“Appropriate and Fair”: Modeling Equitable Compensation for Lived Experience Experts in Local Public Health Programming

A local health department in Southern Arizona developed an equitable compensation model for a community-driven health literacy initiative. Guided by human-centered design principles, which emphasize the expertise of those most systemically impacted, the model sought to equitably value lived experience alongside subject matter expertise, in alignment with distributive justice. The model blended market, reimbursement, and wage-payment frameworks, with adjustments based on local labor conditions and federal funding limits. Payments to participants were capped below IRS reporting thresholds to avoid disrupting eligibility for public benefits. Implementation challenges included gift card fraud, administrative delays, and barriers related to public-sector procurement. Promotoras and partners reported that compensation supported participation, especially among individuals new to public health programs. Although outcomes were not formally evaluated, this case study offers practice-based insights and addresses gaps in the literature by detailing rate structures, payment mechanisms, and budget considerations for appropriate compensation in community-centered public health work.