Chelsea Clinton and Andrea Palmer on Mending Medical Distrust

In November 1991, Chelsea Clinton was at her father's presidential campaign headquarters stuffing envelopes while a news segment aired. Magic Johnson had earlier that day publicly disclosed he was HIV positive. News commentators, Clinton remembered, remarked on Johnson's "courageous decision" to disclose his HIV status. Tony Coles, president of the Black Information Network, interviewed Clinton during a fireside chat at Publicis Health Media's (PHM) HealthFront on April 28, where she recalled the memory. "I remember thinking, why does that have to be a courageous decision?" Clinton said in front of an audience of potential advertisers. "That question really started my interest first in HIV/AIDS and then my interest in stigma as a real public health challenge itself." As Clinton noticed from a young age, media has the power to create stigma. It can influence how the public perceives health crises and disease. Advertising as a form of media can also make significant public impact. Clinton, who is the vice chair of the Clinton Foundation, a global health advocate and the host of the iHeartPodcast network's In Fact with Chelsea Clinton podcast, spoke with Coles about how pharmaceutical companies can champion inclusivity in public health. Adweek covered the fireside chat and later spoke with Clinton and with Andrea Palmer, president of PHM, about equity in health care and what health care advertisers must do to advertise ethically. Ameliorating medical distrust Health care advertisers are caught in a dilemma. On the one hand, pharmaceutical companies like Pfizer became household names during the pandemic. On the other hand, distrust in the medical community is widespread and split down party lines. Fewer Republicans than Democrats trust local news media to deliver accurate information on the Covid-19 pandemic, according to a 2020 survey. "We had people in the late 19th and early 20th century who didn't want to get vaccinated. We had President Reagan who for many years refused to even say the word 'AIDS'. We have long had, both from the public and from politicians, efforts to politicize public health," Clinton told Coles. Communities of color, who have endured a long history of racial bias, are more likely to distrust the medical community than white patients. Serena Williams, a Black woman and one of the world's most decorated athletes, nearly died after giving birth to her first child after medical professionals disregarded her concerns. Williams' experience reflects a jarring statistic—Black women in the U.S. are three times more likely than white women to die from childbirth complications. This and the many other similar statistics mean that communities of color are less likely to trust health care providers. Fewer Black and Hispanic patients than white patients reported that they trust their primary care doctor, according to a 2021 ABIM Foundation survey. "There really are deep understandable questions in many different communities as it relates to medicine holistically, and individual doctors and nurses, because of what has happened historically," Clinton said. This means that for advertisers to reach these communities, they must prioritize inclusion and build trust before they advertise anything at all. "Information can and will travel," Palmer told Adweek. "All it takes is somebody that has trust with a community of other people, regardless of how big or small." Accounting for advertising In recent years, advertisers have made formal commitments to equitable advertising. Initiatives like Publicis Media's Once & For All Coalition pledge a certain amount of the media mix to diverse-owned publications. Still, equitable investments account for just a minuscule portion of most media budgets. Meanwhile, Facebook still accounts for almost a quarter of all U.S. digital ad spend. This means that when advertisers choose to buy media on platforms, it comes at the risk of alienating audiences that might receive the information better were they to consume it on a different channel. Media planners must take this into account when considering minority-owned publications that may not have high ratings compared to other channels. "If [media buyers] are using purely quantitative metrics to make a decision, [diverse-owned publications] are not going to show up as a strong potential or strong performer," said Palmer. Advertisers must make factual information highly visible and easier to find than misinformation, Palmer added. Pharma's responsibility To reach marginalized communities that are less likely to trust health care companies, advertisers need to take a different tack. They can start by working to eliminate bias from clinical trials. With better information on hand, health care companies can not only create better, safer products but also gather important information on all of their audiences that can inform messaging and advertising later on. According to Clinton, they can also utilize "open source, collaborative efforts to educate communities without trying to sell a particular product." This means ensuring factual information, not ads, reach marginalized communities where they are instead of where white audiences may be. Health care advertisers have an equal responsibility to all communities, said Palmer. To close information gaps it is crucial to meet individuals where they are and understand their personal experiences. "Health decisions really are risky when there's a lot of information gaps there, and we have the opportunity and the responsibility to help ensure that those information gaps can be closed, to the best of our ability," she added. How Healthcare Companies Can Address Inequities Through Media Investments

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Chelsea Clinton and Publicis Health Media's Andrea Palmer on Mending Medical Distrust

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Olivia Morley

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Olivia Morley