We strive to be evidence-based communicators here at The Scientific Parent, and sometimes we collectively wring our hands at public health messaging by our counterparts at other organizations. After all, the public health nerd core tends to be made up of nerds, and while we love nerds (seeing as how we consider ourselves members of that tribe), sometimes nerds can get lost in health data and forget that it doesn’t exist in a vacuum. Data may be objective in the eyes of researchers and statisticians, but in the real world and life, those numbers have context.
That’s why over the last two weeks we’ve found ourselves squirming over recent public health campaigns. For example: common sense would suggest that telling women in Texas to simply not get pregnant due to the threat of catching the Zika virus is utterly unhelpful. First, because of the lack of universal access to free contraceptives for both sexes, and also because the messaging places an undue burden on women with no equivalent advisory (i.e.: ‘don’t get anyone pregnant’) for men. Also, family planning and expansion usually doesn’t stop because viral outbreaks, as public health officials in every other country on the planet can tell you (including those in Brazil who are seeing women avoid mosquitos that carry Zika, not pregnancy).
A similarly unhelpful message was also issued by the CDC last week regarding alcohol use in women of reproductive
age. The CDC’s message, which you can see in the accompanying infographic, boils down to “if you’re not on birth control, don’t drink.”
Ummm.. what? (*Leslie and Julia clutch their glasses of wine in horror*)
While their message may be based on solid epidemiological data, in terms of public health policy, the language used is convoluted, and fails to support its targeted audience (fertile women) execute the desired behavior change (avoid combining alcohol with a growing fetus). It also glosses over the fact that birth control isn’t readily available for all women who do want to take it, that men are a part of the fertilization equation, or that drinking alcohol is just drinking alcohol. Drinking alcohol while birth control free doesn’t automatically equal to sex. And then a baby. There are a LOT of assumptions in there.
To put it bluntly, we think the CDC’s messaging on this particular topic was poorly written and completely misses the mark in terms of educating and empowering their audience. And while there isn’t anything inherently wrong with blowing it messaging-wise once in a while, where further clarification is required (we all do it sometimes), what is really problematic is that it creates a credibility issue.
Because how we communicate has a huge impact on how our messages are received. And not just the messages in question but all of our messages. You can have the most beneficial health fact or piece of medical advice to provide, and if you wrap it up in packaging that doesn’t work for your audience? It flops, and sometimes it can flop so badly that it creates a cascade effect that can tarnish an organization’s reputation, what we refer to as the law of unintended consequences.
This means that when we consider our public health messages, we need to consider all potential outcomes of that messaging, both intended and unintended. In the case of the CDC’s messaging about alcohol consumption and birth control the unintended consequences have been that the CDC’s credibility and messaging in others areas has been effected. We’ve already seen blog posts and comments from readers asking, “if CDC is so off the mark on this, why listen to them about vaccines, breastfeeding or hand washing?”
While we wouldn’t take it that far, because there is plenty of incredibly beneficial evidence-based data and messages that the CDC does provide, we do think this was a particularly icky misstep. So in honor of the rigid, inflexible, and paternalistic slant of this particular campaign,The Scientific Parent editorial team (composed of two fertile women of childbearing age) made a concentrated effort to consume alcohol and not to consume birth control pills while writing this post. Daring, we know. We know we’re putting hypothetical babies in danger, in the event that risky sex happens to us unknowingly while we’re watching the X-Files and sitting on the couch with our families, sipping those risky glasses of wine.
We digress. The point is, without universal access to free birth control (hormonal or otherwise) or acknowledgement that it takes at least two people to conceive a child, women are left between a rock and a hard place with both recommendations issued by both the CDC and public health officials in Texas. “Don’t get pregnant under these circumstances … but good luck with that,” is not executable or responsible public health policy.
There’s a point where it’s appropriate for an agency to make recommendations about what individuals do in their free time, and there’s a point where it’s not. Wherever that line is, which we won’t be defining here, it’s pretty clear it’s been crossed in some of these instances.
These two flubs are not alone; the range of awkward public health messaging on social media over the last few weeks has ranged from hilarious to downright offensive. Of particular amusement for us was the “We All Need the D”campaign from the Yukon Territory in Canada, which we’re compelled to share.
“Needing the D” is a slightly crude (albeit we think hilarious) slang phrase that means desiring a part of the male anatomy, which apparently the Yukon Department of Public Health (YDPH) knew when creating the ad campaign. It definitely grabbed our attention, but not for the reasons intended by the YDPH. We also doubt it helped increase vitamin D usage in all the dirty-minded people who saw the ad, included The Scientific Parent’s editorial team. Ok, maybe a little bit. But we had to stop laughing first.
How a message is crafted largely comes from how an organization regards their audience’s intellect, abilities, and way of being. Based on our “Needing the D” example, you can see how assumptions can make an (*ahem*), a** out of you and me, if you catch our drift. And the YDPH is not alone.