Journal of Public Policy & Marketing

The authors evaluate seven nutrition label formats to determine consumer comprehension and acceptance of displayed information. They test comprehension on five tasks: comparing two products, judging healthfulness, verifying claims, estimating servings needed to meet the daily requirement for a nutrient, and balancing nutrients in a daily diet. Performance scores were higher on some tasks—particularly dietary management ones—for formats that displayed nutrient amounts in percentages than for those that displayed nutrient amounts in metric units, even when interpretational aids were included on the metric formats. The two most preferred formats were metric formats with an interpretational aid. The findings have an important impact on decisions about the final nutrition label format required by the Food and Drug Administration.

The authors report the results of a laboratory experiment that investigates whether consumers can evaluate nutrition information in the presence of a health claim. Results show that both health claims and nutrition information influence beliefs about product healthfulness. However, health claims do not influence the processing of nutrition information on a food label. Rather, health claims and nutrition information have independent effects on consumer beliefs. The authors discuss the implications of these findings for the Food and Drug Administration policy on limiting health claims.

The author reports a longitudinal quasi experiment that uses the implementation of the Nutrition Labeling and Education Act (NLEA) to examine the consumer and information determinants of nutrition information processing activities. Over 1000 consumers from balanced demographic, geographic, and site categories and across 20 different product categories were observed and surveyed within a supermarket setting. Findings suggest that consumers acquired and comprehended more nutrition information following the introduction of the new labels. The NLEA did not, however, always influence these outcomes irrespective of individual consumer differences. Specifically, the new nutrition labels were comprehensible to consumers with varying levels of motivation and most types of nutrition knowledge. However, the new labels appeared to widen consumer differences in terms of how much nutrition information was actually acquired—more motivated consumers and less skeptical consumers acquired more information after the NLEA was passed. Finally, consistent with the NLEA's apparent ability to reduce comprehension differences, the new labels narrowed comprehension differences across healthy and unhealthy products. In contrast, the NLEA widened differences in nutrition information acquisition in favor of unhealthy product categories. These results have implications for public health gains, as well as for the degree to which nutrition may become the basis for competition in unhealthy product categories.

Most studies utilize consumer surveys or experimental data to investigate the relationship between socioeconomic variables and food choices. The author examines actual purchase behavior (supermarket scanner data) in the natural shopping environment. The author focuses on whether the propensity to purchase high-fat unlabeled products within a product category varies across supermarkets with different demographic profiles. The results show differences in this propensity across demographic groups, even after accounting for price and sale promotions. The findings are consistent with consumer survey and experimental design research on the relationship between demographic characteristics and the processing of nutrition information.

The Nutrition Labeling and Education Act (NLEA) of 1990 requires the provision of daily value reference information on food labels to improve consumer judgments of product nutritiousness. Yet, a review of the literature reveals little research indicating that daily values (DVs) have such a facultative effect. In light of this, the authors empirically examine how DVs fare against an alternative reference point in the form of average-brand values. Their results demonstrate that these two reference points differ in terms of their impact on consumers’ interpretation of nutritional information. In particular, they find that average-brand reference points better facilitate consumer discernment between healthy and less healthy products than either the DVs currently mandated by the NLEA or no reference information at all. Their findings also reveal the potential for DVs to cause consumers to form incorrect conclusions about a product's nutritiousness. The authors draw implications regarding the provision of reference information on product labels as a means of attaining public policy objectives.

Through a content analysis, the author identifies several patterns in direct-to-consumer prescription drug print advertisements. In general, many of the advertised brands are market leaders within their therapeutic class, are targeted at a broad patient base, and are relatively new drugs used for chronic and frequently occurring diseases. Most of the disease states and associated symptoms and treatments for which prescription drugs are advertised to consumers are easily understood relative to other diseases. Thus, the advertisements attempt to communicate information about diseases and products that consumers are likely to understand. Pharmacists’ assessments of advertising information content reveals that the majority of advertisements present a “fair balance” of benefit and risk information but occasionally omit information that may be useful to consumers. The author concludes by discussing public policy and social marketing implications for the FDA, pharmaceutical manufacturers, and medical advertising agencies.

The authors explore the appropriate utilization of health services—specifically, emergency department services—by consumers with varying levels and types of insurance coverage. The assumed appropriateness of insured consumers’ utilization behavior has been central to key analyses of health care reform proposals in recent years. The authors’ results, derived from the 1992 National Ambulatory Medical Care Survey, suggest that this assumption is flawed, which leads to questions regarding the efficacy of policy evaluations premised on this and related assumptions. Uninsured patients and those with various types of insurance coverage all have high rates of inappropriate emergency department utilization. Compared to the uninsured, Medicaid patients have a higher rate of inappropriate usage, whereas HMO and other prepaid patients have a lower rate of inappropriate utilization. In view of this study's findings, a reexamination of the various health care reform proposals using a revised set of assumptions may yield decidedly different policy recommendations and implications.

Smoking cessation has been examined from several perspectives, including psychological, physiological, and pharmacological. The author takes a sociological approach by examining quitting smoking as an adoption/diffusion process. In particular, adoption of quitting is seen as the equivalent of disadoption of cigarettes. As such, quitting represents a diffusion process, a social phenomenon that is viewed in considerably clearer focus when quitting among adults is segregated from cigarette adoption among younger persons. Three 10-year age cohorts, now ages 45–54, 55–64, and 65–74, are examined over time to isolate quitting behavior from smoking initiation during the teenage years. The results show good conformance to both adoption and diffusion theories. These theories, in turn, offer insights into limitations of the quitting process, forecasts of long-term quitting, and evaluation of segments of smokers that are expected to exhibit varying degrees of resistance to quitting. The author discusses implications for the communication of cessation messages and segmentation of potential quitters.

It is the policy of the United States as a whole as well as the individual states themselves that children receive the appropriate immunizations at the proper ages. Public health officials in Oklahoma used a marketing campaign to increase the likelihood that parents would have their children immunized by age two. The Due By Two campaign, spearheaded by the Oklahoma's first lady, Rhonda Walters, was a unique part of a nationwide effort aimed at increasing childhood immunization rates. The authors examine the results achieved and the cost involved in the Oklahoma campaign.

Elderly consumers are often without adequate social support. Shopping habits may have significant implications for these consumers’ mental and physical welfare. When shopping is seen, at least partly, as a social activity, consumer-market interactions become a widely available substitute for true or traditional social support. By introducing the century-old social support literature and Integrating it with more recent consumer behavior and relationship marketing literature, the authors propose a conceptual framework that delineates the consumer health implications of shopping behavior. On the basis of this diverse literature, they propose several testable propositions. Additionally, they discuss public policy implications and future research directions.

The authors examine consumer survival on welfare within the context of a history of modern welfare policy that demonstrates its cyclical nature. They delineate an analysis of poor families’ consumer needs, paying special attention to health and nutrition, which are affected by the two largest government programs in these areas—Medicaid and the Food Stamp Program. The authors conclude with consumer-based policy implications designed to meet the requirements of financially disadvantaged families.