Some of the people who could benefit most from NHS services can also be among the hardest to reach through traditional healthcare communications. Differences in language, culture, health literacy, digital access, trust, socioeconomic circumstances and previous experiences of healthcare can all influence whether somebody sees a campaign, understands its relevance and feels confident enough to act.
For NHS organisations, this creates a challenge that goes well beyond media reach. A campaign can achieve significant impressions, generate strong engagement and deliver apparently successful marketing metrics while still failing to connect with the communities where the greatest health inequalities exist. Reaching underserved audiences therefore requires more than increasing campaign visibility; it requires a deeper understanding of why people aren’t currently engaging and what needs to change to make healthcare communications more relevant, accessible and trusted.
As NHS campaign specialists, we believe the strongest public health campaigns start by understanding the people behind the audience data. That means combining evidence with genuine community insight, using that understanding to shape strategy and creative development, and designing communications around the realities of people’s lives rather than expecting audiences to adapt to the structures of healthcare organisations.
Start by understanding why an audience is underserved
The term ‘underserved’ can cover an enormous range of people and circumstances. It might refer to communities experiencing socioeconomic disadvantage, ethnic minority groups, people living with disabilities, those with lower levels of health literacy, people whose first language isn’t English, digitally excluded audiences, rural communities or individuals who have historically had lower levels of engagement with particular healthcare services.
Those groups shouldn’t be treated as a single audience. Even within apparently well-defined communities, attitudes, experiences and behaviours can vary significantly. Geography, age, family structure, cultural background, employment, education and previous interactions with healthcare can all influence how somebody responds to a health message.
The first task for an NHS campaign should therefore be to understand what is actually creating the barrier. Is awareness low? Is the service difficult to access? Is the language confusing? Is there stigma surrounding the subject? Do people distrust the organisation delivering the message? Are practical factors such as working hours, transport or childcare preventing action? Until those barriers are understood, increasing the volume of communications may simply mean saying the wrong thing more often.
Community insight should shape the campaign, not validate it
Audience research is most valuable when it happens early enough to change the strategy. Too often, organisations develop the broad campaign proposition internally and then use research to test whether audiences understand or respond positively to it. While that can identify problems, it misses the bigger opportunity to allow community insight to influence the campaign from the outset.
Quantitative data can help identify where inequalities exist and which groups are engaging less frequently with particular services, but data alone rarely explains why. Qualitative research, conversations with community organisations, frontline healthcare professionals, local leaders and people with lived experience can uncover the motivations, concerns and practical realities sitting behind the numbers.
This requires organisations to listen with an open mind. Research may reveal that assumptions about an audience are wrong or that the barrier has little to do with awareness. As we’ve explored previously when considering the relationship between campaigns, media and public opinion in our article on campaign influence and freedom of speech in the media, communications don’t operate in isolation. People interpret messages through the context of their communities, experiences, values and the wider information environment around them. Understanding that context is particularly important when healthcare organisations are trying to engage people who may already feel disconnected from traditional institutions.
The objective shouldn’t be to research an audience simply so a campaign can claim to be evidence-led. Insight needs to have permission to change the strategy, message, creative execution, channel plan and sometimes even the way the service itself is presented.
Move beyond demographic targeting
Demographic data provides a useful starting point, but it rarely explains behaviour on its own. Two people of the same age, ethnicity and postcode can have very different attitudes towards their health, the NHS and a particular service.
More useful audience segmentation often comes from combining demographic understanding with attitudes, motivations, barriers and behaviours. One audience might already recognise the importance of a health intervention but struggle to access it, while another may have easy access but see little personal relevance. A third may actively avoid engagement because of fear or distrust.
Each requires a different communications response. The first may need practical information and easier routes to access, the second a stronger explanation of personal relevance, and the third reassurance from people or organisations they already trust. Treating all three groups as a single demographic audience risks creating a campaign that is technically targeted but behaviourally generic.
Effective NHS campaigns therefore need to move beyond identifying who isn’t engaging and understand why. That’s where meaningful audience strategy begins.
Build trust before asking for action
Trust is one of the most important factors in healthcare communication, particularly among communities that may have experienced inequality, discrimination or poor outcomes from healthcare and other public institutions.
A recognisable NHS identity can provide considerable reassurance, but organisational authority doesn’t automatically translate into personal trust. For some audiences, messages may be more credible when they are supported or delivered by people and organisations already embedded within the community.
Community groups, charities, faith organisations, local healthcare professionals, schools, employers, advocates and people with lived experience can all play an important role. Their value isn’t simply that they provide another distribution channel. They can help shape the communication itself, identify language or imagery that may create unintended barriers and provide credibility that a centrally delivered campaign may struggle to achieve on its own.
Building those relationships before campaign launch also makes engagement more authentic. Community organisations should ideally be partners in understanding and solving the problem rather than simply being asked to distribute finished campaign materials.
Make relevance immediately clear
Healthcare campaigns compete for attention with everything else happening in people’s lives. For someone experiencing financial pressure, caring responsibilities, insecure employment or other immediate challenges, a preventative health message may understandably sit some way down their list of priorities.
Communications therefore need to make their relevance clear quickly. Generic messages about the importance of health may not be enough. Audiences need to understand why the subject matters to them, what action is being requested and what the practical consequences of taking – or not taking – that action could be.
That doesn’t mean relying on fear. Fear can sometimes attract attention, but if it leaves people feeling powerless or anxious it can also create avoidance. Effective creative work balances the seriousness of the healthcare issue with a sense that the recommended action is achievable and worthwhile.
Personal relevance, clarity and a realistic next step can be far more powerful than simply making the message louder.
Language is about more than translation
For audiences whose first language isn’t English, translation may be essential, but effective communication requires more than converting the same words into another language.
Messages need to make sense culturally as well as linguistically. Certain health concepts, symptoms or services may be understood differently between communities, while assumptions that feel completely normal within one cultural context may feel unfamiliar or inappropriate within another.
Translation should therefore be considered as part of audience strategy rather than as a production task at the end of the process. Where possible, translated or adapted materials should be reviewed by people who understand both the language and the community context.
The same principle applies to health literacy. Clear, accessible copywriting benefits almost everybody, not simply audiences identified as having lower literacy levels. Shorter sentences, clear explanations, logical information hierarchies and direct calls to action can make healthcare information easier to navigate without compromising clinical accuracy.
Representation needs to feel authentic
People are more likely to recognise the relevance of a campaign when they can see themselves and their experiences reflected within it. Representation in healthcare marketing therefore matters, but simply including a diverse range of people in campaign imagery isn’t enough.
Audiences quickly recognise when representation feels tokenistic or disconnected from reality. Locations, language, clothing, family dynamics, situations and the overall tone of creative work all contribute to whether something feels genuinely relevant.
Audience insight should help inform those choices. Rather than beginning with a predetermined creative idea and adapting it to appear more inclusive, the lived experiences of the intended audience can become part of the creative development process itself.
Done well, inclusion isn’t something added to the campaign. It’s embedded in the thinking that created it.
Choose channels around behaviour, not convention
Reaching underserved audiences may require a different channel mix from a traditional NHS campaign. Digital marketing and social media can provide highly targeted reach, but relying too heavily on digital communications risks excluding people with limited access, lower digital confidence or different media behaviours.
Outdoor advertising, community publications, local radio, direct mail, pharmacies, GP surgeries, community centres, places of worship, schools, workplaces and local events can all have a role depending on the audience and objective. The strongest campaigns don’t begin with a predetermined list of channels; they begin by understanding where the audience already spends time, seeks information and places trust.
Channel planning should also consider the journey after somebody sees the campaign. A QR code is only useful if the audience is comfortable using one. A website is only effective if it is accessible and easy to navigate. A telephone number may provide a better route for some groups, while others may respond better to face-to-face engagement through trusted community organisations.
The objective is not simply to reach people. It is to create a realistic route from awareness to action.
Remove practical barriers wherever possible
Marketing cannot solve every barrier to healthcare access. However, communications teams need to understand when the action being promoted is unnecessarily difficult to complete.
If a campaign successfully convinces somebody to seek help but the next stage involves a confusing website, unclear eligibility criteria, limited appointment information or a complicated referral process, much of the value created by the campaign can quickly be lost.
This is why NHS campaign planning benefits from looking beyond the advertising itself and considering the complete audience journey. Understanding where people disengage can identify opportunities to simplify instructions, improve digital experiences, explain processes more clearly or provide alternative routes into a service.
Sometimes the most effective piece of healthcare marketing isn’t another campaign message. It’s removing the obstacle that prevented somebody from acting on the message they already received.
Measure who is responding, not only how many
Overall campaign performance can disguise significant differences between audiences. An initiative might deliver impressive reach or response figures while engagement remains disproportionately low among the communities it was specifically intended to support.
Measurement and reporting should therefore look beyond aggregate results wherever appropriate and possible. Understanding how awareness, engagement and action vary between locations or audience groups can help identify whether a campaign is genuinely contributing to reducing inequality rather than simply generating activity.
Qualitative feedback can be valuable alongside quantitative performance data. Conversations with community partners, healthcare professionals and audiences can reveal why certain messages or channels worked and where barriers remain. That learning can then feed into optimisation and future campaign development.
For NHS organisations, the ambition should not simply be to reach the greatest possible number of people. It should be to improve the ability to reach and engage the people who most need the service or intervention.
From audience reach to health impact
Reaching underserved communities effectively requires NHS marketing teams to think beyond traditional definitions of campaign reach. Visibility matters, but being seen isn’t the same as being understood, trusted or acted upon.
The strongest NHS health campaigns begin with genuine audience understanding and use that insight to influence everything that follows: the strategy, proposition, language, creative execution, partnerships, channels, patient journey and measurement framework. They recognise that communities are not simply media audiences to be targeted but groups of people with different experiences, priorities and relationships with healthcare.
For organisations looking to reduce health inequalities, that distinction is critical. Better communication alone cannot remove every structural or practical barrier to healthcare, but it can help make services easier to understand, more relevant and more accessible. It can build confidence, challenge misconceptions and create clearer routes towards appropriate action.
Ultimately, the success of an NHS campaign shouldn’t simply be measured by how widely the message travelled. It should be judged by whether it reached the people who needed it, and helped more of them take the next step.
Mobas works with NHS and healthcare organisations to combine audience insight, strategy, creative communications, digital experiences and campaign activation to reach diverse communities and encourage meaningful action.
Discover more about our approach to NHS and healthcare marketing or talk to the Mobas team about your next public health or healthcare campaign.
