A New Look at “Product”

Apr 04

“Public health is everyone’s responsibility and there is a role for all of us, working in partnership, to tackle these challenges.”
Andrew Lansley CBE MP, Secretary of State for Health, March 2011

Last week, I had the pleasure of participating in the National Social Marketing Centre’s Behavior Change and Corporate Responsibility Conference in London.  While there, I was treated to a number of engaging presentations from leaders in the public and private sectors, and I enjoyed the lively discussion about the importance of corporate involvement in solving the world’s most pressing social challenges (something I personally strongly support).

Regarding this latter point, one presentation in particular, has really stuck with me.  It was Tabitha Brufal’s discussion of the goals, structure, and activities to date of the U.K. Department of Health’s Public Health Responsibility Deal.

The Public Health Responsibility Deal is the U.K. government’s initiative to engage corporations in committing to specific actions that support public health goals within the alcohol, food, physical activity, and “health at work” arenas.  As can be expected, the Responsibility Deal has not been free of criticism, with some detractors saying that the motives of corporate partners aren’t “purely altruistic.”

My response:  why do they have to be?

If we lived in a world without wine and beer, without chocolate and cheese, and without televisions, movie screens and laptops, perhaps we would be healthier.  But that is not the world we live in.  For most of us, these “pleasures” surround us, every day.  We work long hours, care for children and aging parents, and try to find time for friends and leisure activities.

Against this backdrop, it’s easy to over-indulge and under-exercise.  Initiatives that make it easier, more accessible, and more enjoyable to make healthier choices are critically important.  And that’s where the corporate sector, their marketing muscle, and their “products” can contribute.

The companies participating in the Responsibility Deal to date have pledged to make fundamental changes in their products, in their workplaces, and in their marketing practices.  Alcohol manufacturers are reformulating products to lower the alcohol content, and encouraging retailers to promote these lower alcohol versions.  Food manufacturers are reducing salt, trans fats, and calories in their products.  Companies are offering workplace smoking cessation programs, health checks, and physical activity opportunities — and they are stocking their on-site cafeterias with healthier foods and supporting community-wide initiatives to promote active travel (e.g., biking, walking) to/from work.

It makes sense that so many of these efforts involve re-imagining a product or service… after all, products and services are the lifeblood of corporations.  But what struck me so clearly last week was how truly critical it is for the private sector to be encouraged to create innovative new products and services that make it more accessible — and more enjoyable — for all of us to make healthier choices every day.  And how crucial it is for public health leaders to invite corporate leaders to sit at the same table, share goals, and identify opportunities to collaborate and achieve a meaningful impact.

Sure, companies will likely reap some benefits from this collaboration that are not directly related to the public health challenge at hand.  But isn’t this “value exchange” one of the cornerstones of social marketing?  Don’t we promise benefits like:  in exchange for  choosing fruit over candy you will feel better, have more energy, lose weight, etc.?.   Or, as seen in action at the conference: in exchange for your active participation in this afternoon’s discussion, we’ll grab a pint across the street at the end of the day.

In my view, the world’s most challenging public health issues will never be solved unless all parties with a role to play come together and truly collaborate.  It’s time for us to look through a different lens, focusing on where the goals and objectives of the public and private sectors intersect.  It’s a win for individuals struggling to make healthier choices.  It’s a win for society and the public’s health.  And it’s a win for corporations seeking to differentiate themselves from their competition, create innovative products and services, and grow their business.

Sugar: The next public health crisis?

Apr 04

Having worked in Ogilvy’s Social Marketing Practice for almost 12 years on campaigns that address public health issues like heart disease, cancer, and addiction, I was intrigued by the recent 60 Minutes piece “Is Sugar Toxic?” that made connections between the sweet substance and each of these issues.

The highlights for me included:

  • Sanjay Gupta’s interview with Dr. Richard Lustig, an endocrinologist, who gives an evolutionary explanation for our sugar cravings, saying “there is no food stuff on the planet that has fructose that is poisonous to you.  It is all good.  So when you taste something that’s sweet, it’s an evolutionary Darwinian signal that this is a safe food.”  To which Gupta replies:  “We were born this way?”  Lustig:  “We were born this way.”  Cue Lady Gaga.
  • Kimber Stanhope’s research linking sugar consumption to an increase in risk factors for heart disease and stroke, which I thought was the most compelling piece of the segment.  She’s in the middle of a five-year study with results that already show that consuming sugar increases our LDL (“bad”) cholesterol, which in turn increases our risk for heart disease.
  • Sugar activates areas in our brains like cocaine does.  Says neuroscientist Eric Stice:  “If you overeat sugary foods on a regular basis, it causes changes in the brain that basically it blunts your reward region response to the food, so then you eat more and more to achieve the same satisfaction you felt originally.”  Now this I believe.  Just try “quitting” sugar, and you’ll undoubtedly experience some of the same withdrawal symptoms drug addicts face.

As the piece ended, I couldn’t help but picture the scene from “Thank You for Smoking” where the M.O.D. Squad (the “Merchants of Death” representing the tobacco, alcohol, and firearms industries) sit in a darkened corner of what I always imagined was Old Ebbitt Grill.  Does the sugar industry belong at the table too?  I think the science is fascinating, and it certainly makes me want to cut back on my own sugar consumption—but just like I can’t imagine life without a glass of wine every once in a while, I can’t imagine it without a grilled cheese on (gasp, sugar-laden) white bread or (double gasp) a cupcake.  I guess you could say that I’m a proponent of the “everything in moderation” mentality.

That doesn’t mean there isn’t a place for awareness and education—especially for the average American who consumes 130 pounds of sugar per person each year.  Lustig’s parting statement:  “Ultimately, this is a public health crisis.  And when it’s a public health crisis, you have to do big things, and you have to do them across the board.”  What do you think he means, and do you agree?

Wait, no makeup?

Apr 03

Being from the South, I learned from an early age that you never leave the house without putting on your makeup—even if you  are only going to the grocery store.  My mom used to say “you never know who you are going to meet and you should always look your best,” and in the same breath would say “you are perfect they way you are.” Really?  If I am perfect the way that I am, why do I have to wear makeup?

Two women from Charlotte, N.C., asked that same question.  They started The Naked Face Project in which they have abandoned their beauty routines for two months to find the answer to this question: Why do they do these things anyway?  They were encouraged to do this because of questions young girls posed to them, “If you tell me I’m beautiful just the way I am, why do you color your hair or wear makeup?”  The women couldn’t find an answer.  It’s like some unwritten rule that we as women are following.  Who made these rules?  Cosmetic companies.  Well, I am not sure if they made the rules but they fuel our need to keep our beauty regimens.

Cosmetic companies go to great lengths to market to women.  No matter where you look—online, TV, radio, magazines—there is an oversaturation of beauty tips and products that we need to look beautiful so we can get the guy or job.  Companies advertise beauty products and claim that it will improve my appearance, make me attractive to the opposite sex, and promise a general lifestyle enhancement.  Magazines like Redbook tells it’s readers that by using a particular perfume you will be able to “magically reel him in” or by using a particular eyeliner your eyes will “look bigger, brighter, and much sexier.”  I wonder what would happen if social marketing fornatural beauty was conducted with equal enthusiasm.  Would photo-shopped photos of celebrities be so prevalent? Would cosmetic companies be a multi-billion dollar industry?

The Naked Face Project has given the women in Charlotte and other participants a new appreciation for natural beauty.  After abandoning their beauty routines for two months, they realized that they are the same person whether they follow those routines or not.  Why? Because they appreciate who they are and found true, authentic confidence within themselves.

When we wear makeup, high heels, and color our hair, we feel good about ourselves.  It gives us a sense of confidence.  However, like the women in Charlotte, we need to understand that real confidence comes from within.  Am I saying you have to abandon your beauty routines? No.  Just don’t get so caught up with the outward appearance that you neglect what is on the inside.  We are perfectly created as is!

Deadly Silence: Black women and Breast Cancer

Mar 30

For the past few weeks I’ve been following the ongoing feature published in The Washington Post called Black Women in America, which stems from a new nation-wide survey by the Post and the Kaiser Family Foundation that paints an interesting portrait of the lives of Black women. The survey includes interviews with more than 800 women and covers topics such as body image, personal finance, discrimination and overall happiness.  Last week’s article, “Breast cancer toll among black women fed in part by fear, silence” really stopped me in my tracks.

According to the article, Black women are less likely than women of other ethnicities to get breast cancer, but are more likely to die from it.  Death rates are 41 percent higher among African American women than among white women.

A separate study published last Wednesday in the International Journal of Cancer Epidemiology, Detection and Prevention compared mortality rates of black and white women in the nation’s 25 largest cities. The study found nearly five black women die per day from breast cancer.

The article provides the following factors that may contribute to these alarming rates:

  • Black women are getting their diagnoses at later stages
  • Black women are more susceptible to aggressive tumors
  • Lack of information about the importance of breast screening
  • Lack of access to high quality care
  • A sense of hopelessness and fear

As a communicator, I have to ask myself with so much information available on breast cancer why are so many Black women dying from it, and how can we turn this around?

One solution the article identified is the power of word of mouth marketing – in other words, simply hearing stories from other Black women who have had breast cancer would make the difference.

Many Black women interviewed said after they were diagnosed and shared their experience other women began revealing their experiences with the disease. The energy and collective strength that empowers women to boldly participate in breast cancer events, such as Susan G. Komen Race for the Cure, is not being translated into the Black community.  Messages about early detection and images of other women, who look like them, who had the disease and survived, are not being shared.

Black women are suffering in silence.  And their silence is deadly.

This blog post was originally published on WomenOlogy.

The New Face of Beauty: 90-Year-Old Fashion Icon

Mar 29

I don’t think there are many females out there who have not, at one point in their lives, struggled with body image issues. Of course, there are varying degrees, ranging from the more typical thoughts of “I wish my thighs were smaller,” to a desire for plastic surgery (since 1997, the number of cosmetic procedures for women has increased over 164%), to actual struggles with eating disorders (currently, as many as 10 million females in the U.S. battle one).

So why is it that females – both young and old – seem susceptible to outside pressure to obtain a certain body shape and/or remain looking youthful? Well, research says that women often strive for the “thin-ideal,” based on the belief that thinner women and girls are more attractive, more sought after, and perhaps more successful. And you have to look no further than Hollywood to see female celebrities going to drastic measures to make sure they look as young and wrinkle-free as their younger, female counterparts. I’d also be remiss not to mention the somewhat cult following of all the Housewives on Bravo’s hit series.

While we cannot prove cause and effect when it comes to issues of body image (hence, why this topic has been studied and debated for years), there are some major culprits in perpetuating these “ideals” — and that is the mass media. Every day we’re bombarded with media messages that come in the form of advertisements, images, and texts. Now, I’m the first to admit that my guilty pleasure is reading the latest celebrity scandal in gossip magazines at the supermarket. (Ironically, I cancelled my $24 yearly subscription to one of these gossip magazines a year ago out of “moral principle,” yet somehow I continue to buy it every other week at the full $3.99 market price.) But these images aren’t just showing up in magazines. Pictures of “perfect” women (and men) appear on bus shelters, in mall kiosks, the movies, and on television. Sadly, research shows that by the time a young girl starts kindergarten she will have already watched 5,000 hours of television, including 80,000 ads. As we strive to look like the female models and celebrities we view in the mass media, we often feel disappointed with our “average” body shapes, stress about our emerging wrinkles, and are quick to point out our various imperfections.

This led me to ask, is there actual science behind these feelings of inadequacy? Well, one theoretical approach – social comparison – serves as a possible lens through which to understand how the representation of female images in the media can affect body image and self-esteem. This theory, originally put forth by Leon Festinger in the 1950s, stated that individuals have a desire to evaluate their personal opinions and abilities. We do this by comparing ourselves to others who are most similar to us, because this helps us gauge our own capabilities most effectively. However, Festinger highlighted one scenario in which individuals compare themselves to those who are different, and that is when the attraction of a particular group is so strong that an outsider aspires to be a part of that group. Basically, this is all of us who strive to look like the celebrities we see in the magazines or on TV. They’re certainly not our peers, but we definitely emulate them. Unfortunately, this “upward comparison” (i.e., comparing yourself to those better off, or at least those we think of as better off) results in lower self-esteem and feelings of inadequacy.

The social comparison theory and our obsession with Hollywood may help explain why almost 9.5 million cosmetic surgical and nonsurgical procedures were performed in the U.S. in 2010, totaling nearly $10.7 billion. Clearly, Americans and particularly women, who accounted for almost 92% of total procedures, continue to aim for perfection at all costs. It also might shed light on the fact that in the past 50 years, the number of eating disorders has doubled in the U.S.

That’s why it was particularly refreshing to see a piece on The Today Show last week that reported that M·A·C Cosmetics recently collaborated with 90-year old fashion icon and interior decorator, Iris Apfel. Known for her eclectic style, spectacles, and love of all things brightly colored, choosing Iris was a deliberate move on M·A·C’s part to represent real women (see photo below)… women who have lived long, productive lives and who have the wrinkles to prove it. Interestingly enough, this collection created by Iris hit stores this past January and sold out within days.

So what does this tell us about women, beauty, and body images? Well, perhaps the tide is starting to turn when it comes to advertisements and the mass media featuring real women, as opposed to young, “perfect” women. Our societal awareness of body image issues among women (and how devastating they can be) hasn’t been enough to fully change how females are portrayed in magazines, advertisements, movies, and television. Perhaps affecting the bottom line of businesses can…

Warning: Your doctor’s BMI may be dangerous to your health

Mar 28

Social marketers realize the power of encouraging behavior change through the doctor-patient relationship.  With health information coming at us from various sources and channels, the doctor, or more broadly speaking, the health professional, continues to be the #1 trusted source for health advice.  And this is a good thing; health professionals are educated, they know how to interpret and apply research findings to individual patients, and they understand the whole patient.

But, a recent study of 500 primary care physicians presents an interesting wrinkle in this paradigm.  The survey found that doctors who are overweight/obese are less likely to engage in discussions about weight loss with overweight patients than doctors with a normal BMI, and they feel less confident in providing diet and exercise counseling. Even more interestingly, doctors are more likely to have weight loss discussions with patients if they perceive them to be more overweight than they themselves are.  Absolutely fascinating, though not counterintuitive.  And it’s likely that this kind of bias extends to other lifestyle, screening, and disease self-management behaviors.

This is something that we have to take into account when engaging health professionals in patient behavior change campaigns.  Doctors are people too, with their own perceptions, biases, and realities; how to shed those biases is not something taught in medical school…

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.