Fighting the Cancer Alley Myth

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Fighting the Cancer Alley Myth

How do you change a belief?

That’s the challenging question that members of the Lake Area Industrial Alliance (LAIA) presented to Healthy Image, a marketing firm in Lake Charles, Louisiana.

LAIA is a non-profit organization in Southwest Louisiana made up of 23 member companies primarily in the petrochemical sector.  Larry Deroussel, LAIA Director, said the primary goals of the organization are to provide accurate information to the public about industry issues, foster strong industry-community relations and build a positive business environment.

The group has an ongoing commitment to monitor and respond to the public’s perception of area industry, specifically in the areas of environmental performance.    Annual community perception studies are conducted, and specific issues addressed via public information and advertising campaigns.  According to LAIA’s Communication Committee Chairperson, Nancy Tower, with Sasol North America, these efforts have resulted in varying degrees of success – in all areas except one:  the perceived link between cancer and industry.  “There is a pervasive – but incorrect – belief that not only are cancer rates higher in our region, but that this is caused by local industry.   Even in 2006, during the Hurricane Rita recovery period, when our overall approval ratings were at an all time high, 67% of respondents still thought area industry caused cancer.  That’s when we decided to target this one issue head on and see if we could get results.”

Deroussel explained that “cancer alley” is a term coined in the 1980s by environmental activists to describe Louisiana’s industrial corridor.   “The cancer alley label stuck and has become an entrenched belief, in spite of study after study that conclusively disputes its existence.”

The Cato Institute has called the cancer alley label an "environmental myth," but Tower said this is one myth that negatively impacts all of local industry’s progress and efforts to build positive relations with the community.  “After our community survey in 2006, we decided to implement a content rich advertising campaign that provided the facts on cancer incidents. We believed, more like hoped, that if we gave people accurate information we would be able to correct this misperception.”

Deroussel added that this was not an easy decision, but one they felt was important.  “Clearly, cancer rates are not a topic that any industrial group wants to spend their communication budget addressing.  We’d much rather use available funds to provide positive information about the benefits of our products, technological advances, environmental performance, and safety records.   We’re proud of our performance, but beliefs regarding industry’s impact on health are important in determining how the community looks at us in terms of environmental safety.  This was not an issue we could ignore.”

A television advertising campaign was developed to communicate the fact that cancer rates in Southwest Louisiana are comparable to those in the rest of the country.  The spots not only stated this information, with expert sources cited, but used graphs to visually illustrate the key points.  The information was compelling and easily understandable, but it did not achieve the desired results. “In our next community survey, conducted a year after the campaign began, we asked more specific questions about industry and cancer and found that the percentage of people who felt we had a higher cancer rate in our area due to local industry had no significant change,” said Tower.  “Even more disconcerting, many of the respondents who had the misperception said they had actually seen the television ads.”

Dr. Larry Vinson, the researcher who conducts LAIA’s research studies, explained,   “The data analysis from the 2007 survey showed that the campaign had reached the target market, but the message had completely missed the mark.”

Deroussel said, “At this point, LAIA was naturally very frustrated.”

“Rather than scrapping the project, we took a harder look at our situation and realized that we did not have the credibility to deliver this message, regardless of studies cited,” said Tower.  She then contacted Healthy Image, a firm specializing in marketing strategy with a strong healthcare background.  “We asked them to give us their ideas for fighting the cancer alley myth, hoping they would have some new insight into the issue.”

“Understanding this issue was not that difficult for us because we have worked with physicians and hospitals for years,” said Kristy Armand with Healthy Image.  “Understanding how to effectively communicate the facts about cancer rates vs. mortality rates, along with personal responsibility for lifestyle risks was much more challenging.”

After reviewing all the medical research, and the LAIA survey reports, Armand said they realized this would be one of the most challenging projects she and her partners had ever had to tackle.  “It’s a very complex issue, and while we were familiar with the cancer alley myth and knew that cancer rates were not higher here, we also realized how difficult it would be to deliver the right message to help people understand what is really going on with cancer in our region.”

The first step in developing a new educational campaign was determining exactly which key facts needed to be incorporated into the message:

  • 1 out of 3 people will get cancer in their lifetime – regardless of where they live
  • Cancer incidence rates are not higher here, but mortality rates are
  • Two-thirds of all cancers are caused by lifestyle factors which can be modified
  • Getting regular healthcare and recommended screenings can help cancer be diagnosed at earlier stages when treatment can be more successful, dramatically improving survival rates

Healthy Image also identified several reasons people are so willing to embrace the cancer alley myth, even when presented with the facts:

  • Getting cancer is the biggest fear of many people
  • People feel they have no control over whether or not they get cancer and/or die from cancer
  • It’s a natural inclination for people to blame someone or something for things they can’t control (and don’t really understand)
  • Information, regardless of how accurate, provided by LAIA regarding cancer rates is not seen as credible

“In addition to all of these factors, we also had to address the credibility issue,” said Christine Fisher, also with Healthy Image. “How do we not only craft a message that can be easily understood, but also make it believable?  We knew that any message coming from LAIA alone would not affect the cancer alley myth. We needed a highly credible source to shatter this long-held belief, so we came to the conclusion that we needed to enlist local doctors in an educational campaign.  After all, who would be more credible on a health-related issue than physicians?   And we didn’t want just a single spokesperson.  We decided we needed a variety of local doctors, from different specialties, so the public would have no doubt these were real doctors – possibly even their own doctor.”

The next step was finding physicians who would be willing to participate.  “This turned out to be even easier than we had hoped.   The medical community was very eager to be involved in a project that would help people better understand lifestyle risk factors and the importance of early detection. It was the same message they were trying to communicate as well,” said Fisher.

Two area hospitals and one large multi-specialty physician group agreed to partner with LAIA on the campaign.   Eight doctors from the fields of family practice, internal medicine, oncology, radiology, and ob/gyn were enlisted to serve as the visible medical spokespersons in campaign elements.

Working with the LAIA Communication Committee, and the participating doctors, Healthy Image developed a print and television campaign built around the concept of “Fight Cancer with Facts.”     “Actually writing the ad content was very difficult.  We had a lot of information to communicate, but we didn’t want the ads to be so copy heavy that people would not read it,” explained Armand.  “In addition, we wanted the physician to be the prominent graphic element, and to include a personal quote from each one to help drive home the key message.  And then, we had to include logos from the campaign participants to ensure the community understood this effort was a partnership between industry and the healthcare providers.  We went through numerous versions of ads trying to find the layout that would work.”

Healthy Image presented the campaign to the LAIA Board of Directors in March and received approval to implement a “test run” of the campaign.  The board also asked Healthy Image to run a focus group on the campaign before finalizing.  Dr. Vinson conducted this, and the feedback received helped the creative team finalize the ad elements.  “The focus groups validated that we were on target with the message and that using local physicians added the needed credibility to that message,” said Armand.  “Based on their comments, we adjusted the headlines and certain copy points to more strongly emphasize that the facts we were presenting were about Southwest Louisiana and were being given by local physicians.”  

The plan was to run a one-month media schedule, with Dr. Vinson conducting a pre- and post-campaign survey to evaluate whether or not any results were achieved.  The survey instrument asked respondents to rank on a five-point scale whether they agreed or disagreed with three statements:

  • Overall cancer rates are about the same across the country
  • The risk of getting cancer is more about how you live than where you live
  • Local industries keep the community well informed about their effects on the community

Print and television spots ran throughout the month of June.  In addition, Healthy Image also worked to secure free media publicity to help support the media campaign.  Interviews were arranged with local television news stations and feature stories ran in area papers. “Again, the participating doctors agreed to be interviewed and they were able to provide the facts about cancer rates in our region, as well as much needed information explaining the difference between incidence and mortality rates, which would help clear up the confusion between those types of statistics,” said Armand.  “Over $10,000 in free publicity was obtained in just this one month, which gave the short campaign a big boost.  These positive articles also increased the credibility of the message, since the same message was consistently repeated in different media by a variety of doctors.”

Tower said LAIA received very favorable feedback from the campaign from both the community and its member organizations.   “But what we are most excited about are the results of the post campaign survey.  Dr. Vinson did the survey in July, two weeks after the media campaign ended. There was a significant change in the responses received.  In the post-test, survey results showed a movement away from the belief that industry affected local cancer rates and toward the belief that lifestyle choices were an important factor. This was exactly the result we hoped to see. While the changes were statistically significant, they were not very large. However, as Tower pointed out, “It’s amazing to get any movement on this issue in such a short time period.”

LAIA is now considering plans to expand the effort in the 2009 budget, which will hopefully continue to improve the perception of area industry’s environmental performance.   Deroussel said this approach appears to be just what is needed – a combination of the right facts presented by the right source.