There is no doubt that technology is transforming public health. AI-powered tools, digital platforms, and mobile apps are expanding reach and improving how health services are being delivered. But they are not solving one of the field’s most persistent challenges: getting people to engage.

Even in New York City – where these services are widely available – roughly one in seven adults reports an unmet need for care. The issue is not just access. It is human connection.

To better understand what’s driving that gap, our organizations, Public Health Solutions and Eve & Co, convened more than 40 community leaders and service providers across New York City. What we heard was clear: technology can extend capacity, but it cannot create engagement.

That requires trust, human connection, and sustained reinforcement.

If public health leaders want to close the gap between availability and impact, three priorities should guide their approach:

1. Build trust through the messengers people already rely on

Without trust, even the best-designed programs will fall short. Many communities, including immigrant and mixed-status households and justice-impacted individuals, approach new services cautiously. Concerns about how personal information will be used or shared can prevent participation altogether – particularly among mixed-status families who may worry that submitting a form could expose them to government scrutiny.

These concerns are grounded in lived experience. As a result, outreach cannot begin with the program itself – it must begin with the messenger.

Public health outreach efforts should prioritize partnerships with trusted, community-based institutions – organizations, faith groups, and schools that already have credibility and relationships. These partners help people understand what services are, how they work, and whether they are safe to use.

Trust is not a “nice to have.” It is the gateway to engagement.

2. Invest in in-person, relationship-based outreach AND use digital tools community members rely on

Digital platforms can expand reach, but they don’t replace human interaction. Community leaders consistently point to direct, in-person engagement as one of the most effective ways to drive action. PHS participants have welcomed a hybrid (in-person, phone-based and virtual) approach which allows for both flexibility and agency. 

Public health systems should invest in frontline staff and community-based outreach that meets people where they are – at events, program sites, or in familiar, everyday settings such as grocery stores and tenant association meetings. These interactions create opportunities to answer questions, address concerns, and guide people through processes in real time. They also make engagement more accessible and relevant. 

This is particularly important given persistent barriers such as limited digital literacy or access. Without support, even motivated individuals may not complete applications or follow through.

Equally important, people do not always recognize their own eligibility or need. Challenges like food insecurity, housing instability, and transportation barriers are often normalized. It often takes a conversation – not a website – to connect those realities to available services. 

3. Reinforce engagement through consistent, multi-channel touchpoints

Engagement builds over time through repetition and reinforcement. As one leader shared, “People have to hear it multiple times… when they see it the third or fourth time, they think, wait, I’ve seen that before.”

That requires a coordinated mix of channels – real person conversations, printed materials, community events, and digital communication, working together to reinforce the message and drive follow-through.

Just as importantly, outreach should be embedded into interactions that already exist. Integrating service information into intake, case management, and follow-up ensures engagement is continuous rather than episodic. It builds familiarity, reduces friction, and moves people toward action.

As public health systems continue to invest in technology, they should do so with a clear understanding of its limits. Digital tools can support scale, but they do not drive trust, and they do not change behavior on their own.

Closing the gap between access and impact will require a shift in focus, from simply delivering services to actively engaging people. That means investing in relationships, trusted messengers, and sustained, human-centered outreach.

Because in public health, access is not just about what is available. It is about whether people feel ready, safe, and supported enough to use it.

Cassaundra Howell is the CEO of Public Health Solutions,  the largest public health nonprofit serving New York City. Yaritza Holguin is an engagement specialist and community health expert at Eve & Co.