Author: Linden Thayer

Positive messaging

Dove is at it again–its “Real Beauty” Campaign launched in 2004 provided great images and tools to talk to young girls about body image, beauty, and self-esteem. Dove provided a voice of support and compassion in a noisy world full of “you’re fat” and “you’re not good enough.”

This time the company has launched “The Ad Makeover” in Australia – users can download an app and then send an ad to a friend with a positive message that replaces one of the ads that pops up in the sidebar of your Facebook page or Yahoo search. Dove essentially pays to replace ads filled with what it considers negative messaging about women’s health and beauty.

Dove ‘The Ad Makeover’

Dove uses creative communication techniques to improve the tone of the conversation, but it also presumably profits from the loyalty of thankful and supportive consumers. Is this corporate responsibility, or simply genius marketing? What do you think about this health and beauty communication strategy? What are the pros and cons, and which one wins out in your mind?

Image courtesy of Dove ‘The Ad Makeover’ Campaign

Food desert mirage

The nutrition and food justice worlds exploded over an article in The New York Times this week highlighting two research articles (published in reputable academic journals) that claim “food deserts” do not exist in the U.S. The term “food desert” has been used by Michelle Obama and Michael Pollan (to name two) to describe communities that do not have ready access to real, whole foods; more recently, the concept of “food swamp” has gained traction, describing communities filled with fast food and junk food establishments but no fresh food purveyors.

To quote directly from the reach article abstracts:

Population: National sample of children followed from k-5 “…When examined in a multi-level modeling framework, differential exposure to food outlets does not independently explain weight gain over time in this sample of elementary schoolaged children. Variation in residential food outlet availability also does not explain socioeconomic and racial/ethnic differences. It may thus be important to reconsider whether food access is, in all settings, a salient factor in understanding obesity risk among young children” (Lee 2012)

Population: Children and Teens in CAResults: No robust relationship between food environment and consumption is found. A few signifıcant results are sensitive to small modeling changes and more likely to reflect chance than true relationships. Conclusions: This correlational study has measurement and design limitations. Longitudinal studies that can assess links between environmental, dependent, and intervening food purchase and consumption variables are needed. Reporting a full range of studies, methods, and results is important as a premature focus on correlations may lead policy astray” (An &Sturm 2012)

At first glance, the authors are suggesting that child weight and child food consumption are unaffected by access/lack of access to real food. They, and the journalist who reported the story, spent a lot of time suggesting this means “food deserts” do not exist. This simplified message presents real danger, and health communicators should take heed:

If these studies reach the desks of influential policy makers, they will be used as fodder to erroneously cut programs and research in low-access, high need communities. Never mind that 2 research articles do not a solid case make. Of course children’s proximity to a grocery store does not translate to better health outcomes – there are SO many more factors involved. Parent health and cooking knowledge, parent time to prepare food, school food service, child preference and exposure, and affordability of food all play into the healthy eating equation for children. Putting grocery stores close to people will not magically cause them to buy fresh fruits and vegetables (especially children), but that is not to say that access is not an issue. Just as education and race are used as proxy measures of socioeconomic status in other research, food deserts highlight barriers to health access of many kinds – knowledge, skills, money, time, equipment, as well as proximity.

What is your preference when it comes to controversial  and potentially policy-altering research result publication? How can health communicators do a better job of presenting a balanced perspective while still capturing people’s interest through catchy headlines? What is your take on the marketing term “food desert” and/or “food swamp”?

Image courtesy of worradmu.

Indian vegetarian thali

Every kid eats lunch

I spend a lot of my time puzzling over how to make the school lunch program here in the U.S. delicious, nutritious, and cost-neutral (or better).  And I draw on research done in England, Australia, France, and Germany to inform what we might do here.

But I hadn’t thought about India.

Last week NPR reported on Akshaya Patra, a secular public-private partnership that currently serves lunch to 1.3 million Indian school children every day. And they do it for 11 cents a child. Now, circumstances and economics are worlds apart between the schools I work with here and the schools in urban centers in Bangalore, but there are three messages I took away from the story.

The first relates to health: hungry children, regardless of nationality, need food to grow and learn. The students involved in this lunch program have improved grades and behavior. Food is delivered in stainless steel containers (that can be sterilized and reused) – better for the planet (less waste) and safer for kids (no fears of food packaged in BPA-lined cans, served on styrofoam trays). And Akshaya Patra is luring children to school by keeping the lunch+dessert days a surprise – you aren’t sure what day dessert will be served, so you show up most days of the week so you don’t miss out on the sweets. Can you imagine a U.S. cafeteria that only had sweets one or two days a week?!

The second relates to the business of health: they are serving simple, tasty meals that involve cheap and healthy ingredients (rice, lentils, spices, a vegetable). Contrast that with the cheap commodity beef (with pink slime) served in U.S. cafeterias. If school cafeterias must run as a business, that business needs to put health front and center in order to maintain government, school, and community support.

The third relates to health communication: Akshaya Patra’s delivery vans have pictures of smiling kids on the side, making them a visible and attractive presence in the community. And they have a great website, Facebook page, Twitter feed, Google+ account, and YouTube channel. The U.S.’s National School Lunch Program? Nothing to write home about.


What can we learn from Akshaya Patra’s school lunch experience? I think a whole lot, but the most important may be improving communication between lunch provider and recipient: what would happen if we connected American parents and kids more directly to their Child Nutrition Director and School Lunch programs, through Facebook, blogs, and YouTube? Parents want their kids to eat well, and kids want to eat tasty food – perhaps we could finally drum up the grassroots support to facilitate changes to healthier, simpler, tastier school meals.


Image courtesy of smarnad.

We’re all human…

…yet the decisions we make as distinct social groups can be worlds apart. In the new global order, governments can make decisions about protecting citizen’s health based on the same available data, and sometimes the same data yields completely opposite results.

What am I talking about? I’m referring to the decision by Great Britain to phase out a long list of food dyes and additives from the food supply because the British government feels there is enough evidence that implicates the food dyes in aggravating hyperactivity in children. Just across the Atlantic, the U.S. government took a look at the same studies and decided there is insufficient evidence to pull yellow and blue Peeps from the shelves.

The difference in conclusions, and how the governments communicate with their people about the risks and benefits of components of the food system, are illustrative of the U.S.’s “prove its harmful” approach versus Europe’s generally “prove its safe” approach. Two ways to approach the same health issues that may yield contradictory health communication messages.

This World Health Day, take a moment to contemplate the politics behind our health communication, the pros and cons of government control over a population’s food and health, and how communication around topics like food additives that may not have definitive studies to support or reject their use could be improved!

Photo can be found at jmmb.

Girl checking panda's health with stethescope

Waiting for the ACA

In the coming months, while we wait for the Supreme Court to hand down its decisions in the Affordable Care Act (ACA) hearings, all of our healthy and unhealthy, insured and uninsured lives continue.

Two articles in this week’s New York Times highlight a health topic that goes undiscussed in the ACA debates, yet is central to the future health of individuals and our country: child health. While conservatives and liberals duke it out on the public stage over measures that, not too long ago, they would have agreed on (health insurance mandates were the brainchild of Republicans in the 1990s), the one health topic that brings the vast majority of Americans together is sadly overlooked.

Who does not support health insurance and health coverage for children? We know they will need care throughout their young lives, and beyond. So why is it so hard to see all U.S. citizens as grown up children that all require medical support at some point. (If you don’t and you make it to 90 years old – congratulations. Consider yourself more than lucky.)

The ACA debates are political, partisan, and grossly abused. Where are the health communicators providing clear, conscice, factual information on the issues? Do you know a good online resource for the ACA facts, not the rhetoric?

(For more thoughts on the ACA, see Marie’s post about ACA and attitudes towards prevention.)

Photo courtesy of Stuart Miles.

Do less harm

New parents are always paranoid about their baby’s health and safety: don’t sneeze near the baby *germs!*, feed the baby organic food *pesticides!*, put the baby to sleep on their back *SIDS!* These, especially the last one, are legitimate parental concerns. But what about these concerns?

Don’t let the baby chew on toys with bisphenol A (BPA) *endocrine disrupter!*

Don’t let the baby crawl on the floor covered in smelly carpet *may release Volitile Organic Compounds!*

Don’t let the baby near the Wi-Fi when its on *electromagnetic fields!*

Don’t attend a cookout where a grill cleaning fluid is used *diethylene glycol mono-n-butyl ether!*

How many of these compounds/potentially harmful substances can you describe, let alone identify their particular danger to your small child? There has been a lot of hype in the media about BPA-free products, but what about all the chemicals they are using in place of BPA in your plastic bottles and rubber duckies? Are they any better? It strikes me that the EPA, FDA, and CDC lack a comprehensive warehouse of information on all of the components in everyday products to help consumers make informed choices. Health communicators could certainly play a role in improving communication to consumers – the art of informing without causing a panic is subtle and sorely lacking! Even last week’s nuanced New York Times story leads and ends with sensational information (the dangerous chemicals you probably weren’t aware of in your cabinet).

If health communicators have a place, it should be at the health information-public knowledge interface.  They should be there to make sure that health information itself does as little harm as possible. Where are the health communicators in this discussion?

Talking WITH teens

Tomorrow evening I and a team of colleagues/community collaborators are hosting a community forum with teens and adults living in a rural North Carolina county.  Our goal is to talk about health in this rural community, and how we can improve the health of everyone in an area weighed down by obesity, diabetes, cardiovascular disease, and stroke.

The forum is the culmination of many months of work by teens and adults who took pictures of health/poor health in their community; these groups came together weekly to discuss their pictures and their findings, and ways to move forward. Tomorrow, these Photovoice groups, as they are called, will share their ideas and concerns with the broader community and ask everyone “WHAT NOW?”

Which is always a good question to ask. One of our biggest concerns is how to effectively reach out to kids and teens with health information/resources AND include their families in the conversation and health behavior changes. Childhood obesity may be a concern in the community, but if adults aren’t willing to change their behavior along with the kids, how are the kids supposed to eat healthy food, join sports teams, and stop eating all the donuts during coffee hour at church on Sunday?

What are your ideas for reaching out to teens and their families? What role do you think teens play in their own health, versus the responsibilities of the adults in their lives? Do you have novel solutions to reaching teens and parents simultaneously with health messages?


Image courtesy of imagerymajestic.

3 liters down

I just returned from a trip to the West Coast where I spent a good portion of my visit exploring local groceries and markets because I think these places can speak volumes about local communities and culture.

It also speaks volumes about the tension between public health and poverty. In a working class neighborhood south of L.A., I discovered an entire grocery aisle filled with 3-liter bottles of soda (that’s right 3, not 2). While more affluent communities are embracing the 100-calorie cans of Coke and paying more for less, people in this community are still looking for the cheapest deals. And 98-cent 3-liter sodas sound cheap.

What isn’t cheap are the costs to child and adult health: just this week, The New York Times printed a story on the rise of kids under 5 undergoing major dental surgery for largely preventable tooth decay!!!

Julie talked about the 8 dimensions of health, including financial and emotional health. Our health communication campaigns need to speak to these concerns in order to get through to hard-working families that can’t stop to consider the long-term effects of consumption behaviors, and don’t possess the emotional resources at the end of a long day to maintain healthy guidelines for their children.

There is nothing good about 3 liters of soda, but health communicators have not yet figured out how to be heard above the blarring advertisements and large, fluorescent price stickers in the grocery store. I think it’s time to start considering more creative health communication campaigns that address the 8 dimensions of health, not just the obvious ones that practitioners care about. And no more excuses for not campaigning in the languages that reach the audiences most at risk, especially the exploding population of Spanish speakers! U.S. health campaigns must be produced in English and Spanish.

What’s your answer to 3-liter soda bottles?

Photo courtesy of J. Mills and L. Thayer.

Lady Gaga goes to Harvard

That’s right–the most-followed person on Twitter with outfits that do everything but blend in addressed a large crowd at Harvard University yesterday. And what did this pop star have to say to New England’s elite students and academics? You and I and everyone else were “Born this Way.”

More precisely, Lady Gaga announced the launch of her Born This Way Foundation, which she hopes on one level will address bullying that 1 in 5 children experience each year. On another level, “Her aim is a far broader movement to change the culture and create a more supportive and tolerant environment. ‘It’s more of a hippie approach,’ she explained,” according to The New York Times’ Nicholas Kristof.

We often look to celebrities to promote public health messages–think of Nancy Regan and breast cancer screening, or the NFL’s Play 60 Campaign. Beautiful, strong and familiar faces often move the public to take action in ways that faceless public health professionals cannot. Lady Gaga’s interest in bully prevention, self-esteem building and promoting kindness in children is laudable. And she has the power to capture people’s attention.

My concern is that she needs public health, mental health and child development professionals to support her endeavors, and provide current best practices and research that guide and shape the efforts of this new foundation. I think the partnerships between celebrities and public health can be fruitful if they are truly collaborative. We’ll see if Lady Gaga takes collaboration to heart.

How do you feel about celebrities’ involvement in public health campaigns? What are the pros and cons in your mind? Is there potential for a Bad Romance between the two?

Image courtesy of

Laughing boy with glass of milk

Milking it

I admit it: I just spent 20 minutes on “The Breakfast Project” website, the new online-arm of the dairy industry’s Milk Mustache campaign. The new campaign launches this week.

I didn’t grow up drinking milk, I still don’t eat as much dairy as the average American, and as a nutrition researcher, I KNOW there are other ways to get those “9 essential nutrients” that America’s Milk Processors tout in all their ads.

But the new ad campaign has three things going for it that are hard to resist:

1) Salma Hayek is the new beautiful face of the campaign, along with other celebrities that are meant to reach the majority of the American audience (sports fans, Latinos, moms, white middle America…the list goes on)

2) The online campaign, in English and Spanish, is sleek, well designed, interactive and has a large presence on Facebook. They are reaching their audience from so many angles: TV, print media, in-store/school campaigns, websites, social media.

3) The campaign couches milk as an important part of breakfast, and the ads really are pushing America to eat breakfast. The nutritionist in me is shouting HURRAY because the “eat a healthy breakfast” message is so important.

And then there’s the catch. While the dairy industry is promoting their product (milk has its merits, industrial milk has its problems, and the majority of the world is lactose intolerant–all for another post), they are also promoting less-than-healthy breakfast ideas. The pictures on their website are gorgeous, but among the Top 10 breakfast items to consume with milk are yogurt (your body will only absorb so much calcium in one go), bacon (really?!), and cold cereals. Cereals rank #1 on the dairy industry’s breakfast list, but the majority of cereals in American grocery stores contain more added sugars than a kid (or adult) should consume in a day (assuming you eat more than the single 3/4 cup serving–see Allison’s post for serving size commentary). Yes, they suggest fruit, eggs and toast too, but they are equated with waffles dripping with syrup and breakfast sausages.

So here we are: the dairy industry spends $60 million per year on the milk mustache campaign. This year, that $60 million is promoting a public health cause, sort of. How do we deal with advertising that gets part of the health message out there, but then falls short? Should public health have some say in advertising that blurs the lines between profit-driven industry and health communication?

Image courtesy of photostock