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Dee Madigan on advertising and public health

What can the health sector learn from advertising? How can we send a clear health message to the community in advertising and health promotion campaigns that supports healthy lifestyles? How can we promote a positive healthy living message without alienating those who make less than optimum lifestyle choices?

These questions and more were discussed by Dee Madigan at the Australian National University (ANU) recently. Phillip Baker attended this event and provided the following report for Croakey. He writes:

I’m a long-standing fan of the Gruen Transfer, the ABC’s show ‘that lifts the lid on advertising, spin and marketing’. The hosts are always disarmingly honest (and Todd Sampson’s t-shirts super cool).

It brings to mind that famous quote: ‘advertising is the art of convincing people to spend money they don’t have, for something they don’t need, to impress people they don’t like’.

So it was with great interest that I went along to hear Dee Madigan, one of the show’s regular experts and a leading marketing guru, talk about advertising and the public’s health at ANU on Wednesday 7th October.

The session was insightful as to how ‘marketers’ think, with Dee offering ideas as to how we might go about using advertising to address some of our most pressing health problems.

Ways in which advertising is used to promote public health

Advertising is a serious topic for us card-carrying public health folk.

First, we use it as a tool to shape social norms and promote healthy behaviours, sometimes with great reach and effect.

Since the 1980’s for example, ‘Quit’ campaigns were critical in building public support for tobacco control. More recently the ‘Dumb Ways to Die’ campaign (promoting railway safety) logged no less than 112 million views on Youtube (and received widespread international kudos).

[mom_video type=”youtube” id=”IJNR2EpS0jw” width=”560″ height=”315″]

Second, we also advocate for restrictions on the marketing of ‘lethal but legal’ products like tobacco, alcohol, and junk food. Advertising and promotion bans for example, were critical to countering the powerful cultural influence of tobacco companies and driving down smoking rates in Australia (now among the lowest in the world).

These two approaches – social marketing and marketing restrictions – work synergistically as part of a complex mix of other interventions required to address these kinds of population-level health issues.

Dee offered ideas about both of these approaches.

First, what can health experts learn from advertisers to more effectively promote healthy living?

On this Dee offered many Gruen-esque like insights;

  • Start from the position that no one cares at all about your message. Marketing is about persuading people. The key is to do this creatively.
  • The assumption that facts alone work to persuade people is wrong. Sometimes the opposite is true – climate change advocacy is an example of this. Rather, messaging must invoke emotion in order to motivate.
  • In today’s crowded media space using visuals and visual analogies is crucial. When using words, use them sparingly and those that mean something to your target audience (and not just to you).
  • People are much more likely to notice and retain negative rather than positive messaging, though this can backfire if done badly e.g. people can tune-out from gruesome road safety ads.
  • Use Maslow’s Hierarchy of Needs (see image) to understand consumer needs and to develop messaging for various market segments. The more needs a campaign can tap into the better.When needs are non-existent marketers can create ‘perceived needs’ e.g. the L’Oreal ‘Because You’re Worth It’ campaign links beauty products with self-esteem.Focus groups can be used to determine people’s interpretations of their needs and generate ideas for campaigns. If the message comes from other people and not from you, it can be more powerful.Should guilt and stigma be used in public health messaging? With regards to obesity marketers would not rule this out e.g. use guilt to get parents into worrying about their children’s weight.

Maslow

I think many public health people would disagree on this last point. First, ‘guilt-tripping’ alone is unlikely to over-come food-related activation thresholds (see here). At a societal level it can also lead to the stigmatisation of groups most affected by obesity and potentially exacerbate body image issues.

Second, with regards to marketing restrictions, is this even sensible, and if so, how do we make this work?

On this topic Dee’s thoughts aligned more with an industry view:

  • With tobacco, the rationale for restrictions is clear. But with food it is more difficult and complex – how would restrictions differentiate between good foods and bad foods, for example.
  • It is not a good idea for government to regulate in this space and we should not restrict individual freedoms with nanny-state interventions.
  • There are also pretty good industry guidelines in this area. Children under-12 can not differentiate between advertisements and other content, and the guidelines restrict advertising to kids under this age.
  • Admittedly though, industry self-regulation in the food space has not been so successful – see the recent breaches by Hungry Jacks for example. But it’s better than no regulation at all, because government has no appetite to regulate.
  • Education is the best solution. We can also appeal to companies to market their products responsibly (e.g. the alcohol industries Drinkwise initiative).

From a public health perspective some of these points are problematic.

Is it ethical to design campaigns that stigmatise the obese while at the same time failing to restrict the marketing of the very products that contribute to their weight gain?

Can public health social marketing and education campaigns be effective without curtailing the powerful cultural influence of more than one billion dollars spent on advertising and promotion by food and alcohol companies in Australia every year?

Yes, food is more complex than tobacco. But should complexity ever be a rationale for inaction? Not in this case when you consider there are nutrient profiling systems available to differentiate between healthy and unhealthy foods. We have one that sits behind the new health star rating system for example. WHO Europe recently developed a nutrient profiling model.

Do marketing restrictions really take away individual freedoms? Banning ‘products’ (as distinct from advertisements for them), would restrict freedoms. But even tobacco is still widely available and few public health advocates would call for a complete ban. More, marketing restrictions are about curtailing the freedoms of corporations.

Government also has a long history of regulating for public health, particularly in tobacco control and road safety areas. There is strong public support for these interventions, with people recognising the role of government in protecting the public good.

Phillip Baker is a Research Fellow at the Regulatory Institutions Network, Australia National University. His research has recently focused on understanding political priority for obesity and related nutrition issues in Australia and globally. He also investigates the impacts of globalization on food systems, nutrition and public health in Asia. He has a PhD from the National Centre for Epidemiology and Population Health, Australian National University.