An Introduction to the 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 is organized into five domains, each representing a broad demographic category, such as race and ethnicity, or age and life-stage. Multiple diverse groups are nested under each domain.
- Race, Ethnicity and Language Groups:
- Race, ethnicity, and/or language groups describe populations of people who share common racial or ethnic demographics, ancestry, nations of origin, Indigeneity, cultures, and/or languages. People in these groups may experience inequities due to systemic racism, cultural exclusion, or language access.
- Gender and Orientation Groups:
- Gender and orientation groups describe populations of people who share common gender identities, and/or sexual or romantic orientations. People in these groups may experience inequities rooted in sexism, homophobia, transphobia, or other forms of discrimination.
- Age and Life-Stage Groups:
- Age and life-stage groups describe populations of people who are of similar ages and/or stages in their lives, such as children, adolescents, retired adults, or older adults. People in these groups may share unique characteristics, experience distinct circumstances and/or require specific considerations to ensure equity—for example, children with limited decision-making power over their health, young adults navigating transitions, or older adults living on fixed incomes.
- Socioeconomic and Legal Status Groups:
- Socioeconomic and legal status groups describe populations differentiated by factors such as income, wealth, education, employment, housing status, immigration status, or involvement with the justice system. People in these groups may experience inequities that are shaped by the social and legal conditions of their lives–for example people who are housing insecure, undocumented immigrants, and people who are disenfranchised due to a felony conviction.
- Health, Mental Health, Disability, Neurodiversity Groups:
- Health, mental health, disability, and neurodiversity groups describe populations of people living with physical or mental health conditions, disabilities, or neurological differences. People in these groups may experience inequities due to accessibility, stigma, physical capabilities, and varying care needs.
The Priority Population framework gives us language and structure for:
- Understanding and considering differences, disparities, and inequities in health outcomes, health status, and access to the vital conditions;
- Centering people and their lived experience, focusing on co-designing strategies and implementing together; and
- Advancing tailored, equity-driven approaches.
Understanding Disparities and Inequities
Disparities are differences in health outcomes and health status between groups, and inequities are unfair, often avoidable differences in access to the vital conditions for health and well-being—often due to systemic barriers that prevent certain groups from achieving their full potential. Disparities and inequities vary across places and populations. Understanding populations that are at increased risk for a particular negative exposure or disproportionately impacted by a certain health issue helps stewards more effectively and efficiently advance change.
The Priority Populations framework provides a structure through which to consider population groups facing inequities and experiencing disparities—who may be disproportionately affected by an issue, structurally disadvantaged or excluded, and who could especially benefit from community improvement efforts.
Informing Health Improvement Efforts
Tailoring interventions to a community’s specific needs and assets is essential for improving outcomes and advancing equity. The Priority Populations Framework offers a structured way to explore community needs and identify how different groups, for example across race and ethnicity, gender identity, age, or life-stage, are affected by an issue. Recognizing differences allows those leading change to shape approaches that are culturally relevant, responsive to unique barriers, and grounded in community strengths. By understanding who is impacted, how they are impacted, and engaging their leadership in co-designing solutions, improvement efforts become more effective, relevant, and sustainable.
Co-Creating New Legacies of Equity and Inclusion
Legacies of discrimination and oppression are at the root of existing disparities and inequities. Transforming these legacies to advance equity and inclusion requires changing course by shifting power to communities and centering their leadership. The Priority Populations framework offers a lens to identify communities that should be co-leading change. By fostering belonging and civic muscle—through co-designing solutions, participatory decision-making, and co-leadership with those most affected—we can create pathways where equity is both the outcome and the process. The most effective and sustainable solutions often come from those closest to the issues.
The Priority Populations Framework advances equity and inclusion by identifying groups with prioritized needs. It helps us understand whose experiences should guide improvement efforts, who should co-design and co-lead solutions, and for whom approaches must be tailored to address disparities and improve health.
Using the Framework
Getting started with this framework is as easy as considering the domains with respect to health and well-being issues in your community. This might involve disaggregating or looking at disaggregated community health data, and reflecting on observed disparities and how to decrease them. Researching what has worked elsewhere and how others have approached challenges is helpful. Unpacking learnings through community conversations and other engagement activities adds context, insight, and perspective, ground truths the learnings, and brings stewards together to advance an equity agenda.
Putting the Framework into Practice for Birth Outcomes
Birth outcomes in the United States remain among the poorest of any high-income nation, with stark inequities across racial, socioeconomic, and age groups. Many communities are mobilizing to change this, working to ensure that every parent and child has the conditions needed for a healthy start. The Priority Populations Framework helps changemakers focus on groups that are disproportionately impacted by providing a structure for identifying these groups, elevating their experiences, promoting their engagement and leadership, and tailoring interventions to their needs.
For example, Black women, adolescents under the age 20, uninsured women, and women with certain health or mental health conditions face greater risks of poor birth outcomes. By centering their voices and lived experiences, changemakers can better understand the factors driving disparities—things like racism in healthcare settings, weight stigma, and lack of access to perinatal care. Insights gained can drive community organizing and system improvements—for example, expanding access to community-based doulas, expanding cultural competency training for providers, and strengthening peer support networks. By prioritizing the needs and experiences of those most impacted, changemakers can implement tailored, equity-centered strategies that improve birth outcomes and advance maternal health equity for priority populations.