All Hail the PBJ

UPDATE: See also http://www.pbjcampaign.org/

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From one of my new favorite blogs, Well at the New York Times:

Peanut butter and jelly sandwiches are good for you and the environment:

http://well.blogs.nytimes.com/2008/01/09/a-pbj-for-the-planet/

HEALTH

Well: A PB&J for the Planet?

By Tara Parker-Pope
Published: January 9, 2008

The classic sandwich may be a good way to help the world and improve your health.

Obesity, Diabetes Continue Toll on U.S.

From the Associated Press today:

WASHINGTON (AP) -- Americans are living longer than ever, but not as long as people in 41 other countries.

For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and lifestyles.
...

Among the other factors:

•Adults in the United States have one of the highest obesity rates in the world. Nearly a third of U.S. adults 20 years and older are obese, while about two-thirds are overweight, according to the National Center for Health Statistics.

Although the AP story does not mention it, many of the problems with obesity are due to diabetes related complications.

A graduate student recently predicted that perhaps in 20 years we will look at carbonated soft drink manufacturers the way we look at tobacco companies today. As these data continue to emerge, this looks increasingly likely.

Smoking Conquered; Obesity Is Next

In this screen capture from a Family Guy episode, a young "Death" wears a T-shirt that reads "Smoke Cigarettes." From many popular culture references such as this, it is evident that most people realize the health dangers from smoking. A recent Gallup poll suggests that Americans are now realizing the dangers of obesity.

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Regular readers know that I have spent the better part of the past two months indirectly fighting diabetes. Not for me, but for rural Hispanics in West Texas.

We are currently testing public service announcements (PSAs) that we created over the past few weeks.

In the current experiment, we are showing the anti-diabetes PSAs along with some filler PSAs about smoking, AIDS, marijuana, and cocaine.

During an experiment the other day, master's student Wes Wise remarked that the battle on smoking was pretty much won. Now, he predicted, more efforts could be targeted toward obesity and related health problems.

Turns out that many Americans are at least acknowledging the danger of obesity. A recent Gallup Poll shows that Americans acknowledge that being significantly overweight is just as harmful to your health as smoking.

Of those polled, 83% said being obese was "very harmful" to your health, whereas 79% of Americans said smoking was "very harmful" to your health.

When we surveyed rural West Texas Hispanics earlier this year, we found that about half were overweight according to the Body Mass Index, and another quarter were overweight. That's more than two-thirds of those polled.

Echoing the diabetes problem, many of our experimental participants are self reporting family members with serious diabetes-related health problems. Many of the participants report having lost a loved one to diabetes.

According to the Gallup poll, 28% of Americans report that obesity has been a cause of serious health problems within their family. I would venture to guess that this number is higher among our populations of rural West Texans (of both Hispanic and non-Hispanic descent).

Although we will learn something from the current endeavor, PSAs will not be enough. Our focus group data has shown that there are two major causes of the current eating concerns: economy of time, and economy of money (thanks again to Wes Wise for coining these terms).

It's faster and cheaper to eat at the dollar menu. You can walk out of McDonald's absolutely stuffed for about $3.21 in Texas. Just order two double cheeseburgers and a 99-cent order French fries.

It's a lot of food. It's also a lot of grease. I just looked up the nutrition facts online. Each 99-cent double cheeseburger has 440 calories, 23 grams of fat, and 11 grams of saturated fat. Those 11 grams of saturated fat represent 54% of the recommended daily allowance for a 2,000 calorie a day diet. The medium fries add another 380 calories, 20 grams of fat, and 4 grams of saturated fat.

So your $3.21 bought you 1,260 calories, 66 grams of total fat, and 26 grams of saturated fat. With that one meal you have 128% of the saturated fat you were supposed to eat for the day.

It is almost impossible to get that much sustenance for that little money in any other fashion. And when you're broke with a lot of mouths to feed -- and I've been there -- it's difficult to look at the single bunch of broccoli that the $3.21 will buy.

Add to the fact that for most people, those fat and carbohydrate grams taste really good. There's a reason they taste so good: you get the most energy (i.e., calories) per gram with those molecules. When you're just trying to survive, fat and carbs keep you alive.

When I was a little kid, our house backed up against the old Missouri River bluffs, and much of that land was a park. Since the bluffs made a cliff, it was basically our private park since no one climbed the cliff to get there.

My father used to like to photograph the wildlife, so one day he put out a dog food bowl full of bacon grease. The animals went crazy. I believe raccoons would just lay by the bowl lapping up that congealed bacon grease as if it were pure heaven. Scavenging from trash cans had never tasted so good! [If dad will send a picture, I will post it here].

Their bowl of bacon grease is our dollar menu and all-you-can-eat buffet. You cannot get much more appetitive than that. And unlike illegal drugs where you can get arrested right now, the danger from overeating is distant. Your heart does not stop today. You do not have a stroke today. You do not lose your foot to diabetes today.

So you eat from the dollar menu today. You'll eat right tomorrow. Sadly, for too many Americans that healthy eating tomorrow never comes.

I'm not picking on McDonald's. They claim to be committed to Hispanics, and I am sure that they mean it. But combining the dollar menu with any economically disadvantaged population does not and cannot encourage healthy eating.

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Our research project is funded by the West Texas Rural EXPORT Center, however, opinions shared here are solely my own.

Anti-Diabetes PSA Filming Concludes

Now more than ever I appreciate how much work goes into a 30-second commercial.

Wow.

Thanks to all of the great people who helped with this project, especially the citizens turned actors and actresses who recited their lines time and time again.

Also thanks to local production house Digital Base Productions, which did a great job.

Having Fun Shooting Anti-Diabetes PSAs

Health Care on the U.S.-Mexico Border

Decisions have never come easy for me. I have trouble letting go of the road not taken.

There was, however, one decision that was amazingly easy for me.

When I started college, it was my goal to become a physician. I was -- and am -- fascinated with human physiology and the brain. When you're a pre-med student, they urge you not to focus upon a specialty before you get to medical school, but I was interested in the brain. I was thinking psychiatry, but I'm betting that I would have ended up in neurology.

All was going well. I was checking things off the pre-med checksheet.

Until one day my wife was sick. A routine cold, I think. Perhaps a flu. We went to see her primary care physician.

As she was called back to see the physician, I sat there for a moment looking around the room. There were people of all shapes and sizes -- and degrees of cleanliness. They coughed, sneezed, and generally were sick.

And that it hit me.

I DON'T LIKE BEING AROUND SICK PEOPLE!

My would-be career in medicine died that moment. And I have never looked back.

Yet sometimes I am fascinated by how the turns of life bring us back again to where we once were.

Sometime about three years after that fateful day in the waiting room, I was hired to cover education and health care for the Las Cruces Sun-News. It was now my job to explain medicine although I had no formal training in it.

I liked this job. I care about sick people. I care about making it better. I just don't want to actually touch the sick people (my friends and family are laughing as they read this).

A promotion and then a bigger circulation paper took me away from that job.

Six years or so later, I found myself in Annie Lang's lab at Indiana University studying cognitive science and performing funded research on health communication.

That scratched my brain itch.

Now a few years later I'm sitting in West Texas increasingly thinking about health communication. Texas Tech is aggressively seeking full funding for a new 4-year medical school in El Paso, which borders Mexico.

And the more that I think about it, the more that I realize how much I care about border health. Perhaps it's the old health care reporter in me.

In the TTU Health Sciences Center's institutional goals, they say, "we must position our new four-year medical school in El Paso as the national leader in border health. No other medical school in the nation is as well-positioned or ideally suited to impact border health, which is quickly becoming a health disparity issue with enormous national implication."

I left medicine behind in that waiting room more than a decade ago. Somehow, however, medicine keeps finding me.

Hispanic Health Interest Increasing

One of the many things that attracted me to Texas Tech was our Institute for Hispanic and International Communication (new Web site pending).

Prior to graduate school and a faculty position in the mid-west/east coast, I spent seven years in the Southwest, and I was anxious to return. In part, the psychological processing of media messages across multiple language and multiple cultures interests me.

At present, I am playing a small role in an internal Texas Tech grant to study a health campaign aimed at preventing/treating diabetes among Hispanics in West Texas. The problem is dire. I do not have the statistics at hand, but I am told that this looks to be the first generation of people in America whose life span is shorter than that of its parents.

Friday morning we had a meeting to plan the second phase of grant applications. Usually I hate meetings, but I walked out of this meeting totally energized. We have assembled an amazing interdisciplinary team of scholars from across the campus and the Texas Tech University Health Sciences Center.

The work we're planning is meaningful. It is important. And it has the power to improve / extend / save lives. This is an opportunity that comes across too seldom in communications research.

Clarifying Thoughts on Ads, Careers

More often than not, I find that when I try to be brief, I end up being unclear. It appears this was the case with the most recent post. Let me try to respond to the thoughts individually.

Teaching Is a Reward
Absolutely! I really enjoy the contact with both undergraduate and graduate students. I believe that we can make a difference in their lives. I still keep in touch with a couple of students from the first class I ever taught. This contact with students is a perk of the job.

Advertising as Noble Pursuit
Mostly, my response is, "whatever helps you sleep at night." There are a lot of positive things that I can say about advertising. I find it fascinating that people identify so strongly with brands. That is why I have spearheaded research in this area. However, fascinating does not mean noble.

Although I usually avoid the topic, I think we have to delve into the notion of social capital. Robert Putnam's Bowling Alone comes to mind. There is a reason that we can so easily identify with brands. I see two major possibilities.

First, brands may take advantage of our evolutionary heritage. That is, we were not engineered to cope with artificial brands. I am specifically thinking of Reeves' and Nass' The Media Equation. If we treat mediated messages like we treat real people -- as Reeves and Nass allege -- then it logically follows that we would treat brands like read people.

The second possibility is that brands are taking advantage of some sort of void in our lives created by a lack of social capital. If you look at the transformation of advertising from informational to transformational, then the time lines are concurrent. As social capital has decreased, advertising has used fewer information-based appeals and more emotion-based appeals.

To state this more clearly, perhaps we form relationships with brands because other relationships are lacking in our lives. This would be in accord with Putnam's argument.

Here is a related quotation from a story today on CNN.com, " 'Families today are pretty disconnected,' says [noted genealogist Maureen] Taylor. 'It is important for kids to have that sense of connectedness to everyone else, at a point where many kids and teenagers are feeling quite alienated. It is important for kids to know where they fit in.' "

The reality surely combines those two plus several things beyond the scope of this post. However, neither of these possibilities is especially flattering toward advertising.

Furthermore, if you look at L. J. Shrum's recent work on the cultivation of material values, then there is more unpalatable evidence for advertising and marketing.

My dad once told me that every successful salesperson that he ever met really believed in the product/service that s/he was selling. Surely this must be true. You have to force yourself to believe. The two quasi-anonymous comment writers here surely have done this. And there is no arguing that advertising can be beneficial for small businesses, large businesses, and for the adoption of new ideas. But that does not make it good for society overall. And there is some pretty strong evidence that it is not wonderful for the average individual.

I'm no media critic, and I'm not lambasting advertising. However, I do think it is extremely self-serving to find some inherent nobility in getting people to pay more for Tide when Gain works just as well. I completely believe that the "no laws" clause in the First Amendment should be interpreted as "no laws." But this does not mean protected speech is good speech.

Academic Versus Industry Pay
This obviously varies across industries and department. However, Texas Tech pays well. We are easily among the top quartile in communications. Despite the generous salaries, I could easily take on a marketing research position tomorrow for a hefty increase in salary. It is no stretch to say that I -- or an equivalently trained peer -- could come close to doubling our salary with a large market research firm.

But I don't want to do that, in part for the contact with students.

Appetitive Versus Aversive Processing
One of the many reasons that this broad topic interests me is that advertising theories do not easily translate to health communication messages. I would argue that this is due to, in part, the fact that selling is an appetitive approach. We try to activate existing appetites with our ads.

Conversely, most public service announcements attempt to get you not to do something. This is an aversive function. With low level appeals, it is difficult to activate the aversive motivational system. We believe that this is due to concepts we call negativity bias and positivity offset.

At low levels of intensity, the appetitive motivational system is more active that the aversive motivational system. And if you make a health appeal extremely intense, it is likely that viewers will avoid the message altogether rather than the specific behavior targeted.

Some health topics do make proactive appeals (e.g., use a condom) but these are not especially appetitive and usually involve eschewing some simpler, more pleasurable activity.

It's an interesting challenge.

Communication Profoundly Affects Society

I study human communication. Specifically, I study the cognitive processing of mediated messages.

I do not try to cure cancer. But I think that my research matters anyway.

Two of my friends seem to suffer from mild inferiority complexes about what we do. They tend to lament that we're not curing cancer.

Early in my career, I had similar reservations. I considered pursuing a Ph.D. in cognitive psychology because I did not want to dedicate my life to "helping people figure out how to sell cheese."

One day I was discussing this with Kansas State psychologist Richard Jackson Harris. He told me that I had it wrong. Instead, he said, the media shape the way people view the world, and that impact cannot be underestimated.

It was what I needed to hear, and it stayed with me.

Here at Texas Tech, we have the new Institute for Hispanic and International Communications. One of the overarching interests in the institute is the delivery of health care information to rural Hispanics.

Although this is an interesting topic, it did not seem especially related to my own research interests.

Until Thursday.

We were driving south on I-10 on the way to El Paso, and I turned off onto N.M. highway 404, affectionately known as the "Anthony Gap."

As I began to head east, I remembered something that happened almost a decade ago.

In fall 1997, I was the education and health care reporter for the Las Cruces Sun-News. One day I was travelling that same highway to cover a story in Chaparral, N.M. I was going to write about Las Cruces-based Memorial Medical Center's mobile health care unit.

I spent part of this afternoon looking through my clips (cut out articles I wrote) for this story, but it appears as if it never got clipped. Therefore, I cannot tell you much about the story I ultimately wrote. However, it dealt with bringing medical services to the rural and largely Hispanic population of Chaparral (64.5% Hispanic by one estimate I found online).

Reading that story in the Sun-News may have been all that some readers ever learn about delivery of health care to rural Hispanics. More importantly, that article barely touched upon the delivery of health care information to rural Hispanics. For those who showed up to the mobile health care center that day, how did they decide to go there? More importantly, why did those who never showed fail to do so? How can we get them there?

I'm not curing cancer. But our research may lead to more effective communications, which will get patients to go see the physicians, who can cure their cancer. And that is important.

It's a lot easier to go to work each day when you believe in what you do.