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Combating the Perpetuation of Vaccine Misinformation: Health Communicators Have a Role and a Responsibility

“Health communication is the science and art of using communication to advance the health and well-being of people and populations.” (Society for Health Communication)

The World Health Organization (WHO) named vaccine hesitancy, the reluctance or refusal to vaccinate despite available vaccines, one of the top 10 global health threats for 2019. The reasons why people choose not to vaccinate can be complex, but as we have heard reported for several months around the current outbreak of measles, which had been declared eliminated from the US in 2000, the perpetuation of vaccine misinformation has reached a tipping point.

A recent call to action on the issue from the American Academy of Pediatrics (AAP) states, “Though robust scientific research demonstrates that vaccines are safe, effective and life-saving, inaccurate and misleading content about vaccines proliferates online. As parents increasingly turn to social media to gather information and form opinions about their children’s health, the consequences of inaccurate information play out offline.”

As health communicators, we not only have the opportunity to play a critical role in addressing this public health crisis, we have an absolute responsibility. What can we as health communicators, especially those of us working in the vaccination space, do to help stem the tide of vaccination misinformation across social media and beyond?

  • Plan, plan, and plan some more. A 2015 study on Health Communication and Vaccine Hesitancy found that, “…communication can be an effective tool, if utilized in a carefully planned and integrated strategy, to influence the behaviors of populations on a number of health issues, including vaccine hesitancy.” A thorough, thoughtful strategic issues management approach is critical in the vaccination space. Take the time to fully assess the environment in which your campaign or outreach strategy will be implemented and be sure to include formative research as a key starting point. Be proactive in considering the “what if’s” and plan your communications tactics and messages accordingly.
  • Translate the science. As Paul Offit, MD, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia often states, science doesn’t speak for itself. As noted in his most recent book, Bad Advice, “Scientists are often unable to package their insights into the neat narratives that the public requires.” As health communicators, we are by nature, communicators of science. As such, our role must include effectively and accurately translating complex scientific, regulatory, and medical information into clear, plain-language content that our audiences can comprehend.
  • Use trusted sources to deliver the message. Even when translated clearly and accurately, science on its own is not enough. The audience must trust the source delivering that message—be that an entity or an expert. According to WHO, “…health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions.” As health communicators, we have a responsibility to engage and include clinicians and health workers in our strategic planning and to provide them with clear, science-based, credible information to deliver to their patients.
  • Be mindful of the use of imagery as a communications tool. Images used in health communication have long been shown to affect perspectives and attitudes towards health issues, including vaccination. Nearly one in eight images included in vaccine-related online news coverage contained features which may promote negative sentiments, such as fear or mistrust about vaccination. This according to a study published in Pediatric News, which also concludes that there is a great need for images that communicate encouraging information about vaccination and the protection vaccines provide. As health communicators, we must be mindful to advocate for, produce, and utilize images using careful consideration of the potential impact on public health.
  • Be respectful of the audience. Granted, as a parent especially, it can be difficult to empathize with those who choose not to vaccinate. But as a health communicator, empathy and understanding are imperative. We need look no further than to the example of 18-year-old Ethan Lindenberger, who recently testified before the Senate Committee on Health, Education, Labor, and Pensions about his decision to catch up on missed vaccinations against the wishes of his mother, who chose not to vaccinate Ethan or his siblings. “A necessary clarification must be made when discussing this misinformation: anti-vaccine individuals do not root their opinions in malice, but rather a true concern for themselves and other people,” he testified. “Anti-vaccine parents and individuals are in no way evil… Using the love, affection, and care of a parent for their children to push an agenda and create false distress is shameful. The sources which spread misinformation should be the primary concern of the American people.”

While recent steps to manage content from Facebook, Pinterest, Amazon, and other platforms are meaningful, the sea change cannot and will not occur without clear, accurate, effective communication and the dedicated commitment of health communicators to accept the responsibility and the critical role we can play in combating the perpetuation of vaccine misinformation.

Katherine Nicol is a Senior Vice President at Hager Sharp, a member of the Society for Health Communication, and sits on the National HPV Vaccination Roundtable.

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4 Ways Good Food Can Change the World

Can you imagine if there was one invention that could help people live healthier lives, reduce healthcare costs, boost the economy, increase education outcomes, and improve the environment? Now, imagine that it’s not an invention at all, but something that has been around for, well, ever, and something you not only encounter every day but also need to live. That’s right, I’m talking about food.

Humans—and Americans in particular—have a complicated relationship with food, as exemplified by fad diets, ever-changing (and often conflicting) dietary recommendations, the widespread presence of food deserts, and of course the obesity epidemic. But if approached and consumed in thoughtful, healthy, and sustainable ways, food can be a catalyst for positive social change. Here’s how.

It’s no secret that good food is essential to health. Yet, our nation is in the midst of an enormous health crisis caused specifically by failure to prioritize nutrition. Four of the leading causes of death in the U.S. are diet-related, and an unhealthy diet contributes to approximately 678,000 deaths each year.

The good news is that where food is the problem, it’s also the solution. Approaches to food that emphasize nutrition education and improving access to healthy food can dramatically increase public health. A Tufts University study, for example, found that a reduction in the price of nutritious foods like fruits, vegetables, and whole grains coupled with a tax on unhealthy foods like red meats and sugary drinks could prevent roughly 23,000 deaths each year. Food is one of the most powerful health promotion tools, so imagine how many lives we could save by focusing on preventing diseases through healthy diets rather than treating diseases caused by poor diets.

It may be difficult to consider how an individual’s food choices can impact the economy, but simply looking at how much our nation could be saving if we ate healthier starts to bring this concept into perspective. In 2016, the U.S. spent a staggering $480.7 billion treating chronic diseases caused by obesity and being overweight. But treatment isn’t all we pay for when it comes to diet-related diseases. After accounting for indirect costs, like lost worker productivity, the total cost jumps to $1.72 trillion. That’s approximately one-tenth of the 2016 U.S. gross domestic product.

The need for a “health is wealth” approach to food policy and nutrition promotion has never been clearer. Targeted initiatives that promote healthier eating, like nutrition education in schools and food prescription programs, invest not only in population health but also in economic health. In other words, helping people eat healthier keeps dollars out of healthcare and saves them for other causes—education, urban renewal, you name it.

Good food in schools should be a no-brainer. If children are the future, then we need to ensure they have the proper tools to succeed in school, starting with food. And not just any food, but food that is full of the nutrients our bodies and minds need to function properly. Since better nutrition makes students healthier, they’re more likely to show up to class ready to learn and have fewer absences. Additionally, studies have shown that a high-quality diet is associated with better performance on exams.

Despite these facts, the standard for school meals remains low. Pizza, cookies, and French fries take center stage while fruits, vegetables, and whole grains take the back seat (if present at all). Foods with high levels of saturated fats, however, have been found to impair learning and memory, and sugar plays a role in hindering student performance, too. School food should help, not hurt, students’ academic performance. Prioritizing school nutrition and helping families access healthy food is critical to boosting education outcomes, which, of course, has positive implications for the economy as well.

Our food and the global environment are inextricably linked (food does come from nature after all…). There currently exists a vicious cycle in which our food system is wreaking havoc on the environment and environmental degradation is putting our food system in danger. Between runoff from pesticides and herbicides, air pollution from transporting food across the country (and around the world), immense resource losses from wasted food, and the release of methane gas into the atmosphere from cattle waste, our current methods of food production are threatening the environment at unprecedented levels.

Sustainable food production and consumption, however, has the power to mitigate the effects of climate change and ensure there are enough resources to continue feeding the growing population. So how can our food choices help protect the environment? Some options are to focus on eating foods that are lower on the food chain and less processed, like fruits, vegetables, and whole grains; reduce or compost your food waste at home; and buy local food, which has a much smaller carbon footprint, whenever possible. On the national scale, policies that promote organic and regenerative agriculture methods rather than commercial farming and monoculture crops, as well as innovations that repurpose food waste and unwanted produce, have tremendous potential for reducing air pollution and sustaining resources for future generations.


It’s time to start viewing food as the powerful tool for social change that it is. After all, food is medicine, food is community, and food is culture. Food touches so many aspects of our lives, so it is critical to view diet from a holistic perspective as opposed to viewing it through only one lens, such as health. While it may not be a cure-all, food still has the power to transform not only individual lives, but also the prosperity of our entire nation and the world. At Hager Sharp, we’re committed to improving health, advancing education, transforming our communities, and making meaningful change in the world. Therefore, we’re investing in good food and nutrition in 2019 and beyond. Are you with us?

Maddie Stein
Account Executive

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3 Lessons in PR and Education Equity from “America to Me”

Last year, just before school began, Starz premiered its critically-acclaimed documentary series, America to Me. The 10-episode series profiled students, teachers, parents, and school administrators at Oak Park River Forest (OPRF) High School in the suburbs of Chicago, Illinois.

I recently finished watching the mini-series as a way to broaden my own understanding of racial equity in education. That’s because OPRF, with one of the most diverse student bodies in Metro Chicago, also suffers from a widening achievement gap between its White and Black students.

It’s only natural that I viewed the series through the lens of a PR professional, and I couldn’t help but notice the tie-ins to the skills needed by communicators. These skills are best exemplified by OPRF’s teachers, a handful of whom do their part to narrow the achievement gap. In the process, they serve as a master-class on how to build mutually beneficial relationships that allow them to serve their students’ needs—the same way communicators should conduct themselves to provide quality client service.

Here are some tips to consider along with examples from the show (spoilers ahead):

  1. Use research to prove your pointAmerica to Me showcases how race plays a factor in student-teacher relationships. To persuade OPRF’s school board into taking more concrete action in addressing the achievement gap, English teacher Jessica Stovall conducts a multi-school study with other Chicago-area schools that observes the communication styles of White teachers in predominantly Black classrooms. Part of Stovall’s goal is to implement mandatory racial bias training with the school’s teachers, among other initiatives. By providing the school board with data to help inform their decisions, Stovall hopes they will be convinced of the need for this training as a step towards more equitable solutions for minority students. Her actions are a reminder to communicators that the first step in creating a client’s plan is to gather the facts that will inform and support your communication strategies. The most effective plans are based on research.
  2. Meet them where they’re at – OPRF’s talented Spoken Word Club provides an example of what educational equity could look like. The diverse team of students are led by a teacher who allows them to use their performances to speak freely on issues like racism, social injustice, and domestic violence. Just as this club provides an inclusive environment, communicators need to be sure that they understand the needs of their clients’ audiences in order to meet them where they are at. Grassroots outreach is a common strategy that illustrates this point because it involves direct audience communication. Like the Spoken Word Club teacher, sometimes our clients need to take a grassroots approach to be effective at engaging with their audience.
  3. Go above and beyond – In profiling OPRF’s minority students, America to Me sheds light on reasons for the school’s achievement gap. The profiled students endure struggles in their respective classes for intrinsic and extrinsic reasons. Despite their setbacks, the students are supported by teachers who meet with them outside of school hours to receive tutoring and make up assignments and exams. It’s with this extra push from their teachers that these students learn how to be successful. The same holds true for communicators, because not all challenges can be anticipated. We’re often tasked with going the extra mile to come up with creative and practical solutions for our clients.

America to Me provides insightful material for educators to consider, and it offers examples for how communicators should serve their clients as well. When we counsel clients on their strategy for building relationships with its audience, it’s important that we do our homework or research to make sure we understand the audience’s needs, where they get their information, and what it takes to bring change. If we can do that for clients, there’s almost nothing that can stop us from overcoming challenges—just like the students of OPRF.

Cedric Brown, MS, APR
Senior Account Executive

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Family History Is Black History: Elevating the Importance of Health in the Black Community

Black History Month is a time for us to remember, share, and celebrate the achievements and contributions of notable Black figures. It’s also a great time for us as a Black community to remember and learn more about our own history and families to better understand ourselves and where we come from. Our bloodline and DNA don’t just tell the story of who we are, but they also provide us with information about our health. That’s why developing a family health history, a record of health information about a person and three generations of his or her relatives, is important. Not enough of us know our unique health histories and hereditary risk factors. Black History Month is the perfect time to talk about and create a family health history.

One of the most significant memories that I have growing up is the day that my mother came home from the doctor and said to my sister and me that she had something important to tell us. When my mother was 40, she sat our family down and shared that she was diagnosed with type 1 diabetes, which is a chronic disease that currently has no cure but can be managed by taking insulin and monitoring glucose levels up to 10 times a day. I distinctly remember the look on her face before she said anything. She was concerned, but it was more for her children than it was for herself—about how it may change our lives because of potential hereditary risk for us and our children in the future.

At the time, I was only 14 and didn’t fully grasp the severity of the disease, nor did I understand the genetic impact. The risk for diabetes (both type 1 and type 2) is higher for those with a family member who has the disease. I know now that in my family health history, this disease stretches back to my great grandfather and reached three other generations—including my grandfather, uncle, mother, and young cousin who have all been diagnosed. What I’ve recently learned is that the disease could be more likely to occur in an individual whose father has the disease, which is exactly the case for each of my family members who have been diagnosed. According to the American Diabetes Association, researchers are still trying to discover what factors can put you more at risk for type 1 diabetes. The odds are not clear, but African Americans that have the gene called HLA-DR7 may be at higher risk than those who don’t have the gene. Although I have not been diagnosed with diabetes, I’ve had my own health challenges, which I read could potentially be linked to having a parent with diabetes.

Stories like mine are not uncommon in many families. There are many Black people who don’t know that diseases and conditions, such as type 2 diabetes, heart disease, high blood pressure, stroke, and certain cancers, run in their families. Black people face social and economic disparities, such as less access to health care and information, that put them at heightened risk for bad health. In fact, the life expectancy of African Americans is four years less than Whites, and young African Americans under the age of 50 live with and die from diseases that typically happen in older ages. The health disparities that exist are alarming, but knowing and understanding the breadth of family health concerns could help us take preventative steps toward good health. A family health history isn’t just beneficial for each individual; If we encourage each other to prioritize our health by sharing information with each other, together we can work toward improving the health of our families, community, and future generations.

Often, health can be a sensitive and difficult topic to bring up with our families, and health information may many times be a “hidden” piece of our history. But what I’ve learned from my work at Hager Sharp and in communications is how important it is to recognize social and cultural barriers and share tools and resources to help people overcome them.

Here’s how those same ideas can apply to and encourage the Black community to create a family health history:

  1. Tap into the power of storytelling to educate and engage your audience. Stories have the power to connect us to who we are, influence our emotions, and help us commit what is important to us to memory. Storytelling is one of the many long-held traditions in Black culture that stems from the African diaspora. Embracing storytelling can help open up conversations between family members to talk about health.
  2. Listen. Though talking is an important aspect of communication, listening is just as important. When developing a family health history, it is necessary to listen to understand and gather the information needed. To take listening a step further, we also need to consider listening actively by asking questions, repeating the information for accuracy, and responding appropriately. Listening to each other not only can help gather the information needed to develop a family health history, but it can also help us build stronger relationships, strengthen trust, and encourage healthy conversations between family members.
  3. Identify opinion leaders and influencers. If the goal is to encourage family members to share information and take preventative steps for better health, consider who the influencers are within the family or community. The message can hold more weight and value depending on who delivers it. Whether it’s the matriarch or patriarch of the family, or even an outside influencer such as a pastor or other well-known community leader, having an influential figure can help our families and communities understand the importance of knowing about our health.
  4. Promote transparency and relationship-building to create trust. Within the Black community there are long-held beliefs and stigmas that prevent us from sharing health information, including fear of exposure, judgment, and shame. Offering a safe space for transparent conversation and using communications tools can help open the door to knowledge sharing. Encouraging the use of resources like the My Family Health Portrait Tool in safe spaces, such as family reunions or holiday gatherings, can help influence or change beliefs about sharing health information.

At Hager Sharp, we value people from diverse backgrounds and the opportunity to reflect multiple voices in our work. We work tirelessly to help people live healthier lives and understand how imperative it is to consider the specific health concerns of multicultural audiences. And I hope that this is a commitment that we will all make. Now is the time for us to carry out the tradition of sharing stories and information to better understand our histories, improve our health, and pave the way for future generations.

Chelsie Pope, MPS
Account Executive

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What’s in Store for Social Marketers in 2019?

New Year 2019 opened with plenty of controversy, including partisan disagreements over funding for a border wall that has resulted in a government shutdown. As we worry about the impact a prolonged government shutdown will have on public health, education, and other social supports, let’s consider some of the biggest issues in public health and education that social marketers will need to address in the year ahead.

I asked my colleagues at Hager Sharp to do a bit of crystal ball-gazing, and here’s what they said will be important in public health:

  • Senior Account Executive Monica Carano predicts health privacy will be an issue requiring increased focus in 2019, as technology enables ever-increasing information collection through innovations, such as wearable devices, home monitors, patient portals, and patient-generated health data. Patients need to be able to trust that their data is safe, and cybersecurity will be more important than ever. For more on this topic, check out expert predictions in the Journal of AHIMA.
  • Monica also suggests that social isolation will be a hot topic to address in 2019, especially given former Surgeon General Vivek Murthy’s recent focus on the problem. Several countries, including Britain, Denmark, Australia, and Japan have taken steps to address the issue, launching public campaigns and even, in the case of Britain, appointing a minister for loneliness. In the U.S., social marketers can follow the Kaiser Family Foundation’s work in this area to keep up with news and trends.
  • According to Account Executive Maddie Stein, “the relationship between diet and health simply cannot be ignored any longer, especially as four of the leading causes of death in the U.S. are directly linked to food. As rates of diet-related diseases continue to rise, people have become increasingly interested in and aware of the critical role that food plays in human health. Therefore, I predict that 2019 will be the year that the ‘food as medicine’ movement―with a focus on the power of produce―finally takes off. We’ve started to see this idea come to life through concepts such as food prescription programs and innovative marketing initiatives like FNV, and I can’t wait to see more in the new year.”
  • Along with a heightened awareness of nutrition as a determinant of health, Maddie also predicts that “we’ll see a greater focus on the tremendous disparities in healthy food access that exist in this country. Whether it be through public-private sector partnerships, school garden programs, or changes in food policy, I hope to see significant strides toward eliminating food deserts and closing the ‘grocery gap’.”
  • Senior Account Executive Laura Koehler predicts that emergency preparedness will take center stage in 2019, as communities take steps to prepare for natural disasters, terrorist attacks, and other incidents that affect public health. The American Journal of Public Health has issued a call for papers on this topic, and as social marketers, we will be looking for the resulting supplemental issue.
  • According to President and CEO Jennifer Wayman, as an increasing number of states and communities legalize marijuana for medical and recreational use, social marketers will need to focus on public health communications about the health effects and public safety effects of marijuana use. Hearing a radio advertisement for “pot as a Christmas stocking stuffer” made her realize that marijuana is not regulated for public health effects in the way that alcohol and tobacco are, so policymakers will need to consider these two case examples as they create a public health framework and policies for legalized marijuana.
  • As for me, I think food sustainability will continue to grow as an issue. The Economist’s recently released Food Sustainability Index (in partnership with the Barilla Center for Food & Nutrition Foundation) reminds us that the issue is complex and far reaching—the Index tracks data by country on three separate but related facets of food sustainability: food loss and waste, sustainable agriculture, and nutritional challenges. It is a global issue and one that spans a variety of environmental, economic, and social disciplines. Therefore, coordinated approaches across disciplines may prove to be most effective.

My colleagues working in the education sector also made some predictions about hot issues to address in 2019:

  • According to Senior Account Executive Cailin Jason, “school safety and gun violence will be a continued hot topic in 2019, and on many levels. For instance, as schools and campuses explore how safety measures might be taken (given the lack of any sensible gun control laws), it will be critical to think about the impact that precautions may have on students—and if they pose more harm than good.” Those interested in this topic and the potential for unintended consequences can check out a recent article in Education Week. Cailin also notes that “gun safety obviously will also be a significant health issue, especially considering the recent #thisismylane movement.”
  • Senior Account Executive Samantha Prior suggests that expanding and improving early learning will be a key focus in 2019. She notes this was a hot topic in the midterm elections in the fall, with many polls showing widespread popular support across party lines. Samantha believes “the key question that will start to emerge in 2019 is, what’s next? Now that people broadly support early education and ensuring access for all children, more focus will turn on how to deliver high quality early childhood education, as a recent study found that many state-funded pre-K programs did not meet a number of high-quality indicators.”
  • Samantha also suggests that workforce preparedness will be a hot topic in the public and private sectors. “On the K-12 level, the conversation is moving from the importance of STEM (Science, Technology, Engineering, and Mathematics) to the importance of STEAM (STEM + Arts), as many employers want employees with strong hard and soft skills, such as critical thinking, creativity, and problem-solving. I think support for interdisciplinary education is growing, but there isn’t as much agreement on what that actually looks like in schools. There’s also an interesting interplay between how much schools want to involve private companies and technology (see this recent example). On the post-secondary level, the conversation is shifting to one about access and financial stability—for example, the idea of apprenticeships is gaining popularity, recognition, and bi-partisan support from lawmakers (one example of recent legislation).”
  • Senior Vice President David Hoff suggests we should expect to see increased action around the concept of education as a basic right. He notes the recent lawsuit filed by a group in Rhode Island that seeks to establish a constitutional right to an education. He says, “It’s a long-shot, but it may change the conversation about the quality of education, particularly around preparing people for civic education.” Those who want to learn more about this can check out an article in The Atlantic.
  • Across the health and education sectors and in all of the work we do as social marketers, Account Supervisor Emily Martin suggests we consider authenticity as an essential ingredient in the communications materials and tools we produce. “We all keep hearing the importance of video, but what I think is really interesting is that apps like Snapchat and Instagram have made informal-looking videos more ‘normal’ looking for brands. It’s not uncommon to see videos on a brand’s social media sites that look like someone took them on an iPhone—and that’s okay because social media audiences are used to seeing them that way and perhaps even prefer the authenticity behind them. What is really neat about this is how affordable and accessible video then becomes to nonprofits and smaller companies.”

So, my fellow social marketers, we clearly have our work cut out for us. Here’s hoping for a productive and fruitful 2019!

Christina M. Nicols, MPH, MS, MS
Senior Vice President, Director of Strategic Planning, Research & Evaluation

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