What heart patients can learn from Pinktober pinkwashing

by Carolyn Thomas  ♥ @HeartSisters

October (also known as Pinktober in corporate brand marketing circles) is the annual holy month of breast cancer awareness-raising, a month of feel-good retail branding opportunities, bathed in a pretty cloud of pinkwashing, a campaign once described by author Barbara Ehrenreich (a breast cancer patient herself) as the “cult of pink kitsch”.  You’ve seen these marketing campaign ads:

“For every _______ (insert name of the company’s special pink product, e.g. a pink-labeled can of Campbell’s soup or a pink-handled Smith & Wesson handgun) that you purchase this month, we’ll make a donation to help raise breast cancer awareness!”

As the late Barbara Brenner reminded us: “If breast cancer could be cured by shopping, it would be cured by now.”

I worked in the field of public relations for well over three decades, and I can tell you that my colleagues working in breast cancer fundraising have done a  remarkable job of raising both awareness and money for their cause. So remarkable, in fact, that women have been mistakenly convinced that breast cancer is our biggest health threat – which, of course, is not true.

It was only after surviving my own misdiagnosed heart attack that I learned heart disease kills six times more women than breast cancer each year.  Only about half of women recognize that heart disease is the number 1 killer of women worldwide.(1) 

Please don’t misunderstand. This isn’t a spitting contest around who suffers more. None of us would ever argue that a diagnosis of breast cancer – and indeed any form of cancer – is not a horrific experience for both patient and family. . This is about my annual question at this time of year about why heart patients and those who care for us seem so quiet by comparison.

Yes, we heart patients do have our very 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.

Much of the growing controversy over the Pinktober commercialism of breast cancer awareness comes, surprisingly, from breast cancer patients themselves. Nancy Stordahl, for example, who was diagnosed with the same type of breast cancer that had killed her own mother just two years earlier, once wrote in her no-nonsense breast cancer blog, Nancy’s Point, that breast cancer is not pretty, pink or party-like.  Period.

And Dr. Gayle Sulik, researcher and author of Pink Ribbon Blues:  How Breast Cancer Culture Undermines Women’s Health, warned:

“Breast cancer is not a ribbon, a screening test, or a leisure activity. It is not a sassy t-shirt, a proclamation of survivorship or a gift worth giving. It is a disease process that ignites what is all too often a cycle of medical surveillance and interventions. For too many, it will be the eventual cause of death.They deserve better than this, and so do we.”

Here are some observations about why heart disease faces an uphill slog to catch up with all that pink:

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 seems to do. Heart disease is still perceived by many to be self-inflicted.  Read this before you decide: Heart Attack:  Did You Bring This On Yourself? 

2.  “Pick a sexy cause” –  Breast cancer, unlike other health threats to women, was described as “loaded”  by The National Alliance of Breast Cancer Organizations in 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 or lung cancer, breast cancer is relatively free of what some marketers euphemistically call “lifestyle issues.”  PR consultant Carol Cone of Boston once said, 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 showed 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.

But many large 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. For more about how to tell, visit the non-profit Think Before You Pink,  a very useful project of Breast Cancer Action. Here’s an example of a common consumer concern:

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

Under the noble auspices of charity, argues Queen’s University professor Dr. Samantha King in her book, Pink Ribbons Inc: Breast Cancer and the Politics of Philanthropy,  global corporations and politicians are all getting a big shot in the arm from this pink ribbon juggernaut. She calls breast cancer “a corporate dream come true.”

Dr. King also suggests that, before you purchase any 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 donate 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, on prevention, and on the largely ignored subject of end-stage metastatic breast cancer ).

Meanwhile, we can all do our part, big or small, in helping to raise awareness of a condition that women really do need to know more about.  See also: When a red dress just isn’t enough to raise awareness

We know that there is a profoundly significant gender gap in cardiology, and we can help to shrink that gap by sharing with other women what they need to know about women’s unique cardiac risk factors and symptoms.

This October, decide to learn all you possibly can about women’s heart disease (and the fact that you’re reading this Heart Sisters post means you may already have some interest).

Without asking anybody to buy a pink-handled gun, I believe that we can move the needle to help inform the women we care about. Knowledge, as we know, is power.

But I want more than just increased awareness of heart disease (although that would be nice!)  Want to know just how bad women’s awareness of heart disease actually is? The most recent American Heart Association’s National Survey reported that women are far less aware than they were 10 years earlier!  For some demoralizing examples of this awareness-raising disaster, read: “Women’s heart disease: an awareness campaign fail?“

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Other ways I want to move that needle for women’s heart health:  start with cardiac research, which for decades has focused only on (white, middle-aged) men. Even the lab animals used in early cardiac research were male animals. Diagnostic tools, drugs and treatments have all been developed with men in mind, NOT women.

I want that research to be sex specific so that female participants are not lumped in with males when arriving at conclusions or publishing scientific guidelines.

I want medical and nursing schools to start teaching students that, when it comes to our hearts, women are not just small men.

I want to see every major teaching hospital opening up a Women’s Heart Clinic that hires staff with specific expertise in women’s cardiac diagnoses, treatment and outcomes.

I want women to take our own troubling symptoms seriously so that we stop this insane cycle of what researchers call “treatment-seeking delay behaviours“ even while suffering distressing symptoms that, if happening to anybody else we loved, we’d be forcibly dragging them to seek immediate help.

I want paramedics and Emergency Department staff to believe women when we tell you we’re sick.

One last voice in this mix:  the late Shelli Ray Gibbons, a woman with metastatic breast cancer and the founder of the popular site, The Dirty Pink Underbelly, once wrote this to me:

“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.”

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©Carolyn Thomas – Heart Sisters www.myheartsisters.org

1. Mosca L et al. American “Fifteen-year trends in awareness of heart disease in women: Results of a 2012 American Heart Association national survey.” Circulation. 2013;127(11):1254–63.

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NOTE FROM CAROLYN:   I wrote much more about differences between how men and women are researched, diagnosed and treated in my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (and use the code HTWN to save 30% off the list price).

Q:   Have we gone too far with Pinktober?

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See also:

♥ Modern medicine is male-centric medicine, and that’s a problem for women.

♥  A heart film to watch before “Pinktober” arrives

♥  Fewer lights/sirens when a woman heart patient is in the ambulance

♥  Same heart attack, same misdiagnosis – but one big difference

♥ When cancer treatment damages your heart

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