Wednesday, November 17, 2010

What can we learn from public health education initiatives?

A few weeks ago, I attended the fascinating Climate Change Education Roundtable meeting sponsored by the National Research Council's Board on Science Education.  A series of papers were commissioned for the meeting that give a picture of the diversity of approaches to climate change education discussed at the meeting.  There's some good stuff in those papers -- do give them a look.

One session at the meeting included discussion of what we can learn from successful public health campaigns, noting successful efforts that have substantially slowed the spread of sexually transmitted diseases (STDs) and decreased the number of unwanted pregnancies.  I'm pretty confident we can learn some things from that body of work, but the particular health campaigns used as examples probably aren't the best ones to look to.  I suggested as much at the meeting, making the connection to obesity.  Unfortunately, I'm a poster child for the failure of that public education campaign, and there are a great many fellow poster children out there.
Me, being fat in front of the White House.

And, unfortunately, I think this largely unsuccessful effort is a closer analog to climate change education.

If you're healthy and have unprotected sex tonight with an STD-infected partner, you've got a pretty strong chance of having that STD tomorrow.  If you're thin today and have an extra brownie after dinner, you're still thin tomorrow.  You have to keep up those bad behaviors for a while for it to make a noticeable difference.  Likewise, to undo the damage, you've got to drop those obesity-inducing bad habits and hopefully pick up some good ones and keep them going for a while to notice much difference.

That sounds a lot like the problems of climate change.  Buying a big house in the exurbs doesn't do much to the climate immediately, but add up the effects of a bunch of people over a bunch of years, and you've made a difference in the climate system.  And, as with obesity, figuring out what to do with that big house and killing your long commute won't make much of a difference tomorrow.  But it will eventually.

And, unfortunately, obesity prevention programming hasn't worked very well so far.

(As I type this, I'm telecommuting to a birthday party at work.  I don't think virtual cake is any part of the answer.  It's not very satisfying, and has me thinking of actual cake.)

We should keep watching those efforts and pay attention to what works and what fails to work, and we should look for other analogs.

How about smoking?  

Like climate change and obesity, the most serious effects of partaking in the activities that lead to big trouble don't get you in trouble right away.  And it takes a while to recover from the damage (if you can recover from the damage).  Unlike obesity and climate change, public education has actually decreased rates of smoking in the broad population.

What's worked in anti-smoking campaigns?  Importantly, it's not just one thing.  Smoke-free workplaces and public places, comprehensive advertising campaigns, increased taxation on tobacco and strong graphic warning labels on cigarette packages quickly reduce tobacco consumption.  Additionally, supporting smokers in the quitting process matters.  Counseling and pharmaceutical aids help, as do access to toll free support services.  Call 1-800-QUITNOW if you're looking for support in stopping smoking.  (See more about smoking reduction here).

Most of those strategies (and the idea of using many strategies simultaneously) are translatable to efforts to reduce carbon emissions.  Making places smoke-free is akin to regulating emissions, and perhaps more directly to making city centers automobile-free. Advertising campaigns are in existence on some scale already.  Taxation on carbon emissions is a direct analog.  Support lines are imaginable too.

Graphic warning labels is an interesting proposition.  The link above and here takes you to the proposed FDA graphic labels for cigarette packaging.  Ick.  But maybe it's an effective ick.  What would the greenhouse gas reduction parallel look like?  Graphics added to the price stickers on new cars?  Images of sea-level rise, famine, hurricanes, or drought printing out with your boarding pass?  And how about putting such stickers on fighter jets to discourage the government from making those purchases?  Hmm...

I don't know about that, and I don't know if we can come up with a pharmaceutical aid to help us wean of carbon emissions, but it does seem that are lessons that can be learned here.  What do you think?

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