By Matthew Holt

Late last year PR/Communications giant Edelman released a survey called the Health Engagement Pulse. (Here’s the press release and here are the charts) This is separate from both Edelman’s Trust Barometer which has looked at consumer engagement and trust in business and institutions for years, and their Health Engagement Barometer (HEB) which looked at engagement in health in five countries in 2008 and is going to be run again this spring. At Health 2.0 we;ve worked with Edelman and featured the HEB data in our meetings and will continue to do so. Recently I “chatted” with Edelman’s President for Health, Nancy Turett, to find out what she thinks the data is telling us about people’s attitudes towards “health”.

Matthew Holt: Nancy, Edelman’s been looking at Health for a long time and also Engagement with the well known Engagement Barometer separately. In late 2008 you did the first Health Engagement Barometer. What does Health Engagement mean, and why have you put the two concepts together now?

Nancy Turett: Over the past several years, our engagement in all things health has growth dramatically, giving us a particularly useful whole-egg look at health industry, issues, and especially the growing convergence of public and personal health imperative. With clients from all industries and sectors grappling with health — costs, social expectations, pressures to innovate, and policy changes underway — we’ve found it useful to all to provide insights about what the public-at-large — wearing their many health hats — knows, wants, cares about and does as relates to health.  And as a communications and engagement firm, we’ve delved particularly deeply into how people are influenced and how they influence others.

The Health Engagement Barometer, which we created and conducted for the first time a year ago, shone a bright light on some key issues, and identifying a fascinating cohort of people who by dint of their engagement, involvement, and information about health, have high influence over the attitudes and actions of others. We called them the “Health Info-entials.” We also learned a lot about people’s interest in engaging with health brands and companies — and we found people crave more connection than they’re getting — and that transparency and completeness trumps perfection when it comes to building trust between a health-involved brand and a consumer.

Matthew: So at the end of last year (2009) you released a new survey called the Health Engagement Pulse–that one is just in the US, whereas the Barometer is in many countries. You’re doing the Barometer again later this year–so why do Pulse right now? And what did you learn?

Nancy: That’s right. We’re gearing up for Health Engagement Barometer II, to go into the field in several countries next month, but we felt that the current moment in the US screamed out for a quick Health Engagement Pulse-taking. We set out to learn whether and how the public expects engagement by business in health at a time when the American conversation is intense but largely about what government is going to do to reform health (which by the way is really shorthand for health care insurance coverage reform — reforming health as you know will take much much more!).

Matthew: OK, but given that government is the biggest payer in health care, and that most businesses realize that government policy matters most to companies (as evidenced by all the lobbying we’ve seen over the last few months), why should businesses care about what consumers think about their role in health?

Nancy: First thing we need to do is recognize that “consumers” are also citizens, voters, activists, employees, patients, caregivers, advocates, and in many cases, in jobs that involve health and health care. Second, that in this Era of Public Engagement, when everyone can be “the media,” it doesn’t take a PhD or SVP title or any other official credential to influence others and go really, really wide in doing so rather efficiently. The Internet sparked and has continued to fuel this Public Engagement revolution, but now it’s gone offline too — to the soccer field, hair salon, supermarket, dinner party.

Matthew: So you’re saying that health is important, social media and Health 2.0 has empowered consumers and therefore business needs to pay more attention.

Nancy: Sure am.

Matthew: So before we talk about the survey results, are the companies you work with paying enough attention?

Nancy: Gee Matthew, of course we feel that our clients need to pay even more attention, but frankly, they’ve largely made an amazing effort to bone up on health engagement — those in the pharma, biotech, personal care, and device businesses have been working hard to understand how they need to revise both their strategies and how they engage with their publics about them. And many of our clients in other, non “health care” industries, are getting that health is everyone’s business.

Matthew: So turning to the Pulse, what are three top findings?

Nancy: First, that the majority of Americans now feel that it is as important for businesses to engage in health as it is for them to engage in the environment. In essence, health is becoming the new/next green.

Second, that the dimensions across which people expect companies to engage in health are many.  They include the obvious — “use operating practices that are not harmful to health” (85%) and and “help employees lead healthier lives (73%), but also include — at similarly high levels — other dimensions such as “transparently communicate the health impact of products and services offered” (72%), “investing in creating healthy communities in the local areas in which they operate” (71%), and “improve health in the developing world” (64%).

And third, in striking contrast to these high expectations, only one in ten Americans think business is doing an excellent or very good job at ANY of these.

Matthew: Great, the chart I included from the survey certainly shows that contrast between “is important” versus “doing a good job

Nancy: And this contrast has very real business impact. We found that people are motivated to take positive action when they believe a business is engaging effectively in health. They are more likely to purchase from them (86%), recommend them to others (86%), trust them (83%), want to work for them 81%), and invest in them (72%).  So health is green in more ways than one — there’s risk to mitigate but also market opportunity to seize.

Matthew: So what do you expect to be the reaction from businesses in health care and outside of it?

Nancy: Well, I can do a bit more than predict, as we’ve already heard from some of our clients that they intend to take this info to their management and boards broadly both to begin to assess their own health engagement status — assets, liabilities — and to ensure that where they are engaging in health, they are communicating about it and where possible, giving their “publics” — employees, communities, business partners, customers, etc — a chance to participate in the planning and execution. In this Public Engagement era, the process is, in effect, the program.

Having said all that, it will vary dramatically not only from industry to industry, but from company to company, and even within that brand team to brand team. This new imperative to engage in health takes a degree of vision and courage to embrace.  But the early movers will be the winners, and the convergence of market opportunity and social responsibility intensifies. Matthew, may I ask you a question?

Matthew: Of course

Nancy: We’re learned a lot from this US Health Engagement Pulse.  It’s findings and the response we’re getting from clients and other partners are giving us good direction for Health Engagement Barometer 2010.  You’re so deeply involved at a leadership level in the 2.0 drivers of business and society in health.

Matthew: Not sure that I lead anything (ha ha!)

Nancy: Well I am sure of that! So, my question is: What do you think businesses involved in applying digital innovation to advancing health most need to understand about the public/consumer/ person/individual?  What do you want us to be sure to delve into in HEB 2010?

Matthew: So I think your analogy to the environmental movement is very prescient here. Twenty to fifteen years ago being green was an enthusiast’s or activist’s cause. Now it’s mainstream, and fer chrissakes Goldman Sachs is going to be making a fortune trading carbon credits.

Health is at the same juncture. We have activist patients who we (and you) feature, but they’re not mainstream yet. So from “activist” to “info-ential” to “everyone,” what is the progression? And then allied to that, what are the channels that really matter? (This is the digital piece). The question is the role of word of mouth through family, caregiver, neighbor, versus online channels, versus news on TV, versus traditional health information sources (like doctors). Pulling apart that puzzle will be very important not only for businesses selling stuff, but also for driving changes in health behavior at a societal level.

Nancy: You’re so right.  And I guess I have a two-part response there:

First, de-constructing the influencers of the influencers, if you will, needs to be a key part of what we explore this round.  Not just who are the Health Info-entials, but what is the “universe” of influences that drive their actions and advocacy?  We’ll go as deep as we can and factor in your input for sure.

Second, the social contract that business of all stripes has with society is fortunately — ironically in light of the financial/ethical come-uppance of the past 18 months — top of mind for many business leaders.  It’s a great time to enlighten them about the health engagement business imperative — minds and strategic plans are more open now that I’ve seen in my 25 years communicating and engaging in health.

Matthew: Nancy, thanks so much  for “chatting”with me about your work in Health and Engagement. It’s good to see you pushing and prodding businesses to get more involved for both their bottom line and the overall good–however cynical most of us are right now!  Meanwhile we really look forward to continuing the conversation and seeing the results of the Health Engagement Barometer coming out this spring.