With responsibility (and a £5.45 billion budget over 2 years) for public health moving to Local Authorities from April 2013, I thought it timely to shine a spot-light on the chief executive of Public Health England.

Recent profiles of Duncan Selbie, chief executive of Public Health England, paint a picture of a modest, disarming leader, with a common touch that has been developed through a non-traditional rise up the NHS leadership ladder. Mr Selbie is not from the traditional medical or academic background that is common-place among his peers. It might be this practical nature that has allowed him to establish a track record of implementing change that is based on the reality faced by his patients and employees.

He understands that public health is related to other equality factors; that education, housing, age and social interaction can have a determinable affect on someone’s health. This understanding is good news and should encourage a joined-up approach by Local Authorities, community groups and health organisations to tackle public health issues.

However, what does he think about behaviour change and social marketing in relation to public health? To my knowledge he has not been probed directly about it, but a recent article I read in The Times might provide some information; in it Mr Selbie comments:

“I cannot be a super-nanny. Telling people what to do, directing them and ordering them, writing strategies and putting together toolkits are a complete waste of time. You create an environment where people feel able to do the best they can, to run towards problems and not be afraid.”

He’s right (partially). No one wants to be told what to do, but creating this ‘environment where people feel able to do the best they can’ is a big challenge. Let’s take the example of cancer awareness. Simply supplying people with information on what to look for and then telling them where to go assumes that they will act on a rational basis. This is, of course, incorrect. People can know what to do and still not do it. Information must be framed in a way that resonates with the target audience – this requires insight, targeted interventions, appropriate reassurance and timely reminders.

You’re never going to create a society where people consciously ‘run towards problems’. It’s within human nature to make things as easy as possible for ourselves; it’s hard-wired into our brains to help us process a deluge of daily information. However through incorporating social marketing techniques you can look to dilute the problem and provide easy, simple steps for people to resolve it.

With such a big change occurring in the public health landscape, my advice for Mr Selbie is to encourage Local Authorities to first of all understand the barriers local residents face in trying to lead a healthy life. After all, we want to ensure Local Authorities don’t run before they can walk.

Delayed gratification is a key concept of behaviour change.

- Eat more healthy now, have a greater chance of living longer
- Stay longer in education and training at a younger age, increase your average wage packet
- Save money for a pension, have a increase quality of life when you retire

However, it’s difficult for us to act now for a possible future benefit and nobody likes to consider the possibility of a bleaker future: ill-health, financial dependency and death.

This is why the Government spends millions on a ‘Change for Life’ campaign, why there’s legislation to keep children in education or training until 16 and soon every employee will be automatically enrolled on to an organisation’s pension scheme.

If we know how human’s think, surely this can be used to ‘help them’ make better decisions. This is a key basis for the development of current nudge agenda. There are examples of this in the health and financial sectors and now more examples are being developed in the sustainability sector.

When new energy-saving light bulbs came on the scene, there were many schemes that provided free samples to consumers to try. In doing so they made the first step an easy one and tried to normalise the practice of replacing old, used light bulbs with energy-saving ones. Over time consumers would reduce electricity bills and save money on light bulbs, as the new energy-saving ones lasted longer.

However, the upfront cost of changing a light bulb is relatively small in order to enjoy the delayed benefit from savings in electricity. What about something a little bigger, say a washing machine or dish-washer? The up-front costs of an energy-efficiency appliance of this nature would be more substantial. Any future savings need to be made relevant to the present buyer who at this moment in time would be embarking on a higher upfront cost.

That’s the idea behind a scheme that ran in a Danish nudging Network, GreeNudge (http://www.greenudge.no/) in Norway who applied a nudge in an attempt to make buyers of white appliances choose the options that benefits the environment as well as saving money in the long run.

The idea is beautiful and simple: If we inform potential white appliance buyers about the impact the device has on your energy bill in the long run, then they might reconsider the more expensive, but more energy efficient – and ultimately more economical attractive – alternative.

Sounds like a bright idea to me.

A new survey states that only 1 in 5 in Britain are eating the recommended five positions of fruit and veg. It’ll be interesting to understand why so few people don’t eat the recommended amount. 

Don’t get me wrong, I don’t eat five potions a day myself, but I eat at least three, which is more that half, so I’d get a pass. However if I’m in the majority behaviour group then Denmark’s campaign (image above) might work well with me as the target moves from 5 a day to 6 potions a day - I’d have to up my intake to ensure I still maintain my pass rate.

However for others this campaign would not work, if they are only eating one or two potions of fruit a week, then the concept of aiming for five is unrealistic. They might never believe they could do this, therefore the campaign would not be considered targeted at them. This means the revised approach of just asking someone to increase their fruit and veg potion by one, might be more obtainable.

Some other secondary fruit and veg messages that can cloud the primary message:
- potatoes don’t count;
- but smoothies do;
- non-fresh fruit (frozen and tinned) counts;
- a satsuma is half a potion, but an apple is a whole potion;
- Pulses counts as one, no matter how many you eat (who knows what pulses are let alone worry about how many equates to a potion?) 

Ideas like Supermeals can work well, as you fold the campaign message into a family meal that is tasty and cheap for families. As the warm weather starts I’m certain more family fun activities will be pushed (strawberry picking and coconut shys) 

This recent article discusses how the marketing profession can win back support by attempting to focus on a number of issues, mainly:

- positioning brands and services to allow the people who use them to lead more sustainable lives
- advocating worthwhile causes and issues with no discernible benefit to the brand itself
- put people (not customers) at the centre of the brand and communicate using easy to understand language 

All this makes sense, but the vision can be broadened even further. Marketing techniques can be used to encourage people to lead longer, fuller lives. Social Marketing places social good at the centre of marketing. This doesn’t just have health applications (healthy living, smoking cessation, organ donation), but should be applied across commercial brands who want to be perceived as genuine and  build trust with people.

Could there be a case that all Marketing should reflect elements of ‘Social Marketing’?