Food Deserts, Social Cognition Model, and Hamburger Helper

There is an an overwhelming focus on personal responsibility in health communication campaigns. Sounds fairly reasonable given that people choose to eat too much, not workout, smoke, drink, etc. However, "psychological research suggest that humans tend to overemphasize individual factors and underemphasize contextual factors when attributing responsibility for others' actions or dispositions" (Niedredeppe, Bu, Borah, Kindig, Robert 2008).

Ok, what does that mean? That people aren't responsible for their own wellbeing? Not quite, "This fundamental attribution error suggests that people are more likely to assign blame for others' poor health to individual shortcomings(e.g., failure to engage in health behavior) than to social or structural factors (e.g. poverty and little education)" (Niedredeppe, Bu, Borah, Kindig, Robert 2008). It seems, at least from this article, that health communications is focused on the individual when a larger focus on the environment in which poor health choices are made might yield better results. Why aren't more people focusing campaigns on the larger social determinants that create unhealthy behaviors? Probably because it's overwhelming to change a system. Wouldn't it just be easier if target audience member B just stopped smoking? Wouldn't that make our campaign effective?

I originally intended to focus this blog post on the effectiveness measures used for health communication campaigns. While doing that research, I realized that there was a more pressing issue. That issue being the way in which health communication professionals go about campaigns in the first place.

While health communications professionals toil away at finding the perfect way to create awareness, change attitudes, and influence individual behavior, a mother in Del Valle has six kids to feed on $4 a day. She has no car and no access to a grocery store, she lives in a food desert. Yes, she knows Hamburger Helper from the Dollar Store isn't good for her kids. She'd love to make them fresh lunches everyday, but, she's at work until 7am. She can not augment her behavior because the social determinants of health (SDH) are stacked against her (Niedredeppe, Bu, Borah, Kindig, Robert 2008) .

It is absolutely not enough for health communications professionals and government agencies to work to change individual attitudes and influence individual behavior. Health communications professionals must understand the larger world in which they are working and then find innovative ways to reach new target audiences (policy makers, politicians, non profits, etc) with social determinants of health change messaging.

Knowing your target audience is important but a deep understanding of the environment in which they make decisions is equally as important. According to the Social Cognition Model, Environmental Determinants are an equally important part predicting actual behavior. Environmental Determinants sit an an equal place with Personal Determinants and Behavioral Determinants (Bandura, 2001).


(Bandura, 2001)

So, if health communications is solely focused on personal and behavioral determinants, we are crippling the ability for individuals to actually make the behavior change we ask of them. We are cutting out a giant piece of the way people make decisions. And we aren't making a healthier neighborhood, city, state or nation. We are only making a nation where people know what a healthy choice is and simply can't make it. At least not those who need the help making the healthy decisions the most.


References

Bandura, A. (2001). Social Cognitive Theory of Mass Communication. Media Psychology, 3(3), 265-299. Retrieved from Academic Search Complete database.

Niederdeppe, J., Bu, Q., Borah, P., Kindig, D., & Robert, S. (2008). Message Design Strategies to Raise Public Awareness of Social Determinants of Health and Population Health Disparities. Milbank Quarterly, 86(3), 481-513. doi:10.1111/j.1468-0009.2008.00530.x.