Social marketing for health
promotion in CALD communities
Is ‘first do no harm’ more easily
said than done?
Kim Webster,
Senior Program Adviser
What is social marketing?
Social marketing is the systematic application
of marketing along with other concepts and
techniques to achieve specific behavioral
goals for a social good.
Campaigns and other methods of persuasion
(community education, advocacy)
About this presentation
Draws on practice experience of VicHealth and its
partners to:

Highlight some of the unintended harms that may
result from using social marketing approaches to
promote health in CALD communities

Discuss some lessons learned

No ‘neat’ solutions but some principles
Applications of social marketing in health promotion in
CALD communities
Behavior change (ether directly or by seeking to strengthen social norms):

to improve individual self care (eg smoking cessation programs)

to reduce the risk of harm to others in the community (eg programs to reduce
drink driving)

to reduce the risk of harm in personal relations (eg programs to prevent
domestic violence, child abuse)

in the ways people and organizations in the wider community treat people
from CALD backgrounds (anti-racism, cultural awareness, more sensitive
service provision)
Messages to CALD communities can be delivered through specifically targeted
programs or general programs designed to reach a diverse audience
Targets for change

Typically a social marketing campaign has a
‘primary target’ (the group of people whose
behaviour the campaign is seeking to
change)

However the messages often reach other
‘secondary’ audiences (either intentionally
or unintentionally)
Potential risks
Social marketing messages can have unintended negative impacts
on:

The primary target audience

Groups other than the primary target
Secondary influences may not always be a bad thing and may be a
specific goal of the program.
For example anti-smoking campaigns = development of broader
social norms against smoking = increased commitment to
take action on tobacco control
Case study 1: primary prevention of
violence against women
Primary prevention involves preventing violence before it occurs

Primary target is men (primary perpetrators and masculine
socialization implicated as a causal factor)

Effective approaches involve addressing gender inequalities and
gender socialization and communicating that violence is
unacceptable regardless of the circumstances

Violence is not confined to CALD communities but emerging
evidence indicates that it may be more prevalent (suggesting the
need for greater resource allocation to these communities to address
the issue).

Accordingly, decision makers/service providers may be a secondary
target.
Case Study 1 cont;
Risks in high-lighting the issue and/or possible higher prevalence in CALD communities
Secondary audience risks



Stigmatizing CALD communities and compounding marginal status
Contributing to stereo-types of migrant men as patriarchal & women as ‘passive victims’
Compromising commitment to settlement of particular groups
In the wider community - undermines understanding that the issue cuts across racial and ethnic
lines (US mainstream campaign example)
Primary audience risks
Risks in a zero tolerance/gender equality approach:
Disrupting social relations in already fragile communities
May have little resonance with, and may alienate those from CALD backgrounds who
have been subject to collective violence and marginalization prior to or following arrival
Risks in NOT addressing the issue/selectively
retreating from zero tolerance

Equity? Is CALD women’s welfare any less
important than the welfare of other women?

CALD women are especially vulnerable – face the
double jeopardy of sexism and racism (domestic
violence markedly increases the risk of domestic
homicide)

Denial of the lived experience of CALD
women/disempowerment

Policy/program neglect
Case study 2: Anti-racism

Target is the wider community

Evidence indicates that effective messages
are those that emphasize commonality with
minority ethnic groups
Case study 2: Anti racism
However this risks unintended harms to the secondary ethnic
minority group audience as:

Portrayal of minority ethnic groups in ways that are
acceptable to the wider community may not be acceptable to
groups themselves (eg emphasis on ‘food and dance’).

Results in minority ethnic groups being accepted only on the
terms of the wider community (thus compromising ethnic
identity)

Denial of ethnic identity now regarded as a form of racism
itself. Has implications for health.
Case study 3: Infectious disease and
refugee trauma

Early intervention critical

Expert consensus that migrants and refugee
present minimal risk to public health
Campaign Targets:
(a) new arrivals to encourage early and active help
seeking
(b) primary care workers to identify and take a more
proactive approach with new arrivals
Case study 3: Infectious disease and
refugee trauma
Unintended impacts (primary and secondary
audiences)





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Moral panic and xenophobia
Stigma
Stereotyping as ‘weak or vulnerable’
Commitment to settlement of particular groups
compromised
Political considerations drive health service
responses – risks over investigation, undermining
of client autonomy
Barriers to services
Case study 3:
Risks in NOT addressing the issue

Undetected disease can be more complex and
costly to treat and may be associated with reduced
quality of life and productivity. May ultimately result
in loss of life.

Inadequate resource allocation

Opportunities to sensitise services foregone
Some principles to consider

Consider impacts on other audiences and explore
this in formative research with a view to addressing
negative impacts where possible

Assess risks and benefits – (but avoid planning to
‘worst case scenario’)

Engagement of affected groups in developing
messages and imagery
Human rights or cultural relativism?
Important in weighing up the potential harms to cultural integrity/ethnic identity
Cultural relativism
The belief that an individual’s beliefs and activities can be understood in the context
of their own culture and that all cultural beliefs and practices are equally valid
A human rights framework
Culture is important and ought to be respected and preserved, but does not
transcend basic human rights, in particular the right to safety and security.
.
Human rights or cultural relativism?
Implications for message framing – the violence against women example
In planning - acknowledging men’s context but not accepting it as an excuse for violence on the
grounds that women’s human rights need to be similarly respected
In message framing – use of messages that achieve the desired outcome while preserving
important cultural values (and promoting these to the wider community)
Using cultural reference points (beliefs, key opinion leaders) to demonstrate that violence is not
acceptable
Examples


Spectrum Migrant Resource Centre video – ‘Family men don’t do family violence’
Northern Inter-faith Communities poster.
Some principles to consider
Plan to contain risk and maximize benefits

Build political support for the campaign

Cultivate leaders in both minority ethnic and wider
communities to respond to problems (but also
strengthen work!)

Social marketing (alone) does not a health
promotion program make!
More information
www.vichealth.vic.gov.au