Education, Public Health and Social Marketing

The evidence is now overwhelming that if you take an average low-income child and put him into an average American public school, he will almost certainly come out poorly educated.

That's the payoff line in an article in Sunday's NY Times Magazine (free registration required).

Paul Tough looks at the promise, opportunities, gaming and potentially fruitless outcomes of the NCLB Act as Congress considers reauthorization legislation next year. Two thoughts occurred to me while reading this piece.

1. It reinforced my belief that social marketing is so popular in public health because there is a strong, centralized research and consensus development process in place in the field of medicine that is virtually absent in education. This infrastructure makes it relatively easy to fund and launch major public health initiatives at the local, state and national levels with few competitors for the mindspace and behaviors we are trying to influence.

In many cases the near monopoly (or lack of well-organized and authoritative alternative viewpoints within the public health community) on the ideas or behaviors we are marketing is what sets the stage for successful programs (along with great people!). Just ask your colleagues or reflect on your own experiences about what happens when a program 'goes live before it's time.' Imagine that states or local medical societies and health departments determine what constitutes a child being overweight, how to prevent and treat elevated blood pressure or diabetes and whether to allow hospitals and physicians to adopt treatment protocols and programs that seem to be successful in other parts of the country ('seem' in the sense that no randomized clinical trials are conducted to test them)?

2. Social marketers, particularly those whose world view encompasses social determinants of health and the elimination of health disparities, should be especially concerned that the state of education is so poor. Educational disparities among groups of children seem to be widening, and the single best predictor of health status is educational attainment. The recent findings on the prevalence of low health literacy among adults and its relationship to perceived health status should be a wake-up call that many public health goals will not be achieved without progress in attaining education goals as well.

Systems theory, social ecology and the upstream perspective all argue for the need for social marketers to become involved in education issues and reform. But the lack of consensus as to what is needed (other than 'proficiencies' that vary from state to state), balkanization of the education enterprise, and the strong encouragement of local ownership and guidance of the process, makes the type of programs we are use to doing in public health extremely difficult to simply transplant to the education world.

Is the education infrastructure as weak and fractured as Tough suggests that national, or even community-wide, efforts to market success are doomed to failure? Are political solutions the only answer to education reform in the US?

The problem boils down for me to who decides? School vouchers. Performance pay for teachers. What's important to teach or to test. Longer school days. Greater parent engagement in schools. Employer incentives to make that happen. What we spend on education for those who enter school already at a disadvantage. Universal preschool. Education to enhance self-control or self-esteem. Is the solution simply as Tough suggests:

The schools that are achieving the most impressive results with poor and minority students tend to follow three practices. First, they require many more hours of class time than a typical public school. The school day starts early, at 8 a.m. or before, and often continues until after 4 p.m...

Second, they treat classroom instruction and lesson planning as much as a science as an art. Explicit goals are set for each year, month and day of each class, and principals have considerable authority to redirect and even remove teachers who aren’t meeting those goals...

Third, they make a conscious effort to guide the behavior, and even the values, of their students by teaching what they call character. Using slogans, motivational posters, incentives, encouragements and punishments, the schools direct students in everything from the principles of teamwork and the importance of an optimistic outlook to the nuts and bolts of how to sit in class, where to direct their eyes when a teacher is talking and even how to nod appropriately.

Until we have a process using an objective basis for reaching a national consensus on these and other issues, I wonder about the viability of grassroots efforts to tackle problems like these in any sustainability and scalable manner. And I also wonder if evidence-based practices in education will ever get to the point where decisions can be based on facts and not faith and ideology. Until then, can social marketing, or any other public health approach for that matter, really make a difference in improving the education of our children? And what happens in the meantime?

Comments

[Nedra Weinreich]

I, for one, am hoping that social marketing can make a difference in improving the education of our children. I'm working with a client right now on addressing the issue of school choice with social marketing at a national level. There are a lot of different audiences that have to be engaged to bring about adoption of school choice policies in a community or state -- parents, policy makers, media, taxpayers -- and some very powerful opponents in the form of the teachers unions. Just throwing more dollars at the problem has been proved ineffective since it gets swallowed up by the bureaucracy. It's certainly a challenge, but I think not undoable.