Critical matriarchal futures: reimagining public health communication leadership as response to state-sanctioned violence

Front Public Health. 2026 Jun 23;14:1831079. doi: 10.3389/fpubh.2026.1831079. eCollection 2026.

ABSTRACT

This commentary argues that the crises facing the U.S. public health workforce – marked by mass attrition, particularly among Black women, increasing incidence of disease and illness, loss of critical social safety nets, mediated surveillance, and eroding public trust – represent a manifestation of state-sanctioned violence through decades of systemic divestment and political attack. Drawing on Black feminist, Indigenous, and decolonial theoretical traditions, we propose the Critical Matriarchal Framework for Health Communication as a transformative alternative to hierarchical, extractive models of public health practice. This framework centers relational authority, collective responsibility, intergenerational knowledge, and care-based leadership to address and reduce persistent health inequities that are fundamentally rooted in fractured systems of care and community relationships. Using case analyses, authors will demonstrate that without trusted communicators embedded in communities, without frameworks that center reciprocity and care, and without addressing the trauma and structural violence that undermine trust, public health institutions cannot effectively communicate for behavioral changes during emergencies. This intervention has implications beyond public health, offering a model for sectors experiencing similar legitimacy crises and calling for institutional realignment that examines power structures, redistributes leadership, and centers community accountability over bureaucratic metrics. The Critical Matriarchal Framework for Health Communication is necessary because it transforms crisis communication from a technical problem (how to disseminate information) into a relational practice (how to build trust, share power, and co-create solutions with communities). This perspective is about fundamentally reimagining who has authority to speak, whose knowledge counts, and what public health communication is ultimately for: institutional legitimacy and community flourishing. In the context of ongoing and future crises (climate disasters, pandemics, political violence), this framework offers a pathway toward health communication practices that do not just inform behavior but transform systems, that reach communities and honor their wisdom, and that manage crises by building collective capacity for resilience.

PMID:42415769 | PMC:PMC13337831 | DOI:10.3389/fpubh.2026.1831079