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How do you improve access and engagement for hard-to-reach communities facing the greatest healthcare barriers in 2025? Health providers need to rethink how they communicate with people facing these barriers—whether it's financial hardship, digital disconnection, or previous negative experiences with the system. Reaching 'hard to reach' people—those who resist taking action regarding their health until it becomes a crisis—requires a more nuanced, empathetic, and often community-centred approach. In this Executive Forum for health leaders, The Culture and Design Lab will discuss how to rethink barriers to healthcare including: • Geographical isolation (rural areas with limited services) • Economic constraints (low-income individuals who deprioritise healthcare) • Digital divide (people not engaged in traditional healthcare messaging) • Distrust in the health system (those with negative past experiences) • Complex health conditions (people who need multiple services but struggle with engagement) • Language or cultural barriers (English as a second language or cross cultural misunderstandings) Communications expert, Iulia Leilua, will also talk about the number one strategy for moving people along the continuum from hard to reach to most likely to engage. And she’ll give a detailed break down of how this strategy can be executed in any location across New Zealand. Iulia Leilua (Māori | Ngāti Hāua, Ngāti Hekeāwai, Samoan) is an award-winning journalist, communications expert, and entrepreneur with 37 years in media, cultural advocacy, and strategy. She champions equity, cultural intelligence, and inclusion across Aotearoa and the Pacific.