European Public Health Alliance Using information and communication to reduce health inequalities Tamsin Rose WHO Regions for Health Network Katowice, 24 November 2005

Inequalities and information gaps Evidence of strong links between social deprivation and addiction, risky behaviour. Health inequalities are often underlined by - Little awareness of services that are available - Low literacy levels and inability to navigate through ‘the system’ - Tangible barriers - physical accessibility and transport - Intangible barriers - language, culture, administration - Poverty - Mistrust of authority - Low self-esteem and ability to control the social and physical environment

Information in the context of health promotion In the context of the growing burden of chronic disease, action needs to be taken on determinants and risk factors. Begin health promotion early in life and integrate the key messages into daily living through the whole life span. Traditional health education campaigns - top-down planning, centrally planned and expert driven, based on best practice and literature reviews. Social marketing - vivid, personalised information, localised, responsive, involve target audiences in defining the messages, multiple media.

Examples of public health information campaigns Seatbelts and speed reduction campaigns Childhood immunisations Oral rehydration salts and diarrhoea Hygiene and handwashing Breastfeeding Cancer screening (breast, cervical, bowel) Binge drinking Safe sex and HIV prevention Harm reduction for drug use

Expected outcomes for health information Increasing healthy behaviour patterns - measured by reduced incidence and severity of ill health Greater awareness of health services Appropriate use of health products and services Enhanced user satisfaction rates Better compliance with treatment regimes BUT - concerns that it encourages unhealthy behaviour by creating visibility and awareness or reduces stigma and ‘normalises’ activities that some may consider inappropriate, immoral or illegal.

Young people - a key target group Six priority health risk behaviors contribute to the leading causes of death, disability and social problems. These behaviors, often established during childhood and early adolescence, are Tobacco use. Unhealthy dietary behaviors. Inadequate physical activity. Alcohol and other drug use. Sexual behaviors that may result in HIV infection, other sexually transmitted diseases, and unintended pregnancies. Behaviors that contribute to unintentional injuries and violence.

Increasing the uptake of information Before people will use health information, it must be (1) available, (2) seen as useful and new, (3) processable, or format-friendly. It must also be reliable, trustworthy and result in positive outcomes for the individual.

Hard to reach communities Rural communities tend to have lower incomes, poorer health, higher percentages of elderly, fewer local medical practitioners…and proportionally the fewest telephones, the fewest personal computers, internet connections and leisure facilities. Excluded groups such as the homeless, IDUs, sex workers often have multiple health conditions, chaotic or disorganised lives, little awareness and access to services, low literacy rates, limited resources and options. Migrants and ethnic minorities face linguistic barriers, cultural and religious taboos, may not be registered for services, messages may be irrelevant.

Selling ideas and behaviours “Social marketing seeks to influence social behaviors not to benefit the marketer, but to benefit the target audience and the general society”, Philip Kotler and Gerald Zaltman - getting the right mix - mass media and interpersonal communication - learning to listen to the needs and desires of the target audience themselves, and building the program from there - focus on the "consumer" involves in-depth research and constant re-evaluation of every aspect of the program.

The basics of social marketing These key concepts can be abbreviated as follows: * Action is the objective * The target audience is the focus * The exchange is critical * Segment markets * Use all four Ps - Price, Product, Places, Promotion * Analyze and beware of competition * Monitor and be flexible

Basics of a health communication strategy Information + context = communication Background - what is the issue, the processes and timeframe? Define your messages - what needs to be said? How should it be differentiated for the audiences? Identify your targets - who takes the decisions? Who do they listen to? What is important to them? Select your vehicles - activities, events, information releases, meetings, conferences, media relations, peer groups, demonstrations, publicity stunts. Check the landscape - who are your allies and opponents? Track their messages and respond.

Beware of information overload

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