Marketing Social Change

Source: AARP Press Center | June 14, 2004

Marketing Social Change

William D. Novelli, AARP CEO
21st Annual Summer Series on Aging
University of Kentucky, Lexington, KY

June 14, 2004

Good morning. And thank you Nelda, for that kind introduction. As you know, Nelda is a member of AARP’s national Board of Directors, a volunteer, non-paid position. Most of you are familiar with Nelda’s work here in Kentucky on behalf of older Americans, and I can tell you that as a member of our Board, she is a tireless advocate for older Americans throughout the country. Let’s give her a hand.

Today we are talking about marketing social change. Someone once said that a little change can hurt a lot; and a lot of change doesn’t hurt that much more. Of course, it depends on what kind of change is taking place.

I’m pleased to be here this morning to talk about marketing social change and how to make it happen. And, I want to leave ample time so we can have a dialogue and discuss how all of this relates to our work and to aging in America.

You are the right people for a discussion of social change, because you’re on the front lines. You are changing people’s lives, and in the process, changing society. We believe at AARP that we have the power to make it better. And that’s what you do, too. Whether you’re a nurse, a social worker, an educator, a pharmacist, therapist, or direct a senior center, you are improving the quality of people’s lives as they get older. That’s what we all try to do. And if you’re a student, you are the social change agent of tomorrow.

The notion that marketing can be applied to ideas, issues and causes—has been around a long time. Back in the 50’s, someone asked, why can’t we sell brotherhood like soap? Well, I’ve sold soap, and I’ve marketed social causes and issues. I’ve concluded that there are similarities…but also substantial differences.

Have you ever heard the old saying that if you build a better mouse trap, the world will beat a path to your door? Well, most of the time, that’s not marketing. We don’t want to start with the mouse trap, but rather with the consumer…the people who have mice in their homes. Do they want to get rid of them? How satisfied or dissatisfied are they with current mouse removal systems? How much would they pay to remove mice? With the answers to these kinds of questions, a marketing person can then go to the R & D people and design a product for the market. This focus on the consumer is the essence of good marketing.

Some of the roots of social marketing go back to family planning applications in the 1960s. Initially, the practice of social marketing was closely identified with marketing of products involved in social change (e.g., contraceptives, oral rehydration salts to control infant diarrhea). But it has evolved into a broader concept of the marketing of behaviors. I have worked in reproductive health and infant survival programs in the developing world, and the behaviors—and non-behaviors—have got to lead to the products, and not the other way around.

I had a colleague, Rachel Greenberg, who was returning to the U.S. from working on a family planning project in Egypt. The customs agent at Kennedy Airport asked her whether she had been abroad on business or pleasure, and she said, "both." He asked her what was in her travel case, and Rachel said, "condoms, oral contraceptives, foaming tablets and IUDs." The agent looked at her passport and said, "Ms. Greenberg, does your mother know what you’re doing?"

Today, social marketers, both scholars and practitioners, have come to accept that the fundamental objective of social marketing is not just the marketing of ideas, but the influencing of behavior.

• Getting people to start and maintain a positive behavior, e.g., physical activity.
• Persuading people to stop, or not to start, a negative behavior, e.g., smoking.

And some behaviors—or non-behaviors—are much more resistant to change than others.

In commercial marketing, you are rewarded if you affect the bottom line, not simply for creating great advertising, clever positioning or memorable slogans. In my early days in package goods marketing, the VP of my division came into my office one day and said he heard that I was decreasing my product sales projects. He said, "I can hire a monkey to do that. Your job is to get them up!" – Clearly, a bottom line orientation, to say the least.

Likewise, the goal of social marketing is not awareness or attitude shifts, but to influence behavior—to get individuals (and organizations) to change their behavior in ways that will lead to positive social change and that will benefit the individual and society as a whole.

One health insurer puts it this way in an ad: "When one person exercises, it impacts his or her health; but when one million people exercise, it impacts the health-care system."

Now for a confession—at AARP, I don’t talk about or promulgate social marketing very much. There are two reasons. First, as robust it is as a discipline for creating change, marketing is still not broad enough. It does not include policy advocacy, for example, nor legal sanctions. Second, marketing has a lot of emphasis on the individual (e.g., the consumer who wants to get rid of her mice). But we need to think not just of the individual consumer, or patient, but of environmental change as well.

So, at AARP, we talk about leading positive social change, or creating social impact and our approach is two-fold:

1. To influence our members (and others) to change their behavior in ways that will improve the quality of their lives as they get older, and
2. To change the whole environment, including social norms, so that the desired behavior becomes the expected behavior and change is sustained.

Influencing behavior change is complicated, difficult and takes time. And as I said, it is important to influence the environment in which we operate. It is not enough to focus on the behavior of individuals alone, because often, individuals can’t or won’t do it alone.

Influencing the environment often involves changing public policy at the national, state and community level; influencing the private policies and practices of business and other organizations; and changing long-held norms and expectations. Moreover, the social problems we all are concerned with are so tough that it takes all the tools in our toolbox to bring about change—advocacy, legal means, communication, pricing and distribution strategies, services and products.

Many people equate communications with marketing. But they aren’t the same, and communications alone is almost never enough to create social change. Advertising and public relations are just two parts of communications, and communications is only one element in a marketing mix. Now let’s look at how we apply this to aging.

The aging of the American population is a paradox. On one hand, our increased longevity and vitality are tremendous accomplishments. More people are living longer, and generally, are in better health than ever before. On the other, increased longevity, combined with the fundamental change in age distribution in our society resulting from the aging of the baby boomers, is putting increased strain on our social structures, institutions and programs that serve older populations, raising questions about their affordability and long-term viability.

As you probably know:

• The 50+ older segment will more than double over the next 35 years. This is changing the fundamental age distribution of our population. In 1900, only 13 percent of the population was age 50 or over. In 2000, it was over 27 percent. And, by 2020, it will be over 35 percent.
• We added more years to average life expectancy in the last century than in all previous history combined. People turning 50 today have half their adult lives ahead of them. And, people turning 65 can expect to live, on average, 18 more years.
• The number of Americans aged 45-64—i.e., those who will reach 65 over the next two decades—increased 34 percent over the last decade.

The oldest boomers turn 58 this year. As a prototype, think Bill Clinton. (Or, don’t think Bill Clinton.) In just four years—one more presidential election cycle—they will hit what until recently has been the "predominant" retirement age and they will be eligible for Social Security’s early retirement benefit. And, I would also note that in that same year, 2008, we expect boomers to become a majority of AARP members. In 2011, the oldest of the boomers will turn 65, and be eligible for full SS benefits and become Medicare beneficiaries.

All this is causing policy makers, pundits and others to contemplate how the coming deluge of aging boomers will affect our society. It’s shaping our social agenda at AARP…and no doubt influencing your own planning, as well.

We are all trying to anticipate the changes, challenges and opportunities presented by the aging of the baby boomers. The birth of the baby boom generation created a tremendous demographic upheaval in our society. Surely someone glanced around in 1950 and said, "Look at all these babies!"

The nation responded to this demographic change by investing in school construction, teacher education, housing, highways and public health. We created the Department of Health, Education and Welfare, and Americans discovered a new place to live, called suburbia. We invested in research and developed vaccines and cures for childhood diseases. As a result, diseases such as polio, that afflicted thousands of children every year, have all but been eradicated. Vaccinations for chicken pox, measles, and mumps are today the rule and not the exception – although there are still far too many exceptions, especially among the poor and disadvantaged.

So, we should not be surprised that the aging of the boomers will cause similar disruption. It is already bringing new focus to health care, retirement security, long-term care, elder abuse, grand-parenting and research into diseases associated with aging such as Alzheimer’s.

We’ve also come to recognize a segment of Americans whom we call the "sandwich generation." These are people, typically between the ages of 45 and 55, who are simultaneously caring for their children and their parents. And, we now see emerging a "club-sandwich" generation of people who are also caring for grandchildren and/or grandparents.

Richard Hobbs, of the American Institute of Architects, has observed, "The impact of the aging population on markets, employers, and culture cannot be overstated. Just as the baby boom flooded maternity wards, ignited school construction, and made ‘youth’ the cultural icon of the 1950s, ‘60s, and 70s, the ‘senior boom’ of this century will shape the 2010s, ‘20s, and ‘30s."

The changes will be substantial, as the largest generation in American history begins to leave one stage of life—work, for another—retirement. But just as boomers shaped other periods of their lives, they are going to alter what we mean by "retirement." This is already happening.

These changes will exert enormous pressures on our nation’s social structure, and some will not wait until 2011 to boil over. This demographic shift is already triggering changes in work, retirement, health, education, community and family life. So when we talk about social change, there are two options: we create positive social change, or the social forces change us. Both options are possible…in fact, probable.

Boomers have concerns about three primary issues: financial security (by this I mean financial well-being; not being rich, but self-sustaining), health and quality of life, (or, more specifically, maintaining long-term independence). These will increasingly dominate our nation’s social agenda, and they are defining AARP’s social change agenda as well.

How can we work through this to benefit both the boomers and successive generations? How do we adapt—as individuals and as a society—to longer life expectancy? How do we meet the immediate needs of today’s older Americans… and help those nearing retirement to prepare adequately for their future… and use what we have learned about aging to guide the life choices of the youngest of our society so they, too, can lead healthy, productive lives and enjoy a high quality of life as they get older?

These are questions we have been contemplating at AARP for some time. We have concluded that America has to change, and change substantially. We need a new vision of 2011 and beyond, framed by a productive, high quality of life and active engagement throughout the human lifespan.

We need to change the partnership among government, private institutions and the public to help our nation cope with the realities of not just aging, but longer life in the 21st century.

Some serious and thoughtful people are looking down the road at 2011 and beyond, and they’re putting up warning signs:

• Warning: Aging Boomers Will Bankrupt the Nation
• Warning: Medicare and Social Security are Unsustainable
• Warning: Gloom and Doom Ahead

These points of view remind me of a story from the Peanuts comic strip. Charlie Brown’s team is beginning another baseball season. Lucy, the existential right fielder, told Charlie Brown that this year things would be different. She was going to be a better player.

Well, the team was ahead by a run, there were two out and a man on, and the potential winning run was at the plate. He hit a high fly ball. Lucy positioned herself to make the catch. But, as the ball came down, it hit her on top of the head and rolled out toward the fence. Everyone scored, and Charlie Brown’s team once again snatched defeat from the jaws of victory. After the game, Lucy walked up to apologize to Charlie Brown, "Sorry I missed that fly ball, manager—I thought I had it, but suddenly I remembered all the others I’ve missed. The past got in my eyes!"

The "gloom and doomers," like Lucy, are well-intentioned, but they’re letting the past get in their eyes. They are looking at the future through the eyes of past generations of older Americans. They’re basing their predictions about the next generation on previous aging trends. They are assuming that as boomers age, they will behave like those who came before them.

They don’t sufficiently consider:

• That the greatest driver of future Medicare costs is not demographics, but rapidly rising health care costs throughout the system.
• That the rate of disability among the elderly is actually falling, not rising. So, the number of people going into nursing homes is lower than predicted.
• That boomers want to continue working as they get older, and the trend toward earlier retirement has been reversing for the last several years. People are staying in the workforce longer, thus contributing to Social Security, and for those who have them, pensions.
• That older Americans don’t simply drain the nation’s resources, they contribute to them as workers, consumers, volunteers, mentors and caregivers.

Yes, there are big challenges ahead, but as we look toward 2011, we can’t let the past get in our eyes. We have to look at things much differently. We have to create change.

• We must help people adapt their individual behaviors to reflect increased longevity and productivity,
• We must change our social structures and our communities to meet the needs of an aging population that seeks to remain in their homes and communities as long as they reasonably can, and
• We must advocate — to update and sustain government programs that assist the elderly and the disadvantaged by guaranteeing a basic level of health care and economic security and help to fund needed services.

As leaders and activists in the aging community, we must lead the nation in achieving these important changes.

So, when someone looks at the aging of society and says, "America, we have a problem." We must stand up and say, "America, we have some answers."

At AARP, we have created a Ten-Year Social Impact Agenda. It is among your handouts. The goal is that "People 50+ will have independence, choice, and control in ways that are beneficial and affordable for them and society as a whole." So there are two sides to the goal: the quality of life for older people, and the sustainability for society and all its generations. To achieve this goal, we are focused on five priority areas:

1. Economic Security
2. Health and Supportive Services
3. Livable Communities
4. Global Aging, and
5. Navigation

At the very top is Social Security. For Americans to have economic security as they get older, they must be able to rely on a Social Security system that is solvent for the long term and that maintains a guaranteed benefit and income protection features. We need to generate stronger public support for Social Security improvements and to enact legislation to make Social Security stronger.

This will be an issue in the upcoming election, and our next President and the Congress will face increasing pressures to deal with it. We have to make sure that it’s done right.

Another important aspect of economic security for the 50+ population is continued earnings from work. Many boomers and older employees say that they want to continue working beyond traditional retirement age—some because they want to, and some because they have to. In fact, this has already begun. We must ensure that those who want to remain in the workforce have the opportunity to do so. We believe we can be a catalyst in this important social change.

It includes leading in the fight against age discrimination in the workplace to reduce unfair and discriminatory treatment of workers 50-plus.

We’re also reaching out to corporate America through our program that recognizes the Best Employers for People 50 and Older, to encourage companies to adopt policies and practices that afford workers more and better workplace options.

And, through our Senior Community Service Employment Program and partnerships like the one we formed earlier this year with The Home Depot—we’re helping underserved populations obtain employment.

For most Americans, an economically secure retirement is based on accumulating and effectively managing adequate retirement assets. So we need to protect, and where possible, expand pensions and retirement savings.

We also have to help individuals manage financial decisions better and make sure that consumers are protected from financial fraud and abuse that can erode retirement savings and financial assets.

One other aspect of retirement security is to ensure that older Americans have access to affordable, quality utility services. This is a big issue at the state level, as many utilities are deregulated and costs rise.

As we look at how the boomers are aging, one of the alarming trends we see is the growing disparity between the "haves" and the "have nots." This trend indicates that we will need to do even more in the future to advocate for the less fortunate in our society. This was a major reason for our support of the Medicare law that passed last year.

The second goal on our ten-year social impact agenda is to ensure that Americans have affordable coverage for, and access to, quality health care and supportive services. To achieve this requires that:

• Medicare is strengthened as the most important source of quality health care for older Americans
• Prescription drugs are more affordable.
• Individuals have access to home and community-based care
• Appropriate, quality services are delivered efficiently and effectively across all settings, and
• Stable and affordable health coverage for all is available.

Yes, prescription drug coverage is finally in the Medicare law. But we have to do even more to make drugs affordable and bring prices down.

We must make prescription drugs not only more accessible and affordable for people on Medicare, but for everyone, including the large number of uninsured and under-insured between the ages of 50 and 65.

We all know that affordable, quality health care is essential for keeping people living independently, as long as possible. Within the next two decades, the oldest of the boomer segment will begin to swell the ranks of those who require long-term care services and other accommodations for disability.

And as we showed in our Report to the Nation on Independent Living and Disability, America is not prepared for this situation.

One major need is for coverage of more home service, which is less expensive than nursing homes and usually more satisfactory. This is an area of opportunity as boomers age, and some states are making real progress. This is an aspect of social change where advocacy is critical.

We need to make sure that the home and community-based services needed to care for elderly people are available and affordable and of high quality.

Another important aspect of health and supportive services is to improve the health status of Americans 50+ through healthy behaviors. Our focus is on increasing the number of individuals 50+ who become physically active. My mantra is: If you’ve got a moving part, move it! An important predictor of premature death among older people is lack of physical activity. And being physically active helps people stay healthy and independent.

But sedentary lifestyles—like so many social change issues—are very hard to alter. The price of physical activity—mostly time and effort—is high. The competitive activities, such as TV and reading, chatting with friends and neighbors and driving two blocks to buy a loaf of bread, are readily available and far easier—i.e., lower cost—to perform.

We have been working for several years in two pilot markets, Richmond, VA and Madison, WI to promote physical activity. We have changed awareness, we have taught people the CDC goals for healthy exercise, but we haven’t achieved actual behavior change. We’ll keep after this until we figure it out. Our goal is to get it right and then take it to a national scale. As I said, this isn’t easy.

On a related issue, obesity among the old and the young is advancing. And America leads the world in this major risk factor. Perhaps we need an intergenerational program, such as grandparents exercising with their grandchildren. We certainly need to deal with childhood obesity. I even have a slogan for the campaign: "Leave No Child with a Big Behind." And we must look at other health promotion opportunities, as well.

Next on our social impact agenda is more livable communities. To be more "livable," communities must include the physical features and readily accessible services that enable older residents to remain independent. Better transportation is the top priority, but not the only one. Making communities safe from crime is also important. And it’s important for older people—in fact, all people, for that matter—to reside close to basic services, such as food and pharmacies, medical services and places to worship. Sidewalks, centers where people can socialize, restaurants and libraries are also necessary.

We have made livable communities one of the priorities on our ten-year social impact agenda because we want to make sure that people are able to stay mobile and avoid isolation as they age. That means that they must have adequate options when driving is not feasible, and that competent drivers retain their driving privileges to the maximum extent possible.

We also want to ensure that Americans have appropriate and affordable housing options that enable them to age in place, in their communities. More than four in five Americans say they would like to remain in their current residence for as long as possible.

But, elderly homeowners, especially those with lower incomes, face significant barriers to remaining in their own homes. We need to break down those barriers. We recently initiated a collaboration with Fannie Mae that is very promising. Among other things, we are collaborating on anti-predatory lending guidelines. And with The Home Depot, we are looking at the possibility of a presence in every one of their stores to teach people how to modify their homes—or their parents homes—to live independently as long as possible.

As we adapt to our aging society, we are finding that we can learn a lot from the experiences of other countries—especially those whose populations are older than ours. And there is much we can teach them. So, we are becoming more engaged in international dialogues on global aging. Our goal is to ensure that nations exchange experiences and best practices on global aging issues.

The final priority on our social impact agenda is navigation, or useful access to information. We can’t lead positive social change if the people we seek to help don’t have access to, and use the information and resources they need. Through information technology and helpful volunteers, we want to provide one-stop access to needed information and resources—community-by-community—on a national scale. It’s a big challenge, but we believe it can make a huge difference in people’s lives.

A key part of achieving social change is a relentless focus on the target audiences. I have been talking about the boomer population. How do they compare to Americans who are older than they are? How has AARP been able to recruit the boomers and appeal to them, while remaining relevant to our older members? Our research suggests the answers.

In terms of what people want, boomers are different from older generations. They use information and media differently. They are much more focused on instant gratification. And they tend not to be as socially engaged as their elders.

But when it comes to needs, there is more similarity across the generations. People 50 and older tend to have two overarching needs: health and health care (which enables them to live independently and well), and financial security. These are constants.

And at an even deeper level—that of values, I think the generations are truly alike. They don’t necessarily use the word, but a common value is a sense of legacy. They care about their children, their grandchildren, and about leaving America a better place than they found it.

Now to return to our earlier point: as agents of social change, we must focus on environmental and individual change.

Our national challenge is to improve the quality of people’s lives while finding ways to keep America’s pension, health care and other systems affordable so they will endure for generations to come. And, we must do this in a way that builds generational equity and fairness.

We all see a clear need to motivate individuals to take more personal responsibility for their own well–being. But we also recognize that strengthening our institutions—Social Security, Medicare, Medicaid, community service, and education—is more important than ever. These are the foundations to build upon.

As we do this, we must make sure that changes in public policy are aligned with social attitudes and practices. Our nation needs policies and strategies to encourage wealth accumulation, health promotion, opportunities for older workers and support for long-term independence.

None of this will be easy, but all of it is possible. There is a haiku that says: "Problems worthy of attack, prove their worth by attacking back." Those are the kinds of problems we have in front of us. But these problems are surmountable.

I have had a personal goal throughout my career—to make a significant contribution to solving major social problems. I’ll bet you feel the same way.

So let’s be architects of change. Let’s tackle the realities of 2011 and beyond, with new ideas and structures so that we can get the best from all our citizens at every age.

We can help people to understand the choices available, take hold of opportunities, reach their chosen goals, and make the most of their lives, from early youth to the greatest old age. 2011 is imminent. America must prepare to meet it. And, as the influencers of social change, we can lead the charge.

Thanks very much. And now, let’s have a good discussion.