Walk into a shoe store and picture every box on the shelf holding the exact same size. The salesperson beams and says, “This will fit you perfectly.” You tug it on, and of course, for most of us, it pinches at the toe or slides off the heel. Now replay the last public health message you absorbed—eat this, not that, move for this many minutes, get screened at exactly this age. It rarely fits cleanly either. Yet a startling amount of health communication still broadcasts to a single, imaginary, “average” person.
I’m Dr. Priya Menon, and across my years in clinical practice and public health research, I’ve watched well-meaning guidance fall short because it doesn’t leave space for how different we are. The sticking point isn’t that the science is wrong. It’s that science describes trends, averages, and whole populations—while you and I live as individuals, with our own histories, biology, and daily realities. When health messaging treats everybody as interchangeable, we lose trust, effectiveness, and sometimes even safety.
Where the “Average” Comes From
Most public health recommendations rest on large epidemiological studies or randomized controlled trials. Those studies are essential. They tell us, for example, that cutting back on sodium can lower blood pressure across a population. But a population-level truth doesn’t translate neatly to the person sitting across from me. The same sodium reduction that helps one patient might leave another—someone with a condition like postural orthostatic tachycardia syndrome, for instance—feeling dizzy and faint.
Guidelines are built on group averages. An average blood pressure target, an average daily calorie need, an average response to a drug. The mathematician Nassim Nicholas Taleb once pointed out that if you stand with one foot in a bucket of ice water and the other in a bucket of boiling water, on average you’re comfortable. The average hides the extremes, and in medicine, the extremes are real people.
The Hidden Diversity in Our Bodies
When I teach medical students, I use a simple example: glance around the room. Some of us digest milk easily; others get cramps within minutes. Some metabolize caffeine quickly; others are jittery for hours after a single espresso. These differences aren’t random quirks—they’re grounded in genetics, gut microbiome composition, liver enzyme activity, and even the time of day. A health message that announces “drink milk for strong bones” overlooks the millions of adults with lactose intolerance. It’s not a bad message, but it’s incomplete.
Think about pharmacogenomics—the study of how genes shape drug response. The blood thinner clopidogrel is less effective in people with certain CYP2C19 gene variants, a finding that affects roughly 30% of people of European ancestry and up to 50% of people of East Asian ancestry. Yet standard prescribing often starts with the same dose for everyone. When health messaging around medication adherence fails to acknowledge that the drug might not work well for everyone, patients can end up feeling blamed for a poor outcome they didn’t cause.
The Context That Gets Left Out
Biological variation is only part of the story. The bigger blind spot in uniform health messaging is context. A recommendation to “exercise 150 minutes per week” sounds crisp and clear. But for a single parent working two jobs, living in a neighborhood without safe parks, and already walking miles each day just to reach the bus stop, those 150 minutes may be happening—just not in a gym or with a fitness tracker. The message doesn’t validate their reality, so it can feel irrelevant or even dismissive.
Public health has a term for this: structural barriers. They include income, housing stability, food access, and the subtle but powerful drag of racism and discrimination. When we skip over these factors, we imply that health is purely a matter of personal choice. The evidence is solid that structural conditions shape health outcomes as much as—and often more than—individual behaviors. A message that treats everyone the same inadvertently loads the full weight of responsibility onto the person, ignoring the rickety scaffolding beneath their choices.
When Neutrality Becomes a Disadvantage
Some health communicators aim for neutrality to avoid offense. But evidence shows that neutral messaging can deepen disparities. For example, cervical cancer screening reminders that rely on generic language tend to be less effective for women from marginalized groups who already face greater barriers to care. Tailored messages—ones that acknowledge cultural values, language preferences, and specific fears—consistently outperform generic ones in getting people screened.
This doesn’t mean every message needs a bespoke version for every possible subgroup. It means we need to design communication with “differentiation by default.” Start by recognizing that the audience isn’t uniform. Ask: Who might not see themselves in this message? Whose barriers are we unintentionally minimizing?
The Unintended Consequences of Uniform Advice
When people repeatedly encounter health advice that doesn’t fit their lives, something predictable happens: they tune out, or they feel shame. I’ve had patients tell me they stopped reading nutrition labels altogether because the guidance seemed to shift every few years and never applied to their cultural diet anyway. One woman from a South Asian background told me she felt judged when a well-meaning nurse suggested she switch to oatmeal for breakfast, without understanding that her family’s traditional fermented rice dishes were already rich in resistant starch and gut-healthy probiotics.
Shame is a lousy motivator. Research on health behavior change consistently shows that autonomy-supportive approaches—those that respect a person’s values and circumstances—lead to longer-lasting improvements than prescriptive, one-size directives. Yet public health campaigns still frequently lean on fear-based or uniform messaging, perhaps because it’s easier to design and distribute at scale.
The Evidence for Tailoring
There’s a sturdy body of research on “tailored health communication.” A meta-analysis published in the Journal of Health Communication found that tailored messages—those customized to an individual’s demographics, psychological characteristics, or behavioral context—are significantly more effective than generic messages, particularly for nutrition and physical activity. Another study in Preventive Medicine showed that culturally adapted diabetes prevention programs improved outcomes for Hispanic and African American participants far more than standard programs did.
Tailoring doesn’t demand fancy technology. It can be as simple as asking “What does a healthy meal look like in your home?” rather than handing out a one-size Mediterranean diet pyramid. It’s about starting where the person is, not where the guideline presumes they should be.
Moving Toward Messaging That Fits
So how do we do better? First, we can acknowledge the limits of any single recommendation. Health organizations can add brief context: “This guideline is based on studies of adults under 65. If you are older or have chronic conditions, talk with your provider.” That small addition signals that the advice isn’t absolute, and that individual differences matter.
Second, we can use “segmenting” strategies without stereotyping. This means creating different versions of a message for different life stages or contexts—like a physical activity poster that features older adults doing chair exercises alongside one showing parents playing actively with children. The core recommendation stays the same, but the visual and narrative framing changes.
Third, we can listen more. In my own practice, I’ve learned that the most effective health communication often starts with a question rather than a declaration: “What matters most to you about your health right now?” That question opens up the conversation to the whole person—their worries, their strengths, their reality—instead of reducing them to a number on a lab report.
The Role of Trust
Trust is the invisible ingredient in every health message. When people feel seen and respected, they’re more likely to engage with the information. This is especially true for communities that have been harmed or ignored by medical systems. Uniform messaging can inadvertently signal that the messenger hasn’t bothered to understand the recipient. Tailored messaging, done respectfully, says: “We see you. This is for you, too.”
Trust also requires humility. Public health agencies need to be willing to say “the evidence is evolving” or “we don’t have strong data for your specific situation yet.” That honesty builds far more trust than projecting certainty that doesn’t exist. During the COVID-19 pandemic, we saw both sides of this: moments when evolving guidance eroded trust because it was communicated as flip-flopping rather than honest updating, and moments when transparent explanations strengthened it.
FAQ
Why don’t public health agencies just create personalized advice for everyone?
Personalized advice at a massive scale is resource-intensive. However, moving toward “segmented” messaging—different versions for different groups—is feasible and more effective than a single message. Technology can help, but so can involving community voices in message design from the start. The goal isn’t perfect personalization; it’s moving away from the fiction of the average person.
Does this mean I should ignore standard health guidelines?
Not at all. Guidelines are a starting point, not a finish line. Think of them as a map of the terrain, not a precise turn-by-turn GPS for your unique journey. Use them to understand general principles, then adapt with the help of a clinician who knows your context. If a guideline says “limit saturated fat,” but your cultural diet relies on coconut milk, the conversation shouldn’t be about abandoning your food traditions—it should be about balance, portion, and what else is on the plate.
How can I tell if a health message is too one-size-fits-all?
Ask yourself: Does this message acknowledge any exceptions or differences? Does it assume a certain type of household, income level, physical ability, or cultural background? If the answer is yes and you don’t see yourself in it, that’s a clue the message wasn’t designed with you in mind. Good health communication leaves room for your reality. Seek out sources that frame advice with qualifiers like “for many people” or “in general,” and that invite you to consider your own circumstances.
The problem with public health messaging that treats everyone the same isn’t laziness—it’s an outdated model of how people actually live and make decisions. By shifting toward approaches that honor difference, we don’t weaken the science. We make it more useful, more compassionate, and far more likely to land where it’s needed most.
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