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High-risk health messages can prevent one disease, promote another

So you rolled in December’s holiday excesses then rang in the new year with a resolution or two to undo the damage. Now it’s late January, and you may be finding yourself stressed out by the annual onslaught of appeals to improve yourself.

“It’s certainly the time when people consider the impact of the holiday season, and take stock of their health and happiness,” says Nidhi Agrawal, the Michael G. Foster Associate Professor of Marketing at the University of Washington Foster School of Business. “We all want to turn over a new leaf. And companies and organizations try to cash in on this by broadcasting all of these messages about the need to be healthy.”

Lose weight. Drink less. Exercise more. Quit smoking. Get a flu shot.

Appeals such as these—and many others combating an array of diseases and disorders—accentuate risk and heighten feelings of anxiety, according to a new study by Agrawal, Sokiente Dagogo-Jack and Echo Wen Wan.

This anxiety can be a good thing, sparking your intentions to address the particular health issue raised in the message.

It also can be a bad thing, undermining your efforts to address other important health concerns.

Mixed messages

In a series of five studies, the authors examined responses to public health messages that highlight the elevated risk of contracting a specific disease. Among them, meningitis, avian flu, dental disease, a supervirus, and hepatitis C. The advertisement encouraging testing for the latter closed with this dire warning: “Every living breathing human being can get hepatitis C—even you.”

Made aware of their high risk of contracting a particular disease, subjects responded to these scary messages with the intention to take positive action, change behavior, see a doctor. No surprise there, perhaps.

But when asked about addressing health issues unrelated to the message, they reported a lack of will to take positive action. They also ate more unhealthy snacks.

Anxiety toward one disease exhausted resources to deal with another.

“Reading this threatening message that’s personally relevant, I’m going to feel some anxiety,” explains Dagogo-Jack, a doctoral student at the Foster School. “That anxiety is going to have some positive effect. But trying to quell that anxiety is depleting my regulatory resources and impairing my self-control to address any other health issues.”

Say, for example, you read the message warning you about your real risk of contracting hepatitis C. You also smoke and are overweight, elevating your risk of lung cancer, diabetes, heart disease and a litany of other grave maladies. The anxiety created by your exposure to the hep C ad will likely raise your awareness and maybe inspire you to get screened. But that same focused anxiety also lowers your guard against over-eating, exhausts your energy to diet and exercise, and saps the will-power it would take to overcome your nicotine addiction.

Feeling anxious?

Dagogo-Jack says that this unintended ill effect of high-stress public health messaging can extend to almost any health-related concern—from appeals to reverse obesity to ads promoting influenza vaccination to the recent campaign to discourage texting while driving.

“This same emotional effect could be generalized to many conditions,” he says.

Agrawal adds that it’s not only the obviously frightening messages—highlighting one’s elevated risk—that create anxiety. Even positive messages can subtly activate feelings of anxiety. January’s phalanx of upbeat encouragements to lose weight, for example, insinuate past failures. Ads bearing relentlessly cheery sentiments that “this is your year,” dramatic testimonials of implausible slimming, and overly optimistic body models can instill stress rather than their intended inspiration.

“There are public health domains in which a message has to be very negative to cause anxiety,” Agrawal says. “But in some domains, even what looks like a pretty positive message can be very anxiety provoking. They call us to come to terms with our vulnerability and, in some cases, our own mortality.”

Knowledge is power

The finding that one public health appeal can undermine others presents a difficult dilemma for organizations and governments who work to prevent diseases and disorders among their constituencies. As with any kind of advertisement, the public’s attention is a competitive marketplace.

“Most of these public health messages are financed by an organization or foundation that is committed to battling a single disease,” says Agrawal. “They’re all important. But in the context of society, some present a greater risk than others. Hepatitis is a small problem relative to obesity in the United States. In trying to persuade a small portion of the population to be on guard against one disease, we are pushing people toward a disease they are much more likely to have. Is this really a public service?”

Agrawal stresses that the paper underscores the need to find the right tone in public health messages, craft a message that tempers the scare with solutions.

“If we look at the history of public health messages, it’s been a fairly common practice to freak people out so that they will do something about it,” she says. “But we now know that this approach has costs. A better strategy would be to provide people with a realistic solution, empower them with a tool kit to address a given health concern.”

She adds that simply being aware that public health messages are intended to cause anxiety will make us feel less anxious. “Being aware of why I’m feeling worked up after New Year’s will help contain some of this anxiety that exhausts my will-power to address other important health issues.”

“Preventing One Disease, Promoting Another? Anxiety-Driven Effects of Health Message Processing on Subsequent Self-Control” is the work of Nidhi Agrawal, Echo Wen Wan and Sokiente Dagogo-Jack.