Mind the gap

This blog post was published on August 28, 2012 at 01:36 pm GMT

Five years of social marketing were held to account in the Guardian last week  as the Kings Fund thinktank reported on the effectiveness of campaigns to support healthier behaviour in England 2003 – 2008. The study monitored change in four areas of activity which threaten long-term health (smoking, excessive drinking, poor diet and physical inactivity).

The good news (and it is good news) is that 2003 – 2008 saw a drop in the number of people indulging in three or more of these behaviours from a third to a quarter of the population. The bad news (apart from the fact that even this improvement leaves much life-shortening behaviour untouched) is that the gains have been restricted to the top end of society. The best-off and best-educated have been swift to embrace healthier lifestyles, leaving the poorer and less well-educated more or less where they were at the beginning of the period.

In traditional marketing terms the social composition of your customer base is less important than the fact they are buying your product. In fact many successful brands make their profits through being socially exclusive. Health isn’t like that, however. While it’s heartening to see an overall change towards healthier lifestyles, it’s in nobody’s interest for this change to be widening the gap between rich and poor. It’s morally miserable, socially divisive and wasteful of resources — both now and in the future treatment of avoidable conditions.

Today’s social marketers face straitened circumstances compared to a decade ago. But with less to play with, the challenge is to concentrate resources and creativity on closing the health inequality gap. This means turning standard marketing logic on its head. Instead of pursuing the most likely customers, health marketers need to prioritise the ones we used to call ‘hard to reach’ (a phrase which promotes the marketer’s view of the world, rather than meeting the customer on their own terms. You’re only hard to reach if nobody knows how to find you).

Rather than the ‘quick wins’ and ‘low hanging fruit’ beloved of management consultants, this gap is going to be a slow, tough nut to crack. But only by taking the long view, and acknowledging the difficulty, expense and time required, will policy makers ever hope to make an impact on the health behaviour of poorer and less well-educated citizens. If government really wants to bridge the widening health gap in society, it needs to close the gap between what we expect social marketing to achieve and the resources available to it.