By 2050, the United States population will include almost 30% Hispanics/Latin-Americans, 13% African-Americans, and 9% Asian-Americans, with less than half of the population being Caucasian. Multicultural marketing is described as targeting and communicating to ethnic segments on their diverse cultural framework. Pain management is a universal dynamic among all cultures. The pharma marketing of pain medication to a culturally varied audience will be successful by understanding the Anderson Conceptual Framework and developing specific targeted strategies.
Anderson Conceptual Framework
Health beliefs are predisposing characteristics that are not easily changed.
- In the African-American culture, pain medications may be passed over due to the fear of addiction. Patient education should be incorporated into a strategy which not only teaches the facts about addiction but also allows individuals to accept medication while foregoing the use of folk healers, prayers, laying of hands and speaking in tongues.
- In the Japanese-American culture, patients may believe that it is honorable to suffer silently through pain. A successful marketing strategy for this particular culture should include a clinical environment where the patient is comfortable expressing his feelings about drug acceptance while incorporating acupuncture, herbs and other natural remedies which are aligned with their culture.
- In the Mexican-American culture, pain may be viewed as penance for sinful behavior or a poor life style while the machismo(a) attitude acknowledges they are courageous without medication. Once again, patient education should be part of the strategy to explain pain can be controlled with medication and also the negative impact when pain remains uncontrolled.
Enabling or Impeding Factors
Family support, access to medicine, and individual community are the enabling or impeding factors with pain medication supported by high, medium, and low degrees of ethnicity.
- A high degree of ethnicity is found in patients who are first generation immigrants strongly affiliated with their culture, raised outside of the United States but now live in areas with a high ethnic concentration, not fluent in English and speak mostly their ethnic language in heavy accents.
- A medium degree of ethnicity is found in patients who are second generation or acculturated first generation belonging to both worlds, have spent up to half of their lives in the United States but now live in areas with moderate ethnic concentration and are proficient in both their native language and English while speaking in light accents.
- A low degree of ethnicity is found in patients who are second generation and onwards, less affiliated with their original culture, born and raised in the United States but now live in areas with low ethic concentration and bilingual but prefer speaking English in a neutral accent.
Perceived and Actual Need Factors
Pain medication is based on the perceived and actual necessity of drugs. Some cultures show a “nocebo” effect where individuals who do not believe in medication experience deteriorating symptoms due to pessimism about becoming healed. The opposite end of the spectrum is a placebo effect where medication is more beneficial if it is more intrusive. The Asian-American culture may view pain as a sign of weakness, believe that medication is inadequate without an injection and prefer an intravenous medication rather than highly effective analgesic tablets. The Mexican-American culture may view medication as unnecessary since they believe they are strong enough to endure the suffering naturally, and believe that a larger pill or bitter medicine are more effective than a smaller pill or medicine that has a pleasant taste. The African-American culture may perceive pain toleration without medication as heroic with past generations in slavery and reject medication entirely out of fear of a detrimental impact.
Developing Specific Targeted Strategies
In a study conducted by Experian Simmons, almost 10 million Hispanics between the ages of 35 and 64 did not use a prescription drug during the past year with 61% spending up to 40 hours of their time each week watching Spanish language television, surfing the web, and visiting social media sites. In terms of context, behavior, and demographics, specific targeted digital and media marketing strategies will increase pharma revenue in pain medication by 50%. Also, strong brand affinity by a culturally diverse population encourages pharma to create direct relationships with target markets that are growing exponentially.
In conclusion, under the medical ethics tenet of beneficence, it is the duty of the physician to intervene with pain medication for the comfort and well-being of the patient with the goal of alleviating distress. Pain is applicable to all cultures. Different cultures create the formation of certain values and then these particular values create perceptions that motivate behaviors. Understanding the Anderson Conceptual Framework with unique cultural insights allows pharma to formulate successful specific targeted multicultural marketing strategies for pain medication.
Alvarado, Anthony J. “Cultural Diversity: Pain Beliefs and Treatment among Mexican-Americans, African-Americans, Chinese-Americans and Japanese-Americans.” (2008). Senior Honors Theses. Paper 127.
McDonald. K.M., Sundaram, B., et al. “Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies.” Agency for Healthcare Research and Quality. (2007)
Guion, Lisa A. and Kent, Heather. “Ethnic Marketing: A Strategy for Marketing Programs to Diverse Audience.” Allied Media Corp. Multicultural Communication. (2014)
Young Entrepreneur Council. “5 Tips to Refresh Your Multicultural Marketing Strategy.” Forbes. (2013)
Millerman, Steve. “Multiethnic Marketing: The Billion Dollar Upside.” PharmaExec. (2015)
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