Social Determinants of Health: Addressing Equity with Strategic Communications

Authored by Ⓒ Selena A. Ramkeesoon, MBA, PMP, MLS

Good health and coping with the inevitable challenges one encounters during a lifetime are a journey. Inadequate resources make a successful journey harder. At an individual level, lack of personal resources such as income and knowledge, limit an individual’s ability to follow optimal paths to health and vice versa. At a macro level, our society has a finite amount of resources—both monetary and service‐related—that realistically will not provide everything to everyone. We do not naturally think about health in terms of social factors. However, our health is significantly affected by our homes, jobs, and schools. The social determinants of health are the economic and social conditions—and their distribution among the population—influencing individual and group differences in health status.

In 2010, the U.S. Department of Health and Human Services unveiled Healthy People 2020, the nation’s 10-year goals and objectives for health promotion and disease prevention. The Healthy People initiative is grounded in the principle that setting national objectives and monitoring progress can motivate action. Healthy People 2020 highlights the importance of addressing the social determinants of health by including “Create social and physical environments that promote good health for all” as one of the four overarching goals for the decade. This emphasis is shared by the World Health Organization, whose Commission on Social Determinants of Health in 2008 published the report, Closing the gap in a generation: Health equity through action on the social determinants of health.

We generally recognize five determinants of health of a population:

1. Biology and genetics (e.g., gender).
2. Individual behavior (e.g., alcohol or injection drug-use, unprotected sex, smoking).
3. Social environment (e.g., income, education level, marital status).
4. Physical environment (e.g., place of residence, population density, built environment).
5. Health services (e.g., access to and quality of care, insurance coverage).

Although we do not know the exact impact of each of these five determinants of population health, in theory, social environment, physical environment, and health services (which combined make up social determinants of health) represent 50 percent of the factors that influence population health. This leaves us subject to our choices and circumstances for safe and affordable housing, access to quality education and job training, public safety, health services, and availability of healthy foods. These factors and social patterning of health, disease, and illness often plague individuals seeking to break the vicious cycle of barriers that prohibit them from making positive lifestyle changes. These are key factors in health inequity or health disparity—a particular type of difference in health (or in the determinants of health that could be shaped by policies)—in which disadvantaged social groups systematically experience worse health or more health risks than do more advantaged social groups.

As a social marketing professional who has developed and implemented several health campaigns, I believe communicators must take into consideration and address each of the determinants when developing awareness and education programs; especially when we seek to reach and encourage action among special populations. For example, racial and ethnic minorities, the elderly, women, children, individuals with disabilities, and LGBTQ populations. It is these populations who are often heavily impacted and in the greatest need of such health messaging. Yet, it is also the same populations who are often “stuck” in a vicious cycle of barriers that prohibit them from making positive lifestyle changes.

Social determinants challenge us to take into consideration a person’s/or population’s environment and circumstances to appropriately develop messages and strategies that resonate, reaching the audience at the right time and in the right place, and that are realistic—meaning that audience circumstances truly allow them to act in the desired manner. Behavior change is difficult and individuals cannot do it themselves without support. Behavior change communication programs are designed to bring about behaviors that will improve health status and related long-term outcomes. Such programs are key to providing the support structure that help people make the necessary health changes in their lives. Effective action to address the social determinants of health requires having sufficient knowledge of the mechanisms influencing health inequities, and adopting a conceptual framework that not only clarifies the relationship between social determinants and health inequities, but also helps to identify entry points for intervention.

This article was written by Dr. Selena A. Ramkeesoon. Selena is a communications strategist in the Washington, DC metro area. Ⓒ 2019, Selena A. Ramkeesoon. All Rights Reserved.

Should Hispanic be marketed as General Market?

Should Hispanic be marketed as General Market?

One of the key issues marketers are struggling with is the cultural tension between general and Hispanic marketing strategies to reach and engage Hispanic customers so they can grow, make profit and/or make a social impact. And with limited resources cultural marketing strategies might become an afterthought or the team would default to just translate the general market strategy for the Hispanic customer.

But, not all consumers are created equal. So, if two customer segments are different, why shortchange your growth potential by marketing Hispanic customers as general market?

Here are a few ideas on how you can diffuse cultural marketing tension:

Cultural Insight Drives Strategy and Strategy Drives Impact

Consumers are not isolated entities. Past experiences and social interaction dictates the outcomes of their behavior. Cultural insight will help you develop solutions and create an original narrative storyline that evokes emotions. Emotions that are relatable and familiar with your audience’s real-world experiences, which might be different from each customer segment you want to reach.

Developing relevant products and creating an emotional connection starts on the front end with understanding your customer’s pain points, the progress a customer is trying to make in a given situation, and knowing their emotional drivers to prove that you get them.

When Natural Valley wanted to reach the Hispanic market, they asked, “How do we tell the Natural Valley story to Latinos?” The answer in the general market was: hiking to the top of the mountain or kayaking on rapid waters. Adventure stories of how nature was conquered. However, when Casanova Pendrill, asked the question, they uncovered that to Latinos the parks served as their natural adventure and that all natural ingredients get you into the nature lifestyle.

Emotionally Connected Customers are More Valuable

Emotional drivers vary by customer segment and product category. Customers who form an emotional attachment to a brand are 52% more valuable than those who are just highly satisfied, according to a Harvard Business Review article by Scott Magids.

But, gathering demographic facts about a customer and implementing general market strategies or translations won’t capture what really motivates Hispanic customers to take action. Think of it this way: You can know a person’s age, height, and family size, but that won’t tell you why she bought a camera today. Maybe she needs to feel that she belong —a reason no amount of demographic data will reveal.

When Little Cesar’s Pizza wanted to reach Latinos in California’s Central Valley, we found out that eating pizza for first generation Latinos meant going to a seat down restaurant to celebrate with family and friends. The experience gave them a sense of accomplishment. It was not a utilitarian transaction to ease the day and cook a meal. Thus, Little Cesar’s Pizza needed to change the customer behavior and idea that eating at restaurant is the only way to celebrate special occasions.

Being Relevant Is About Helping Your Customers Tell Their Story With Your Brand

Helping your customers tell their story is about understanding how your brand enables your customer tell who they are. It requires exploring your consumers cultural and social context to learn how they feel and how to capture the unseen cultural subtleties. By understanding how they feel, think, say, and do about life, you will get a better understanding how your product or idea might fit into your customers lives, helping you become relevant.

When we worked on the Centers for Disease Control and Prevention’s (CDC) Zika campaign in Puerto Rico, we learned that living with mosquitos is part of their daily life and that mosquito-born desease campaigns were nothing new to them. Thus, the new campaign was rapidly falling into depth ears. Like a new song played too many times, goes into a background noise. So we asked how does mosquito preventing measures fit into their daily life? And we uncovered that what we needed to do was not telling what to do instead reminding them that preventing measures are part of their daily routing to enjoy the things they like to do, such drinking coffee with friends, going to the beach, and watching movies.

Given the enormous opportunity to capture the Hispanic market and create value, companies should diffuse the cultural tension between marketing to Hispanic consumers as general market. It will be harder to make an emotional connection that inspire action if you don’t develop a Hispanic strategy based on cultural insight.

You can begin to lessen general versus Hispanic marketing strategy tension by developing a strategy with cultual insights, uncovering emotional drivers, and helping your customers tell their story with your brand.

Hispanic, Latino, Markerting,

3 Horrible Mistakes You’re Making with Latino Marketing

If your growth plans includes tapping into the Latino market, you’re probably taking into some consideration how to implement your plans for a positive ROI. These can range from using internal staff, translating English campaigns to Spanish or hiring a subject matter expert or an agency. All these are viable options to look at. Regardless of what option you choose to go with, three tactics that you should consider carefully are:

Audience:

The Latino market is growing and changing. Now you have different segments with different cultural values going from traditional to non-traditional with shades of grey in between. Treating everyone equally will not resonate and capture their attention.

What can you do? Segment your audience by cultural orientation and focus on aspirational values to engage and develop messages. Remember that one message does not fit all.

Mobile:

“Hispanic consumers see mobile technology as critical to support their mobile lifestyle”- Price Water Coopers

Latinos are mobile mavens and are using smartphones to engage with brands on a deeper level. They are more socially connected with friends and family according to the latest report from univison.com. They are actively seeking out deals and making purchases – all day long on their smartphones. Look at some of the numbers from Google, Univision and eMarketer research:

  • 81% of Hispanic mobile subscribers own a smartphone.
  • 80% more likely than their non-Hispanic counterparts to actually purchase the products they see advertised on their mobile devices.
  • 20% more likely to download and 18% more likely to video stream than non-Latinos.
  • 68% of the respondents who search at least monthly do so on their mobile devices to find the information they need.
  • 11+ hours each month watching digital video.
  • 39% more time watching video on their smartphones each month vs. total population.

What can you do? Think mobile first, then create content that is engaging, easy to consume, and helps your audience move towards their aspiration and intentions. Remember that Latino generations differ on the digital channel purpose and how they are used.

Influence:

Latinos want to hear from people like them.

Culturally, Latinos are well connected in their personal lives on and offline with influential networks of friends and family. The power of word of mouth is an influence driver to their purchase decision.

According to Keller Fay Group, Hispanics are talking about 20 more brands per week than non-Hispanics. Further, Univision reports that 79% of online Latinos have a presence on social media sites and they share 5 times more often than non-Hispanics via social media. What is more interesting is that 35% of the content they share is more likely to be clicked on by others.

What can you do? Develop a communication program that sparks conversations on and offline with content that is sharable. This can involve working with influencers to share your content or create user generated content that supports your brand, implementing a twitter chat, Google hangout or on the ground event.

Whatever option you choose to implent to grow with the Latino market, start with understanding your audience, thinking mobile first, and  answering the following questions- What do you want others to say about your brand? What are you doing to promote conversation around your brand?