Look Out for Pinktober

Look around. You can already see it gaining momentum. The rise of PINK OCTOBER, that gargantuan commercialized, media-friendly, feel good activity of the year. It’s almost like Christmas! Only instead of red and green, we see a plethora of pink draping across the social landscape, as lovely and innocent as new fallen snow. In the midst of peace and good will toward women, we see individuals, organizations, and corporations putting on their best advertising and public relations campaigns to scramble for a bigger piece of the breast cancer pie. They’ll probably even try to sell you some pink pie (or m&ms, or cupcakes with hot pink frosting) to sugar you up while assuring you that your purchase is vital to the war on breast cancer. In a way, it is.

Though there is some funding for cancer research through centers at the National Institutes of Health, the Centers for Disease Control, and the Department of Defense, the National Cancer Institute is the principal agency responsible for cancer research at the federal level. The budget for NCI to research all types of cancer is under $5 billion. Of the top ten cancers (those with the greatest incidence rates), breast cancer receives the highest budget allocation, just under $600 million. This amount, however, is minuscule compared to the nearly $6 billion raised for breast cancer from industry and the philanthropic community. Though the industry monies fund a combination of awareness, education, detection, and support activities in addition to research, it is apparent that organizations and research centers rely on corporate fundraising and cause marketing to pay for their programs, do their research, and care for patients.

The University of Texas M.D. Anderson Cancer Center is on track to receive $8 million over 8 years for the Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, which American Airlines pledged through its Komen corporate partnership. Inflammatory breast cancer is an aggressive breast cancer that represents 1 to 5 percent of diagnoses and has a 5-year survival rate of only 40 percent. The center received funding in 2007 from the state legislature to create the “State of Texas Rare and Aggressive Breast Cancer Research Program” and then partnered with the University of New Mexico (UNM) Cancer Center in 2008 to organize research and expand clinical capacity. According to center directors, a clinical trial developed from the Komen Promise Grant will be the first line of treatment specifically targeting this type of breast cancer.

The Evelyn H. Lauder Breast Center at Memorial-Sloan Kettering Cancer Center is another facility supported through cause marketing fundraising. The center is named for its primary benefactor, Evelyn Lauder, who founded the Evelyn Lauder Breast Cancer Research Foundation in 1993 to raise money for research. According to the Sloan-Kettering website,”The Breast Center provides pioneering, comprehensive breast cancer prevention, diagnostic, treatment, and support services that go beyond the standard of care, all under one roof.” A video with a classical music accompaniment features philanthropist Evelyn Lauder and Deputy Physician-In-Chief Dr. Larry Norton as they walk viewers through a facility that boasts private chemotherapy rooms, natural lighting, original art work, separate patient and public waiting areas, a boutique, an education center, and a concierge to great visitors. Such amenities enhance the patient experience and illustrate how the the center attends to the patient as a person. In addition to lovely surroundings, the center offers integrative medicine and art therapy.

What the two centers have in common, beyond a commitment to breast cancer treatment, is that they would not exist in their current form without the funding they received from cause marketing and corporate philanthropy. Indeed, there is a place for corporate investment toward the betterment of society. The question is: Do the ends justify the means?

In conjunction with American Airlines’ commitment to the Morgan Welch Clinic through Komen’s Promise Grant, the airline simultaneously dedicated two airplanes to Susan G. Komen for the Cure. Purportedly, employees and volunteers from American Airlines and American Eagle applied Komen’s trademark running ribbon from nose to tail on the Boeing 757 and the Embraer 145. This was the first time AA featured another organization’s logo on any of its planes. Through an association with the good cause of breast cancer, AA could improve its public relations, create charitable tax deductions, and encourage spending in the midst of “record-high fuel prices and the financially fragile condition of the industry.”

The fact that a corporation is not completely altruistic in its philanthropic endeavors is neither surprising nor wholly negative. However, in the case of pink ribbon culture there are important negative consequences, including: spreading misinformation about breast cancer, using fear mongering to sell products and ideas, abuse of the cause for public relations and revenue production, trivialization of the disease, and use of health promotion projects to divert attention from environmental health risks posed by the companies themselves. While numerous companies participate in cause marketing for breast cancer and contribute to these and other positive and negative consequences, I highlight some of the specific effects from AA’s approach.

Misinformation. According to the Dallas Morning News, AA is now using the pink ribbon on eight of its planes to symbolize the fact that one in eight women will be diagnosed with breast cancer in their lifetime. This is a common statistic in pink ribbon culture that has shifted between 1 in 7 and 1 in 9, depending upon the year, with the aim of letting the public and the powers know that breast cancer is an epidemic. This statistic is both overused and misunderstood. The “1 in 8” statistics implies to many people that if there were 8 women sitting in a room, one of them will surely get breast cancer. This is not true. As a ratio, “1 in 8” is an average probability of risk for an entire population of women that builds across their total lifespans. Breast cancer risk increases with age. For women under age 80, the risk is NOT 1 in 8.

In fact, for women under 40 the ratio is 1 in 208. For women over age 70, the ratio is 1 in 16. Only by the age of 80, will 1 out of 8 women who avoided serious life-threatening situations while they were younger be diagnosed with breast cancer. And, 7 out of 8 of these women will die from something else. The 1 in 8 ratio is important for health policy and programming (e.g., it is useful to know that the overall risk was about 1 in 11 in 1975.) But, it does not do much for individual women when it comes to understanding their personal risk. Unfortunately now, with the help of eight flying billboards, the statistic will be advanced and decontextualized further.

Fear Mongering. Misuse of cancer statistics such as the “1 in 8” ratio in pink culture and advertising leads to an abundance of fear about the disease. The seeming inevitability of breast cancer contributes to stress, increased medical surveillance, and unnecessary procedures including unnecessary biopsies, treatments, and prophylactic mastectomies. In addition, women tend to be more concerned about their breast cancer risk than they are about more prevalent health conditions.  Women are ten times more likely to die from heart disease than from breast cancer, and they are also more likely to die from cancers of the respiratory (71,550 per year) and digestive (59,810 per year) systems than they are from breast cancer (40,170 per year).

Pinking. This refers to companies that use the pink ribbon as an integral part of public relations and revenue-production portfolios. American Airlines’ expanded partnership with Komen in 2008 occurred when the the airline was facing near bankruptcy. In addition to high fuel prices, low consumer demand, debt, and an aging fleet, the airline now had to generate another $8 million for a Promise Grant. This shouldn’t be a problem though. With income from the “Miles for the Cure” program, American Airlines gift cards, proceeds from AA’s annual celebrity golf and tennis event, and other promotions the company should be able to raise the funds in 8 years. More importantly, the partnership, and the myriad publicity campaigns that would advertise it, will promote good will toward the airline and higher sales.

Trivialization. In addition to advertising the partnership with Komen on the bodies of eight planes, the airline posted pink ribbons at their gates, advertised it in their magazine, sent postcards to consumers, and even created collector editions of the American Eagle ERJ-145 Susan G. Komen Livery toy plane with running ribbon. For only $22.00, the toy planes will be in stock on or around October 13th! My husband received a holiday card from AA last year with Komen’s logo on it with the message: “Here’s wishing that the hope of the holiday season follows you on all your adventures.” Replacing action with symbolism, the card reiterated the word HOPE in relation to cause of breast cancer. Consumers are supposed to think pink, fly pink, and do pink while hoping beyond hope that some miracle will end breast cancer forever.

Pinkwashing. Breast Cancer Action coined the term pinkwashing to identify companies that claim to care about breast cancer by promoting sales-driven contributions, but manufacture products that are linked to the disease. Companies that emit cancer-causing, disease-producing toxins may also fall into this category. According to a study by MIT, airplane emissions at 35,000 feet can lead to health hazards on the ground, including respiratory problems and lung cancer. Using corporate philanthropy in the name of health promotion while contributing to ill health is another complex piece of the pinkwashing puzzle.

AA’s tactics, and they are not alone in these efforts, are used strategically to keep hope, and the cause, in the forefront of customers’ minds without question. Accurate and evidence-based information about breast cancer falls between the cracks while fear mounts about breast cancer risk. Simultaneously, advertising, press releases, news items, and videos on organizational websites emphasize the good that will surely result from pink ribbon fundraising. Select accounts stress philanthropists’ generosity and, overtly or subtly, the gratitude of the beneficiaries.

Aside from those pesky negative consequences, pink ribbon fundraising seems to be working though, right? MD Andersen got a grant to research an understudied form of breast cancer; Sloan-Kettering got a fancy new breast center; Komen got money and free advertising; American Airlines avoided bankruptcy; and the cause got more publicity. Still, these efforts don’t even come close to the oft-quoted $6 billion raised for breast cancer. In fact, we have no idea how much money actually goes toward breast cancer research, how that money is spent, and what it accomplishes. When asked for specifics, Dr. Larry Norton of Sloan-Kettering stated that “the lines are just too amorphous and fuzzy” because “science simply doesn’t work that way.” In other words, keep buying pink and don’t ask any questions.

For more on cause marketing, see:

From Disease-Specific Symbol to Brand Logo

Feeling Good About Cause Marketing?

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“Pink Ribbon Blues”

Paperback includes a new Introduction on fundraising controversies and a color insert with images of, and reactions to, the pinking of breast cancer (2012).


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* GAYLE IN THE MEDIA *

"Seeing clearly through the pink haze" Toronto Sun

*Sad face*: Being happy does not help you live longer" New Scientist

How should we address breast cancer when norms continually change? The Guardian

Your Fun 'No Bra Day' Photos Are Overshadowing Terminal Breast Cancer Patients Broadly

Backlash against “pinkwashing” of breast cancer awareness campaigns BMJ

Breast Cancer to Rise 50 Percent by 2030? Hey, Not So Fast! Health News Review

Breast Cancer: The Flaws in the Cause iafrica.com

How to Make the Biggest Impact With Your Breast Cancer Donations Money

The Very Pink, Very Controversial Business of Breast Cancer Awareness Racked

NFL, Pink Ribbons Not Enough to Win over Women CNN

3 Questions We Need to Answer for Breast Cancer Awareness Month Chronicle of Philanthropy

The problem with National Breast Cancer Awareness Month Women's Health Magazine

Pink Ribbon Envy: Living with an Uncool Cancer The Nib

A Year After Bombings, Some Say 'Boston Strong' Has Gone Overboard NPR, All Things Considered

Canadian Mammogram Study KCRW, NPR Affiliate

Time to Debunk the Mammography Myth CNN

Breast Cancer: Awareness, Activism & Pinkwashing NPR Charlotte

Buying Pink Al Jazeera's The Stream Watch »

The Pink Backlash Orlando Sentinel

Why Jolie's Test Costs So Much CNN

Preventative Mastectomies: Disease and Deception BlogTalkRadio

Angelina Jolie and the 'Breast Cancer Gene' KCRW

Our Feel-Good War on Breast Cancer The New York Times Magazine.

The Story Behind the Pink Ribbon Campaign Sisters Talk Radio

WISH Interview Women's International Summit for Health

Making Cancer About The Patient, Not The Body Part CBS Pittsburgh

Sexy breast cancer campaigns anger many patients USA Today

The perils of pink The Daily

Komen pink campaign creates breast-cancer blues for some Dallas Morning News

A yellow flag for the NFL's pink New York Daily

Gayle Sulik named #7 in SharecareNow’s Top 10 Online Influencers in Breast Cancer

Breast cancer cancer causes so easily derailed Philly Inquirer

Komen Charity Under Microscope for Funding, Science Reuters

The Fight Against Cancer - And Abortion? Salon.com

Susan G. Komen For the Cure defunds Planned Parenthood. In Deep with Angie Coiro

Amid Breast Cancer Month, Is there Pink Fatigue? NPR's All Things Considered

How is Breast Cancer Culture Undermining Women's Health? America’s Radio News Network

Pink Ribbon Culture and Breast Cancer The Kojo Nnamdi Show

The Big Business of Breast Cancer
Marie Claire

Does Breast Cancer Awareness Month Crowd Out Other Diseases? Slate

Pink Inc. Has Many Starting to See Red The Sacramento Bee

Get Your Pink Off Ottawa Citizen

Komen Pink Ribbons Raise Green and Questions USA Today

** MORE MEDIA LINKS **
** MORE RADIO INTERVIEWS **