Branding Public Health

In the opening episode of “Mad Men,” advertising executive Donald Draper pitches a new campaign to a client, Lucky Strike cigarettes, that ditches any pretense of health benefits in favor of an emotional appeal, telling them, “Advertising is based on one thing: happiness.”

In a December 1 talk sponsored by the Lerner Center for Public Health Promotion at the Mailman School of Public Health, W. Douglas Evans, a professor at George Washington University, argued that it’s high time public health channeled its inner Draper to sell the world on health.

“We operate in a marketplace in public health, like it or not,“ Evans explained. Anti-obesity campaigns compete against billion-dollar budgets pushing soda and fries. Vaccination campaigns square off against anti-vax skeptics intent on equal time.

Public health may have science on its side but the facts don’t matter if nobody acts on them. According to Evans, few public health campaigns have sufficiently marshaled the powers of persuasion. “One of the big problems we face in public health is that a lot of our interventions are hard, boring, and not really a lot of fun,” he said. “We’re just not that good at it.”

A spiffy logo and a slogan aren’t enough, Evans explained. A brand is something bigger: a persona  your target audience can identify with and aspire to, like how Nike is synonymous with world-class athletes such as Michael Jordan. 

Selling a brand means selling a behavior. While Nike sells apparel by getting people to invest in an athletic lifestyle, tobacco companies imbue smoking with attributes from sex appeal to rugged individualism. “They’ve been able to position the act of smoking—not just the cigarette, but the act of smoking—in our consciousness,” said Evans. “If they can do it, why can’t we?”

Evans offered several instances where public health has already used branding to great effect. Take breast cancer. In less than a generation, he said, it’s gone from taboo subject to mainstream topic, thanks in part to the pink ribbon campaign.

One of the best case studies of public health branding, according to Evans, is the “Truth” campaign to stop teen smoking. Earlier efforts that adopted a preachy tone (“Tobacco Is Whacko,” “Think, Don’t Smoke”) backfired, making smoking a forbidden fruit. Truth took a different approach by offering teens a more enticing brand: empowerment and rebellion.

The campaign outflanked Big Tobacco by painting them as controlling parents. “Truth made the tobacco industry into ‘The Man,’” said Evans. “The idea was to beat the competition at their own game.”

Sure enough, it was a huge success. Subsequent analysis found that 22 percent of the overall drop in smoking rates in young people could be attributed to the campaign, accounting for 300,000 youth who didn’t take up smoking between 1997 and 2002. A paper by Evans identified branding as the mechanism behind the behavior change.
 
Smaller scale interventions have made branding work too. Text4Baby, a program featured in an episode of MTV’s “16 and Pregnant,” uses cell phones to share health tips with Medicaid-eligible women who are pregnant or mothers of  young children.  A randomized trial found evidence that it changed attitudes and beliefs on issues like alcohol use during pregnancy.

Despite these highlights, some in the audience were discomforted by the use of commercial language in the context of public health. Ronald Bayer, professor of Sociomedical Sciences, said, “What we give is not a product, and our community is not consumers.”

Evans countered that the techniques of branding don’t fundamentally change public health into a for-profit business. The bottom line? “We can learn from what people do in the commercial sector… and make our programs better."