The Everything Approach

20130523-173341.jpg My undergraduate degree is in sociology, which means I’ve got a theory for just about everything. One of my favorite theories is the social ecological model. Basically it means that in order to completely understand why someone is doing something, we can’t look at one facet of what they do and attempt to use that to explain it entirely. People don’t ignore hurricane evacuation warnings because of the messages, they ignore them because of their families, because the last two evacuations didn’t pan out, because the dog’s sick and can’t be kenneled, because their work isn’t closing, because they don’t have money for a hotel. I like to call it the Everything Approach.

A perfect illustration of this phenomenon is our weather warning system’s infatuation with lead time. If we can warn people earlier, goes the thinking…

Except that even with 36 minutes of lead time, there wasn’t much any of them could do.

Our friends over at PopHealth investigated further:

Over and over, Meteorologists kept saying- “it would be very hard to survive this storm above ground”. And then we heard that basements and safe rooms are not common in Moore.

So how can that be? How can a town situated in an area of the country ripe with tornado activity be without basements and safe rooms?

Well- as with most public health challenges, the answers are complex [and include]: Environmental, Urban Sprawl, Cost, [and] Access.

Our messaging wasn’t the real problem. The public had plenty of time to hear the warnings, and Moore had been hit by an EF-5 tornado just fourteen years ago, so it’s not like the impetus to be ready wasn’t there. People weren’t in tornado shelters because of, as Leah said, all of the other influences. Money, ability, priorities.

So much of what we do, as communicators, focuses on the message and we hope that the government funding fairy and “rest of people’s lives” fairies hold up their end of the bargain. As we’ve seen over and over again, though, they don’t. The wonderful Alex Bornkessel highlighted this idea when talking about health communications and how just focusing on messages doesn’t help:

The study shares interesting insights on the relationship between messaging and behavior change based on its 12 years of longitudinal data from the Canadian National Population Health Survey among Canadians aged 50 or older with a chronic disease. Findings show that:

  • 3 in 4 smokers with respiratory disease… do not quit smoking
  • Most people with diabetes or heart disease… will not become more physically active, and
  • For people diagnosed with cancer, heart disease, diabetes or stroke… virtually, no one will increase their intake of fruit and vegetables.

Indeed, the reviewer of the study shares: “As many experts in health promotion are well aware, knowledge and warnings are the least effective measures to change health behaviours.”

The easy answer as to why we do things this way is because it’s how we’ve always done them. Communicators communicate. We message. We have no control over if people build storm shelters or if they start eating vegetables or not. They’re the ones who are ultimately responsible, it’s up to us to raise their awareness of the situation.

The thing is, as we’ve seen above, we don’t need messaging. We need full wrap-around, we need to approach our work from a social-ecological model point of view. We need to not only to tell them they need a storm shelter, but advocate on their behalf to make it easier for them to get one. We can’t just tell people to walk for thirty minutes after dinner, we need to make their streets safe and well-lit and make sure they have sidewalks.

You want to change a life, to save a life? Then you need to drop the awareness campaigns and make your work part of life itself.


4 thoughts on “The Everything Approach”

  1. I beat this drum on the daily. But how to get everybody on board that it is indeed “everything” that we need to acknowledge/confront, and not just some specified behavior or lack of knowledge. Are there some good examples of people or campaigns who have taken this “everything” approach and succeeded? And then how do we know when we’re doing it right?

    1. I think that smoking is a good example. Between our messaging, scientific research, pressure on industry groups (especially the movie industry), and sin taxes, smoking rates in the US have fallen. Think about safety belts in cars, too.

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