2. The second global exploration by
Edelman of the public’s evolving
attitudes, actions, influences and
expectations in relation to health
HealthEngagement 2
3. Methodology
Fielded February 24 – March 8, 2010
15,257 adults 18+
10,078 interviews across 10 countries and 5,179 in the US
Brazil, Canada, China, France,
Germany, India, Italy, Japan, Mexico,
the United Kingdom, and the United States
142+ questions, online
Total margin of error <1%
Conducted by StrategyOne
Note:
Canada, France, Germany, Italy, Japan, the UK , and the US were weighted to be representative of the total population.
Brazil, China, India and Mexico were weighted to be representative of the total online population.
HealthEngagement 3
4. 6 key findings
1 Health joins Green as central to sustainability
2 Personal and public health are converging
3 The public naturally clusters into six health engagement
segments
4 Health action is motivated by several factors
5 Health engagement drives trust and action
6 Health is now a strategy for business across industries
HealthEngagement 4
6. %
say that it is as important to protect
the health of the public as it is to
protect the environment
HealthEngagement 6
7. Health joins Green around the world
90%
81%
76% 77% 78%
73% 75% 72%
65% 64% 64%
64%
Global US Canada Mexico Brazil UK France Italy Germany India China Japan
Emerging Markets Developed Countries Japan
Q58. For the following series of statements, please indicate how strongly you agree or disagree with each. Please use a one to nine scale where one means you disagree
very strongly, nine means you agree very strongly and five means you neither agree nor disagree. “It is as important to protect the health of the public as it is to protect the
environment” (Top 4 Box)
**Emerging Markets include: Mexico, Brazil, China and India; Developed Countries include: US, Canada, UK, France, Germany and Italy
HealthEngagement 7
8. %
say that sustainability is as much
about the health of people as it is
about the health of the planet
HealthEngagement 8
9. Globally, people see health as central to sustainability
89%
79%
68% 70%
65% 66% 64% 64%
63%
59%
47% 49%
Global US Canada Mexico Brazil UK France Italy Germany India China Japan
Emerging Markets Developed Countries Japan
Q60. For the following series of statements, please indicate how strongly you agree or disagree with each. Please use a one to nine scale where one means you disagree
very strongly, nine means you agree very strongly and five means you neither agree nor disagree. “Sustainability is as much about the health of people as it is about the
health of the planet” (Top 4 Box)
**Emerging Markets include: Mexico, Brazil, China and India; Developed Countries include: US, Canada, UK, France, Germany and Italy
HealthEngagement 9
11. Engagement in personal health is virtually universal
Majority also interested in public health
Personal Health 91%
Family Health 89%
Nat’l Health 56%
Community
Health 55%
Global
Health 49%
Q4. – Q8. Please indicate how engaged you are in the following types of health (Top 2 Box on a 4-point scale, Very/Somewhat Engaged) (Global)
HealthEngagement 11
12. Public health engagement is higher in emerging markets
100%
80%
National
60% Community
Global
40%
20%
0%
Global US Canada Mexico Brazil UK France Italy Germany India China Japan
Q6. – Q8. (National, Community, Global) Please indicate how engaged you are in the following types of health (Top 2 Box on a 4-point scale, Very/Somewhat Engaged)
HealthEngagement 12
13. Public health engagement is highest in young adults
60%
40%
20%
0%
Ages 18-24 Ages 25-34 Ages 35-49 Ages 50-64 Ages 65+
National Health Community Health Global Health
Q6. – Q8 (National, Community, Global). Please indicate how engaged you are in the following types of health (Top 2 Box on a 4-point scale,
Very/Somewhat Engaged) (Global)
HealthEngagement 13
14. Public health engagement is higher in college educated people
60%
40%
20%
0%
Community Health National Health Global Health
Less than college educated College educated +
Q4. – Q8. Please indicate how engaged you are in the following types of health (Top 2 Box on a 4-point scale, Very/Somewhat Engaged) (Global)
HealthEngagement 14
15. What matters to me is what matters to us
Globally, the issues that matter on a personal level are also
major public health issues
Fighting cancer
36%
Providing access to affordable healthcare
31%
Preventing disease
30%
Improving the quality of healthcare
30%
Eliminating global infectious diseases
28%
Solving chronic health problems
22%
Addressing obesity
18%
*Top 7 most important health issues globally (out of 15)
Q13. The following is a list of health issues affecting the world today. Please indicate which are most important to you. (Select up to three) (Global)
HealthEngagement 15
16. Disease prevention most important in emerging markets while
fighting cancer top health priority in developed countries
28%
Fighting cancer 44%
23%
24%
Providing access to affordable healthcare 36%
31%
33%
Preventing disease 27%
40%
32%
Improving the quality of healthcare 29%
24%
28%
Eliminating global infectious diseases 28%
26%
20%
Solving chronic health problems 25%
12%
24%
Addressing obesity 16%
12%
Emerging Markets Developed Countries Japan
Q13. The following is a list of health issues affecting the world today. Please indicate which are most important to you. (Select up to three)
**Emerging Markets include: Mexico, Brazil, China and India; Developed Countries include: US, Canada, UK, France, Germany and Italy
HealthEngagement 16
17. 3 The global public naturally clusters into six health
engagement segments
HealthEngagement 17
18. New dimension to how we view our publics
Health
Actionists Health
Apathetics
14%
20%
Health
Traditionalists
14% Health
Neophytes
15%
Health
On-Demanders
Health
20% Disempowereds
15%
HealthEngagement 18
19. Health Actionists
This group is highly engaged and interested in
health; and, unlike other segments, these people
persuade others to take action
DEMOGRAPHICS
Likely to be female, married and have kids at home
Most likely to live in a urban area
Significant numbers are on the Internet all day; they are
the highest number of social media users
HEALTH BEHAVIORS
They are likely to take OTCs, vitamins and least
likely to smoke or be overweight
However, they are most likely to be a caregiver for
someone else
20. Health Traditionalists
This segment is very interested in health, particularly
as it pertains to sustainability and nutrition. But, the
main distinction compared with the health actionists
is that they tend not to persuade others to take action
DEMOGRAPHICS
Slightly more female, a bit older, more likely to be
married and least likely to have kids at home
Most likely to be retired
Low use of the Internet; infrequent users of
social media
HEALTH BEHAVIORS
They see the doctor most frequently, are
most likely to take a prescription treatment
option and are most overweight
21. Health On-Demanders
Health is something this group thinks about when
they need to. They are the least likely to care about
being healthier, and most likely to only think about
health when they or a member of their family
becomes sick. The Health OnDemanders are also
the group that is most likely to say they usually look
to others to form their opinions about health.
DEMOGRAPHICS
Most likely to be male, slightly younger
They are likely to be a college graduate and employed
HEALTH BEHAVIORS
They are not as likely to see a doctor frequently or take
prescription meds
22. Health Disempowereds
For these individuals, barriers to better health
are attributed to confusion and lack of financial
resources. They are the most likely to find health
information confusing and contradictory and say they
don’t have enough money to take good care of their
family’s health. Yet, interestingly they are least
trusting of the information they get from their
doctor or health care professional.
DEMOGRAPHICS
Most likely to be female
May have children in the household, but
less likely to be married
They tend to be lower income and less educated
Least likely to live in an urban area
HEALTH BEHAVIORS
They are the most likely to suffer from a chronic
condition, smoke and likely to be overweight
23. Health Neophytes
This segment tends to be
younger, healthy and carefree.
DEMOGRAPHICS
Slightly younger and equally male and female.
This is a heavily urban segment, the least likely to
be married
HEALTH BEHAVIORS
They have the highest number without insurance
They have the fewest reported doctors visits per
year, and are the least likely to have a chronic
disease and are least likely to be a caregiver
24. Health Apathetics
This group is less likely to be
motivated to take care of their health.
They are also less likely to share
opinions about health with others
DEMOGRAPHICS
Slightly more male and less likely to be a college
graduate or work in a managerial position
HEALTH BEHAVIORS
While they tend not to take any prescription meds or
suffer from any chronic conditions, they tend to see the
doctor more frequently
25. Health Actionists most interested and involved in public health
Health Actionist
Health Traditionalists
Health On-Demanders
Health Disempowered
Health Neophytes
80% Health Apathetics
60%
40%
20%
0%
Community Health National Health Global Health
Q6. – Q8 (National, Community, Global). Please indicate how engaged you are in the following types of health (Top 2 Box on a 4-point scale,
Very/Somewhat Engaged) (Global)
HealthEngagement 25
27. Life moments are the right moments …but not alone
Aging
Aging 30%
Realize unhealthy behavior negative impacts 27%
Renewed emotional/spiritual conn.
Renewed emotional/spiritual conn. 26%
Becoming aaparent
Becoming parent 25%
Began/ended relationship
Began/ended relationship 23%
Became advocate/caregiver 23%
Changed healthcare cov.
Changed healthcare cov. 23%
Found/lost job
Found/lost job 21%
Retired
Retired 21%
Death of loved one 20%
New medical condition
New medical condition 20%
Gained weight
Gained weight 19%
New info from HCP 19%
Advice from friends/family 19%
News Reports 19%
Participate in health/wellness prog. 19%
Stopped being able to to do somethingenjoyed
Stopped being able do something enjoyed 18%
LeLearned about new prevention/treatment option 18%
Q78. Which, if any, of the following have motivated you to take better care of your and your family’s health? (Select all that apply)
HealthEngagement 27
28. Loved-one Connection: An important second ingredient
Aging 30%
Realize unhealthy behavior neg.behaviors
Realized unhealthy impacts 27%
Renewed emotional/spiritual conn. 26%
Becoming a parent 25%
Began/ended relationship 23%
Became advocate/caregiver
Became advocate/caregiver 23%
Changed healthcare cov. 23%
Found/lost job 21%
Retired 21%
Death of ofloved one
Death a loved one 20%
New medical condition 20%
Gained weight 19%
New info from HCP 19%
Advice from friends/family 19%
News Reports 19%
Participate in health/wellness prog. 19%
Stopped being able to do something enjoyed 18%
Learned about new prevention or treatment options 18%
Q78. Which, if any, of the following have motivated you to take better care of your and your family’s health? (Select all that apply)
HealthEngagement 28
29. Information & Advice: Important but not sufficient to spur
strong behavior change
Aging 30%
Realize unhealthy behavior negative impacts family 27%
Renewed emotional/spiritual connection 26%
Becoming a parent 25%
Began/ended relationship 23%
Became advocate/caregiver 23%
Changed healthcare coverage 23%
Found/lost job 21%
Retired 21%
Death of loved one 20%
New medical condition 20%
Gained weight 19%
New Info From HCP
New info from HCP 19%
Advice from friends/family
Advice from friends/family 19%
News/Reports
News Reports 19%
Participate in health/wellness prog.
Participate in health/wellness prog. 19%
Stopped being able to do something enjoyed 18%
Learned about new prevention or treatment options
Learned about new prevention/treatment option 18%
Q78. Which, if any, of the following have motivated you to take better care of your and your family’s health? (Select all that apply)
HealthEngagement 29
30. The Health Motivation Equation includes more than new
information
My life
moment + Loved-one
Connection + Trusted
information/
advice
The personal
and public
health factor =
32. %
say that business should be as
engaged in maintaining and
improving personal and public
health as it is in maintaining
and improving the environment
HealthEngagement 32
33. Health joins the environment as a business imperative
87%
82% 80%
69% 70% 69% 69% 68%
64% 65%
52%
48%
Global US Canada Mexico Brazil UK France Italy Germany India China Japan
Emerging Markets Developed Countries Japan
Q59. For the following series of statements, please indicate how strongly you agree or disagree with each. Please use a one to nine scale where one means you disagree
very strongly, nine means you agree very strongly and five means you neither agree nor disagree. “Business should be as engaged in maintaining and improving personal
and public health as it is in maintaining and improving the environment” (Top 4 Box)
**Emerging Markets include: Mexico, Brazil, China and India; Developed Countries include: US, Canada, UK, France, Germany and Italy
HealthEngagement 33
34. Globally, only about one third trust business to
fulfill its role in addressing health
HealthEngagement 34
35. When it comes to health, business faces a trust deficit while
other institutions have a trust advantage
71%
68%
58%
53% 51% 50%
45% 46% 45%
36%
29%
26%
Academia NGOs Government News Media Primary Schools Business
Trust to fufill role in health Distrust to fulfill role in health
Q21. – Q26. How much do you trust each of the following institutions to fulfill their role in addressing the health of people in your country? Please use a 4-point scale where one
means that you “trust them a great deal” and four means that you “do not trust them at all.” (Top 2 Box, Trust) (Bottom 2 Box Distrust) (Global)
HealthEngagement 35
36. Academia and NGOs most trusted to fulfill role in health
Government and news media also highly trusted in India and China
80%
60%
40%
20%
0%
Global U.S. Canada Mexico Brazil U.K. France Italy Germany India China Japan
Academia NGOS Government News Media Primary Schools Business
Q21. – Q26. How much do you trust each of the following institutions to fulfill their role in addressing the health of people in your country? Please use a 4-
point scale where one means that you “trust them a great deal” and four means that you “do not trust them at all.” (Top 2 Box, Great deal/Some Trust)
HealthEngagement 36
37. Health engagement drives trust
Trust less: a company that is NOT
effectively engaging in health
_+ Trust more: a company that is
effectively engaging in health
57% 72%
If you think a company is (Q101. effectively engaging in health (Top 2 Box on a 5-point scale, Trust much more/more)] [Q108. NOT effectively engaging in
health (Top 2 Box on a 5-point scale, Trust much less/less)], how does that affect your trust in that company? (Global)
HealthEngagement 37
38. Health engagement drives purchases, recommendations and
investment
Companies not engaged in health
_ + Companies engaged in health
48% 65%
Criticize it to others Recommend its products or services
51% 65%
Refuse to buy its products or services Buy its product or services
49% 64%
Share negative opinions/ experiences Share positive opinions/ experiences
50% 48%
Would not want to work for it Want to work for it
54% 40%
Not invest in it Invest in it
39%
Pay a premium for its products or services
How likely would you be to do the following in relation to a company that you believe is (Q102 – Q107. effectively engaging in health?) (Q109. – Q113. NOT
effectively engaging in health?) (Top 2 Box on a 5-point scale, Very/Somewhat Likely) (Global)
HealthEngagement 38
39. Health is now a strategy for business
across industries
HealthEngagement 39
40. The public expects business to engage in health in multiple ways
Ensuring their health-related products or services are
78%
accessible
Communicating health risks of their products or
78%
services
Helping employees and their families lead healthier
77%
lives
Educating the public on health topics related to their
75%
products or services
Creating new products or services that maintain or
75%
improve health
Supporting the health of their local communities 71%
Helping to address obesity 70%
Contributing to global health 67%
Participating in health public policy 65%
Q81.- Q89. The following is a list of ways that business can engage in health. Please indicate how important you think it is for business in general to engage in each of these
actions. Do so by using a scale of 1 to 5 where 1 means “not important at all” and 5 means “extremely important.” (Top 2 Box, Very/Extremely Important) (Global)
HealthEngagement 40
41. People in emerging markets have higher expectations for
business to engage in health
85%
Ensuring their health-related products or services are accessible 76%
56%
85%
Communicating health risks of their products or services 76%
61%
86%
Helping employees and their families lead healthier lives 71%
73%
Educating the public on health topics related to their products or 85%
71%
services 66%
84%
Creating new products or services that maintain or improve health 70%
71%
83%
Supporting the health of their local communities 64%
60%
78%
Helping to address obesity 66%
61%
80%
Contributing to global health 60%
53%
78%
Participating in health public policy 56%
58%
Emerging Markets Developed Countries Japan
Q81.- Q89. The following is a list of ways that business can engage in health. Please indicate how important you think it is for business in general to engage in each of these
actions. Do so by using a scale of 1 to 5 where 1 means “not important at all” and 5 means “extremely important.” (Top 2 Box)
**Emerging Markets include: Mexico, Brazil, China and India; Developed Countries include: US, Canada, UK, France, Germany and Italy
HealthEngagement 41
42. All industries expected to engage in health beyond helping
employees
90% 90% 89% 88% 86%
83% 82% 82% 82%
77%
Bio/pharma & Healthcare Food/ OTC/ Media/ Insurance Consumer Brewing/ Retail Banking/
Medical Providers Beverage Personal Care Entertainment Technology Spirits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Selected at least one option other
than “Helping employees and their families lead healthier lives”) (Global)
HealthEngagement 42
43. Expectations of industries vary by
dimension priority: Global
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
*Not all bars may appear due to overlap
HealthEngagement 43
44. Ensuring health-related products or
services are accessible
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 44
45. Communicating health risks of products
or services
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 45
46. Helping employees and their
families lead healthier lives
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 46
47. Educating the public on health topics
related to products or services
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 47
48. Creating new products or services
that maintain or improve health
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 48
49. Supporting the health of
local communities
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 49
50. Helping to address obesity
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 50
51. Contributing to global health
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 51
52. Participating in health public policy
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
HealthEngagement 52
53. Expectations of industries vary by
dimension priority: Global
70%
60%
50%
40%
30%
20%
10%
Bio/ Pharma Healthcare OTC/ Food/ Media/ Insurance Consumer Brewing/ Retail Banking/
& Medical providers Personal care Beverage Entertainment technology Sprits Finance
Products
Q91. – Q100. Below is a list of industries. For each, please indicate the ways in which you think it is important for that industry to engage in health. (Global)
*Not all bars may appear due to overlap
HealthEngagement 53
54. Health Engagement Strategic Imperatives
Assess and address your organization’s and brand’s health assets and liabilities
Treat health as a growth and innovation opportunity
Leverage existing competencies in health education and marketing
Enlist employees to participate in your health engagement strategies for other stakeholders
Factor in people’s complex relationship with health, from consumers to carers to citizens
Include Health Actionists in your channel plans
Factor in the public health interest of not only emerging markets but emerging (younger) adults
Don’t just inform, inspire
55. Data analysis
COUNTRY ANALYSIS TYPES OF HEALTH COVERAGE
Brazil Public or government-sponsored
Canada Employer or union-sponsored
China Private insurance paid for by me or someone I am dependent on
France
Germany
India
DISEASE STATES
Diabetes
Italy
Heart disease
Japan
Cancer
Mexico
Anxiety, depression or other mental disorder
United Kingdom
Rheumatoid arthritis, Crohn’s disease, lupus, psoriasis or other auto-immune disease
United States (*5,000 interviews in the US)
Asthma, COPD, emphysema or other respiratory disease
Seasonal allergies
DEMOGRAPHICS Macular degeneration, glaucoma or other eye disease
Age Chronic pain
Children under 18 Osteoporosis
Mothers (Female + Children under 18) Insomnia, sleep apnea or other sleep disorder
Marital status GERD, irritable bowel syndrome, ulcers or other gastrointestinal condition
Live in a city, town, suburb or rural area Incontinence or other urological condition
Employed vs. unemployed
Employed by a health related company
Managers and above
SEGMENTATIONS
How to reach them?
Gender
Attitudes towards health
Race (in the U.S.)
Attitudes towards business
Political party (in the U.S.)
Health-related behaviors
College educated or less than college
Disease states by segmentation
Income (high, medium, low)
Health categories
HEALTH DEMOGRAPHICS HEALTH CATEGORIES
Number of doctor’s visits per year Health and wellness
Take prescription medication Science and medicine
Take over-the-counter medication Healthcare
Take vitamins or supplements Health policy
Suffer from a serious or chronic health condition
Caregiver
Smokes cigarettes
Overweight, normal weight, underweight (self perception)
HealthEngagement 55