Friday, March 22, 2013

NYC Pregnancy Posters Hit a Nerve - But Which One?

I am still conflicted about the new NYCDOH pregnancy prevention poster campaign . The ones that depict babies speaking messages to their supposed pregnant teen moms.

I've been thinking about it for over a week now.  Bus stops, on the subway...those babies's faces - inconsolable, accusing.

When I first saw the ads I said –“Brilliant.  Blunt, dramatic phrasing and visuals, supported be scientific evidence – memorable, takes your breath away – right out of Madison Avenue.”

But then, as I read the torrent of outraged posts from colleagues and the public I was shamed and guilt-ridden – How could I not see the truth.
      “This is insulting”      “There they go stigmatizing women again.”  
            AdWeek’s headline was –
               Teenage Parents Have Only Miserable and Vindictive Babies, Say NYC Ads.

NY Planned Parenthood blasted the ads for creating “stigma, hostility and negative public opinions about teen pregnancy and parenthood rather than offering alternative aspirations for young people" and Gloria Malone’s NYT Op Ed  I Was a Teenage Mother summed it up. Pregnant with her daughter at 15, she writes,
The blame, shame and stereotypes expressed by so many others simply told me to give up. Stereotypes and blame do not stop teenagers from engaging in unprotected sex or discourage teenage pregnancy. 
Malone goes on to explain how encouragers along her path gave her hope and lead her to exert extra-ordinary efforts to work, go to school and raise her young daughter.

Right.  She’s right. 
We, in public health, are all about Hope and Change.  

I put aside the CNN blog commenters who supported the poster messages:
This is great "in your face" advertising, which today's kids NEED. There should be more to this, boys still are rarely held accountable to keep their zipper up. These ads should target young girls and boys alike. And their usually-absent parents, too.
My enthusiasm for the ads extinguished. I didn't mention my first unschooled reactions to anyone.

But here’s the problem with arguing against the ads because they stigmatize or punish and demonize people. Public health messages have a very long history of doing precisely that.
  • Early TB ads ridiculing the poor for their poor housing conditions.
  • Polio ads that forever scarred parents who innocently took their child to a public swimming pool
  • AIDS ads that stigmatized gays and lesbians

And no need to go back to the turn of the last century or the 1980s – stigmatization and ridicule are alive and well today in our public health ads. Here are just a few illustrious examples:

1. Quit Smoking Ads

Take the TV ad of the young boy who’s temporarily lost his mother in a train station.  We watch being crushed by his growing fear, loss and despair.
“If this is how your child feels after losing you for a minute, just imagine if they lost you for life.  We are warned.

 Or if that isn’t blaming and stigmatizing enough there’s a British ad pronouncing that  your child will "get to heaven sooner".


2. Obesity Ads
I find it hard to imagine 2 ads more stigmatizing than these two: one aimed at an obese child and the other at the obese Dad of a (potentially) obese child.

(Originally part of the state of Georgia's Strong4Life childhood obesity campaign )
(my words here)
“Hea, kid, if you keep drinking a lot of soda you could wind up with no legs.”

And the ad created by Blue Cross and Blue Shield of Minnesota

Two kids sitting at a fast food place animatedly talking up whose father can eat the most burgers and fries. 

So, here is what I’m left with.
It’s not just that the pregnancy ads stigmatize young women – young pregnant women.
I think it's the VOICE of the ads.
Most health ads are voiceless - the scientific expert or the public health official delivering the message.

Not here. Not even close.
Here the child is speaking.  Thus the  innocent, haunting "wisdom of the child".
The accusing, prescient, "I told you so and now my life is ruined" child.

The message is delivered directly, inevitably, with a condemnation and sureness that no scientific expert's voice can come close to getting across.
So, we see incarnate, the unhappiness and hopelessness of little kids, innocents, in bad situations.

No Hope. 
No Change. 
Maybe that's too much to bare.  


  1. Hey I know this is off topic but I was wondering if you knew of any widgets I could add to my blog that automatically tweet
    my newest twitter updates. I've been looking for a plug-in like this for quite some time and was hoping maybe you would have some experience with something like this. Please let me know if you run into anything. I truly enjoy reading your blog and I look forward to your new updates.

    Stock Tips Equity Tips

  2. Thanks What a great info you have given us by your blog. I like it and will share it to my friends.

    Coral Springs family dentist

  3. Thanks Mohammad. Do they have this type of health promotion campaigns in Fla area?

  4. Chris, Hi, I cannot agree more with your post and what you say about the VOICE of the ads. I have also been haunted by these ads and have been discussing them with colleagues from different sectors. I was looking at expert reactions and came across your post.. I am honestly surprised about the ads' blindness to the many socio-economic, policy-related, family, and community issues that may contribute to high rates of teen pregnancy among vulnerable and underserved populations. We, in public health, may be more effective if we stop demonizing and condemning pregnant teens (and many others). We should start looking at the key social determinants that affect teen pregnancies and start addressing them along with promoting behavioral change among teens and their key influencers. Thanks for a great post, Chris.

  5. Renata, as always, you've hit the nail on the head. Society finds it easier to throw ad dollars at the problems rather than fix them.
    Every day I see these "pregnancy" ads as I walk to work at the School of Public Health in East Harlem. A neighborhood where approx 25% of the male pop is incarcerated at any given time, most of petty drug offenses.
    So we have a legal system that stops young men's lives in their tracks, works against any sustainable family formation, personal life actualization or community or society prosperity.
    But these are not the issues we highlight, promote, educate about...

    On just this one socio-economic- policy issue:

    And Michelle Alexander's book, The New Jim Crow
    Bill Moyers has recently done a series on this

    How we redirect the discourse - name the real problem - fix the problem? As with the critics of this campaign, you get called "too politically correct"!