What insights, opportunities and projects does transformative consumer research offer people and organizations who work to improve the lives of people identified as being in an 'at risk' group? That was the assignment for our small group that met at the Second Annual Transformative Research Conference. Our discussion group was one of nine convened during the day designed to create an agenda for the field that will continue in ongoing intellectual exchange, research collaborations, and/or projects aimed at social change.
Our group began by working through the many different types of determinants and moderating variables that are used to traditionally define 'at risk' - among them genetic susceptibilities; social determinants; socio-demographic characteristics; cognitive, emotional and physical (CEP) handicaps; and behaviors. We soon realized that we could spend the day (and even longer) on this descriptive exercise - one that has been ably addressed by many others including the WHO Commission on Social Determinants and McGinnis and Foege's review of the actual causes of death in the US in the Journal of the American Medical Association (free pdf - and updated by Mokdad et al, 2004). What, we asked, is the unique contribution that consumer research and marketing can make towards understanding the concept of 'at risk?'
A definition of an 'at-risk' population, from a marketer's POV, that we roughed out is: someone who has a personal or situational disadvantage in the marketplace that might create negative outcomes for the individual or society. It is a draft idea at this point, and will need more discussion and refinement. However, putting 'at risk' in the context of the marketplace - and here marketplace is a broad space and not restricted to shopping and financial transactions - offers social marketers a starting point for what we (should) do best: conduct market analysis to uncover what forces in the marketplace potentiate the impact of personal factors (genetic, biological, CEP handicaps, risky behaviors) and situational ones (poverty, housing, transportation, life stressors, environmental disasters) and how market forces - including changes in the product, service and behavioral choices that are available; their accessibility; the incentive structures and rewards; and how they are communicated to people - can be harnessed to mitigate or even eliminate their impact. [See Making change happen: The marketing approach].
Throughout the day, our discussion ranged over a number of ideas and approaches to thinking about and serving 'at risk' groups. At one point we stopped to identify some of the tensions emerging in our conversation. The point of this list is not to decide which is necessarily 'right' or 'wrong,' but to offer you what a few consumer researchers and social marketers see as important issues to address when working with these populations:
1. Framing people in these groups as 'vulnerable' versus possessing unique strengths and assets.
2. Focusing on the characteristics of 'typical' people (i.e., how do we work towards inclusion?) versus the uniqueness of people identified as being 'at risk.'
3. Planning for marginal changes in their status (or what was referred to as a corporate model) versus seeking radical changes that are fostered by grassroots activities.
4. Using targeting to focus marketing and other resources versus protecting these groups from it (think about minority population groups and their resistance to targeting by tobacco and alcohol advertisers, other groups who shun being targeted by public health programs because it may lead to further marginalization and stigma).
5. Thinking about people in these groups as being unaware or naive of their elevated risk status (with an accompanying sense of calm) versus stimulating them into action (with the attendant sense of worry and/or fear - is this where people who question when to use fear-based communications need to think a bit longer and harder about what they are doing?).
The challenge for our group, and the others, was to develop several ideas for research projects or programs that could be used to create a transformative consumer research agenda. Our suggestions, that I am sure will be massaged many more times and adapted, are:
1. Conduct a sociological or historical analysis of consumer movements by 'at risk' groups that resulted in positive effects on the marketing practices of corporations and brands. We are especially interested in how a subset of these movements changed the marketers' perception of them as being marginalized (for example, they did not talk about the problem, develop offerings specifically for them, or use models in their ads like them) to being included in the range of target audiences they serve (for example, the emergence of the gay market, people with CEP handicaps, seniors).
2. How to design decision-making environments that lead to better outcomes in at-risk situations, such as how to display foods in cafeteria lines that lead to lower caloric trays at the cashier or providing health insurance and health care information to different consumer groups.
3. Conduct consumer studies of at-risk groups to understand how to create an ideal consumer space that can then be used by change agents to inform and guide corporate, government, NGO and community actions to achieve them.
4. Studies on how social networks and new information and communications technologies are creating or affecting at-risk populations, for example, by their influence on information processing abilities and skills. [See The social life of health information.]
5. Studies on whether there are shared motivational drivers for risky behaviors that may need to be considered in designing programs to address them to avoid unintended effects such as substitution or adoption of other addictive behaviors.
For researchers who are looking for other ideas on topical issues, we just heard a number of them from Cynthia Baur of the CDC at the Social Marketing in Public Health Conference.
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