusetts or Texas, you can go to our website or contact me to learn more about that work and how we work with our community health center partners.

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Ben Ruxin - A Healthier Democracy: And with that I'd love to pass it over to Aysha to take us through the next presentation.

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Aysha Pamukcu: Amazing. Thank you so much, Ben and Nora, and really appreciate the collaborative and everyone who's joined today.

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Aysha Pamukcu: I'm really excited to be chatting with you all today about, you know, really just one key point, which is that civic health is public health.

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Aysha Pamukcu: And in, you know, full disclosure, I'm wearing a number of hats today. In one hat, I lead the policy fund, where we have government-community partnerships in passing equitable policies that make communities healthier and more resilient.

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Aysha Pamukcu: In another hat, I am the co-author of Advancing Equity and Justice, and you will see a lot of the material, including the amazing graphics, are drawn from that book.

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Aysha Pamukcu: And in the third hat, I really am putting my money where my mouth is, and I myself am a candidate for City Council, trying to make a difference in my own community. So, let's get into it.

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Aysha Pamukcu: Before we really decide how to communicate the value of public health.

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Aysha Pamukcu: I would suggest we can go back to the basics first, and really ask what we mean by public health in the first place. We will often describe public health through the work that our institutions and our practitioners are doing. So, right, we're preventing disease, we're collecting data.

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Aysha Pamukcu: We're operating programs, responding to emergencies, so many emergencies, and we're developing policy.

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Aysha Pamukcu: And, of course, we do all that. But public health is also, and Nora talked about this, a collective commitment to create the conditions in which everyone can be healthy and flourish. And I think this distinction can really help us as communicators, because if public health is only a collection of programs.

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Aysha Pamukcu: people then are just audiences or passive recipients of information. But if we're really thinking about public health as creating shared conditions for health, then communities are participants and co-creators in shaping those conditions. So.

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Aysha Pamukcu: I'm going to be using my time to talk about the value of community power and its role in collective well-being, and what we mean by public health. And I will say, this can be daunting. Power's a big idea, but I want to propose that it's ultimately hopeful, because instead of chasing election cycles and policy votes.

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Aysha Pamukcu: we actually can weather tough losses, like, you know, Nora talked about, because the goal is actually shifting power to community, and that's the Civic Participation we're talking about.

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Aysha Pamukcu: So, let's get into what we mean by public health.

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Aysha Pamukcu: In our book, Advancing Equity and Justice, Jamila Porter and I talk about public health as a set of commitments that

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Aysha Pamukcu: have to do with the kind of society we want to build, and the conditions that people need to flourish. So, you know, under these commitments, community organizing, that's public health work. Civic participation, absolutely public health work. Changing a budget, a policy, an institutional practice, or how resources are distributed.

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Aysha Pamukcu: All public health work.

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Aysha Pamukcu: And so, we break it down in terms of

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Aysha Pamukcu: Prevention, so stopping problems before they occur, instead of waiting till people are already sick, injured, displaced, or in crisis.

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Aysha Pamukcu: The second, commitment is scale, promoting collective flourishing, so not only helping one person at a time, creating the conditions that allow entire communities, entire populations to be healthy.

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Aysha Pamukcu: The third, of course, is root causes, addressing the systems behind the symptoms. So, we're talking about the structures that produce poor health, rather than only treating their consequences.

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Aysha Pamukcu: And the fourth is justice, and…

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Aysha Pamukcu: that's building power for lasting change. And I would say these final two commitments are really important for today's conversation, because we certainly can identify a root cause and propose a solution, but without the power to change policies.

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Aysha Pamukcu: To direct resources, to influence institutions, and sustain progress, that solution might never become real.

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Aysha Pamukcu: And I really want to stress, especially in these times, that a focus on justice and power in public health is not new. And, in fact, it's actually a return to form for our field.

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Aysha Pamukcu: Nancy Krieger and others have written about public health's early ties to social movements, and how the field was motivated by a desire to improve community health and demanded things like clean water, better working conditions, and dignified housing.

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Aysha Pamukcu: So, civic participation really sits within all four of these commitments. We are helping communities prevent harm, influence conditions at scale, demand justice, and build the collective power that we need to change these root causes. So, it's a long way of saying, civic participation is how public health change happens.

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Aysha Pamukcu: And when we talk about civic participation and power, I think some of the most impactful words to help us understand power come from Martin Luther King Jr.

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Aysha Pamukcu: And he says.

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Aysha Pamukcu: Power, properly understood, is the ability to achieve purpose. It's the strength required to build… to bring about social, political, or economic changes. And he also goes on to talk about, in this sense, power is not only desirable, but necessary in order to implement the demands of love and justice. And I wanted to add the extra piece of the quote, because I think

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Aysha Pamukcu: Love can be sort of a squishy concept sometimes in public health, but I would argue our work is absolutely based in both love and justice.

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Aysha Pamukcu: And I think also this framing matters, because we in public health can be wary of power, and

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Aysha Pamukcu: You know, sometimes I think there's a temptation to feel like our good work should speak for itself, and that should move people. But we really have to pair our field's remarkable moral clarity and ability to spot and diagnose the problem with a capacity to act.

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Aysha Pamukcu: And so, we should be asking ourselves questions like, who has power?

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Aysha Pamukcu: How's it being exercised?

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Aysha Pamukcu: Toward what purpose, and with what accountability?

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Aysha Pamukcu: And that means that our goal is never power for its own sake, but it's about building, shifting, and sharing power so that people can shape the conditions required for health and flourishing. And so this is the change that is bigger than a single election cycle, and bigger than an individual leader. And I would say naming power and being honest about it is one of our most important roles as communicators.

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Aysha Pamukcu: But, of course, power can be difficult to see, and much less communicate about, because it operates invisibly underneath the events immediately in front of us.

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Aysha Pamukcu: So, to shift power, we need to shift, what we call in the book, misleading mindsets. And I'm sure many of you are familiar with this thinking tool, the iceberg model, and it helps us look beneath an individual event.

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Aysha Pamukcu: further down to the causes underlying it to explain what's happening. So if we're at the surface, we see an event, and, you know, usually that's something that harms public health, and we say, okay, what's happening here? Just descriptive. Then we look for patterns, and I will say, our field is so good at this.

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Aysha Pamukcu: What is the thing that keeps happening? Epidemiology, for example, is a great way to explore beneath the surface. Like we are patterns people. But I would say what we're less practiced at is the bottom two levels.

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Aysha Pamukcu: So where we have to keep diving deeper is to the structures and the systems, asking ourselves, how are the structures and systems interacting to keep this pattern locked in place?

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Aysha Pamukcu: And underneath those structures, we have an even deeper root cause of mindsets. So these are the worldviews and stories that make existing systems.

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Aysha Pamukcu: seem reasonable, or natural, inevitable, or maybe worse, impossible to change. So, if we want to shift power, we have to identify and change the misleading mindsets that are hiding power.

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Aysha Pamukcu: And this gives communicators a critical role, because we can ask deep questions that go below the events level of the iceberg.

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Aysha Pamukcu: So we'll talk about some misleading mindsets, in this next slide. I… in the book, we talk a lot about some of the most harmful mindsets to public health. This, and I apologize, maybe small graphic, is an example of some of those common mindsets.

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Aysha Pamukcu: But I think the one I want to focus on today is one of the most important shifts in public health, moving away from a frame of individual responsibility to shared conditions. And of course, we all are steeped in the social determinants of health, so we know this, to our bones.

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Aysha Pamukcu: But this frame of individualism is so pernicious, and it can really easily creep into our communications because of how pervasive it is.

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Aysha Pamukcu: So, instead of, you know, beginning and ending with what choice did this person make.

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Aysha Pamukcu: We have an opportunity to prompt people to ask what choices were actually available, and what systems shaped those choices.

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Aysha Pamukcu: Excuse me.

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Aysha Pamukcu: So this requires us to go deeper with our questions. Who's defining the problem?

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Aysha Pamukcu: And when we frame the problem, does that name power, or does that actually hide power?

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Aysha Pamukcu: What solutions make this framing possible, and what solutions does it kind of push out of the boundaries of consideration as sort of impossible or not feasible?

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Aysha Pamukcu: And most importantly for today's conversation, can Civic Participation alter the outcome?

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Aysha Pamukcu: And I would argue good communication is something that makes systems and power visible. But of course, we know that communication alone is not going to change decision-making authority, or redirect funding, or guarantee that people's participation will matter.

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Aysha Pamukcu: Talia Baroncelli, The next framework is the one that helps us assess whether we are actually creating those opportunities.

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Aysha Pamukcu: So this, Ben did an incredible job talking about the importance of trust and how we help build it, and this is the spectrum of community engagement to ownership, which we have adapted and talked about in the book, Advancing Equity and Justice, and it really helps us as communicators

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Aysha Pamukcu: By, forcing us to ask a pretty straightforward question. Who has power in this process?

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Aysha Pamukcu: And whatever we communicate, our words should be accurately reflecting the authority being offered. And you'll see.

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Aysha Pamukcu: There's basically a spectrum starting with ignore, where you have decisions made behind closed doors, and people are being told, whatever you want or need does not matter in this decision.

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Aysha Pamukcu: Then we have… Inform, which…

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Aysha Pamukcu: can be a type of placation, where an institution is sharing information, but it's a one-way participation, right? Saying, hey, we're going to give you updates.

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Aysha Pamukcu: we go then to consult where an institution's asking for input, you know, and that might be a lot of the tools we're familiar with, right? Surveys, forums, public comment, but still holding decision-making authority. And so that's saying, essentially, like, we care what you think, but we're the deciders.

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Aysha Pamukcu: And then we go further up to involve, where community perspectives are actually changing and influencing what happens. People are shaping the plan, even if the decision-making is still staying with the institution as the final authority. And then we get to co-govern, and this is where a lot of my day job falls.

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Aysha Pamukcu: And power is more meaningfully shared. We see institutions and communities developing solutions and making decisions together, and community leadership is essential to the process.

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Aysha Pamukcu: Finally, at the far end of the spectrum, we have self-determination, or defer to. And this is where communities are really driving the solution and owning the process, and institutions provide resources and implementation support. And it's worth noting not every public decision can or should

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Aysha Pamukcu: promise complete community control, right? Government and, still has really essential public responsibilities and legal duties and obligation to protect people's rights. But I think the takeaway that I'd love folks to have from this is that

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Aysha Pamukcu: We do need to be honest about where a process sits on the spectrum, and one of the things we can do as communicators is, just be real. If an institution is only prepared to consult, we can name it.

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Aysha Pamukcu: And, we can also not over-promise. For example, say something's co-governance, where we actually just want input, maybe through a survey.

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Aysha Pamukcu: So, we can be real with people about what's actually open for influence, what has already been decided, and who's going to make the final decision, and once that happens, what will happen after people participate. So, every engagement process, every

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Aysha Pamukcu: Civic process communicates who has power, it's just we get to choose whether we're explicitly naming it or not.

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Aysha Pamukcu: So what does this mean for the daily practice of communication?

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Aysha Pamukcu: Of course, you know, communication cannot substitute for participation, but there are some different things that we can do, right? We talked about what are the ways that we can make power visible. Iceberg model helps, naming, where things sit on the spectrum.

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Aysha Pamukcu: And we can be clear with people about who sets the agenda, makes decisions, when those decisions are happening, and what is actually open to influence.

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Aysha Pamukcu: And we can also invite people in in an honest way, right? We can match our invitation to the actual resources, choices, and authority being offered, and we can respect people's agency by not asking for ideas if the decision's already been made.

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Aysha Pamukcu: And we can also make sure to not confuse feedback as shared decision-making. Those are really two different processes.

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Aysha Pamukcu: And we can also close the loop.

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Aysha Pamukcu: Ben did a great job about talking about the importance of follow-through in building trust, and people should also hear about what was learned from their participation.

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Aysha Pamukcu: what, if anything, changed because they participated, but also what didn't change and why. So without that feedback loop, I think participation sometimes runs the risk of feeling extractive. And closing the loop is one of the clearest ways we can communicate that participation was

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Aysha Pamukcu: consequential.

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Aysha Pamukcu: Rather than, symbolic or ceremonial.

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Aysha Pamukcu: Finally, we can support community leadership, and I see this as supporting people in telling their own stories, naming their own priorities, and shaping the narrative.

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Aysha Pamukcu: Public health communications can sometimes portray people as the recipient of services or audiences who are receiving expert information. We also have an opportunity to show people.

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Aysha Pamukcu: as organizers and neighbors and experts in their own right, and leaders and decision makers who are part of this collective process of creating healthier conditions.

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Aysha Pamukcu: And so, you know, communication and civic participation in this way have a very reciprocal role, and we can help shift the center of gravity towards community leadership by making power visible, insisting on honest invitations.

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Aysha Pamukcu: Creating accountability and supporting people in shaping the stories that are told about their lives and their futures.

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Aysha Pamukcu: And that just takes me to my closing slide, which is that healthy communities really depend on power and civic participation.

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Aysha Pamukcu: Civic Participation is not just a way to, sort of.

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Aysha Pamukcu: promote our public health programs or persuade people to support government services. This is actually the substance of doing the work of public health, because, as Nora pointed out, voice, agency, self-determination, that all actually affects whether people can influence the conditions of their lives.

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Aysha Pamukcu: And leads to healthier, more resilient communities. And we as communicators have an important role in that work, and I would argue that even includes people who may not self-identify as communicators.

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Aysha Pamukcu: We can use our role to obscure power, or we can use it to name power and help shift it, so…

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Aysha Pamukcu: I hope that the future we're working towards is not just one where people have a better understanding of public health and the importance of civic participation, but also is one where people and institutions work together, share power, and stay accountable to each other, so we can all build the conditions where everyone can flourish.

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Aysha Pamukcu: And I'm so pleased to pass it over to David.

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David Heayn-Menendez: Thank you so much Aisha and for all the other speakers, you have perfectly set me up for my speech.

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David Heayn-Menendez: So when people hear public health, as you've heard from the others, we don't usually picture a lot of concrete things like this alley.

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David Heayn-Menendez: But this site in the borough of Lewisburg, where I live, taught me something really important about health and its interaction with civic life.

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David Heayn-Menendez: So, the sidewalk that is kind of covered over with a graphic here a little bit.

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David Heayn-Menendez: ended at that alley, White Pine Alley, in a set of irregular, jagged, steep steps that no one currently living remembers when they were installed.

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David Heayn-Menendez: But a person using a wheelchair certainly could not go down that block, nor a parent with a stroller, and the brake created a really serious barrier for essentially anybody with other mobility limitations, blindness, low vision, and at night.

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David Heayn-Menendez: So…

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David Heayn-Menendez: For me, that is a really crucial health issue in my community, because it was directly impacting the people on my block, in my neighborhood, and in the ward that I represent as a councilman.

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David Heayn-Menendez: It is also a public decision about what… how do we… Plan and navigate our infrastructure.

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David Heayn-Menendez: Our access… How do we use our public money, and whose daily experiences

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David Heayn-Menendez: Do government agencies notice and act upon?

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David Heayn-Menendez: So I'm going to use 3 examples today. This sidewalk project.

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David Heayn-Menendez: COVID outreach with the MENA, Middle East North African Communities, and a statewide advocacy for children's mental health that I work on through the Strong Minds Bright Futures Partnership.

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David Heayn-Menendez: And they all look very different, but they reveal the same communication problem.

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David Heayn-Menendez: People experience the consequences of public health decisions every single day.

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David Heayn-Menendez: They often cannot see which decisions created that condition.

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David Heayn-Menendez: Who controls it, what laws are in place, or how their participation could actually make a difference in their lives and their communities.

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David Heayn-Menendez: So my background allows me to see this problem from several different sides.

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David Heayn-Menendez: I've worked as a community organizer and civic engagement director.

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David Heayn-Menendez: including voter registration and public education with Augustan, Aklamo, Pennsylvania Voice, and the New Pennsylvania Project, all who not only

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David Heayn-Menendez: Endeavored to communicate health issues, but also registered people to vote, tell them about this election, and everything in between, because

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David Heayn-Menendez: Oftentimes, you will see this big push for voter registration and civic engagement when it directly serves the purpose of the person trying to register you.

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David Heayn-Menendez: But as you heard earlier, the trusted messenger, the person in the community, the person that can communicate in the language with cultural competency matters so much.

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David Heayn-Menendez: And that's…

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David Heayn-Menendez: a lesson I learned when I worked with communities on environmental policy through the Pennsylvania Interfaith Power and Light, where I was in rural communities, talking to people about the moral and ethical imperative of being stewards of our natural environment for ourselves, for our children, for the future, and for

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David Heayn-Menendez: to live our own faith community direction in life.

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David Heayn-Menendez: I also, as I mentioned, serve in municipal government on my borough council, where

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David Heayn-Menendez: Residents expect understandable answers about things like streets.

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David Heayn-Menendez: About flooding risk, about street trees, about how we are creating our budgets, and who's making those decisions, but also really tangible things like public safety and health concerns.

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David Heayn-Menendez: So today, at Children First, and that Strong Minds Bright Futures partnership, I…

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David Heayn-Menendez: help connect what young people and families experience to those statewide decisions about children's mental health.

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David Heayn-Menendez: And across those settings, the same question keeps returning.

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David Heayn-Menendez: How do we help people connect what is happening in their lives to those public decisions they can realistically influence?

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David Heayn-Menendez: Next slide.

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David Heayn-Menendez: So, I use 4 questions to make that connection visible.

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David Heayn-Menendez: First, What is happening in a person's daily life?

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David Heayn-Menendez: We need to begin with that experience.

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David Heayn-Menendez: That person, that, that… Neighborhood that we are able to connect to and communicate with directly.

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David Heayn-Menendez: Not necessarily starting with institutional memory and policy that already exists. We will get there, but without centering that community, you kind of miss the whole thread.

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David Heayn-Menendez: The second is, which rule, which budget, program.

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David Heayn-Menendez: public body actually shapes that experience, and many people that I interact with in these communities across my entire state have very little understanding of

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David Heayn-Menendez: those exact things. Was this an individual's decision? Was there public feedback? Was there an opportunity for me to have been involved in the first place, or is there still an opportunity?

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David Heayn-Menendez: It's a general request for government to help really doesn't tell people where the authority sits, but it is where people start their conversation, start their involvement in civic life.

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David Heayn-Menendez: And then third, where can someone realistically enter that process, then?

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David Heayn-Menendez: Like, is it a council meeting, right, where capital projects may matter quite a lot? Is it a community dialogue where people are seeking to reveal statewide patterns and hear from communities?

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David Heayn-Menendez: Or maybe it is a legislative meeting, where you're sitting with your representative.

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David Heayn-Menendez: Brian Vila, That could be the right place for that policy ask, but the invitation must match the decision.

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David Heayn-Menendez: or else we have

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David Heayn-Menendez: people with concerns not talking to the people that can address them, and finding the channels of power that Aisha so eloquently spoke about earlier.

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David Heayn-Menendez: And finally, what happens after people participate, right? There's so many times where we ask a team to tell us about what they're experiencing, or we say, there will be a town hall.

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David Heayn-Menendez: But if we don't tell them what changed, or what could not change.

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David Heayn-Menendez: What are the next steps that they could take to continue to be involved? Without that follow-through, Participation can feel, at best, vague.

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David Heayn-Menendez: And at worst, Extractive.

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David Heayn-Menendez: abusive, and communities have that memory of people coming to them in the past. So these questions explain why the three examples I'm talking about belong together. Each begins with a health experience, and asks whether people can follow it

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David Heayn-Menendez: into public life to be engaged. Next slide.

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David Heayn-Menendez: So this White Pine Alley project shows why Civic Participation cannot simply mean asking the public to approve a finished product.

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David Heayn-Menendez: The accessibility problem was evident. It was urgent for some. And the sidewalk, as I said, interrupted the alley, and those steps were just impassable. My children, when they were young, could barely walk up and down them themselves.

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David Heayn-Menendez: So when proposed designs.

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David Heayn-Menendez: came out, a new council member who has a lot of experience in transportation and mobility.

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David Heayn-Menendez: Created a design that had a continuous sidewalk.

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David Heayn-Menendez: And added green infrastructure to boot, because we had the funding available.

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David Heayn-Menendez: It addressed… the accessibility. It addressed the stormwater issues that we were having in the same area.

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David Heayn-Menendez: But residents were so angry.

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David Heayn-Menendez: They were angry about losing vehicle access.

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David Heayn-Menendez: They were angry about changes to the way they use the block, and they were angry about what this meant for property values and the homes that they lived in and wanted to maintain a certain standard for.

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David Heayn-Menendez: And we could have treated the reaction as simply resistance to the proper project, right? The proposed project was the most

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David Heayn-Menendez: Beneficial to people with mobility and other issues to navigate that sidewalk.

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David Heayn-Menendez: But instead, I knocked doors.

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David Heayn-Menendez: I sent them direct mailers. I called ad hoc town hall. I walked the street and the sidewalk with residents to show them what we're talking about, what was possible, possibilities that we were still exploring, and things that we really needed to make sure were getting done in this project.

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David Heayn-Menendez: So, together, residents, our engineers, borough staff, and elected officials, and experts.

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David Heayn-Menendez: all continued to have that discussion with the residents of the community. And we considered things like the grade and the drainage, the pedestrian access, vehicle access, and even the trees.

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David Heayn-Menendez: And the final design wound up actually keeping the alley open, not blocking it off for a continuous sidewalk. It did remove the steps and created a more continuous slope that was an accessible route for most people.

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David Heayn-Menendez: It did also improve the stormwater management, and while, unfortunately, some reasonably mature trees had to be removed, we included within the project their replacement.

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David Heayn-Menendez: So the outcome was by no means perfect.

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David Heayn-Menendez: The process was also not perfect or unanimous, but the project did wind up getting built.

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David Heayn-Menendez: It did improve the block, and it responded more closely to what residents told us they needed.

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David Heayn-Menendez: because they weren't resisting improvements to their neighborhood, they didn't understand and didn't feel that they were communicated to appropriately, early enough, or in ways that brought them along in the process. And I think Aisha really outlined that super well in one of her graphics, but

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David Heayn-Menendez: The communication lesson here is not that every disagreement needs to end in consensus. It is that people need to know what remains open to influence.

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David Heayn-Menendez: And the residents were not being asked whether accessibility mattered, right? They… their experience really helped shape how the borough pursued accessibility, while also addressing the legitimate financial and legal concerns and accessibility issues.

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David Heayn-Menendez: So public Participation became useful because it was connected to a real design decision.

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David Heayn-Menendez: Those individuals have remained engaged within borough life, and they are an asset to us to understand what's going on in the neighborhood and what they're seeing.

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David Heayn-Menendez: It was an entry point for many of these people who I had never once before seen in a borough council meeting, or at a committee meeting, or a design meeting, for that matter, because this project that they were so upset about had been in the workings for years prior to that moment.

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David Heayn-Menendez: So.

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David Heayn-Menendez: Next slide.

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David Heayn-Menendez: Stepping back a little bit, during the early COVID response, I saw a different version of the same problem.

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David Heayn-Menendez: Arab and Middle Eastern North African communities in Pennsylvania are really difficult to see within government data because federal standards classify this MENA identity as essentially white.

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David Heayn-Menendez: So, agencies had very limited community-specific information.

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David Heayn-Menendez: And… Lacked entirely a relationship or even the capacity to communicate in ways that fit the community.

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David Heayn-Menendez: They didn't even know how many people in the community needed that language access, and they didn't know where they were in the city itself.

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David Heayn-Menendez: So, in talking with Government agencies at the local, state, and federal level

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David Heayn-Menendez: It was important for me to help them understand that we weren't…

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David Heayn-Menendez: doing enough to make sure that there wasn't an outbreak, especially because there was a risk created by the recently arrived Syrian refugees in Philadelphia who didn't know our health systems or

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David Heayn-Menendez: other families that could help them navigate a new health system. They also had limited access to English, and

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David Heayn-Menendez: As we all remember, changing vaccine guidance and misinformation was really all over the place as people were fearful of what was going to happen to themselves and their families as they're navigating the difficult mental health landscape of being indoors in a small space in a new country that they didn't know.

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David Heayn-Menendez: So I worked with these different agencies, but information could not simply travel from government outward.

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David Heayn-Menendez: They needed those trusted community organizations and Arabic-speaking partners, had to really shape the message, be the messengers, and provide that service when possible. So, the organization I was at, Albustan Seeds of Culture, we combined pop-up vaccine access

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David Heayn-Menendez: With voter registration.

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David Heayn-Menendez: And connections to public resources that could also be at an outdoor space.

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David Heayn-Menendez: They… they brought together, at first, Handfuls, dozens.

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David Heayn-Menendez: then hundreds, and then we had a community day where, for the first time in Philadelphia's history, more than 2,000 people from the community, from the MENA community, all gathered together. We provided

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David Heayn-Menendez: Free food, free information, free vaccines, voter registration, and as much education about all the resources and all that was going on in our community as possible.

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David Heayn-Menendez: But it gave visibility to the community to see itself.

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David Heayn-Menendez: To be seen when it wasn't being seen in the data, to create trust, and all of that was built upon what you see on this slide.

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David Heayn-Menendez: videos, flyers, social media graphics in English and in Arabic that featured people and voices familiar to the community. And the video isn't working on the screen right this second, but I will definitely send it out later.

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David Heayn-Menendez: And the lesson for communication is, I think, pretty straightforward, that translation alone is not a relationship.

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David Heayn-Menendez: information works when trusted people carry it, and when it leads to services people can actually use. And I've been in too many circles where a government agency may put something that you can click to translate, or go to another website, but

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David Heayn-Menendez: that meant you had to travel through the English language website to get there, and it meant that people knew which website to go to in the first place, and trusted that agency with their information, or with their recommendations.

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David Heayn-Menendez: Predicates communication on a relationship that doesn't yet exist.

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David Heayn-Menendez: Next slide.

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David Heayn-Menendez: Then lastly, at Strong Minds Bright Futures, the issue is children's mental health.

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David Heayn-Menendez: But the civic problem is essentially familiar, right? Adults tell young people to ask for help.

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David Heayn-Menendez: What happens?

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David Heayn-Menendez: After they do that.

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David Heayn-Menendez: We've taught two generations now that it is okay to seek assistance, support.

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David Heayn-Menendez: But across our, seven community dialogues in Pennsylvania, and… young people, families, educators, providers, and even local leaders are all telling us about long waits.

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David Heayn-Menendez: Transportation problems, insurance barriers.

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David Heayn-Menendez: Limited school capacity and services that just do not connect them to the help they need, when they need it, where they need it, with people who are actually able to provide it.

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David Heayn-Menendez: With cultural competence, with language competence, or…

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David Heayn-Menendez: Just to be able to connect to a person that you can feel comfortable sharing and being supported by.

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David Heayn-Menendez: And we heard really broad agreement from young people who needed help that the gap appeared when

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David Heayn-Menendez: Concern had to become…

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David Heayn-Menendez: a public decision, right? Like, a Medicaid change is going to get headlines, and… you know, we talk about workforce issues, we talk about schools and how they can support young people, because we have moments of clarity around this, but the everyday lives of young people in Pennsylvania

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David Heayn-Menendez: are recognizing that there isn't anything that exists for them between when they are feeling something that they need to talk about.

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David Heayn-Menendez: That prevention's next step doesn't exist.

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David Heayn-Menendez: So every day I see advertisements for crisis hotlines and walk-in centers and inpatient care.

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David Heayn-Menendez: But that feels very distant from the lives of the young people that I talk to, who just need a trusted adult who will hear them and be there for them when and where they need them.

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David Heayn-Menendez: So communication must therefore do more than raise awareness. It must show which decisions remain unfinished.

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David Heayn-Menendez: who has the authority to make those decisions, and what actions would move that work forward? Because young people want to be involved when you give them an opportunity, but they also need to have people help them understand

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David Heayn-Menendez: Where they can actually make decisions and be influential to lawmakers and government agencies.

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David Heayn-Menendez: Both young people and families define their experience differently, and schools and providers need to explain what implementation requires to state agencies.

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David Heayn-Menendez: Well, elected officials like myself.

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David Heayn-Menendez: Who.

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David Heayn-Menendez: Have control over the rules and resources.

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David Heayn-Menendez: Are generally not really aware of

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David Heayn-Menendez: This kind of experience in our community.

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David Heayn-Menendez: We can hear a story about somebody who tried to commit suicide, or we can hear about an active shooter. We can hear about those stories, but what's the path to resolution? Where is sustainable funding going to come from? So, our partnership connects those perspectives together.

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David Heayn-Menendez: We created a very big tent to then come up with specific reforms that have pathways and timelines and measures to actually achieve the public health

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David Heayn-Menendez: goals that probably all of us on this call, whether it's about ACEs or…

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David Heayn-Menendez: Any other number of components that can.

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David Heayn-Menendez: Gary Holness@push forward prevention into our communities.

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David Heayn-Menendez: We need to be able to provide that, but it has to be coming from.

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David Heayn-Menendez: people with that lived experience in a way that resonates and is effective. We cannot promise an immediate policy victory.

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David Heayn-Menendez: Right? But we can show where people's information went.

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David Heayn-Menendez: How it shaped our partnership and our requests, and which decisions come next once we've achieved one reform and we're moving on the next.

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David Heayn-Menendez: So listening in these ways, whether it's directly to youth in schools or in our community dialogues or in our partnership, which now has 63 counties out of 67 in Pennsylvania and over 120 partner organizations, not counting youth and parents who are also there with us.

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David Heayn-Menendez: That listening is an essential part of Civic Participation when

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David Heayn-Menendez: It actually reaches accountable public decisions.

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David Heayn-Menendez: We can't just

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David Heayn-Menendez: have a meeting to hear, but do nothing with it, or provide a path, or a pipeline, or training, or some next step to actually get to decision makers.

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David Heayn-Menendez: Next slide.

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David Heayn-Menendez: So these examples lead to three messages of public health communicators can actually use. The first is a sort of decision. Right? This experience is shaped by this decision made by this public body on this timeline.

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David Heayn-Menendez: Being that clear is really important, because

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David Heayn-Menendez: We can talk all day about how much we care and how much we want to make change, but if we're not actually providing that level of support to realize something that people are experiencing, we are missing a big part of the roadmap.

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David Heayn-Menendez: Richard D. DeBoest II, And that sentence locates authority before we're asking them to ask for help, or ask for a decision. The second is an invitation with a sort of job.

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David Heayn-Menendez: Right? At this forum.

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David Heayn-Menendez: Share this specific experience because it can inform this decision.

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David Heayn-Menendez: I was on a call last night with a group of teens that said they are very tired of people telling them that we need to hear your voice.

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David Heayn-Menendez: That you need to vote for the sake of voting, that it's going to save our democracy, we care so much about your voice. They're like, to what end, is the question that they were asking me.

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David Heayn-Menendez: What are you going to do with it? How can I continue to do this? When are we going to see some palpable change? Because they see the suffering in their friend group, their school, and their community. They see what they're going through.

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David Heayn-Menendez: And people should understand why their time, why their story, is being requested in the first place.

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David Heayn-Menendez: So then the third is a kind of public receipt, right?

402
01:09:56.530 --> 01:09:58.110
David Heayn-Menendez: We heard this theme.

403
01:09:58.710 --> 01:10:04.179
David Heayn-Menendez: This is the action that we're taking or going to change, we're going to do something in this way.

404
01:10:04.450 --> 01:10:09.709
David Heayn-Menendez: And this is the constraint, whether it's legal, Moral, financial.

405
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David Heayn-Menendez: But the decisions will happen here.

406
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David Heayn-Menendez: That receipt might be something as simple as an email, or a meeting update, a one-page summary, a short video, but it has to be communicated out, right? This… if we're going to be effective communicators, there has to be more ongoing, continuous, parallel communications between us and others.

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David Heayn-Menendez: So, role clarity also matters in this kind of cross-sector work, right?

408
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David Heayn-Menendez: Community members, service providers, agencies, and elected bodies control different parts of the process, but naming those differences prevents overpromising.

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David Heayn-Menendez: and helps people direct their effort where it can matter, right? I don't like bringing a group of teenagers into the Capitol in Harrisburg and tell them that if they meet with this legislator, this will happen tomorrow, or we will pass this bill.

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David Heayn-Menendez: I tell them that this is an essential part of moving things forward, that it is training for you, and you must make sure that they hear you, and that you are ready to continue to respond, that this is not a one-day thing, and that is exactly what I told those people that approached me for the, sidewalk project.

411
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David Heayn-Menendez: They were upset about that one thing, but I am insistent that they understand the processes of future planning, of future design, and they have been showing up.

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David Heayn-Menendez: Next slide.

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David Heayn-Menendez: So, voting helps determine who holds public authority, and participation between elections helps shape how that authority is actually used, right? I, in one election cycle at PA Voice.

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David Heayn-Menendez: led the registration of over 90,000 Pennsylvanians. That is larger than the margin of victory for every statewide election in the state that year.

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David Heayn-Menendez: Gary Holness@But we did that through a year-long process with partners embedded in communities who could speak the language and connect with people. And when I walked up to somebody on the streets in Pittsburgh, and I tried to encourage him to vote, and he felt so despondent, so not relevant to his life.

416
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David Heayn-Menendez: I talked to him about potholes in the street. I talked to him about children in his neighborhood and lights that were not working properly along his highway.

417
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David Heayn-Menendez: And he registered on the spot.

418
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David Heayn-Menendez: Because.

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David Heayn-Menendez: as much as we can have the most effective and catchy headline and provide the information, people also need to feel that level of investment to get them an entry point into the process. So.

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David Heayn-Menendez: Public health communicators… excuse me, public health communicators can make that participation more meaningful through those kinds of conversations.

421
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David Heayn-Menendez: Begin with that sidewalk that someone cannot use, the information a family cannot access, and what happens when a young person asks for help, right? Then we make the public pathway visible.

422
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David Heayn-Menendez: We name the decision, we show where we can enter, and

423
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David Heayn-Menendez: what you can do with that, and that is how public health information can strengthen civic life and make government more understandable, more usable, more accountable, because I, as an elected official, need them to communicate to me, but

424
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David Heayn-Menendez: I also need to make an invitation that is an intelligible and effective one to ask for their communication in the first place, to hear from them, and for them to know that this is not just going into a void.

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David Heayn-Menendez: Thank you all for your time, and I will pass it back to Nora.

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Gnora Mahs: Awesome. Thank you to all of our presenters for sharing all of this great information and their experiences.

427
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Gnora Mahs: We have received several great questions in the chat.

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Gnora Mahs: And from the registration form. We won't be able to answer all of them today, but we really appreciate all of them, and may use these questions to create follow-up resources.

429
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Gnora Mahs: Katie Reilly, for the future. So to get us started before today's event, we received several questions about working in smaller or more local context.

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Gnora Mahs: A registrant asked, how can I apply some of these ideas and concepts to my very small jurisdiction? I work with a population of 4,900 people. This question is for the full group, so does anyone want to get started?

431
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David Heayn-Menendez: I wouldn't mind taking it, because my town is literally 4,600 people.

432
01:14:44.050 --> 01:14:51.499
David Heayn-Menendez: But I guess the heart of the question is, like, how can you apply this? I think that every one of us was speaking about

433
01:14:51.600 --> 01:15:03.310
David Heayn-Menendez: the processes of communication, the people who are communicating. We weren't saying, like, this is the message, because that's also a moving goalpost, significantly. But I think

434
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David Heayn-Menendez: I would like to go back to what I started my slides with, which is centering that person and that issue in that time, because they don't want to hear about

435
01:15:13.750 --> 01:15:25.950
David Heayn-Menendez: we are improving public health. That is such a broad, abstract thing. They want to understand, like, as Ben said, like, that doctor is saying, are you registered to vote, is a very low…

436
01:15:28.010 --> 01:15:35.859
David Heayn-Menendez: standard to start the conversation, but when a doctor is asking you that, the follow-up question I imagine is, why would I, or…

437
01:15:36.110 --> 01:15:51.120
David Heayn-Menendez: why are you asking me this? Like, there must be follow-up questions there that I'm very curious about, but it would shift the person's attention to what we're talking about here, which is there's more to voting, to participating, than

438
01:15:51.260 --> 01:16:10.709
David Heayn-Menendez: just getting another person elected, or passing a bill, right? There's a much bigger kind of role that we have to play, and, you know, when you're talking about 4,000-some people, it is possible to go have those conversations, or set up something in the park, and, you know, have some pizza and music, and just…

439
01:16:10.840 --> 01:16:14.389
David Heayn-Menendez: Create a little bit more of that, like, third space community

440
01:16:14.660 --> 01:16:31.449
David Heayn-Menendez: communication opportunities that I think are often a little bit harder in our modern day, but when you are in those smaller spaces, there's absolutely an opportunity to take many of these lessons and apply them in different ways.

441
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Ben Ruxin - A Healthier Democracy: And David, I felt like you did such a good job.

442
01:16:36.490 --> 01:16:53.780
Ben Ruxin - A Healthier Democracy: sharing how to… how you try to make it tangible when you're talking to people, and… and that would be to the kind of rhetorical question you asked, what would… what would be the next response from that healthcare professional if someone says, why are you asking me this question, or why would my vote matter?

443
01:16:54.140 --> 01:16:57.910
Ben Ruxin - A Healthier Democracy: For us, we feel that the response is most often not

444
01:16:57.960 --> 01:17:15.099
Ben Ruxin - A Healthier Democracy: you should vote because your voice matters. That's true, but a lot of people feel like their voice doesn't matter. You have to show them something more tangible than that. And so what we really try to train our people on, our healthcare professionals on, is to talk about real issues regarding healthcare that are impacted by

445
01:17:15.100 --> 01:17:18.770
Ben Ruxin - A Healthier Democracy: voting. That could be the air that you breathe, that could be.

446
01:17:19.020 --> 01:17:28.510
Ben Ruxin - A Healthier Democracy: that pothole being filled, that could be that sidewalk being completed so that the street is safer for pedestrians. Oftentimes, the most tangible things are the most local things as well.

447
01:17:30.390 --> 01:17:34.490
Gnora Mahs: Awesome. And Aisha, you were about to say something. So do you want to hop into?

448
01:17:34.700 --> 01:17:43.470
Aysha Pamukcu: Sure, just briefly, I think the smaller the community or group that you're looking at, the greater the opportunity in terms of

449
01:17:43.580 --> 01:17:56.219
Aysha Pamukcu: power shifting, because, as David and Ben pointed out, you can reach more people with more trusted messengers, and that's why I really like tools like the spectrum of community engagement to ownership, because

450
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Aysha Pamukcu: Any communication or decision you put out can be pretty easily mapped along that, giving you the opportunity to say, well, is there an opportunity to move it up one rung on the ladder? And wherever stage we're at, can we just accurately name it? Which, David spoke really well to. So I think there's so much opportunity in smaller jurisdictions or smaller communities.

451
01:18:16.660 --> 01:18:19.160
Gnora Mahs: Yeah, I also think it's easier.

452
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Gnora Mahs: to get a response sometimes in smaller jurisdictions and at the hyperlocal level. I know that when I call my, you know, congressional reps, they are very unlikely to respond to any call or email that I send.

453
01:18:32.540 --> 01:18:42.960
Gnora Mahs: Sarah Horn, But when I talk to my city council rep, if me, maybe two of my friends send a similar email, we will undoubtedly get a response from that member.

454
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Gnora Mahs: And that representative about our concerns. And so I think you can also see your actions take shape and be effective, much more rapidly at the local level.

455
01:18:53.880 --> 01:19:00.499
Gnora Mahs: Someone also shared, I have a big question, and I'm curious to get various perspectives.

456
01:19:00.500 --> 01:19:14.019
Gnora Mahs: How can we communicate across party differences to be able to reach people where they are and to help them understand and potentially even change their minds about important programs and services that some want to cut?

457
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Gnora Mahs: Aisha, is this a scenario you have come across? Do you want to kick us off?

458
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Aysha Pamukcu: This is live, this is live in San Mateo County.

459
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Aysha Pamukcu: So I'm on the West Coast, and in San Mateo County.

460
01:19:28.040 --> 01:19:28.970
Aysha Pamukcu: Oh.

461
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Aysha Pamukcu: for…

462
01:19:30.580 --> 01:19:40.539
Aysha Pamukcu: complicated budget reasons. We are not getting money that's expected from the state, and are looking at severe and drastic cuts.

463
01:19:40.670 --> 01:19:58.959
Aysha Pamukcu: To emergency services, essential services, and I think our government's, reps are doing a really good job, right, including folks in nonpartisan roles, saying, hey, this much money was expected, this is the shortfall, and this is what we stand to lose.

464
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Aysha Pamukcu: if we are not made whole. And that is an entirely fact-based, nonpartisan conversation, but I have seen folks really activated across partisan lines, right? And that's not just our electeds, right? Even city staff are part of that conversation. So, I think

465
01:20:15.600 --> 01:20:21.630
Aysha Pamukcu: you know, right, we want to talk about, like, should government be big or small? That's not a conversation you want to have, but…

466
01:20:21.630 --> 01:20:35.650
Aysha Pamukcu: did we not get money we were expecting from the state, and what are the consequences? That is a conversation you 100% can have. So I think just use that as, like, a practical example of setting the stakes and not venturing into partisan waters.

467
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Gnora Mahs: Yeah, that's great. Ben, David, do you want to chime in too?

468
01:20:44.070 --> 01:20:53.220
David Heayn-Menendez: So I probably live in a very different place than Aisha. So I I'm from Philly, but I currently live in deep northern rural central Pennsylvania.

469
01:20:53.590 --> 01:21:02.250
David Heayn-Menendez: Where my town is very politically different than literally everything else around me.

470
01:21:02.460 --> 01:21:03.720
David Heayn-Menendez: So…

471
01:21:05.760 --> 01:21:14.819
David Heayn-Menendez: It would be difficult for me not to get reelected, but at the same time, we don't talk about our party affiliations when we're having these conversations.

472
01:21:14.980 --> 01:21:24.149
David Heayn-Menendez: I've had some really… Strange and difficult conversations with people who aren't always being the nicest about.

473
01:21:24.330 --> 01:21:33.960
David Heayn-Menendez: Partisan things, or… My ethnicity or background in one way or another, but, You know it's.

474
01:21:34.250 --> 01:21:39.890
David Heayn-Menendez: you're having a conversation with a real person in front of you, and I think Aisha said it really well about, like.

475
01:21:40.660 --> 01:21:47.780
David Heayn-Menendez: it's that… it's that issue there, right? It's about that funding thing, and I know somewhere else in Pennsylvania, Delaware County.

476
01:21:48.350 --> 01:22:01.690
David Heayn-Menendez: reasonably affluent, but not entirely suburb county of Philadelphia is one of the largest counties in the state or in the country that didn't have a public health department. And they got one a few years ago.

477
01:22:02.510 --> 01:22:06.349
David Heayn-Menendez: However, the county government has switched from one party to another.

478
01:22:06.670 --> 01:22:18.689
David Heayn-Menendez: The last administration didn't raise taxes for decades and then left them with a ridiculous shortfall that now they are blaming on the public health department for costing too much.

479
01:22:19.060 --> 01:22:23.499
David Heayn-Menendez: So the question in my mind to Aisha's point is not about.

480
01:22:23.920 --> 01:22:39.610
David Heayn-Menendez: who did what, and finger point, and, like, those bad of that party, but it's rather, like, the public health department is an essentially good thing that we actually really need. So the messaging needs to be about, don't you want somebody checking to make sure that your air and water is safe?

481
01:22:39.870 --> 01:22:52.790
David Heayn-Menendez: Like, your children are playing on that playground. Don't you want to make sure that there aren't toxic fumes coming from a tire-burning facility down the road? I mean, the conversations are really much more about

482
01:22:52.840 --> 01:23:00.310
David Heayn-Menendez: The tangible impacts that good policy, good public health can do for you and your community.

483
01:23:00.680 --> 01:23:11.769
David Heayn-Menendez: I've never had a conversation where I'm like, I won't talk to you because you're of that party, or I'm of that party, so I'm just gonna stick to my talking points and support only what my party says.

484
01:23:11.940 --> 01:23:13.540
David Heayn-Menendez: I I I.

485
01:23:13.980 --> 01:23:21.430
David Heayn-Menendez: even as an elected official, I don't do that. I mean, that's not… that's not what I'm here for, and I don't think anybody that's in public health is going to.

486
01:23:21.570 --> 01:23:24.750
David Heayn-Menendez: Live and die on the hill of partisanship, and I…

487
01:23:24.950 --> 01:23:33.619
David Heayn-Menendez: You know, it's all about the people that we're trying to support, and these are essentially good policies that are going to benefit people.

488
01:23:34.650 --> 01:23:46.699
Gnora Mahs: Yeah, exactly, I think in my own personal experience, talking to my friends and neighbors about things that they that really matter to them or what's affecting their everyday life, it's oftentimes stop signs or

489
01:23:46.760 --> 01:23:53.100
Gnora Mahs: Karen Stiner, or holes in the road right that are that are rubbing up against our cars when we're driving down the street, or

490
01:23:53.150 --> 01:24:12.800
Gnora Mahs: Sarah Horn, the city's ineffective address of snow, right? It's those things that, to me, are very nonpartisan, and when we can have conversations about how government shapes those decisions, I think we can make real headway, and I love both of your examples in talking about that kind of change and reaching across, kind of, varying perspectives.

491
01:24:13.070 --> 01:24:29.579
Gnora Mahs: The last question we're going to get to are kind of two thought-provoking questions in one. How do you get both sides of the aisle to agree on putting into practice what would be beneficial to all populations within a local health department's reach?

492
01:24:29.710 --> 01:24:47.939
Gnora Mahs: Additionally, how do you get people to make change happen instead of just holding meetings to look productive? And you can answer these together or separately, but it definitely seems the audience is interested in how to put practice into action, or do things that go beyond the surface.

493
01:24:51.020 --> 01:24:54.290
Ben Ruxin - A Healthier Democracy: Well, I can start quickly. One…

494
01:24:54.470 --> 01:24:58.789
Ben Ruxin - A Healthier Democracy: One thing that comes to mind, especially on the second part of that question of how to get

495
01:24:59.030 --> 01:25:02.090
Ben Ruxin - A Healthier Democracy: Change to… to happen is…

496
01:25:02.620 --> 01:25:05.400
Ben Ruxin - A Healthier Democracy: Kind of trying to start with,

497
01:25:06.110 --> 01:25:15.250
Ben Ruxin - A Healthier Democracy: Addressing the cynicism that people often enter situations with because of how they've been treated in the past.

498
01:25:15.800 --> 01:25:27.759
Ben Ruxin - A Healthier Democracy: I still remember where I was sitting when I first read that $140 billion stat, that $140 billion of benefits go, unclaimed each year.

499
01:25:27.810 --> 01:25:43.720
Ben Ruxin - A Healthier Democracy: And if you… if you compare that to benefits that are designed for high-income people, like mortgage interest deduction, virtually zero of those benefits go… go unclaimed. And I think when you can start showing people that there are ways to

500
01:25:44.750 --> 01:25:52.319
Ben Ruxin - A Healthier Democracy: To benefit from these systems, even though they're imperfect, and you actually can put the impact in front of them.

501
01:25:52.580 --> 01:26:11.449
Ben Ruxin - A Healthier Democracy: then it becomes easier to bring people to the table for bigger asks, like participating, not just in voting, but in Civic Participation more broadly, and some of the conversations that, you kind of allude to in that, in that question. So, that'd be, I think, one part of the answer, but I'm sure, some of the others on the panel might be able to kind of

502
01:26:11.600 --> 01:26:16.479
Ben Ruxin - A Healthier Democracy: carry that ball forward a little bit. So I'll I'll open up the floor, too.

503
01:26:18.840 --> 01:26:21.989
Aysha Pamukcu: Thanks, Ben. I really agree. I think.

504
01:26:22.610 --> 01:26:39.700
Aysha Pamukcu: Well, I try to take a step back and remember, people don't have relationships with institutions, and they don't have relationships with political parties, they have relationships with people, right? So there's people within any number of these institutions. And so, in my work at the San Francisco Foundation.

505
01:26:39.770 --> 01:26:51.680
Aysha Pamukcu: We do what we call an inside-outside strategy to move policy, where we are setting up durable and trusted relationships between people who are outside of government and people who are insiders.

506
01:26:51.700 --> 01:27:00.930
Aysha Pamukcu: And try to build the trust and the communication, ahead of time, ahead of crisis, and ahead of the vote.

507
01:27:00.930 --> 01:27:12.209
Aysha Pamukcu: Because a lot of times, by the time, right, David will know this well, by the time you reach the dais, a lot of times it's too late, right? Your decision makers are prepped, informed, and largely have, you know, decided the course.

508
01:27:12.210 --> 01:27:26.119
Aysha Pamukcu: And so, if you have channels that exist before you reach that voting point where people are communicating and are building trust across institutions, then you stand a lot better chance of having a community-informed and community-owned decision.

509
01:27:28.080 --> 01:27:29.290
Gnora Mahs: Amazing.

510
01:27:30.010 --> 01:27:33.529
Gnora Mahs: Thank you all for sharing your perspectives and your thoughts.

511
01:27:33.970 --> 01:27:45.979
Gnora Mahs: We always want to give our guests the final word. So Ben Aisha David, is there anything we didn't discuss that you want to share, or anything we did discuss that you want to go into greater detail.

512
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Aysha Pamukcu: Well, I heard people clamoring for practical pieces, so one thing I'll say is this.

513
01:27:56.350 --> 01:28:03.620
Aysha Pamukcu: It can be very tempting as communicators to try and… Talk about what our ideal.

514
01:28:04.080 --> 01:28:18.380
Aysha Pamukcu: public health vision is, but as a practical example, we are running a regional measure in the Bay Area in California, a transit measure to save our transit agencies from a fiscal cliff.

515
01:28:18.550 --> 01:28:36.950
Aysha Pamukcu: And we are tempted to be a transit-oriented development, and, you know, climate, and all of these amazing public health benefits, but you know what's really moving people? Speaking of the day-to-day traffic. Images of traffic, and how bad it could be without our public transit agencies, and how much better it is.

516
01:28:36.950 --> 01:28:49.980
Aysha Pamukcu: when we keep all those extra cars off the road. And so I think that's a messaging example of we hold our values, we hold our knowledge, but we meet people where they are, in terms of what they're seeing and what moves them on policy and issues.

517
01:28:52.880 --> 01:28:56.340
David Heayn-Menendez: I think, I just want to speak a little bit more to the last question of…

518
01:28:57.010 --> 01:29:03.539
David Heayn-Menendez: People are not nearly as far apart on… Everyday common sense things as.

519
01:29:03.770 --> 01:29:09.180
David Heayn-Menendez: Partisanship and political discourse makes it seem, because the role of…

520
01:29:10.030 --> 01:29:22.010
David Heayn-Menendez: That level is to make oppositional kind of claims that they aren't doing the thing we are doing. We are doing this great work and they're failing and, you know, it's getting across the line.

521
01:29:22.370 --> 01:29:29.569
David Heayn-Menendez: But on the vast majority of issues that I work on, which is really across a broad spectrum.

522
01:29:29.940 --> 01:29:31.609
David Heayn-Menendez: People are in agreement.

523
01:29:32.090 --> 01:29:37.890
David Heayn-Menendez: But the people in power don't necessarily respond effectively to that. And I think that that's.

524
01:29:38.090 --> 01:29:48.790
David Heayn-Menendez: Either because exactly what Aysha just said is like, they've already had all the meetings with all of those others who influenced them before the vote, but not the broader public.

525
01:29:49.080 --> 01:29:54.740
David Heayn-Menendez: Some of that's a time constraint, some of that's the interest of the elected official or otherwise.

526
01:29:56.400 --> 01:30:05.280
David Heayn-Menendez: But if you can get those relationships in advance, if you can maintain them… I spent yesterday, I had many meetings, and we never asked them for anything.

527
01:30:05.530 --> 01:30:07.410
David Heayn-Menendez: We were building relationships.

528
01:30:07.560 --> 01:30:20.620
David Heayn-Menendez: We were talking to them about the work that we're doing and getting their thoughts on it and answering their questions. That's where the conversation and the relationship starts. Because as Aisha said, like it starts with the relationship, not with anything else.

529
01:30:20.820 --> 01:30:23.159
David Heayn-Menendez: And the second thing I'll just say is…

530
01:30:23.470 --> 01:30:34.130
David Heayn-Menendez: Something I said in my presentation, which is we as elected officials actually don't know a lot of things because we can't be an expert in everything, and we don't know the path always, and we need people to help us.

531
01:30:34.380 --> 01:30:39.790
David Heayn-Menendez: Right, so if you can be that person that can be trusted and effective.

532
01:30:39.910 --> 01:30:44.199
David Heayn-Menendez: Or you can find those that are and support them in their work. That.

533
01:30:44.330 --> 01:30:48.789
David Heayn-Menendez: Relationship building needs to start with that level of.

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David Heayn-Menendez: Having that conversation, giving that advice, building it, moving it forward so that when that vote comes, when that proposal comes, that they've already kind of embedded within their psyche that they are going to move in the direction that is what 80, 90% of the population might actually want, not what maybe…

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David Heayn-Menendez: Of special interest, or others might actually have tried to influence them on.

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Ben Ruxin - A Healthier Democracy: I know we're at time, so I'll be brief. Every interaction that you have is an opportunity to talk about civic engagement in some way, and that does not mean that you need to be an expert. It just means that you have to

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Ben Ruxin - A Healthier Democracy: Have your own, have your own spiel, have your own kind of 30-second version of why it matters, keep it local, keep it tangible, and people will trust you.

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Gnora Mahs: Amazing. Thank you so much, Ben, Aysha, and David, for the inspiring conversation, and also thank you to our ASL interpreters for keeping this conversation going, for folks who can't hear us.

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Gnora Mahs: I'm especially grateful to all of you for showing up and asking such insightful questions. We're excited to continue hosting this conversation space for you. You can find the latest public health messaging and other communications resources on the PHCC website, publichealthcollaborative.org.

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Gnora Mahs: Sarah Horn, and on PHCC's LinkedIn. You can also download and customize Get Out the Vote social media graphics that help make the connection between civic engagement and public health.

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Gnora Mahs: Right after this event, you'll receive a short survey about today's conversation in a pop-up Zoom. Please share your feedback and let us know who you'd like us to talk to next. A recording of this event, along with related resources, links.

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Gnora Mahs: Samantha Bromberg, will be available on our website soon. Thank you again, and see you soon.