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

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, publ