Instead of Raising Awareness, Make People Care. Here’s How.

by Mark R. Miller

Throughout my career, I’ve heard nonprofit communicators complain about their lack of resources compared with larger organizations. If you’re in that position, there’s good news — you don’t have to bust your budget to apply the same science-based approaches corporations routinely use. But you might need to think differently.

In “The Science of What Makes People Care” in the Stanford Social Innovation Review, authors Ann Christiano and Annie Neimand of the Center for Public Interest Communications argue that nonprofits are overspending on education and awareness-building and overlooking the science of what actually motivates people to care, to donate, and to take action. Awareness campaigns “ignore the scientific principles of what motivates engagement, belief, and behavior change,” they write. This echoes the conclusions from their 2017 article “Stop Raising Awareness Already” — awareness campaigns are expensive, labor-intensive, and unlikely to improve outcomes.

In a science-based field like public health, it’s easy to assume that data will drive policy and behavioral change, and there’s plenty of research shows that investing in prevention will lead to better health outcomes. Eating better and exercising more will increase your health and life expectancy. So why don’t elected officials, other policymakers, and individuals make the decisions that public health advocates know will improve health? There are actually several reasons, and many relate to the way issues are framed and communicated. Whether you’re talking to elected officials or parents, providing information is not enough — you need to make them care.

For their latest article, Christiano and Neimand reviewed years of research, including what works in corporate marketing and what has made social campaigns effective (such as racial and gender quality, reducing deaths from smoking and drunk driving, and marriage equality). Research from multiple disciplines led them to five principles to make people care:

  • Join the community.
  • Communicate in images.
  • Invoke emotion with intention.
  • Create meaningful calls to action.
  • Tell better stories.

Join the Community

Research consistently shows that people choose to seek information that affirms their core beliefs and worldview. Instead of talking about your organization and the great work you do, consider what value you can offer your target audiences. What problems are they trying to solve? How does your mission align with their own values and priorities? “People seek information that makes them feel good about themselves and allows them to be a better version of themselves,” Christiano and Neimand write. “If you start with this understanding of the human mind and behavior, you can design campaigns that help people see where your values intersect and how the issues you are working on matter to them.”

Communicate in Images

Abstract concepts like wellness, equality, justice, and innovation mean different things to different people. Instead, use direct and visual language. When you communicate in descriptive terms, people will form a picture in their mind, and they will be more likely to remember your message and care about it.

Invoke Emotion with Intention

Nonprofit professionals often talk about the need to “pull on the heartstrings,” but be careful not to take that too far. People avoid or tune out information that makes them feel bad — especially it makes them feel sad, fearful, or guilty with no way to resolve those feelings. You can’t be positive all the time, of course, but look for ways to stir up positive feelings, like pride and hope. Christiano and Neimand suggest, “Think about what you’re trying to get people to do and how they would feel if they were doing it. Then think about stories that would make them feel that way.

Create Meaningful Calls to Action

Calls to action should follow three rules:

  • They should be specific.
  • People should understand how the action will help solve the problem.
  • The action should be something people know how to do, and something they can easily work into their daily lives.

Tell Better Stories

The importance of storytelling is nothing new to anyone in communications, but pay attention to the wording. The advice is not to “tell stories,” but “tell better stories.” I’m sure you know that stories capture the imagination and can explain complex issues in a powerful, memorable way. However, Christiano and Neimand argue that many nonprofits are sharing messages and vignettes rather than stories. “Stories have characters; a beginning, middle, and end; plot, conflict, and resolution. If you do not include these elements, you are not telling a story.”

They recommend finding interesting stories with unusual characters and unexpected twists. And they ask this important question: “Are your stories interesting in their own right to merit a listen — even if the listener isn’t passionate about your issue?” The best stories don’t tell people more of what they already know. They engage different audiences and motivate people who are already on board.

People don’t fail to act because they don’t have enough information, Christiano and Neimand conclude. It’s because they don’t care or they don’t know what to do. Your job is to show them why they should care, and give them a specific way to help. Read the full article here.

What stories do you use to describe your organization, its mission, and its accomplishments? Tweet us at @deBeaumontFdtn or send us an email.


Fresh Perspectives: Paving the Way for Better Health

Over the next few months, the de Beaumont Foundation is partnering with the American Public Health Association on a new blog series, titled “Fresh Perspectives.” Between now and the APHA Annual Meeting in November, “Fresh Perspectives” will provide insights from people with a range of perspectives who will offer practical lessons and tips. You’ll hear from a former broadcast journalist, a researcher, the mayor of a large Midwestern city, and the former CEO of the American Academy of Pediatrics, to name a few. The series kicked off with this post by Brian C. Castrucci, MA, chief executive officer of the de Beaumont Foundation. 

One of the best parts of my job as CEO of the de Beaumont Foundation is the opportunity to connect with people from all sectors — government, business, community organizations, advocacy groups, health care — who are devoted to improving the health of all Americans. However, being effective requires trusting partnerships among these and other groups, many of which don’t have a history of collaboration.

The de Beaumont Foundation focuses on creating and sharing practical solutions to help build healthier communities, which includes informing policy, building partnerships and empowering the public health workforce. Multi-sector partnerships, sometimes with nontraditional allies, are key to making lasting change in health, and that’s why we initiate and showcase partnerships with elected officials, business leaders, housing, education and other sectors.

“We need to untangle the complex web of social and economic factors that influence health if we are to make real progress. No one industry can do this alone, and we will all likely find ourselves in some odd relationships and uncomfortable allegiances.”

Partnership is critical to the people who are on the ground each day, including the committed people in state and local health departments. In our 2014 PH WINS survey, we found that more than 90 percent of the state health agency workforce chose to work in public health because they wanted to make a difference. I’m not sure that you could find a more mission-driven workforce in any other field. Sure, there are theories and models, but it’s the passion of those working in governmental public health that distinguishes them.

Public Health 3.0, a new organizational framework for governmental public health, stresses the role of the Chief Health Strategist and highlights the need for public health agencies to leverage other resources to accomplish their goals. Governmental public health agencies are no strangers to partnership. Ask any public health employee and they will give a list of like-minded organizations serving on health department-led advisory committees or providing in-kind services. But to maintain and extend gains in outcomes like life expectancy, a new partnership paradigm is needed — one that’s defined not by the number of organizations that agree to work with government public health agencies, but by the number of organizations that reach out to those agencies to reach their own goals. For example, the relationship between chronic disease and reduced worker productivity is well documented. This creates a natural point of collaboration between the business sector and public health, but partnerships of this type are limited.

Getting to know leaders from other sectors and communicating the value of public health is not easy. That’s why the de Beaumont Foundation is working with the Aspen Institute on a project called Public Health Reaching Across Sectors (PHRASES), to craft tested messaging to help public health leaders engage other sectors more effectively. Our research will result in a practical communications toolkit for the Chief Health Strategist. This is just one way we are working to build bridges and extend the impact of the public health field.

We need to untangle the complex web of social and economic factors that influence health if we are to make real progress. No one industry can do this alone, and we will all likely find ourselves in some odd relationships and uncomfortable allegiances. We have plenty of pills, health plans and competing perspectives. What we need is a good dose of partnership. We hope these “Fresh Perspectives” will inspire you and motivate you to look beyond traditional partnerships as you as you work to advance public health.

This blog post was first published by the American Public Health Association at

PHRASES: Plain Talk about Public Health

by Mark R. Miller

Governmental public health has a communications challenge – how can health officials build partnerships and communicate their value when the term “public health” itself isn’t clear or, even worse, is misunderstood?

PHRASES, which is a clever acronym for Public Health Reaching Across Sectors, is one of the de Beaumont Foundation projects I am most excited about. Because public health is intertwined with sectors like housing, education, and business, the de Beaumont Foundation and the Aspen Institute are funding research and creating tools to help state and local public health officials better explain their value to potential partners. To form partnerships and make their communities healthier, government public health officials need to be able to explain what public health is and what they do.

PHRASES is led by an advisory committee with prominent names in health and journalism. It is chaired by Karen DeSalvo, MD, MPH, MSc, who served as Assistant Secretary for Health and the national coordinator for health information technology during the Obama Administration and the health commissioner of the City of New Orleans, and Soledad O’Brien, CEO of Starfish Media Group, host of “Matter of Fact with Soledad O’Brien,” and former anchor and correspondent for CNN, MSNBC, NBC, and other media outlets.

O’Brien brings an outsider perspective as someone who is not in the public health field but has spent her career telling stories in clear and compelling ways. “I’ve seen that public health departments and officials do incredibly important work that touches people’s lives in ways they don’t even know,” she said. “But I’ve also seen that people in the field often struggle when trying to explain what public health is in a way that engages and inspires people. I’ve heard more conversations about what they do – the tactics – rather than why they do it and the value it adds to people’s daily lives.”

DeSalvo said, “Public health professionals can’t reach their goals alone, and to build partnerships they need to be able to communicate the value they bring. This initiative will help make the role of public health visible, useful, and relevant to decision-makers in housing, education, business, and other areas.”

To better equip the field, the de Beaumont Foundation and the Aspen Institute are working with the FrameWorks Institute, which conducts and publishes research that identifies the most effective ways to frame social and scientific topics. The goal is to learn what people outside the field think of public health, the value they see (or don’t), and their likelihood of partnering with public health professionals to improve their communities.

They started by interviewing leaders in public health and found that the way they describe public health can vary significantly, as you can see from the responses below.

What public health is:

  • The field that works to understand and improve the many social determinants of health.
  • A state or local government agency that defends the population against health threats and responds to community health needs.
  • A function overseen by the federal government, which plays a key role in disease outbreaks and prevention and funds state and local health agencies.
  • The health of the public, or population health.

What public health professionals do:

  • Prevent health problems by addressing the social determinants of health.
  • Create physical, mental, and social well-being by working to ensure living conditions that facilitate health outcomes.
  • Advocate for policies that protect and preserve health.
  • Use data to assess and manage risk, make decisions, and solve problems.
  • Promote health services through education campaigns.
  • Identify and respond to disease outbreaks and other emergencies.

These statements are all accurate, but they don’t inspire and communicate the true value of the field and the relevance to every citizen. One challenge is that public health does so many things. Now that the FrameWorks Institute has helped identify the challenges, they are working with the PHRASES team to the positioning and refine the language, so we can develop practical tools to engage and inspire others. Stay tuned.


Public Health Has a Plain Language Problem

by Mark R. Miller

A few weeks after I started working at the de Beaumont Foundation, I was talking to a friend about the organization and our focus on public health. That led to the obvious question, “What exactly is public health?” I did my best to answer him, giving several examples and explaining what it is not, and I told myself, “I need a better answer for that.”

It turns out, the entire public health field struggles with that same question – and that’s a problem. If you can’t explain what you do and why it matters, how can you possibly build support and make others care? This lack of understanding is one of the reasons public health is underfunded and underappreciated, even though public health affects every person in the world, every day.

Professors Aaron E. Carroll and Austin Frakt recently wrote an op-ed for the New York Times titled “It Saves Lives. It Can Save Money. So Why Aren’t We Spending More on Public Health?” Citing numerous examples, they write: “Americans spend relatively little money in [public health] and far more on medical care that returns less value for its costs. Instead of continually complaining about how much is being spent on health care with little to show for it, maybe we should direct more of that money to public health.”

But even in this insightful commentary, Carroll and Frakt fall short in defining public health, describing it this way:

Public health “encompasses efforts made to improve the health of a broad population with investments not ordinarily considered ‘health care.’ For example, ad campaigns that encourage better health behaviors – like exercising or quitting smoking. Or efforts to improve housing and nutrition for low-income populations or the quality of air or drinking water for everyone. An obvious success is vaccines. In the 1900s, polio and smallpox were eliminated in the United States. Other diseases – such as measles, rubella, diphtheria – became very, very rare.”

This illustrates the communications problem, because it’s not a clear or compelling description. As with many other attempts to define what public health is, Carroll and Frakt focus on what it is not (health care) and then list vaccines and many other examples (car safety, workplace safety, clean water, and more). Defining public health as “not health care” is similar to the problematic term “nonprofit” – which describes mission-based organizations as “not businesses” instead of explaining what they are and why.

As with nonprofits, part of the challenge is that public health does so many important things. As our CEO Brian Castrucci asks, “We have all the ingredients, but do we know what we’re baking?”

In my next post, I’ll share preliminary findings of new research funded by the de Beaumont Foundation to explore this communications challenge and uncover opportunities to better define and promote public health.

Mark Miller is the Vice President of Communications at the de Beaumont Foundation.

Health Starts in the Community, Not the Clinic

by Brian C. Castrucci

We are fortunate to live in a nation where our healthcare system is filled with dedicated providers offering cutting-edge, innovative clinical care to prevent and control diseases. However, despite all the money we spend on health, the United States still lags behind other countries in terms of health outcomes such as life expectancy.

The reason this paradox exists may be found, in part, in an article summarizing a discussion recently held by the American Medical Association, “2 Ways to Spark Change in Minority Patients and Prevent Diabetes,” AMA Wire, June 18). The discussion focused on ways providers can encourage patients to take the steps needed to control their diabetes, but much of the advice is not practical for people who live in communications without access to conveniences that many of us take for granted.

As the head of the de Beaumont Foundation, which focuses on public health, and as a type 2 diabetic myself, I found the advice valuable but incomplete. In pursuit of the dream of “no new cases of preventable type 2 diabetes,” Dr. Niva Lubin-Johnson recommends that providers should “stress things the patient can control” like “diet, exercise, and getting enough rest.” She advises physicians to talk to patients about what they are willing to do, and she notes possible barriers to behavior change like time management. Because “it’s not easy for a single mother with school-aged children to go grocery shopping or find time to exercise,” she encourages providers to “spend the time to talk with them about how it can be done.”

While this advice is reasonable from a medical perspective, health professionals can’t ignore the indelible link between individual and community health. If we stop at simply identifying what the barriers are, and don’t intentionally look at why they are there, we miss a critical opportunity to address the root causes of chronic diseases like diabetes. A clinical approach alone to preventing diabetes — or any chronic disease — places the burden on the patient and his or her willingness to make necessary behavioral changes.

Yes, that single mother may have challenges finding time to exercise or go grocery shopping, but challenges with time management aren’t unique to any person or group in our culture. But maybe she doesn’t have access to places that offer affordable exercise options, or safe places to walk, bike, or run after dark, or grocery stores where she can buy fresh fruits and vegetables. Maybe her employer doesn’t have policies that allow her to take time during her workday to exercise, even though it might be in its best interest. (Each year, $90 million is lost in reduced productivity due to diabetes.) These community factors shape our individual choices, and no amount of talking can change them.

The truth is, health starts — and is sustained — in the community. If the places where you live, work, and play don’t allow you to achieve optimal health, there is very little that can be done in a doctor’s office that can change that. And that’s not a criticism of healthcare. It’s just a reality. A large percentage of Americans get a 30-minute wellness visit once a year, but what about the other 525,530 minutes?

To be honest, I am the type of person who would have benefited from the interventions Dr. Lubin-Johnson described. My community fully supported any choice that I wanted to make to improve my health. I have access to at least four large grocery chains that sell every fruit and vegetable there is. I can afford a gym membership and extended day care for my children. There’s a safe and well-lit park in my neighborhood with outdoor exercise equipment. In my case, it was my health choices — a poor diet and a general disregard for exercise — that led to my disease, but my behavior also led to control of my diabetes when I made better choices.

For people who have chronic conditions but don’t share my privilege, no amount of clinical intervention will make them healthy. Achieving and maintaining health requires the efforts of not only physicians, but also urban planners, housing experts, political leaders, educators, and many others. Only when we pair clinical intervention with smart policy and intentional planning will be able to envision a world free of preventable disease.