What women with heart disease can learn from “pinkwashing”

by Carolyn Thomas  @HeartSisters

In this month of all months, in Pinktober, in the holy month of All Things Pink out there, author and cancer patient Mary Elizabeth Williams dared to post a brave if not downright shocking perspective in Salon she called The Smug Morality of Breast Cancer Month.

She included this jibe at a pink ribbon campaign that she describes as an increasingly pervasive branding opportunity”:

“Perhaps it’s time to consider what this glut of pink says about our attitudes about the meritocracy of disease, and the ways in which we dispense compassion.

This year lung cancer will kill triple the number of people that breast cancer does. Ovarian, cervical and prostate cancer will kill more individuals than breast cancer. And alcoholism, addiction and depression will this year continue to kill not just via the overt channels of overdose and suicide, but in their brutal toll on overall health.”

And let’s not forget to add to Mary Elizabeth’s deadly list heart disease, the #1 killer of women.  It was only after my own heart attack that I learned heart disease kills more women than ALL forms of cancer combined.  But targeting any disease as a “branding opportunity” is not about being anti-pink.  Instead, as Mary Elizabeth Williams warns us:

“We run the risk of ennobling those with certain sicknesses while stigmatizing others.”

Yes, we heart patients also have our own month for raising awareness (February is Heart Month) and our own colour (red) and even our very own awareness-raising lapel pin (the Red Dress).  But that’s where our two branding opportunity similarities end.

I’ve worked in the public relations field for well over three decades, and I have to tell you that my colleagues working over in breast cancer fundraising are doing an outstanding job of raising awareness and money for their cause. It is indeed a world of pink out there.

So what can those of us wanting to educate women about their actual #1 health threat learn from the amazing success of breast cancer’s “pinkwashing” campaigns? Here are a few observations:

1. “It’s not my fault” –  First, it helps to have one of those diagnoses that strikes innocents out of the blue, just as breast cancer does. Or does it? Emerging research links increased breast cancer risks with environmental influences, alcohol consumption, lack of exercise, or obesity (especially for post-menopausal women).   If women were truly serious about fighting deadly cancers, we would be all over the far more dangerous lung cancer. But lung cancer is one of those diagnoses, rightly or wrongly, that is largely perceived as a self-inflicted condition that can be justifiably blamed on the patient’s lifestyle choices.  We may also have felt a twinge of sympathy towards people who have throat cancer, but we’ve also heard that throat and mouth cancers are largely due to heavy drinking and smoking.

Mary Elizabeth Williams is one who lumps heart disease in with other self-inflicted conditions like throat or lung cancer, as she points out in her Salon essay that “the leading non-accident-related cause of death in North America is heart disease, frequently a diet and lifestyle-related problem. Is she correct?  Read this first before you agree: Heart Attack: Did You Bring This On Yourself?

2.  “Pick a sexy cause” –  Breast cancer, unlike other health threats to women, has been described as “loaded” by The National Alliance of Breast Cancer Organization’s former executive director Amy Langer.  She once told The New York Times magazine:

“Breast cancer is all about body image, it’s about nurturing – it’s certainly about femininity.”

Heart disease, by comparison, is apparently just not that feminine. And unlike diseases like AIDS, breast cancer is free of what some marketers euphemistically call “lifestyle issues.”  PR consultant Carol Cone of Boston says simply:

“Companies want to support breast cancer. Breast cancer is safe.”

3.  “Get the Big Guys on board” –  Breast cancer meshed very nicely with the corporate world’s discovery during the mid-1980s of cause-related marketing. Research had proved that, given the same cost and quality, more than half of consumers would switch from a particular store or brand to one associated with a good cause.

Consider Campbell’s soup, for example. In 2006, Advertising Age reported on a Campbell’s soup cause-related marketing success story – “turning its iconic soup can on its ear by replacing the traditional red-and-white label with pink-and-white, and adding a pink ribbon for Breast Cancer Awareness Month”. The result? Campbell’s sales doubled for their pink-clad varieties that month, and even motivated store managers to display the soups outside the soup aisle. Campbell donated 3.5 cents per pink can to its breast cancer charity in exchange for its doubled order. But the financial payoff was huge for the company, even after the breast cancer donation was deducted.

How about a pink Taser?

Some breast cancer advocates, patients and survivors are now questioning whether the pink ribbon movement has gone too far.  Last year, pink products included a pink taser and a Smith & Wesson handgun with a pink handle. Really? Seriously?  Many companies seek higher sales from cause-related packaging without pledging much – if anything – in return. It’s left up to shoppers to read the labels on pink-packaged products and determine if their purchases will actually help a breast cancer charity or foundation.

Barbara Brenner, the outspoken executive director of a terrific site called Breast Cancer Action, told a Daily Finance interviewer:

“If the label says ‘Money will go to support breast cancer’ – well, what does that mean? If it just says it ‘supports breast cancer awareness’ without being specific, it’s not going anywhere!”

Breast cancer “pinkwashing” has an impressive history in corporate brand marketing, according to the non-profit Think Before You Pink, a project of Breast Cancer ActionTBYP was launched in 2002 in response to the growing concern about the overwhelming number of pink ribbon products and promotions on the market (what author Barbara Ehrenreich calls the “cult of pink kitsch”).

Their campaign calls for more transparency and accountability  by companies that take part in breast cancer fundraising, and encourages consumers to ask questions about pink ribbon promotions.

The history of the pink ribbon goes like this: 20 years ago, the Susan G. Komen Breast Cancer Foundation used to hand out bright pink sun visors to breast cancer survivors running in its Race for the Cure. But in the fall of 1991, the Foundation gave out pink ribbons to every participant in its New York City race. A few months later, the editors of Self magazine in New York were planning their second annual Breast Cancer Awareness Month issue. They came up with an inspiration – create a ribbon and enlist the cosmetics giant Estée Lauder to distribute it in New York City stores.

Then Self  learned of a woman named Charlotte Haley, who was already doing a peach-colored ribbon for breast cancer awareness. Charlotte, who was the granddaughter, sister, and mother of women who had been diagnosed with breast cancer, had been hand-making her peach-colored loops at her dining room table. Each set of five peach ribbons came with a card saying:

“The National Cancer Institute’s annual budget is $1.8 billion, yet only 5% goes for cancer prevention. Help us wake up our legislators by wearing this ribbon.”

Charlotte was strictly grassroots, handing out thousands of her cards at her local stores and writing to prominent women. Her message spread entirely by word of mouth. 

Then Self magazine from Manhattan called. They told Charlotte: “‘We want to go in with you on this and we’ll give you national attention.” But spunky Charlotte surprised the big city editors, according to Self’s editor-in chief Alexandra Penney at the time:

“She wanted nothing to do with us – said we were too commercial.”

By September 1992, it was reported that Estée Lauder had experienced “problems” trying to work with Charlotte Haley.  Self asked her to relinquish the concept of the ribbon.

“We asked our lawyers and they said, ‘ Come up with another colour’.”

They chose pink.

Within a year, Charlotte Haley’s loop of peach ribbon was history, and Estée Lauder makeup counters had handed out millions of their pink ribbons.

Dr. H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice is critical of the sponsorship of Breast Cancer Awareness Month by the drug company, AstraZeneca. He told the Los Angeles Times this month:

“It’s a common problem with disease awareness campaigns and patient advocacy groups. If you look into their funding sources, you’ll often find a pharmaceutical company or device maker or diagnostic screening manufacturer who stands to benefit.”

Dr. Welch calls AstraZeneca’s sponsorship of the awareness month “a huge conflict of interest” – since the company manufactures breast cancer drugs Arimidex, Faslodex, Nolvadex and Zoladex.  

Dr. Welch cites a paper published last month in the New England Journal of Medicine that estimated for every life saved by a screening mammogram, 5-15 other women needlessly became diagnosed and treated for cancers that would never become a threat.

Under the noble auspices of charity, argues Queen’s University professor Samantha King in her book, Pink Ribbons Inc: Breast Cancer and the Politics of Philanthropy, global corporations, politicians, and “regressive white middle class family values” are all getting a big shot in the arm from this pink ribbon juggernaut.

She notes that, beyond being an all-too-frequent and still-too-lethal disease for many women, breast cancer is a corporate dream come true.

“Corporations secure  free publicity and a means to expand their market share via enlogoed ‘awareness’ campaigns. The rank and file, conditioned by now to believe that there’s no problem shopping can’t solve, are invited to feel virtuous and altruistic whenever they buy a Yoplait yogurt or a pink KitchenAid mixer.”

Dr. King also suggests that, before you purchase yet another pink product this month, you should ask the following questions:

1.  How much money actually goes to the cause? (If very little. it’s best to give directly to organizations whose work you support rather than filtering it through a large corporation).

2.  Where will the money end up? (Information about this is usually hard to find and often vague; if you can’t tell, don’t buy the product).

3.  What types of programs will benefit? (If we want to see real innovation in the breast cancer research agenda, we should target our generosity to those organizations that focus on the causes of the disease, and how to prevent them, and the largely ignored subject of end stage metastatic breast cancer ).

Mary Elizabeth Williams adds:

“It’s certainly more pleasant to buy a pink bucket of KFC and congratulate oneself for ‘promoting awareness’ than it is to march for cirrhosis, hepatitis and gonorrhea, but what if we had even a measure of the same generous, unconditional support we give this month to women with breast cancer for those living with less morally unambiguous conditions?

“What if October wasn’t just pink? Imagine how much suffering we could eliminate.

“Imagine how much we could cure.”

© 2010 Carolyn Thomas – Heart Sisters www.myheartsisters.org

NOTE FROM CAROLYN:   I wrote more about raising awareness of women’s most dangerous health threat in my book, “A Woman’s Guide to Living with Heart Disease”.  You can ask for it at your nearest library or local bookshop or order it online (paperback, hardcover or e-book) at Amazon,  or order it directly from my publisher,  Johns Hopkins University Press (use the code HTWN to save 20% off the list price)..

♥   See also A Heart Film To Watch Before the ‘Pink Season’ Gets Here

Read Nancy Stordahl’s excellent essay on her blog Nancy’s Point called Another Breast Cancer Awareness Month: Silence is Not an Option.   Nancy was diagnosed with the same breast cancer that killed her mother, and has become a powerful voice for women with breast cancer, especially concerned about what she calls the ‘pink ribbon nonsense’ that she says trivializes a wretched disease while raising money that essentially  ignores those living with advanced breast cancer. 

   Watch the trailer for the National Film Board of Canada’s documentary Pink Ribbons Inc. based on Dr. Samantha King’s book.

♥   Read the Los Angeles Times story, The Downside of Awareness Campaigns, and Barbara Ehrenreich’s article in Harper’s magazine called Welcome To Cancerland: A Mammogram Leads To A Cult of Pink Kitsch.




24 thoughts on “What women with heart disease can learn from “pinkwashing”

  1. A great contextualization of potential parallels between breast cancer and heart disease cause marketing, especially now as word is finally getting around that women get heart disease too! And we don’t experience it the same way as men.

    Whenever something is revealed to also be a women’s issue, campaigns often try to make it feminine, gender normative, sexist, infantalizing, intensely commercial, uninformative. I strongly see that happening for campaigns around women and heart disease and I think we bloggers can let people know what’s going on and why it’s a problem. I think many have become desensitized.

    Last Pinktober, I wrote a blog post about how Pinktober exploits women with breast cancer, if you’re interested.


    1. Hi Ashley – I loved that post of yours: 11 terrific points covered. Well said, e.g. “commodifying and sexualizing breast cancer and women in general is wrong”. Thanks for sharing this with us.


  2. Could not agree more. I’m just about ‘pinked out’ by this stage. And those who organize these walks/runs for the cure and ‘feel righteous’ shopping incentives are still not addressing those who most need it: women with deadly metastatic breast cancer. They don’t even want to talk about those who are not suitably “triumphant” over cancer. Hypocritical.


  3. Oh believe me, those of us in the thick of breast cancer are SICK of the pink and the hype…at least the realistic among us are.

    Breast cancer gets the attention because of society’s objectification and sexualization of women and breasts. Can we please spread the word that it’s not about boobies…it’s about life and death, like every other cancer out there!

    I wish that October were about women’s health in general, and I wish we could get away from the commercialization of it all, and the trivialization of women and the disease that Pink Industry Month perpetuates.

    I have cancer. It happens to have started in my breast. It has metastasized to my bones. It will eventually spread. It will kill me, if heart disease doesn’t sneak up on me first.


    1. Hello Shelli and thanks for your unique perspective. I love your writing (readers, check this out). I was also glad to see you posted Barbara Ehrenreich’s little interview, “An ocean of pink positive thinking won’t cure cancer”. Keep up the good work.


  4. This is an important and useful account of what can be learned from pink ribbon missteps so they can be avoided elsewhere. The pink ribbon is no panacea. “Keep what is worth keeping, and with the breath of kindess blow the rest away.” #ReThinkPink

    Gayle Sulik


    1. Thanks so much for taking the time to comment here, Gayle. Your book Pink Ribbon Blues is a must-read for any of us who are feeling dismayed as we watch “cancer rates rise, the cancer industry thrive, corporations claiming responsible citizenship while profiting from the disease”.

      Keep up the great work! Your voice is a powerful beacon of sanity.


  5. Your commitment to getting this “Pink” informational message along is quite valuable and has encouraged girls like me. Thanks so much.


  6. Hello Carolyn
    Love your new website look 🙂
    Unfortunately, we are so “pinkwashed” that any voice objecting in any way to the pinkness out there is somehow seen as being non-supportive of breast cancer patients. NOT TRUE! Nobody denies the trauma of this diagnosis, but as somebody once said: “If shopping could cure breast cancer, it would be cured by now.”

    It’s the corporate hijacking of the cause that upsets me.


    1. Santa Fe, did you ever consider that perhaps breast cancer treatments available today are available only because of all the important donations collected during Breast Cancer Awareness month?


  7. Hello all,
    For those interested in stories of heroic survivors who are making a difference (entirely without the corporate funds from selling pink cans of Campbell’s soup!) consider breast cancer survivor Jeanine Patten-Coble, who reminds us that a breast cancer diagnosis hits the whole family, not just the patient. She has founded a practical, real-life project she calls Little Pink Houses of Hopeto encourage people to donate the use of their beach cottages to use as retreats for breast cancer patients and their families:


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  9. Excellent article. I’m a breast cancer survivor with a family h/o heart disease, as it happens. I’m working on a blog post myself & will link to this.

    I’m sick to death of the Pink Hype. I’m still not able to work full-time, two years after acute treatment for BC, because of cancer-related fatigue & cancer-related concentration changes (which do NOT only happen to those who’ve had chemo, as in “chemo brain”).

    No one is helping me pay my bills while I earn less money, I assure you. No one is helping me clean my house or cut my grass when my right shoulder still aches from being fried by radiation & tightened by surgery. There needs to be much more & a much better focus on how to help those of us who survive to get our lives back. And touchy-feelie workshops just don’t cut it.

    We need financial help, insurance help, practical help, and better information & options when we are diagnosed, but BEFORE we decide on a treatment plan, in order to lessen the impact that cancer & its treatment has on the rest of our lives. Where’s the money for that?


    1. Thanks for the link to THINK BEFORE YOU PINK. This is such a good resource for all consumers, including that helpful list of questions to ask before we assume a pink ribbon or a pink yogurt package or a pink handgun (you’ve GOT to be kidding!) means that any portion of the item purchase price will do anything for any breast cancer organization. Even when money does get donated, the reality of social cause marketing as you point out is that going pink is also a great money-making scheme for business.

      In 2008, for example, General Mills/Yoplait yogurt donated 10 cents for every pink lid sent in during its Save Lids, Save Lives promotion, raising a whopping $1.5 million in charitable donations, BUT this promotion also meant almost $6 million in yogurt sales that year, a record 14% increase over the previous year’s sales. It pays to pink!

      As a woman living with metastatic breast cancer, I can reassure your readers that what we do not need is more “awareness” (oh please is there anybody in the Western World who is not already “aware” that breast cancer exists?) but what we need is more ACTION, and reassurances that appropriate, affordable and timely treatment will be provided to ALL those facing cancer (of all kinds).


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  12. I found the history of the pink ribbon very interesting. I had not heard about that before.

    It was a very interesting and informative article.



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  14. Thanks for a great article. I cringe when I see all the pink.

    Just last night they offered Pink reusable bags with eh Publix logo for sale at the grocery store. I had a dear friend die of breast cancer, I’m not begrudging their exposure, it just seems to me a lot of profit is being made by someone while other deadly diseases are as you said, seen as preventable or not seen at all.


  15. Yes, Carolyn, I think about this every (YES, every!) day I click for breast cancer. It’s not that we wish them to not cure BC, but CHD is the #1 killer!


  16. I am a huge supporter of the AHA!!! Family history, genetics led to my my almost near death experience with an MI.

    There is a lot to learn from how the Pink revolution came into existence, and I will be there to support any efforts on the number one killer which is heart disease.

    Very well written article.


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