Developing Non-Stigmatizing Communications Messages for Cdc's First National Report on the Health Risk Behaviors of Lesbian, Gay, and Bisexual High School Students

Background: Stigma is a mark of shame or discredit. In public health, stigma can cause negative health consequences in populations. Stigmatized people include those living with mental illness, HIV infection, sexually transmitted and other infectious diseases, or people that do not identify as heterosexual or cisgender. Health research has linked stigma to the limitation of health resources, a lack of supportive social relationships or connections, negative psychological responses, and exposure to more stressful environments – all factors that can contribute to negative health outcomes. For these reasons, health communicators should avoid further stigmatizing vulnerable populations when promoting surveillance findings. CDC communicators faced this challenge in the summer of 2016 when planning the release of the first-ever national data on the health risk behaviors of lesbian, gay, and bisexual youth.

Program background:  Findings from CDC’s Youth Risk Behavior Surveillance System (YRBSS) included critical information about disparities in the majority of violence-, sexual-, alcohol-, and drug-related health risks affecting lesbian, gay, and bisexual high school youth. However, because significant media attention to the topic was expected, CDC communicators considered the risk that media coverage could increase existing stigma on sexual minority youth that could increase the risk of negative health outcomes – including suicidal behaviors. In order to promote actions supported by the new data in a way that would benefit public health without further stigmatizing lesbian, gay, and bisexual youth, CDC staff explored the likely causes and solutions to the key risk factors as part of a workgroup composed of subject matter experts (SMEs), communicators, policy analysts, and leadership across multiple divisions and centers within CDC. Information gathered from communications-led exploratory sessions with SMEs was used to develop messages that were reviewed and finalized with input from the workgroup. The resulting messages were integrated into a number of external materials, highlighting the key findings of the data and providing further context on the possible causes of and solutions to the health disparities.

Evaluation Methods and Results:  A content analysis of news media coverage found 146 unique media stories about the new data, with a potential audience reach of more than 941 million people. Message analysis found that about 97 percent of news media stories featured at least one of the pre- release topline messages developed by CDC to highlight the important data, but also avoid stigma. Social media efforts on Twitter resulted in a Twitter reach of about 2.9 million impressions from 812 mentions.

Conclusions:  The release of these data was a successful communications effort resulting in mostly non-stigmatizing media coverage and productive public conversations about the need to address these important public health problems. As a result, potentially harmful media coverage blaming these youth, or making such health outcomes seem inevitable, was avoided.

Implications for research and/or practice:  Taking the time upfront to understand the science behind the data and carefully crafting messages that avoid stigmatizing vulnerable populations are critical steps to communicate important public health messages.