Transforming the Narrative on Taxes

Tips to Write a Letter to the Editor
Fact Sheet: Tax Policies Impact Health
Toolkits and More


Transforming the Narrative on Taxes


In the fall of 2017, Public Health Awakened members formed the Taxes Narrative Workgroup to start the long-term process of shifting the dominant public narrative about taxes in the US. Our goal is to shine a light on how our journey to health and equity is hastened when we pool our resources together for collective good.

What are public narratives? Public narratives are shared stories about how and why the world operates that shape public consciousness, including our collective values and senses of responsibility and possibility. Public narratives inform what policy change is possible.

The current public narratives depict us in a world of scarcity, where we don’t have enough resources to achieve what we want, where the government is considered corrupt or inefficient, and where “the middle class” is used as code to protect resources for White communities. These threads pit us against each other instead of uniting us to fully uphold health equity.

Elements of a Transformative Public Health Narrative about Taxes

A just and fair society provides everyone with an opportunity to live a long, healthy life. By building an inclusive society, we improve everyone’s health and ability to thrive along the way. The public health data are clear: we all do better when we all do better.

Our tax structure is a critical component of building an inclusive, healthy society. The tax system and our budgets are moral documents. The decisions we make about taxes make concrete what we value — they reflect who we are and who we want to be as a society.

High-quality public goods must be equally accessible to everyone. Taxes fight fires. Taxes educate our kids and prepare us for jobs. Taxes build our roads and bridges. Taxes sent us to the moon. Taxes protect our food and our water. Taxes heal our poor and elderly. When they are properly allocated, taxes build healthy communities.

We can move to a fair and inclusive society with a social compact that supports everyone’s health. We have the knowledge and resources to achieve this, but right now our collective resources are not shared appropriately.

We need to reimagine, reinvent, and transform our systems to create a better lot for future generations. This includes realigning the gross imbalance of wealth and ensuring all our policies and systems support everyone’s opportunity to thrive.

We have the knowledge, resources, and the power to change our tax system so that we all can all thrive. We need to get better at demanding policies that move us forward and, at the same time, correct structural inequities enshrined in past policy decisions.

Taxes and health equity — letter to the editor tips

Adapted from Berkeley Media Studies Group’s Tips for Writing Effective Letters to the Editor

Letters to the editor can signal community interest about a particular public health issue and send a message to policymakers. But what makes for a compelling letter, and how can advocates increase their chances of getting published?

To support public health advocates in writing effective letters to the editor on the importance of how taxes can advance health and equity, the Berkeley Media Studies Group (BMSG) and Public Health Awakened created this resource.

This resource includes:

  • General tips for writing effective letters to the editor
  • Specific tips on writing letters to the editor about the role of taxes to advance health and equity
  • A letter to the editor template about the importance of taxes to protect everyone’s health
  • Examples of framing taxes as a public good for health and equity

General tips for writing effective letters to the editor

Letters should be short and punchy, about 100 to 200 words, and if the subject matter is in response to a news article, it’s best to respond the same day the article is published. As with other media strategies, always keep your overall objective in mind. It can be tempting to respond with anger to an article or column “to set the record straight,” but will your response further your overall advocacy goal? What would you like readers, or your policy target, to do? What solutions would you like them to support as a result of reading your letter?

When writing a letter to the editor of a newspaper or magazine, keep the following tips in mind:

Respond quickly. If you read or see something you want to respond to, send your letter by email (or use the news site’s online form if they have one) the same day, or by the next day at the latest.

Mention your reason for writing, preferably in the first sentence. If you are responding directly to an article you’ve read in the publication, state the article headline and publication date. If you are commenting on a local current event, be specific about the issue or event.

Take a strong position. Editors look for fresh facts, honest statements of opinion, and creative takes on news. If you can, offer a compelling fact that shows the urgency or importance of your issue. Include a call to action.

Make sure to include your full name and contact information. You may be contacted to verify your identity before the letter is published.

Check with your organization before including any information about their work in the letter. Organizations will have different policies about how employees interact with the media, and it’s important to understand them before identifying yourself as an employee. You can always use more generic terms if you want to include info about yourself, such as, “As a public health worker/nurse/researcher/student, I’m concerned about …”

Look up the editorial policies for each outlet you submit to. Some have different word count restrictions or policies on how many letters they will accept from the same individual in a specific time period.

Don’t send the same letter to competing publications. Newspapers and magazines want to publish original content. Engaging your allies may be a way to have several different letters published that are worded differently but point to the same policy solution. Also, follow the news your target follows. Your choice of where to submit your letter should be a strategic one.

Tips for writing effective letters to the editor on taxes and health

Upcoming events will trigger news stories related to taxes — Tax Day on April 17, new legislation, anniversaries of key events, like the Boston Tea Party, government shutdowns, presidential speeches and tweets, Congressional decisions, political campaigns, disasters and emergencies, and budget shortfalls are just a few. There might also be positive stories on government-funded programs that you can link to taxes and health. You can also tie stories about public health issues to the need for taxes and a strong social safety net. For example, you could respond to articles about opioid use with a letter about how taxes fund education, job training, housing options, and more — all of which are needed to address opioid use. Use the tips below to take as many opportunities as you can to expand our public discussion about the relationship between taxes and health.

Start with a goal and stick to it. What do you want to achieve and who has the power to make that change? Are you concerned about federal, state, or local tax policy? Is there an upcoming decision you care about? Who will be making the decision and what do you want them to decide? Knowing what you want before you start writing will help you prioritize what info goes into the letter and what information you reserve for another time.

Limit the content to one or two key points. A letter to the editor is a concise statement or argument, not an in-depth analysis. Since letters typically respond to current news, think about how to piggyback from the article you are responding to and connect that to the overall message you want readers to get from your letter. Do you want to focus on how federal tax cuts will wipe out social supports needed for healthy communities? Do you want to illustrate that a program on the chopping block is effective at saving lives? Do you want to focus on how tax cuts will increase inequities? Or maybe you want to share a personal story from your unique public health perspective and relate it a broader policy. All of these are important, but you can only focus on one at a time, and even within each one, you can only make one or two points. You can always write multiple letters that take different viewpoints and submit them to different news outlets.

Remember your audience. Are you trying to reach a senator? City council members? Do you want their constituents to take action? Most likely, your audience will not be immersed in the world of public health. Use simple language and easy to understand data that resonates with those outside of the field of public health.

Focus on the solution. Our tendency is to spend the most time and space on the problem. Try to flip that emphasis and devote more of your letter to the solution.

State your values clearly. Why does this matter to you? In public health, our values include health but also interconnection or the idea that “we are in this together” versus “you’re own your own.” Research shows that people are proud to pay taxes because it helps them feel connected to others as a member of civic society — letters illustrating how our taxes improve the public’s health can build on those deeply held values, engage the base of people who care about this issue and, as the Haas Institute puts it, “widen the circle of human concern” among a growing number of people.

Use data, but explain them. Data and research should support your goal and key points. If you are focused on the need for social supports, use data on social supports. If you are focusing on taxes and health equity, use data and research focused on equity. One or two key facts will be enough. And just a reminder — while you should always use accurate data and research, you do not need to use citations for letters to the editor or op-eds. Instead, work the citation into the text (e.g., “According to the National Institutes of Health, …).

Act quickly. Be prepared by drafting letters ahead of time. Start writing now, and then when opportunities appear in the news, you will be ready to tailor your letters and send them right away. Use a portion of staff or coalition meetings for quickly writing and/or reviewing one another’s letters.

Portray government as part of the solution. There are clearly areas of our government that we need to improve and many community-based organizations and coalitions have important critiques of government. However, the government is an essential part of the public health system that can improve conditions for whole populations. If we talk about government only as part of the problem, it is hard to advocate for funding to improve our public health system and other sectors that impact health, like education and housing. Use your letter to remind people that taxes can improve health, lead to equity, and build on what’s working in government to support and increase the positive impacts.

Avoid otherizing language. For example, using terms like “them” or metaphors that indicate distance or gaps can be otherizing (e.g. “too many people are falling behind”). It can be easy to slip into language about the government or a non-profit helping “others.” Instead, use language that helps show interconnectedness and shared fates (e.g. “we can create a community where everyone can thrive.”).

Avoid the scarcity frame. While in public health it never seems like we have enough resources, the fact is that everyone in the United States could have housing, food, educational opportunities, safe places to play, and more if we allocated our resources differently. A scarcity frame makes this vision and opportunity invisible. Instead of arguing about how to split up a small pie, help people move toward thinking about how we can have a society that values, includes, and provides for everyone.

Avoid passive voice. When we use passive voice, it obscures who is (or should be!) taking action, whether it’s a positive action we support or a negative action that we want to stop. Passive voice can also add extra words that you don’t need in short letters. For example, instead of saying “a tax cut was passed” we can say “Congress cut taxes.”

Avoid elephant triggers. George Lakoff describes how once someone says “don’t think of the elephant,” all you can think about are elephants. An elephant trigger is when you repeat your opposition’s argument. This often happens when we focus on rebuttals. You have very little space in a letter to the editor — instead of rebutting the opposition, reframe the issue, speak about why it matters to you, and talk about taxes and health equity in your own language.

Repeat your favorite phrases. Some succinct phrases we like are:

  • Taxes are shared resources.
  • Taxes are simply a way to pool our resources so, together, we can accomplish together what is impossible to do alone. It took all of us to go to the moon or build the Golden Gate bridge. It takes all of us to maintain and build the community we can thrive in together.
  • Everyone pays taxes that help build healthy communities — when they work, through payroll taxes and income, and when they buy things, through sales and excise taxes.
  • Taxes are how we come together and invest in the things we need for strong and healthy communities.
  • Taxes fund our future — they help create schools and hospitals, keep our parks and libraries open, and ensure that our children have the opportunity to thrive.
  • People in the past paid taxes to build what we currently have — we have a responsibility to do the same for future generations.
  • When we invest in the public sphere through progressive taxation — or taxes where high-income earners pay a larger percentage than low-income earners — we create a more stable and just society, with more opportunities for everyone.

These phrases are adapted from the following sources: Berkeley Media Studies Group, the Center for Community Change, Demos, FrameWorks Institute, Opportunity Agenda, Tax Policy Center, and In These Times.

Activity: Letter to the editor

Here is a sample letter to the editor format to help you organize your ideas. Be creative, clear, opinionated, and succinct — and keep it under 200 words. After you draft your letter using the prompts below, you can revise it to put it in your voice and adapt it to the format of the outlet you are sending it to.

Newspaper name:
Newspaper address, fax or email:
Dear editor:

Yesterday, you reported that _____________________________________________


  • Some ideas:
    • Legislators are threatening to cut [X] program.
    • Another company that benefited from the tax cut eliminated [X number] of jobs.
    • Our county has seen a drastic increase in [health problem or risk factor, e.g., opioid use, cases of the flu, chlamydia, etc.].

This is [timely/important/ironic] because _________________________________


  • Some ideas:
    • It’s almost Tax Day, and the tax cuts for corporations and the wealthy that Trump and Congress pushed through could have supported this program.
    • Our county has reported worse health outcomes in numerous areas last year, and access to good jobs is a building block of healthy communities.
    • And yet as we near Tax Day, we are reminded that many of the very things that can help prevent [opioid use, other health issues, etc.] — good jobs, quality housing, educational opportunities — are under threat.

As a [nurse/public health worker/parent/teacher/physician/community member/voter] I see the direct impacts of this every day. For example, [add one data point, research finding, or story]


What people may not realize is how pooling our resources through taxes improves health for everyone in our community. When we do that, we ______________________________________________________________________


  • Some ideas:
    • … support the programs and institutions that build strong and healthy communities, and these cuts will harm all of us.
    • … have a community where everyone thrives, which is completely in our reach if our politicians stop making choices to benefit the few at the expense of the many.
    • … can prevent and treat drug use to create healthy, supportive communities.

One thing that could really make a difference is



  • Some ideas:
    • Ensuring that legislators do not cut this program, or other critical programs that create healthy communities for all.
    • If we fight back against the tax bill and put our country’s values first — fellowship to each other, cooperation for the greater good, and strength in standing together.
    • If our Congress puts communities before corporations and prevents further tax cuts that threaten our social fabric. Even better — we should be funding education, housing, and public health at higher levels than before!


Signature [Your name, address, email, and phone number so the outlet can contact you and verify you are the author]

Examples of framing taxes as a public good for health and equity


Fact Sheet: Tax Policies Impact Health

Updated March 2018

Social determinants and public policies drive most of our health

As public health professionals, we know our health is largely determined outside of the doctor’s office. The environmental and neighborhood conditions in which we live, like walkability, parks, access to healthy foods, and quality schools, and socio-economic factors like poverty and racism and other forms of discrimination drive the majority of our health.

Our tax structure and public policies can support — or undermine — public health and our collective well-being. Tax policies can help redistribute income to bring about more equitable societies and life chances for all, or they can exacerbate inequalities and undermine shared prosperity.

Income and wealth inequalities are the strongest determinants of our health

States and countries with greater inequity have worse health outcomes across multiple areas than more egalitarian places. Poverty is associated with worse health status and outcomes — higher rates of acute and chronic conditions including psychosocial problems, barriers to healthcare access, and higher rates of death and disease. Income inequality has also been associated with lower life expectancy, higher rates of infant and child mortality, shorter height, poor self-reported health, low birth weight, AIDS, depression, mental illness, and obesity.

We live in a time of deeply distorted wealth imbalances

Income and wealth inequality in the United States are increasing — the richest 1% have seen their share of national income roughly double since 1980, from 11% to 20% in 2014. The Trump Administration and Republican Congress passed a tax cut bill in December 2017 that massively redistributes wealth to the nation’s richest. It lowers federal tax rates at all income levels for 8 years — after which tax cuts for the middle class expire.

The 2017 Tax Cuts and Jobs Act is poised to have a huge impact on public health

This huge windfall for the rich adds $1.5 trillion to our federal deficit that will lead to draconian cuts in federal programs that benefit all of us. Cuts to non-military federal spending will be so severe that over the coming decade it will be less than half of its 2010 level. Many basic functions of government will suffer, with programs that benefit poor and working class families hit hardest.

  • More housing instability, and a likely increase in family homelessness – The cuts to the housing budget will take vouchers that make housing affordable away from 200,000 low-income households, including the elderly and people with disabilities, and eliminate HUD rental subsidies for people with rents that are too high for their income. If implemented, this could cause a $120/month rent increase for 1.8 million households with 3 million children. The result will be housing instability, which undermines health and will likely lead to an increase in family homelessness, as we saw in the 1980s when the Reagan Administration implemented similar policies. We saw similar impact following the 2008 housing foreclosure crisis.


  • More food instability, with a deeper impact on rural communities and older adults – The food stamp program (SNAP) budget will be cut by 31%, with 18 million White people, 11.6 million African-Americans, and 5 million Latinos losing their assistance necessary to maintain adequate nutrition and avoid going hungry. The Administration also plans to restructure the program to food distribution rather than vouchers to purchase food. In addition to eliminating choice and forcing specific food on beneficiaries, this would destroy the public-private partnership that has characterized SNAP. Community groceries and other small businesses will lose revenue. Rural communities will especially suffer from these cuts, as they will from the elimination of the Community Development Block grant which includes the Meals on Wheels Program.


  • Neglect to maintain clean soil, air, and water, with disproportionate impact to people of color and low-income communities – The Environmental Protection Agency (EPA), which protects all of us from toxic pollution in our air, soil, and water, is slated for a 26% budget cut, more than any other federal agency. Part of the Administration’s justification is that this would share responsibility with the states — however, the Environmental Defense Fund points out that this just shifts costs to the states. Funding to clean up highly toxic superfund sites would be cut by about one-third, with the justification including the notion that this will “encourage private investments in cleanup activities.” Low-income and communities of color who disproportionately live, work, and play near superfund sites will suffer the health consequences.


  • More will lose access to health care, with whole rural communities and counties deeply affected. The Federal budget includes provisions that will make health insurance more expensive and take it away from millions. Federal support to keep Americans insured will be cut by $763 billion. Medicaid expansion under the Affordable Care Act covers 12 million Americans and would be eliminated. Subsidies to assist people who purchase insurance in the open market would be eliminated. Other changes to Medicaid like converting it to a block grant will likely lead even more people with low income or who have a disability to lose coverage. These changes will affect all of us. The stability of our community health centers and hospitals, which serve as healthcare safety nets, will suffer as they lose Medicaid revenue. Access to care will deteriorate in communities and, especially in rural areas, whole counties.


  • Failure to use public health research to protect health and uphold health equity – The Centers for Disease Control (CDC) Center for Global Health that helps control epidemics around the world would be cut by 80%, withdrawing assistance from 39 of the 49 countries where we currently help prevent and respond to outbreaks of infectious disease. Former CDC Director Tom Frieden warned that this will increase the likelihood of epidemics spreading to the US. In addition the Agency for Healthcare Research and Quality (AHRQ), responsible for tracking health disparities and one of the smallest agencies within Health and Human Services, would be eliminated. Their annual report is one of our major sources to track progress in reducing the burden of poverty and other social determinants on vulnerable populations. The Trump budget would undermine our ability to track progress towards health equity.

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