Why public health messages don’t stick

Ayon Bhattacharya
5 min readAug 8, 2020

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Here’s how health professionals typically talk about the current epidemic we’re facing: We have recently reached 5,228,817 cases of SARS-CoV2 nationwide. People are throwing caution to the wind, not taking required precautions and causing great harm. It’s imperative that we follow CDC procedures so that we can slow down the death toll and gradually recover.

Seems reasonable enough, right?

It’s clearly not reasonable to a large proportion of the population however. I believe the reason why comes down to deeply ingrained moral intuitions, the lack of effective communication on the part of highly-educated public health staff, and the porosity of the media environment making even the smallest, best intentioned obfuscation highly damaging to credibility.

There are lessons here for us in the tech sector. What we do is highly technical, and similar to public health officials, we are typically highly-educated, middle or upper middle class urbanites living in western industrial societies: We have moral instincts that are distinct from the majority of the body politic. If we understand this fact, and also understand the effects of mind-blindness and the principles of effective communication, we’ll be able to connect with our users and make the impact we’re all looking to make.

Moral Foundations

How would you feel if you saw someone burning a flag? There’s nothing intrinsically damaging about this act, but I would feel repulsed by an action like that. That type of instinctual moral response comes from deeply ingrained moral intuitions. Jonathan Haidt at NYU spent years studying these types of response across many demographics and locales. He found that they break down into the following moral foundations:

Care/Harm, Fairness/Cheating, Loyalty/Betrayal, Authority/Subversion, Sanctity/Degradation, and Liberty/Oppression.

Public health researchers, college professors, liberal politicians, and most people that fall into the bucket of coastal, urban, and highly-educated tend to have narrow moral foundations focused mostly on harm and somewhat on liberty. That’s not to say that the other foundations aren’t present, especially in the individual case, but that is to say across many individuals a narrower and taller set of foundations characterizes liberals. The other thing that distinguishes liberals is the perception of fairness as equality as opposed to proportionality.

Conservatives, blue-collar folks, people who don’t live in the west, non-white Americans all tend to have a broader set of moral foundations encompassing harm, fairness, loyalty, authority, sanctity, and liberty.

When all of our messaging emphasizes harm above all else it registers as if we’re showing a Jackson Pollock painting to someone who is color-blind: It registers as noise. At best.

But we’re right, aren’t we? Shouldn’t that be enough? Well, we’re certainly righteous. Standpoint diversity is a virtue and if we’re right we have to be able to convince others by painting with a palette they understand.

For example, we could emphasize loyalty: Wear masks because it’s un-American to put comfort over community. Or sanctity: This virus is corrupting the fabric of our nation and must be stopped. How about liberty? Surely we can’t appeal to liberty if we’re locking the economy down? It’s not easy to speak of the lockdown in terms that appeal to liberty, and frankly, we should find a way to re-open as soon as we can responsibly do so. But if we were going to try to be liberty-minded in our appeal, we could say: This virus is impinging on our freedom and we have to come together and beat it. It’s not a perfect reframing, but it’s something.

The broader point here is that different people and groups have different gut feelings that drive their behavior. Our fallacy is implicitly assuming that others feel the same as we do. Our second mistake is assuming others think the same way we do.

Mind Blindness and Communication

Part of the process of gaining technical education is that the abstract becomes concrete. When you have experience in public health, for example, you might have a much richer set of associations with SARS-CoV2 than a lay person. Based on the classification and type of the virus and its relation to other diseases, you might even have a reasonably vivid mental picture of what this thing looks and acts like.

Lay people don’t have those associations. According to Chip Heath from Stanford, great communication must simplify and concretize the abstract. Coronavirus is better than COVID or SARS-CoV2, and better yet would be to create a name associated with concrete symptoms. When we’re talking about the death count, framing large numbers in terms of individual stories is really important as well.

Other principles of good communication are unexpectedness, emotional salience, and narrative emphasis. There’s one more, but we’ll put it aside for the moment and return to it.

The subject matter of coronavirus is inherently unexpected and emotionally salient. But we need to tell a coherent and accurate story with a beginning, a middle, and projecting into the future, an end. Sometimes we become highly numerical and aphoristic in our discussion of the virus, spitting out facts without a clear narrative, to say nothing of a narrative that actually has appeal across a broad swath of society.

Even if we were to tell a concrete, emotionally salient, coherent story about the virus in a way that aligned with the breadth of people’s moral intuitions, we would still need one final ingredient to sell the tale: Credibility.

Media Porosity and Credibility

In today’s porous media environment, inauthenticity is instantly detected and undermines credibility. A large part of the backlash to the CDC’s recommended precautions came from a short episode early in the pandemic when they said that masks did not prevent the virus in order to maintain the supply of protective equipment for use by medical professionals. That is a noble aim and certainly understandable given the circumstances, and since then they have been entirely truthful as far as I can tell, but alas: In a media environment where gatekeepers are reducing in relevancy all the time, any inconsistency is detected,undermines credibility. A lack of credibility undermines effective communication and authority.

The lesson here is that we must be creative about communicating and influencing people without resorting to noble lies and inauthenticity. If we understand the moral instincts that are behind people’s reactions and are able to tell a coherent, concrete, and emotionally salient story from firm and authentic footing, we’ll be able to connect roundly with our interlocutors and have the impact we desire.

If you want to learn more check out the design psychology section of www.ayontech.io.

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