Meeting Crisis with Community

When COVID-19 vaccines first became available, Southern California Pacific Islander Community Response team (SoCal PICRT) launched a campaign that filled critical gaps left by mainstream public health messaging. Rather than relying on  press releases or canned messaging, they grounded their approach in cultural care, community trust and self-determination.

Their strategy combined one-on-one conversations with targeted social media outreach. They co-created content in native languages, featured community members in graphics and videos, and emphasized a shared duty: “It’s up to us to keep us safe.” This campaign wasn't just effective—it was relational, emotionally resonant, and rooted in the narrative that health is a collective project. 

Stories like this challenge a dominant idea that top-down systems alone can fix what’s broken in healthcare. Real solutions are alive in our communities. It’s up to us to pay attention to them. 

This blog is for narrative strategists, healthcare advocates, and organizers  to reimagine how we talk about and advance health equity. You'll find narrative tools and real-world stories The California Endowment grantees who are reframing healthcare—from scarcity and exclusion to abundance, solidarity, and power.

Institutions Are Failing, but Communities Are Rising

In moments of crisis, an important question emerges: Who is caring for our most vulnerable communities?  

The U.S. healthcare is at a breaking point and undeniably strained. A 2023 report from The Commonwealth Fund shows that Americans are living shorter, less healthy lives. This decline is shaped by compounding harsh realities: rising healthcare costs, unequal access to care due to being underinsured or uninsured, workforce shortages, and worker burnout. An even bleaker landscape awaits if plans to cut Medicaid and SNAP benefits by a federal government veering toward authoritarianism succeed.

Community Solutions in Action

The stories shared here were drawn from narrative landscape research conducted for The California Endowment (TCE), a foundation dedicated to expanding access to affordable quality care.  We surveyed TCE grantees across California about grantees working in California focused on racial equity, health reform, and healthcare access. Our research revealed how systemic discrimination– xenophobia, ableism, and racism–create significant barriers to care.

Yet our findings uncovered something more powerful: communities are stepping in where institutions fall short with mutual aid, community health organizations, and reclaiming narrative agency; these communities are fostering solutions anchored in hope, imagination, resilience, and solidarity. Their existence is resistance to harmful narratives of dehumanization, othering, and scarcity that shape the conversation about who deserves care—and how it should be delivered.

Examples of Community-Focused Healthcare Solutions

Frontline organizations and mutual aid networks are leading efforts to meet urgent needs of communities excluded from access to traditional healthcare.

• The Health4All coalition won access to Medi-Cal in 2024 for anyone in California regardless of immigration status. This coalition’s goal was to expand access to preventative healthcare for undocumented adults in California.

  
  

• The California Black Women’s Project invests in the health and wellness of Black women and girls by training women to become engaged in shifting cultural norms around health and to become health advocates in their community to address health disparities

  
  

• California School Based Health Alliance works with school districts and health partners to increase the equality of School-based health centers that students can access comprehensive health services during the day on their school campuses

  
  

Communities don’t just innovate when systems fail—they uplift the idea that care should and can be available to all through concrete action. 

Narrative Strategies for Shifting Healthcare Conversations

Community-led healthcare solutions were made possible because frontline organizations invested in storytelling that helped folks harness their power for the collective good. Below are three narratives they used to organize, mobilize, and expand access to care—tools that can support your work too.

Abundance

Abundance is always a helpful narrative to have in your toolbox. This is a mobilizing narrative. Use this when you need to shift people and audiences from scarcity towards a future where everyone is cared for, on a community and individual level.

Here’s what one immigrant and refugee rights advocate had to say about abundance:

“For pro migrant, pro immigrant communities to build a vision of what could be requires imagination. It requires people to kind of start from a place of abundance. It requires people to think from a place of hope. ”

Deservingness

Deservingness can show up as a helpful or harmful narrative, depending on context. 

Used strategically, these narratives present an opportunity for building cross movement solidarity. One narrative strategist working to expand access basic rights like health coverage to all in California saw positive engagement with messages that centered deservingness as helpful:

“Some of the most successful campaigns that I'm aware of have a framing of 'opportunity for all' or 'healthcare for all', 'driver's licenses for all' because when you start out with that, you pick apart why some people don't have access. It situates people into understanding that's not fair that some people are being excluded or eliminated, restricted or discriminated against."

Solidarity and Shared Struggles

Solidarity looks like communities supporting and empowering themselves and each other to lead and determine their own futures. This narrative is often deployed to express how communities share similarities despite their differences and how those similarities are opportunities to build power.  

One grassroots racial justice organizer we spoke to shared their experience with organizing to build multi-racial solidarity:

"Immigrants relate to the narrative of being undeserving. And honestly, I think there's a lot of parallels with Black communities. There's a lot of parallels with dealing [with] historical racism on who's more deserving and who's taking what jobs. And I think that those similarities allow for greater multi-racial solidarity and support of our kids in particular."

Communities are not waiting—they are organizing and reframing.

While the state of healthcare access wanes, the resilience of communities to use their power to support each other and advocate for change shines. Making healthcare more accessible is possible. This crisis is a call to action—and a reminder of future possibilities as said wisely from one policy and systems change strategist:

“In order to change the work that we do and transform the work that we do together to be more equitable, we actually have to change how we are with one another, how we're in relationship, and how we do the work, not just what we do, but how we do it, and how we're in community with one another.”

Which of these narratives could you apply in your own advocacy efforts for healthier communities and access to care? Let us know what works and what doesn’t and let’s build stronger frames together.