Spheres of Influence

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Environmental Health Perspectives • VOLUME 110 | NUMBER 10 | October 2002 A 583

The Ad Council, a private group in NewYork that is one of the biggest promoters ofpublic service ads, which basically is adver-tising in the public interest, including bothpaid and free ads. The Ad Council has stud-ied the impact of its own work; before-and-after surveys show that public service ads dochange behavior. For example, the councilfound that one year of public service adver-tising about colon cancer increased the per-centage of men who spoke to their doctorsabout their risk for the disease by 43%.

Environmental and public health groupsfirst discovered the value of such ads back in1970. That’s when the Washington, D.C.,advocacy group Environmental Defense(ED)—then called the EnvironmentalDefense Fund—ran an ad in The New YorkTimes (NYT) warning about the dangers ofDDT in breast milk. The ad showed amother breastfeeding her child. The captionstated that if her milk were sold in interstatecommerce, the Food and Drug Admin-istration (FDA) would ban it because of itshigh concentration of DDT.

“A lot of people saw the ad, and it hit anerve, and they donated or became a member

of [the Environmental Defense Fund],”says Robert Harris, associate director of thegroup’s toxic chemicals program from1973 to 1979 and cofounder of the envi-ronmental consulting firm EnvironInternational Corporation in Princeton,New Jersey. The ad brought in enoughmoney to enable the group to launch anational fight against DDT.

The use of eye-catching, prominent,and expensive ads by environmentalistsseems to be growing, says Lois Gibbs,executive director of the Center forHealth, Environment & Justice, a publicinterest group in Falls Church, Virginia.As Michael Replogle, transportation direc-tor at ED, says, “Strategic communicationsand message development is somethingthat the environmental community is get-ting better at.”

“There’s definitely been an increase inpaid public service ads,” says Ellyn Fisher,manager of corporate communications atthe Ad Council. “There was a time when wehad no competition,” she says. “Now moreorganizations are seeing the importance ofpublic communications and the impact of

ads, and so they are putting more resourcesinto it.” The increase in ads is in part due toa sense of frustration in the environmentalcommunity that the mainstream media hasnot paid enough attention to their issues,says one advertising expert who asked toremain anonymous.

It’s not just environmentalist groups thatare seizing the medium to get their messagesout. Other stakeholders that have enteredthe advertising world include the govern-ment and academic groups. For example,the NIEHS runs public service announce-ments on U.S. network and cable televisionstations. The latest ones, begun this sum-mer, target young families and discuss envi-ronmental pollutants at home.

Controversial CCHE AdsOne of the most extensive advertising cam-paigns ever done to promote environmentalhealth ran this summer in the NYT. BetweenJune 6 and August 15, a total of seven adsappeared in the newspaper, giving readersfull-page lessons in the dangers to childrenof toxic chemicals in the environment. Theads warned of the link between exposure to

GE: MARKETINGthe MESSAGES

Does seeing a milk mustache on a child make you think of the slogan Got Milk? Do fried

eggs remind you of the 1987 This Is Your Brain on Drugs ad? In addition to leaving last-

ing memories, such ads have convinced some who see them to modify their behavior, studies

show. And that is the hope of the increasing numbers of organizations that are now starting

to use marketing as a means of disseminating their messages about environmental health.

Spheres of Influence • Environmental Advantage

toxicants and learning disabilities, cancer,and reproductive system abnormalities. Thegovernment needs to assess the health effectsof chemicals, including mixtures of chemi-cals, the ads stated. They also urged parentsto keep their children away from dangerouschemicals in their homes and to buy organicproduce when possible.

The ads also appear in the October 2002issue of the Columbia Journalism Review,which is a cost-effective outlet for reachingjournalists, says Philip Landrigan, director ofthe Mount Sinai School of Medicine Centerfor Children’s Health and the Environment(CCHE). He developed the ads, along withcolleagues Herbert Needleman of theUniversity of Pittsburgh, Lynn Goldman ofthe Johns Hopkins Bloomberg School ofPublic Health in Baltimore, and MichaelMcCally of the Oregon Health & ScienceUniversity in Portland. McCally was co-director of CCHE, the titular sponsor forthe ads, when they were developed.

The ads focus on the most importanthealth effects—including learning disabili-ties, endocrine disruption, and cancer—known to have chemical causes, saysLandrigan. He says the group decided to runthe ads because “there’s been sufficientprogress made in the pediatric communityon children’s environmental health that itwas time to bring to the attention of thepress and policy makers what we now know.There needed to be an effort to present themost recent health-related science and todraw conclusions from it for journalists, pol-icy makers, and the public.”

The scientists hired Fenton Commun-ications, a public relations firm, to create thead series. The Rockefeller Family Fund(RFF) provided $400,000 for the campaign,including $315,000 to run the ads. RFFfunds programs that promote a variety ofissues, including economic justice forwomen and environmental concerns. It hadsupported Landrigan’s work in the past andwas happy to do it again, says LeeWasserman, executive director of RFF. “Wethink the issues in the ads have not beengiven the attention they deserve,” he says.He further asserts that public policy debateson these issues have been highly influencedby people who have direct financial interestin the use of chemicals.

The ads refer readers to the CCHE web-site (http://www.childenvironment.org/),where they can find articles written for a layaudience about the research papers, includ-ing articles from EHP, that support the ads’claims. The site also includes the names of36 researchers who endorse the ads.According to Landrigan, hits on the CCHEwebsite increased more than 10-fold afterthe first ad ran, from less than 100 hits per

day to more than 1,000. He also says that heand his colleagues met with journalists andmembers of editorial boards during the adcampaign to explain the research findingsthat support the ads, to underscore theimportance of the central messages of thecampaign, and to suggest that editors needto pay more attention than they have tochildren’s environmental health.

The ads do indeed reflect scientists’ frus-tration with not being able to get out thestory on environmental health risks to chil-dren, agrees Philip Lee, a consulting profes-sor of human biology at Stanford Universityand former assistant secretary of health atthe U.S. Department of Health and HumanServices. He praises the ads, saying they are“well done, not overstated.”

The New York Times or GoodHousekeeping?Some environmental health advocates arguethat ads must reach a consumer audience tobe effective. Landrigan and colleagues chosethe NYT as the first carrier for the CCHEads because it’s a national paper read bymany journalists and policy makers.Landrigan would have liked to run the adsin more newspapers and magazines to reacha broader audience, but the project didn’thave enough money, he explains.

Environmental health advocates alsoassert that ads should include strong recom-mendations for what readers can or shoulddo—a call to action. Many activists believethe CCHE ads were not purposeful enough,says Charlotte Brody, executive director ofHealth Care Without Harm (HCWH), acoalition of 300 groups in 27 countries orga-nized to reform the health care industry.“But in time,” she predicts, “the CCHEseries will prove to have been worth theresources.” She adds, “It’s unpopular to saythis”—because of the sentiment that the adsshould have been more action-oriented—“but I thought they were terrific.”

The ads are “extraordinary in the sensethat they really catch what’s going on andput out information on health risks,” saysGibbs. At the same time, “I’m not con-vinced that how we make change is throughpeople who read the NYT,” she says. Sheargues that corporate CEOs, professionals,and, to only a small extent, policy makersread the NYT, so it is useful primarily ineducating those professionals. “I’d take thosesame ads and put them in Ladies’ HomeJournal and Good Housekeeping, or in TroutUnlimited and focus on fish and men’s fertil-ity,” she says—since some chemicals foundin fish impair fertility.

The role of scientists, however, is notnecessarily to advocate a cause, saysMcCally. Instead, he says, their role is to

review, evaluate, and interpret science inways that may be helpful to public decisionmaking. In addition, Lee notes that founda-tions have legal restrictions on how muchadvocacy work they can fund, so informa-tional ads may get more financial backing.

Gibbs’s group has twice placed ads innational newspapers, and both focused onspecific issues. One ran during the 1996presidential race, when Hillary Clinton wascampaigning for her husband in Pensacola,Florida, which was home to a neighborhoodcontaminated by hazardous waste. CHEJran an ad in USA Today calling on PresidentClinton to evacuate citizens from the area,and the media repeatedly asked Mrs.Clinton about the neighborhood. Two dayslater it was evacuated.

Not all ads do work, of course. In June2000 CHEJ ran its second ad, on dioxin, inthe Washington Post, timed to appear withthe release of a U.S. EnvironmentalProtection Agency (EPA) draft reassessmentof the health impact of the chemical. The adasked, What are you having for breakfast? andfeatured a picture of eggs and bacon, because90% of the general public’s exposure todioxin comes through food, particularlymeat and dairy products, says Steve Lester,science director at CHEJ.

The ad campaign was unsuccessful,however. “We were hoping it would movepolicy makers to take action on the federallevel, and it didn’t do that,” Gibbs says. Thereasons for its lack of success were varied,she says. For one, the ad didn’t really answerthe question that consumers and policymakers ask when faced with a problem: whatdo you do about it?

Second, for activist ads to succeed, theyneed to be part of a well-organized campaign,and that was not the case here, she says—CHEJ doesn’t have the Washington lobbyistsneeded to make a campaign like that work.Third, she says, the ad upset some allies ofthe group, including organic farmers, who tryto make their products free of chemicals butcan’t do anything about dioxin. Finally, theChlorine Chemical Council ran a moreextensive series of ads that Gibbs says “basi-cally stole the show.” Those ads promotedthe benefits of chlorine, but were not a directrebuttal of the CHEJ ad.

Reaching All AudiencesOne problem with general interest, sports,and women’s magazines is that their adspace costs more because the publicationshave a longer shelf life, explains Brody.But sometimes, when you’re lucky, an adin the NYT gets free publicity in thosepopular publications.

For example, HCWH, the Environ-mental Working Group, and Coming

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Spheres of Influence • Environmental Advantage

Clean—all public interest groups—ran anad in the 11 July 2002 NYT warning con-sumers about phthalates in beauty productssuch as perfume, nail polish, and deodor-ants. The chemical, which softens plasticand is used, for example, to keep nail polishfrom peeling and flaking, can impair humandevelopment and reproduction, according tothe National Toxicology Program.

The groups became interested in doingthe ad campaign after reading an article byBenjamin C. Blount and colleagues in theOctober 2000 issue of EHP, which report-ed that women of reproductive age had thehighest concentrations of a particularphthalate metabolite of any of the age/sexgroups studied. They hired a national labo-ratory to test 72 beauty products andfound that almost three-fourths of theproducts, including all of the perfumes,contained phthalates.

In the ad, a pregnant woman is smellingperfume. Sexy for her, the ad states. For baby,it could really be poison. The ad refers readersto a website (http://www.nottoopretty.org/)that suggests how to take action on theissue—for example, by writing to legislators.“Our ad was tied directly to taking action,”notes Brody.

Self magazine, The Wall Street Journal,the Los Angeles Times, the London DailyMail, Agence France-Presse, and Canada’sNational Post, along with a whopping 342television stations did take action, runningpieces on the controversy over phthalates,says Stacy Malkan, communications directorat HCWH. The ad was even spotted onMTV, she says. By the end of August, theonline version of the beauty products ad hadreceived its one-millionth hit, says ArlieSchardt, president of Environmental MediaServices, a Washington, D.C.–based envi-ronmental and public health news outlet.

The ad was one component of a three-month, $150,000 campaign, which waspaid for by an anonymous foundation. Thecampaign included a report on the dangersof phthalates that cites the group’s ownstudy, FDA and EPA studies, and eightEHP research articles. They are now plan-ning outreach efforts to cosmetic compa-nies and to women’s health organizations,says Brody.

Taking out an ad in a prestigious news-paper makes an organization look legiti-mate, says Brody. “The fact that you havethe money to run the ads makes the worldtake you more seriously,” she says.

Success with RejectionSome environmental health campaigns suc-ceed even when their ads fail. As part of itscampaign to have the arsenic removed frompressure-treated wood, the Healthy Building

Network (HBN) produced a full-pageadvertisement, also in conjunction withFenton Communications. HBN, a Wash-ington, D.C.–based coalition of buildersand environmental and health advocates,opposes the sale of wood treated with chro-mated copper arsenate because the arsenicleaches out of the wood and can cause lung,bladder, and skin cancer in humans,explains Paul Bogart, campaign coordinatorfor the HBN. [See “Caution—Children atPlay: How Dangerous Is CCA?” EHP109:A262–A269 (2001).] Zoos have bannedits use, but Home Depot and other largelumber stores still sell the wood.

The ad, which appears on the HBNwebsite (http://www.healthybuilding.net/arsenic/aindex.html), shows a monkey anda boy, each playing on a jungle gym. Thecopy reads, If arsenic-treated wood is too toxicfor zoo animals, why does Home Depot thinkit’s safe for your kids?

HBN tried to sell the ad last summer toregional newspapers in the suburbs ofWashington, D.C., Boston, Denver, andelsewhere. All but a few papers in theDenver and San Francisco areas refused torun the ad, asserting that its claims couldnot be supported or that the ad was inap-propriate, says Bogart. They did notapproach the NYT because they had a limit-ed budget of about $20,000, he says.

However, their rejection got them moreattention than the ads. Professional Builder, atrade magazine for contractors, ran an articleabout the ad, and included the picture.“That was an audience we could only dreamof reaching,” says Bogart. In addition, awood treater in Wisconsin faxed the ad toabout 10,000 people in the industry. The adnever reached the intended consumers, butword got out anyway. The campaign, whichincluded a report on the amount of arsenicthat is in wooden playsets and retail lumber,began in April 2001. Eight months later,industry announced it will phase out chro-mated copper arsenate in wood for residen-tial uses by 31 December 2003.

The OppositionSome activists argue that money spent onads should go instead to grassroots organiza-tions. But Gibbs disagrees. “Putting all themoney in Pensacola [into] organizing a localcampaign wouldn’t have made the differ-ence,” she says. “It’s the ad that worked.”

While environmentalists and healthactivists may debate the merits of differentadvertising styles and strategies, some pub-lic health groups and industry representa-tives are coming down hard on the contentof some recent ad campaigns. ”We weredisappointed with the alarmist nature ofthe CCHE ads,” says Jeff Stier, associate

director of the American Council onScience and Health, a New York advocacygroup closely associated with the chemicalmanufacturing industry.

For example, Gilbert Ross, medicaldirector for the council, says the ads suggestthere is an epidemic of brain cancer, whenin fact it may just be a case of better detec-tion and changes to the way malignanttumors are classified, according to researchpublished in the 2 September 1998 issue ofthe Journal of the National Cancer Institute.In reply, Landrigan notes that the rate ofbrain cancer has continued to increase, evenafter the new imaging equipment and otherchanges discussed in the fact sheet had beenin use for a long time. “If increased sensitivi-ty to detect disease had been the sole causeof the observed increase,” he says, “the inci-dence should have risen temporarily andthen returned to baseline. . . . In fact, how-ever, in the fifteen years since wide adoptionof new imaging techniques, the incidencerate has continued to rise.”

Stier adds that studies published in “alegitimate science publication,” such as theNew England Journal of Medicine (NEJM),don’t need paid advertisements to get presscoverage. In addition to defending the sci-entific legitimacy of their claims, Landriganand others say that many important epi-demiology and toxicology findings get pub-lished in journals that simply don’t have thepromotional budget of NEJM. As a result,they don’t get covered by the press. In addi-tion, says Landrigan, “The NYT ads wereintended for a different audience thanNEJM readers.”

Despite their differences over manyenvironmental and public health issues,industry and environmentalists once joinedforces to run an ad campaign of their own.ED and the American Chemistry Council,which represents 180 chemical manufactur-ers, placed ads in February 2000 in USAToday, Congressional Quarterly, and otherWashington, D.C., publications to encour-age companies to join in a voluntary pro-gram to review data on chemicals producedin quantities greater than 1 million poundsannually. The proof of that campaign’s suc-cess lay in whether chemical companieswould join in the program, says TomGilroy, a senior director at the council, “andthat’s exactly what happened.”

Whether future environmental healthadvertising campaigns will be successfuldepends on a number of factors, but itseems clear that environmental and healthgroups are learning a basic tenet of market-ing: before you can get people to change,you have to get their attention.

Tina Adler

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Spheres of Influence • Environmental Advantage