The evolution of public health campaigns

By Kerry Brind, Senior Editor

Stay home from the pub to help the war effort. Stop smoking and spend your money on make-up instead. Don’t die of ignorance.

Believe it or not, all these slogans were once part of public health campaigns. Far from the more positive messages we’re used to seeing today, health communications of the past were much less friendly. Some were downright terrifying.

But, as culture has changed and our understanding of health, disease and human behaviour has developed, how have public health campaigns evolved in response? What does the future of health communications look like and how can we ensure that future campaigns are seen, heard, trusted, and acted upon?

Take charge of your health, that’s an order!

Since the First World War, public health campaigns have been used to raise awareness of important health issues and encourage the public to live a healthier life.

It was conscription that first highlighted the alarming state of health among the general population. Soldiers needed to be physically healthy to win wars and the rest of us needed to eat less, improve our personal hygiene, and keep the country going back home.

Early health campaigns used bold design and direct language, usually relying on patriotism to encourage action. Eat Less Bread, produced at the height of the German U-boat campaign, was a no-nonsense demand for people to cut back at a time when grain stocks were running low.

Heading to the local pub was also discouraged, as it was sure to lead to military defeat. “Don’t take alcoholic drinks on Mondays,” cried the poster. “All who remain at home will willingly help the country in this way.

From war directives to public health advertising

Post-war, the Spanish flu pandemic created a new challenge for the government. With no flu vaccine or effective medical treatments, public campaigns encouraged people to wash their hands, wear masks, cover their faces if they sneezed and stay home if they felt unwell. Among these was the still widely used slogan, coughs and sneezes spread diseases.

And the government wasn’t the only one creating health information. Jeyes Fluid promised to guard against flu, while Lifebuoy soap, encouraged consumers to ‘Link up with Lifebuoy for health’s sake’. Boots the Chemist issued healthy living advice such as keeping the home well ventilated and gargling with antiseptic. Health advertising worked, and it was here to stay.

Colourful characters make their mark in health campaigns

WWII saw a return to patriotic health campaigns as food shortages took hold. The government deployed colourful characters like Doctor Carrot and Potato Pete to share the benefits of healthy eating and encourage the public to plant their way to victory.

The use of cartoon characters proved successful after the war too. Initially sceptical of the new national health act, cartoon character Charley was shown first-hand the benefits the new NHS would bring to himself, his family and the local community.

And who can forget the dirty, deadly Nick-o-Teen of the 80s campaign, Stop Smoking? Even Superman made an appearance!

Superman versus Nick-o-Teen is a great early example of a health campaign aimed at children. It included colourful posters, a comic book, colouring pages, badges, and a ‘never say yes to a cigarette’ pledge for children to sign.

Scaring the public into action

But health campaigns weren’t all bright colours and cheery messaging. In the 1940s, the ominous black hand of diphtheria was out to get your babies, and in the 1980s a truly terrifying apocalyptic-style TV advert to raise awareness of AIDS hit our screens. The ad featured an erupting volcano and a thudding funeral bouquet, accompanied by deathly bell tolls and the dark narrated tones of John Hurt. Ad guru and campaign mastermind Malcolm Gaskin admitted that frightening people ‘was deliberate’.

But can you frighten people into taking action? Douglas Hiscock, a Chartered Occupational Psychologist isn’t convinced. “Adverts that scare people look effective, but the problem is that most people think that it won’t happen to them. People are more likely to do something if the perceived outcome is positive, negative outcomes can be overwhelming.”

The AIDS: Don’t Die of Ignorance campaign contrasts with the more positive health messaging we’re used to seeing today. Yet if you look closely at many recent campaigns, there are often links to the past.

Historical campaign methods get a modern makeover

The bright yellow background and direct message of Eat Less Bread, bears a striking similarity to the Stay Home, Protect the NHS, Save Lives lectern sign, used during the Covid-19 pandemic. Patriotism is still a common theme in many health campaigns too, except that instead of supporting the armed forces, the NHS is our new banner.

But while some of the methods remain similar, it’s the approach that’s really changed. Today’s communications adopt a much more informative, empathetic and collaborative tone, encouraging people to use tools, resources and free health services to take responsibility for their own health.

“We need to help people understand that the way they live has consequences,” says Douglas. “If you smoke you are more likely to be unwell, if you are overweight, you’re more at risk of certain conditions. But cutting through the noise and having a coherent, non-judgemental conversation with an audience that has a very short attention span is a major challenge.”

The health campaigns of the future

So, what does the future look like for health communications? We think collaboration and evidence-based behaviour change will continue to drive successful campaigns that empower people to live a healthier life. “The more involved we are in getting someone to change, the less likely it is to last,” says Douglas. “Change can be hard, so we need support people to quit smoking or do more physical activity. We must empower them to be own therapist, their own personal trainer and to make better health choices based on knowledge. Lots of people are already thinking about how they are living, let’s keep that trend going.”

Connection is paramount, so the rise in campaigns fronted by ‘real’ people rather than an authority is likely to continue. This might be an influencer, someone the audience aspires to be or it might be someone just like ourselves, a regular person who makes us think “Oh my gosh, I’m not alone,” or “They’re just like me,” or “I’m not the only one.” Raw stories are powerful.

Social media will also continue to play an important role. In a world where we count likes as well as calories, people love to show how they’ve improved their lives, especially as part of a movement or challenge. The NHS’s free Couch to 5k app recently surpassed over 5 million downloads and Instagram is packed with success stories using #CouchTo5k. Best of all, for small organisations with limited budgets, or campaigns such as awareness weeks, this kind of approach can be cost effective – user generated content is free.

Finally, we think that creating niche campaigns around the needs of specific target audiences will be the next big step. “Personalisation is the future of health,” says Douglas. “Using technology to get more sophisticated about interventions and telling people what they need to live a healthy life as an individual.”

Kerry is a Senior Editor at Thrive. She is adept in planning and delivering successful projects for a range of audiences and brands, and developing messages that have the power to really resonate.

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