Health systems use more LGBT imagery in marketing

It used to be rare to see black actors in American television ads. “You didn't think black people watched television because they didn't appear in commercials,” said Bob Witeck, a Washington, D.C.-based marketing consultant. “It's as if we didn't know consumers came in different colors, let alone sexual orientations.”

The inclusion of lesbian, gay, bisexual and transgender narratives is the next frontier for marketing executives in healthcare and other industries, said Witeck, who advises businesses on marketing to LGBT communities.

“The reality that any marketer would tell you is that people respond to images and portrayals that look like them,” said Erica Neufeld, marketing director at Boston Medical Center, which recently featured a gay couple in an ad campaign encouraging people to seek primary care.

Aetna, Kaiser Permanente and Boston Medical are healthcare organizations that have included LGBT themes in their marketing and advertising. But the healthcare industry overall isn't embracing LGBT narratives in marketing as much as some consumer products companies and retailers, said Stephen Macias, senior vice president of the national LGBT practice for MWW, an East Rutherford, N.J.-based public relations firm.

“When we work with (nonhealthcare) clients in our LGBT practice, much of what's being laid out now is inclusive advertising that is going to be a game changer in 2016,” Macias said. “We don't see the same focus out of the healthcare industry.”

That may be because healthcare organizations generally produce a small number of ads each year, and don't have the marketing resources to target particular market niches. Some health systems participate in gay pride parades and place ads in LGBT publications and business directories, though they're not necessarily including explicitly LGBT people in ads to the general market.

But experts say healthcare marketers need to pay more attention to the LGBT market, which has significant purchasing power. They say there are cost-effective ways to reach out to that market, including the use of marketing materials that include LGBT people along with other diverse groups.

Connecting with LGBT communities is important for gaining the business of their members, but it's also important for healthcare organizations that want to reach millennials in general, Witeck said. A 2014 survey by advertising firm J. Walter Thompson Worldwide found that 80% of Americans believe that showing LGBT people in ads “simply reflects the reality of society today.” And 72% said advertisers that embrace LGBT communities are “brave.”

Millennials “get that the world they live in looks a certain way, and if they don't get that authenticity (from an advertiser), they're not buying what we're selling,” Witeck said.

He acknowledged that LGBT-inclusive advertising has the potential to alienate some segments of the public based on religious or political views. But many advertisers say people with anti-LGBT views represent a shrinking portion of the total market. “They no longer view backlash with alarm,” Witeck said. “They view it as an outlier.”

Marketing and advertising with an eye for LGBT communities could pay off for healthcare organizations, given that LGBT individuals in the U.S. were responsible for over $880 billion in spending in 2014, according to Witeck's consulting firm.

In terms of health insurance, there may be 16 million to 20 million LGBT health plan members paying $89 billion to $110 billion in premiums annually, according to an estimate by Justin Nelson, president of the National Gay and Lesbian Chamber of Commerce. Particularly for insurers, “it's a must” to be marketing in this space and teaming up with LGBT organizations, Nelson said.

Some LGBT advocates and experts identified Aetna as a leader in reaching out to LGBT customers. A few years ago, Aetna determined that it needed to expand its outreach to LGBT customers, whose purchasing power was increasing, said Carrah Kalat, marketing vice president for Aetna's commercial and specialty businesses.

Aetna, which like other insurers recognizes the increasingly retail-based nature of the insurance business, has run a number of print ads in LGBT publications promoting LGBT-friendly health plans with pictures of gay, lesbian and transgender couples and families.

It also released “First Love,” a video of interviews with a man and woman about love. The video gradually reveals that the two people are talking about their same-sex partners, not each other.

The insurer also has made an effort to be transparent about its clinical and coverage policies regarding LGBT-related procedures, including gender reassignment surgery.

Outside of healthcare, several well-known companies in retail, food and travel have taken the lead in using LGBT narratives in their ads and social media marketing.

One recent example is Campbell Soup Co.'s recent “Made for Real, Real Life” TV ad campaign, which features two dads feeding their son. There's also Marriott International's #LoveTravels campaign featuring LGBT couples and families. In addition, there are print and billboard ads featuring gay couples by MillerCoors, Target Corp., Gap and J.C. Penney Co.

The lack of focus on LGBT communities in healthcare marketing and advertising doesn't mean healthcare executives aren't interested in being more inclusive, said Don Stanziano, vice president of marketing and communications for San Diego-based Scripps Health. Rather, it's that most healthcare organizations, particularly hospitals, spend relatively little on direct-to-consumer marketing and have to aim wide.

“Some of the examples you see with Coors or Orbitz are great,” Stanziano said. “But when your budget is limited, you try to meet the broadest possible audience with the dollars you have. When you have those niche markets, you do it in a targeted way.”

On average, hospitals' marketing and communication budgets represent just over half a percent of their net patient revenue, according to a benchmarking study by the Society for Healthcare Strategy & Marketing Development. Marketing budgets for stand-alone hospitals average about $1.7 million, health systems budget an average of $5.1 million, and academic medical centers have an average marketing budget of about $6.9 million.

Advertising and other media comprises 56% of hospital marketing budgets, with stand-alone hospitals budgeting an average of $1.2 million, health systems $2.8 million and academic medical centers $4.1 million.

Smart marketing executives, Stanziano said, implement a targeted strategy by ensuring that a number of ethnicities and races are represented in ads. They leave some narrative elements ambiguous, such as sexual orientation or the nature of a relationship. Some advertisers have featured two men or two women who could potentially be a couple. They leave it to the viewer to decide their relationship, which is called the “gay-vague” approach.

But Richard Waters, an associate professor of strategic communication at the University of San Francisco, said most advertising more recently has shifted to a more explicit portrayal of gay people. The goal is to signal the advertiser's clear support for LGBT communities.

Healthcare is more personal than consumer products and specialized healthcare services can meet the specific needs of LGBT people. Waters said insurers and providers want to make sure the consumer knows the people in an ad “are not two brothers, not two roommates, but in fact they are a couple.” It's also difficult to use the gay-vague strategy when marketing to families, a major audience in healthcare marketing, because audiences generally will interpret two men or two women with a child as a family unit, Waters said.

In healthcare, the most visible examples of LGBT-inclusive ads haven't been targeted specifically at LGBT consumers. Instead, such ads feature gay and lesbian couples as part of a diverse group of people.

Kaiser Permanente's recent TV spot as part of its 12-year “Thrive” campaign, titled “Grow Old With Me,” portrays major moments in the lives of individuals, couples and families, including gay newlyweds. An earlier Kaiser ad encouraging patients to get regular mammograms showed photos of a diverse family, including interracial couples and a same-sex couple with their baby.

“Our goal has been to be as inclusive as possible in our expression because we are just as inclusive in the way we operate,” said Christine Paige, Kaiser's senior vice president of marketing and digital services.

Kaiser's strategy of inclusive marketing can be a cost-effective way to appeal to diverse consumers in terms of race, ethnicity and sexual orientation, said LGBT marketing consultant Jenn Grace. “You get everyone in one ad that shows you're inclusive of all,” she said.

To boost Obamacare enrollment, the Illinois insurance exchange, GetCovered Illinois, ran a TV ad in January featuring a married gay couple from Chicago who signed up for insurance on the exchange. It was part of a series of ads called “People Like Me.”

Smaller organizations are also reaching out to LGBT audiences. Boston Medical Center featured a gay couple in its recent primary-care campaign ad, “Stronger Together,” which appeared on the front page of the Boston Globe's Metro section and inside the Boston Pride Guide. The campaign featured several examples of friends, co-workers and loved ones who support one another and remind each other to see a primary-care physician.

Neufeld, Boston Medical's marketing director, said the ad came about because “we really looked at what we know about people that come to BMC and how we ensure they are represented in our ads.”

Macias said the U.S. Supreme Court's recent decision in favor of same-sex marriage rights will have long-term, practical effects on how Americans live and how businesses operate, and already is prodding companies to be more inclusive. He expects the healthcare industry to catch up to other industries in marketing to LGBT communities.

“The healthcare industry is lagging behind because there has been a lack of demand (for) inclusive imagery from the general marketplace,” he said. Hospitals “need to start reflecting back who their patients look like.”