Priority Populations: Racial, Ethnic, and Cultural Groups
Priority Populations Framework
At Community Commons, we use the term “priority populations” to describe population groups of focus—or priorities—in community improvement work. These groups represent diverse communities with different demographics, identities, statuses, and lived experiences that are—or ought to be—prioritized in advancing equitable well-being.
We developed the Priority Populations Framework as a tool to consider groups who may be disproportionately affected by an issue and to help identify specific groups to engage in community improvement work.
The Framework holds that:
- Priority populations are those who should be included in decision-making about health and well-being policies, programs, and interventions.
- Priority populations are often disproportionately affected by health or well-being issues.
- Working with priority populations is about reducing disparities and centering power, lived experience, and solutions that come from within those communities.
You can read more in “An Introduction to the Priority Populations Framework” on Community Commons.
About Racial, Ethnic, and Cultural Groups
Racial, ethnic, and cultural groups include communities defined by shared ancestry, heritage, language, traditions, and cultural practices. Examples in the U.S. include Black or African American, Hispanic or Latino, American Indian and Alaska Native, Asian American, Native Hawaiian and other Pacific Islander, and multiracial populations. Within each of these broad categories are distinct cultural groups with unique histories and experiences.
These identities shape how people experience health, opportunity, and community. They are a source of resilience and belonging, yet they are also the lines along which inequities often appear most sharply. Life expectancy, infant mortality, and chronic disease rates vary significantly by race and ethnicity. For example, Black Americans are nearly twice as likely as white Americans to die from heart disease before age 65, while American Indian and Alaska Native communities experience some of the nation’s highest rates of diabetes.
These disparities are not simply the result of individual choices. They stem from how systems treat people of different races, ethnicities, and cultures—shaping where people live, the resources available to them, and the opportunities they can access.
Definition / Description
Priority populations defined by race, ethnicity, and culture encompass groups whose identities influence how they interact with health care, education, housing, employment, and other systems. When bias or exclusion is present, disparities in outcomes emerge. Recognizing these groups as priorities ensures that public health and equity strategies focus on addressing systemic barriers, while also valuing the leadership, cultural knowledge, and solutions that come from within these communities.
Applying an Equity Lens
Why are these groups priorities?
Racial, ethnic, and cultural groups are priorities because health and well-being outcomes in the United States are not distributed evenly across populations. For example, the maternal mortality rate for Black women is more than 2.5 times higher than that of white women, even after controlling for income and education. Hispanic adults are less likely to have health insurance than White adults, limiting access to timely preventive care. Native Hawaiian and Pacific Islander populations experienced COVID-19 mortality rates nearly three times higher than White populations at the height of the pandemic. These are not isolated statistics; they demonstrate systematic inequities tied to racial and ethnic identity.
How is health influenced by racial, ethnic, and cultural identities?
Health is shaped not only by clinical care but by the conditions in which people live, work, and learn. Racial and ethnic identities influence exposure to conditions–like racist policies and culturally incompetent practices–that drive neighborhood segregation, differential access to education and employment, unequal treatment within health systems, and other inequities. Discrimination itself is a health determinant: the chronic stress associated with racism and bias is linked to hypertension, preterm birth, and poorer mental health outcomes.
What can we learn by examining inequities and disparities?
Examining outcomes by race and ethnicity brings underlying differences into focus. Disparities are measurable differences in health status and outcomes across groups, while inequities refer to those differences that are avoidable, unjust, and rooted in structural conditions. Without careful analysis, inequities can remain hidden within aggregate data, masking the ways social, economic, and historical forces shape community well-being. Taking this broader lens not only shows where interventions are most needed, but also builds the foundation for understanding and assessing solutions– whether through policy change, community-led movements, or practice-based innovations such as Indigenous food sovereignty initiatives or Black maternal health collectives that have demonstrated measurable improvements in outcomes.
Examining Legacies
People disproportionately experience poor health and well-being outcomes along the lines of race, ethnicity, and other cultural identities because of historical and ongoing systems of exclusion. Legacies of discrimination are not abstract—they are embedded in housing, education, employment, and health care systems and continue to shape outcomes today.
In housing, redlining policies of the 1930s denied Black and immigrant families access to mortgages and homeownership, concentrating poverty in certain neighborhoods. Decades later, these same neighborhoods often have fewer health care facilities, lower-quality schools, and higher exposure to environmental hazards, all of which contribute to poorer health outcomes.
In health care, the legacy of segregated hospitals and unequal access to medical education left many communities without adequate providers or facilities. This history still influences patterns of provider shortages in predominantly Black, Latino, and Native communities, and helps explain persistent gaps in access to preventive services.
In employment, exclusionary labor laws and discriminatory hiring practices kept many workers of color in low-wage, high-risk jobs without protections or benefits. These conditions continue today in industries such as agriculture, domestic work, and service, where workers are more likely to experience occupational hazards and lack access to paid leave or health insurance.
These are just a few examples of how past discrimination produces present inequities. Examining these legacies is essential for public health because it shifts the focus from individual behavior to systemic causes. It underscores that disparities are not inevitable, but the product of decisions and structures that can—and must—be changed.
Co-Leading with Community
Engaging leadership begins with recognizing that people most affected by inequities are experts in their own experiences. Public health must move beyond consultation and toward genuine stakeholder engagement and power-sharing. This means creating structures where community representatives have decision-making authority, not just advisory roles. It involves funding community-based organizations to lead interventions, compensating residents for their time and expertise, and embedding culturally and linguistically appropriate approaches in program design. Partnerships must be sustained, not transactional, so that trust and accountability can be built over time.
Achieving equity requires structural change: redistributing resources, dismantling discriminatory policies, and holding systems accountable for outcomes. It also requires investment in the capacity of community leaders to shape policy, lead research, and direct services. Equity cannot be reached if solutions continue to be designed externally and imposed on communities. Instead, progress depends on elevating the leadership of Black, Indigenous, Latino, Asian American, Pacific Islander, immigrant, and other culturally defined groups, and ensuring their knowledge drives both strategy and implementation.
Public health has a responsibility to create the conditions for co-leadership: flexible funding, inclusive governance structures, transparent evaluation, and long-term commitment. When communities lead alongside institutions, strategies are more responsive, trusted, and sustainable—moving us closer to equitable well-being.
Featured Resources
Discover curated resources focused on racial, ethnic, and cultural groups as priority populations. These materials provide data, case studies, and strategies to help public health practitioners and community leaders understand inequities, examine structural drivers, and elevate community-led solutions.
Bearing the Burden: How racism-related stress hurts America’s black mothers and babies
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Brought to you by Community Commons
Published on 10/02/2018
Get Data for Your Community
Use the IP3 ASSESS Report below as a starting point for examining racial, ethnic, and cultural groups in your community. While this data can provide helpful baseline information, it should not be used on its own to determine priority populations. Identifying priorities requires looking beyond population size to include risk, disparities, and other contextual factors. The data provided here can support your efforts by offering measures of select racial, ethnic, and cultural groups as part of a broader assessment.
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