Saturday, 13 October 2012

What public health can learn from Reader's Digest

Over 25 years ago I stumbled – more or less accidentally – into the world of direct marketing. And many of things I’ve learned from practicing that craft can be applied elsewhere. So it is with “nudge” and the practical application of what the clever folk chose to call “behavioural economics”. You know, the bit that starts with Steven Landsburg’s famous quote:

“Most of economics can be summarized in four words: “People respond to incentives.” The rest is commentary.”

And then continues to the Thaler & Sunstein idea of “nudge”:

“The trick is to promote actual freedom – not just by giving people lots of choices (though that can help) but also by putting people in a good position to choose what would be best.”

The thing is that mail order people and direct marketers had being doing this stuff for 50 years before all the trendy policy wonks picked it up. We’d been carefully learning a whole load of things about human behaviour. And many of those techniques came from the fertile and creative mind of Walter Weintz – someone who the typical academic behavioural economist should have heard of but probably hasn’t. He said:

Once the basic principles and techniques of mail-order promotion are understood, they can be applied in the most unlikely places, and for unexpected products. Although my own initial mail-order experience happened to do with magazines and books, the same rules would have applied had I been working on a correspondence course in accounting, the mail-order sale of Christmas hams or Chesapeake crabmeat, securing leads for Ford cars, or, indeed, getting political candidates elected or fund raising for a political organization...

And of course social policy and public health!

The name may be new to you but his biggest success – the brand that he made famous – is very familiar: Reader’s Digest. And this great man set out the story – as every in his slightly folksy style – in a book: The SolidGold Mailbox. The essence of this direct marketing – of the strategies that Weintz pioneered - lies in two things – incentives and testing.

So when someone arrives with a seemingly wonderful idea – that we can use things other than price or availability to incentivise behaviour – they are merely generalising the specific thing that direct marketers learned from Weintz and others. Things like:

·         The power of words – as Rush Limbaugh famously said: “words mean things”. Words like “free”, “new”, “exclusive”, “limited”, “bestseller” – these are real magic words that trip positive behaviour in people. I know this because it’s been tested and proven by direct marketers hundreds and hundreds of times.

·         The impact of reward - do this and you’ll get (or win or ‘qualify for’)something. It may be a free gift or an “exclusive” discount. Perhaps it’s an entry into a draw or a qualification for a “prize”. Our choice is rewarded – subscribe to the magazine and you are showered with wonders! Choose not to subscribe and these things will be torn from your very grasp.

·         How we love our name. Do you look up, even in a crowded room, when your name is mentioned? You do – that’s why even the clunky personalisation used in Reader’s Digest mailings worked. And because we love our name – think of the silly Starbucks thing about writing your name on the cup – we love to hear others use it. Even when it mispronounced or misspelled! There’s more too – because we like to hear our names, we like to use names too. So asking you to call Ethel or Steve on 0800 123456 works better that call us at that number. It’s a real person!

The point here is to remind us that the idea of “nudge” isn’t about price or regulations but is about language, about the order in which things are written and the way in which the choice is placed before us.  And direct marketers have been playing games with language, with the presentation of offers and incentives, for decades. We can tell you that long letters are more responsive than short letters, that past behaviour (such as buying mail order) is always a good guide to future behaviour and that people don’t read letters the way you think they do. Oh, and if you don’t ask for a response you won’t get one!

All of these things – these little games with words, with design and with non-financial incentives – can be applied to public policy whether it’s getting people to recycle, register to vote, stop smoking or visit the local clinic. Just one simple example will suffice – if you put a map of the clinic location on appointment letters for medical check-ups people are more likely to attend. Even when you know that they know exactly where the clinic is located because they’ve been there dozens of times.

This is “nudge”. Minimum pricing isn’t “nudge”, banning advertising isn’t “nudge”, passing regulations about packaging isn’t “nudge”. Look back at that Cass & Sunstein quote – the bit about promoting “actual freedom”. It’s about the words used and the choices offered – rather than saying “smoking is bad don’t do it” we should argue for point-of-sale-displays setting out the rewards of not smoking not for scary pictures or hiding the product away.

I’m not sure whether “The Solid Gold Mail Box” is still in print but it would be a great boon to effective – and genuinely liberal – social policy and public health campaigns if those creating them read the book. But then I recall a Director of Public Health who rejected a direct marketing approach to a campaign (on HIV/AIDS) because it involved another little thing that Weintz – and every other direct marketing – knows works: targeting those most interested in what you offer. Or, in the case at issue, those most at risk.

Public health hasn’t moved on. It still prefers the general to the targeted – introducing minimum prices that affect everyone rather than targeting campaigns to those most at risk. And they still prefer to say “you mustn’t do that” or “stop that” rather than “wouldn’t it be better if you did this instead?” 



Curmudgeon said...

But who decides what is "best"?

SadButMadLad said...

Public Health still thinks it needs to be involved in every little detail of everyone's health. Even when it has nothing to do with public health. If people want to live dangerous lives such as being a steeplejack or soldier or rock climber public health authorities don't get involved. But if people want to live a life which has a slightly increased chance of danger but which gives them a lot of pleasure then authorities think it's a public health issue. It isn't. It's a private health issue. Public health is stuff like cholera in drinking water. Smoking or drinking isn't a contagious disease.