The Individual Mandate and Affordable Care Act – A Social Marketing Challenge?

Mar 27

The Obama Administration’s landmark health care reform legislation – the Affordable Care Act (ACA) – is again making headlines this week as the Supreme Court hears arguments challenging its constitutionality. On the agenda today – the individual mandate – one of the most contested and controversial parts of the law.

According to the Centers for Disease Control and Prevention (CDC), an estimated 59 million Americans lacked health insurance in 2009. The individual mandate, as part of the current law, will require almost every American to obtain health insurance by 2014. Those without insurance (through an employer sponsored plan or public program such as Medicare) will be required to purchase a policy through an affordable insurance exchange. Failure to obtain health insurance will result in a penalty paid by the individual.

Proponents cheer the mandate believing it will result in greater access to vital health care services and lessen the financial burden on the health care system as the federal government and taxpayers currently foot the medical bill for the uninsured. But, opponents, including 26 states, are challenging the constitutionality of the mandate citing that Congress does not have the authority to require Americans to ‘buy’ anything.

Controversy and constitutionality aside, as a self-professed public health ‘nerd,’ I welcome the notion of attainable health care for all. From a social marketing perspective, however, I ask ‘will the individual mandate and the ACA really increase use of health care services?’ True, more Americans will have access to health care, but will they actually access it? One of the administration’s key priorities with ACA is to improve public health. When people use preventive care services such as annual screenings and immunizations, the burden of disease, over their lifetime, is reduced. In theory, we become healthier people. But, increasing the use of health care services is a multi-faceted challenge, and one that requires a fundamental shift in American behavior.

As we have learned through our work as social marketers, removing barriers – such as cost – that prevent people from action or inaction is an essential first step. We also know that we need to pair that with clear, concise messaging to communicate the value of a new behavior to influence and incite action. When Congress passed it in 2009, ACA removed one of the biggest barriers to preventive care – cost – by providing first dollar coverage for critical cancer screenings, cholesterol and blood pressure tests, and vaccinations, among other services, and the individual mandate (if it stays) will ensure all Americans can access health care. But, according to the Agency for Healthcare Research and Quality (AHRQ), “roughly 60 million people – 1 in 5 Americans –have no usual source of medical care, such as a family doctor or clinic.” Instead of scheduling annual well visits, when early signs/symptoms of disease are often detected, many only seek treatment after an often preventable illness or disease onsets.

It’s too early to tell what impact the preventive services provision has had on American health, and as the drama unfolds in the Supreme Court this week, I keep thinking of ACA and the individual mandate as a social marketing challenge.  If it holds and the ACA remains intact following deliberations, how can we help Americans understand, value, and seek important care that can improve their health?

Raising awareness about…introverts?

Mar 22

Are you energized by social situations and tend to be an assertive multi-tasker who thinks out loud and on your feet? Or do you prefer less stimulating environments and enjoy quiet concentration, listening more than you talk, and thinking before you speak?

If you answered “yes” to the second question you may be an introvert – an often underappreciated personality type.

According to the Myers & Briggs Foundation, the institution behind the popular personality test, being an introvert means you focus your attention on and get your energy from your inner world of ideas and images.  Conversely, extroverts get their energy from the outer world of people and things.  While everyone spends some time “introverting” and some time “extraverting,” we all have an innate tendency towards one or the other.

So why do we need to raise awareness about introverts?

Well, according to Susan Cain, author of Quiet: The Power of Introverts in a World That Can’t Stop Talking, introverts are getting the short end of society’s stick. Cain posits that today’s culture idealizes and accommodates extroverts: children learn in groups, “people skills” are a requirement on any resume, talkers are considered smarter, and many workplaces are designed to foster interactivity. As a result, introverts, who represent as much as half of the population, are overlooked and underappreciated. Cain believes introverts’ strengths, like seriousness and reflection, go unrecognized, and she compares them to women in the 1950s—discounted for a reason that goes to the very core of who they are. While many introverts have learned to adapt to what Cain calls the “Extrovert Ideal,” she argues that introverts aren’t able to be their best selves under these circumstances.

Cain underscores the importance of raising awareness of the power of introverts and erasing the “anti-social” stigma that accompanies this personality type. She also advocates for behavior change. For example, she encourages schools and workplaces to revisit the way they are structured to ensure they are meeting the needs of introverts, creating an environment in which the shy kid at school is given equal opportunity to thrive and where the quiet, reflective employee is just as frequently groomed for a leadership position. In an interview with ForbesJenna Goudreau, Cain elaborates.

Do you agree with Cain that our culture is biased towards extroverts? If so, do you think a social marketing campaign could level the playing field?

Behavior Change to Motivate Millennials

Mar 20

New research published in this month’s Journal of Personalty and Social Psychology has revealed that the Millennial generation, contrary to wide-spread belief, is less civic-minded, especially as it relates to environmental issues than previous generations. One of the study’s author’s notes that there is a perception that young people are being reached sufficiently to act on social issues, but in fact, they’re not.
The research seems to confirm that more is needed to not only generate greater awareness, but importantly, motivate actions that matter and that impact individual and societal well-being.  Could the “more” lie in behavior change efforts?  The power of behavior change can be the missing ingredient for more deeply engaging audiences, including this generation of young American.  Check out more in the Washington Post.

Museums and Libraries Are Promising Venues For Behavior Change

Mar 19

While many of us in social marketing are constantly on the look-out for fresh approaches for engaging target audiences, we do some of our best work when we leverage existing channels as opposed to creating entirely new ones. From partnerships with grassroots organizations, to weaving messages into the packaging of popular consumer products, to tapping individuals with unique powers as “influencers,” we have multiple opportunities to reach people through sources that already have a meaningful impact on their lives. Last week I discovered an approach that utilizes the power of place to engage kids in particular, but was then reminded that it’s been an evolving option for years.

Children's Museum of Manhattan

EatSleepPlay exhibit at the Children's Museum of Manhattan

The “discovery” came from a New York Times article that described several museums that focus on the social needs of children and their families and highlighted an experiential exhibit at the Chilren’s Museum of Manhattan. Incorporating messaging and program support from the National Heart Lung and Blood Institute’s (NHLBI) We Can! initiative, the exhibit leverages the Museum’s deep understanding of early childhood learning and expertise in engaging children and families to promote the importance of nutrition and physical activity in obesity prevention and well-being. It’s a great idea – kids get to act like kids by jumping, pedaling and bouncing to experience the benefits of exercise, and crawl through a facsimile of a giant digestive system to learn about healthy eating. It’s also a great way to utilize a community resource and natural gathering place as a venue for engaging target audiences.

The article reminded me of some of the work I’ve done to raise visibility for the Institute of Museum and Library Services (IMLS), which is the primary Federal source of support for the nation’s libraries and museums. IMLS has always utilized its grants and programmatic support to help these institutions inspire lifelong learning and civic engagement, but in recent years has gotten behind initiatives to promote healthy behaviors as well. The organization is currently working in partnership with First Lady Michelle Obama on a national initiative to encourage libraries and public gardens to promote nutrition and physical activity in collaboration with the Let’s Move! campaign, and with 300 museums to encourage kids and families to make healthy nutritional choices.

The Institute also supports numerous museums and libraries that promote positive practices in environmental conservation and energy use, media literacy and the development of 21st Century skills. Through the last two decades in particular, IMLS has been a key driver in the national movement to transform museums from quiet places emphasizing more passive activities such as viewing exhibits to active, experiential learning places and community centers. And when it comes to health, the organization has clearly stated that libraries and museums should be viewed not only as places for the dissemination of health information but for experiences that support healthy lifestyles as well.

Programming at both libraries and museums tends to be shaped with the needs of local residents in mind, presenting yet another venue for engaging audiences by location and demographic.  Working in partnership with them presents a realm of opportunities for social marketers and educators looking for innovative ways to reach people in places that are already appealing and accessible. Most are supported by foundations that may share our interests in promoting public health initiatives, and opportunities to involve them in campaigns that are fostered by Federal agencies should be explored as well.  At a minimum, they can be sites for the dissemination of information, but their ultimate potential for social marketers will be realized through activities that – like those at the Manhattan Children’s Museum – actively engage target audiences in the behaviors we want to promote.

SXSW Interactive: Innovating Health

Mar 15

The past week my Twitter feed was overcome with South by Southwest, and my bookmarks are overflowing with blog posts to read on new innovations, ideas, and recaps. I was excited to see what came out of SxSW after reading this preview from Bloomberg on the prominence of health: South by Southwest Geekfest Veers From Social Media to Health. While I didn’t make the trek down to Austin (some day!), I did learn a few things from following conversations (#sxswi #sxswh #SXDigiHealth #sxehealth) about health and health innovation, which seemed to be as much in the spotlight as Pinterest and Austin’s culinary scene (maybe that’s a bit of a stretch, but it certainly was a hot topic).

This stat from RazorFish Health kept popping up, over and over, again: The average 24 year-old will spend more time on Facebook than they will with their doctor in 20 years.

Sounds pretty crazy, right? While I’ve spent some time on Facebook in my day, it only took one hand to count the number of times I’ve even seen a doctor in the past year.  One of those times happened to be this week: When finishing my visit, my doctor, going over next steps, said she would email with my lab results and confirmed my e-mail address was correct. This is great!, I thought, no immediate follow-up appointment, no voice mail to listen to, and I would have them in an easy-to-reference place. Sure enough, my lab results came two days later via email (well, via email through a portal, but at least we’re headed in the right direction).

The only issue? I only received lab results. No explanation, no “take a look and let me know if you have questions, but everything looks great”… just me, my iPhone, some wonky lab results, and trusty Google to figure out what I was reading.

In the past few years, health technology has come along way: you can take your pulse on your iPhone, Skype with your doctor, get SMS nudges for a healthy pregnancy or smoking cessation, and the list goes on. More and more there are devices, take the FitBit or Nike Fuel, for example, that are helping people track their overall health. Needless to say, taking social and technological innovations and applying them to making health information and health care more accessible and efficient has only just started. Which is great, because speaking for best practices, when disseminating messages, it’s understood that you want to meet people where they are already getting information. For my generation, and probably many others, we’re not getting our health information from spending time at the doctor’s office like people used to. If I’m feeling lousy, admittedly, the first thing I do is Google my symptom, hoping that some Advil and rest will cure whatever the ailment may be.  The last thing I want to do is try to find a doctor’s appointment- it’s hard to get an appointment, it takes time from my already busy day, and overall, just feels like a hassle, even though I know that my cough that lingered for a month would have been solved pretty quickly had I picked up the phone and got in to see the doctor.

So, while healthcare has certainly come a long way in the past few years, as far as accessibility to information and care,  it still has a long way to go. We need to get a better handle on what we’re currently doing, and continue to innovate, think of these alternatives:

Let’s start simple: my doctor could have easily relieved my natural worst-case-scenario, over-dramatization read of the lab results by adding a quick note explaining what they meant with the lab results.  To be a bit bolder, instead of getting an e-mail to check the message on a website that I can never remember my password for, perhaps we create, and more importantly, train, doctors on how to communicate with patients through Facebook: You have a Friend Request from Dr. Doogie Howser. This gets back to meeting people where they are, instead of continuing to create new apps or technology, let’s innovate what we currently have. Facebook isn’t going away anytime soon, let’s see what else it can do. The innovation also needs to made around privacy considerations, but that’s a whole other blog post.

And as patients, let’s meet doctor’s half way, they are the experts after-all.

PS. In case you missed it, our own Ogilvy Notes was in Austin to capture all the could-not-miss content and news. Among other sessions, they checked out the Wireless Wellness: Apptastic or Just Fun and Games? session with All Things Digital’s Ina Fried and Aetna CEO Mark Bertolini.

What’s the difference between social media and social marketing?

Feb 24

Last week, Ogilvy launched Social@Ogilvy, a global, cross-discipline team of social experts from across all of Ogilvy’s businesses delivering social solutions. Social media is changing our clients’ businesses and we have been quietly building the largest social media marketing communications network in the world.

This exciting news has sparked some discussion and questions about terminology: what’s the difference between social media (or “social media marketing”) and social marketing? This is not a new dialogue—confusion has been brewing ever since the breakthrough of social media and its subsequent impact on marketing, communications, and many other disciplines.

  • Marketing through social media involves having conversations and creating engagement online through a variety of social media tools, such as blogs, wikis, online communities, community websites, video, photos, and social networking platforms. The term “social media” was first used within the past decade.
  • Social marketing is a discipline that attempts to change awareness, attitudes, and behaviors as they are related to advancing social causes. Since its introduction in 1971, social marketing has been used to address many of the world’s most pressing issues, from public health to public safety to environmentalism. Methods include community outreach, direct mail, advertising, media relations, partnership development, events, interpersonal outreach, materials dissemination . . . and social media.


Indeed, in today’s communications environment social media has an important and critical role to play in social marketing initiatives. Good social marketing campaigns contain social media tactics that are based—as the rest of the campaign elements are—on research-derived insights into the campaign’s intended audience. For more on the potential benefits of social media to social marketing initiatives, see this blog post from Executive Vice President and Group Director Jennifer Wayman and many other posts on this blog about the intersections and application of social media to social marketing.

Quantified Self: Is self-tracking the future of behavior change?

Feb 23

Quantified Self: Is self-tracking the future of behavior change?

I sat down with Ernesto for a Q&A on the “quantified self” movement and how it might be applied to public health in the near future.

Will You Be My Valentine? Only If You Wash Your Hands

Feb 16

Valentine’s Day is over – as shown by the discounted boxes of candy, wilting flowers, and picked-over rows of red greeting cards. What’s not quite finished is the flu season.

I recently came across a Valentine’s Day-themed e-card from the American Public Health Association. The text reads: “I wanna hold your hand. But only after you wash your hands for at least 20 seconds with soap and water, scrub vigorously, and remember to clean the tops of your hands and under your nails. And don’t forget to rinse off the soap and dry your hands well. But THEN. Then I wanna hold your hand.”

What a clever, timely, and shareable asset that gets the message across about the importance of hand washing to prevent the spread of influenza. Keeping audiences engaged and amused is important in communications – particularly because annual messages of “wash your hands” can become redundant and easily ignored.

APHA’s Get Ready campaign features other witty e-cards, including emergency preparedness.

Which of these is your favorite? Would you actually share these with a friend through social media or email? Do you see an opportunity to communicate about other topics through similar e-cards?

Social Media Week Event Wrap Up: The Impact of Social Media in Healthcare

Feb 15

This morning we welcomed more than 100 social media and health enthusiasts to the Ogilvy Washington office for our social media week panel, The Impact of Social Media in Healthcare.

The panelists and audience discussed many facets of the same challenge: leveraging social to improve health.

A few highlights and common threads throughout the morning:

Using online interaction to foster offline action. Amy O’Connor of Eli Lilly noted that as her key driver – a much better way to define success than, for example, number of Twitter followers. On a similar note, Danielle Leach of Inspire brought up a case in which a group of women with spontaneous coronary artery dissection connected online and successfully advocated for the Mayo Clinic to create a patient pool of information on the condition.

Creating connections that aren’t likely to happen offline. Ogilvy’s Rebecca Davis emphasized the power of social media surrounding The Heart Truth campaign to bring people together. Danielle noted that people go online looking for people who are experiencing what they are experiencing.

Building community is not based on one-way brand-driven marketing. Joel Selzer of Ozmosis stressed the importance of basic two-way conversation, and Amy shared that she builds community by sharing the voice of others who you agree with rather than just the voice of the organization.


Regulation is a struggle. As one of the most highly regulated industries, we are constantly challenged to be impactful without violating FDA and other regulations or revealing patient information. Adapting engagement in order to be successful is crucial – Amy recommended talking about holistic issues, not products, so that engagement in real time is possible. Joel also endorsed the approach of taking calculated swings to foster a discussion that steers clear of adverse events and off label discussion.

Listening is essential. Rebecca highlighted the importance of listening, not only to identify potential red flags, but also so that senior executives can be educated on the existing conversation. On that note, she also mentioned the necessity for collaboration between web content developers and social media managers – if social media managers know where demand lies, an organization can streamline its content development and ensure that there will be interest.

Defining success is crucial. Amy asks herself who her target audience is and if she is reaching them. Joel aims to improve patient care and reduce costs. Rebecca brought up designating diagnostics that align with key performance indicators.

Achieving actual change in behavior remains the goal (and a challenge!). Danielle pointed out that people are connecting regardless of the stage of change that they’re in, while Rebecca touched on the importance of inspiring in people the motivation to change their behavior.


The future is about streamlining. Amy noted that bureaucracy within our organizations gets in the way, and Joel pointed out that moving beyond social media to social business that makes life easier for health care providers and other entities is where he sees the industry moving.

Like any good discussion, the crowd and panel raised as many questions as they answered. An audience member brought up the importance of prevention, and panelists acknowledged that reaching unengaged audiences is a challenge. Moderator Dana Allen-Greil asked if we’ve actually figured out how social media can improve health – something I think we’re all still refining as we go.

Thanks to everyone who attended the panel, and if you could not attend, view the tweets that made #smwhc a trending topic in DC. You can connect with our panelists at @danamuses @makegood @jbselz @LillyPad and @TeamInspire.

Utilizing Digital Channels to Reach Those “‘80s Babies”

Feb 07


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Utilizing Digital Channels to Reach Those “‘80s Babies”

No matter what we call them, we are reaching out to them more and more, especially in social media. Who are they? What are they doing online? What is the best way to reach them?