Grey has been helping its clients speak the language of culture for decades. Cultural insights overlaid with behavior have driven Famously Effective Ideas for our clients, solved business challenges and changed the perception of brands and categories. A rapid change in consumer and physician behavior, particularly in the last year, has significantly elevated the need to account for cultural impacts, especially in healthcare. In rethinking how externalities impact cultural relevance, we are afforded a new lens on our foundational approach toward marketing.

Within the broad health and wellness space, marketers historically base their strategic decisions at an individual level, ignoring the macro environmental and culture implications. Our current thinking and approach are centered around getting to that one special insight or nugget that is focused on the individual.

This approach has one fundamental flaw: It tends to disregard the impact of the world the decision maker lives in, the culture that directly and substantially influences their behavior. 

At its essence, culture exists at the micro individual level, meso-community level or ultimately the macro level. While culture may be predominant in varying degrees across any of these levels, its impact will have a ripple effect across all three. It can be as specific as the culture around a disease, or simply the results of communal dynamics that impact overall human health needs and habits. The COVID-19 global pandemic has made the necessity of understanding these imperatives at a strategic and executional level a matter of vital importance. 

Simply “knowing” isn’t enough. To truly understand the influential factors of culture, we need to identify the forces that are shaping, driving and evolving the culture. At Grey, we call the most powerful forces, whether direct or indirect forces, the Culture Keepers. And we think about the Culture Keepers as those who influence the cultural influencers. 

Culture Keepers, unlike traditional influencers, aren’t always people; they can be a trend, philosophy, a belief, a religion or even a global pandemic. It is the impact on category overall that changes the lens on brands, treatments, care, category and consequently the overall decision-making processes and, ultimately, their experience. The influence they exert can be positive or negative, but in the end, they are critical and omnipresent. 

In the healthcare space, Culture Keepers have largely been ignored but have been quietly impacting decisions and trends for decades. The current pandemic has significantly elevated their impact, and Culture Keepers have started transcending digital and social channels to change perceptions and alter “reality” despite data, insights and experiences. There are a number of instances across the healthcare space where the influence of the Culture Keepers is running rampant. 

BREAST CANCER: Misplaced perceptions driving category beliefs.

As far as cancers go, breast cancer has been associated with a culture of positivity and hope and almost a sense that it is a “good cancer.” While the therapeutic advancements are a key component of this, ask patients and it is obvious what the Culture Keeper is: the Susan G. Komen foundation and the narrative that it has propagated. There is no denying the impact the foundation has had, not just in terms of patient support but also clinical development. 

However, when you talk to patients with metastatic breast cancer or even triple negative breast cancer, they tend to express a disconnect and relative annoyance with the foundation and its narrative. This is largely due to the fact that this narrative is tied into the dynamics associated with early breast cancer, where outcomes are fantastic, and cure is within reach. For any product or brand launching within the breast cancer space, accounting for this Culture Keeper is imperative, for without doing so it risks coming across as superficial, out of touch with real needs and inauthentic.

PHARMA EQUITY: Standing up and making the corporate image matter.

Pharmaceutical companies have long been vilified, with most accused of subverting widespread access to healthcare. Yet, despite many pharma companies’ best attempts at heralding all the good they do, even the most well-known corporate reputation campaigns were not enough to combat the Culture Keeper: a pervasive belief that pharma companies put profits over patients, exacerbated by years of misattributed global media coverage. The COVID-19 pandemic shifted the reputational fate of the pharma industry on March 12, 2020, when the world awoke to the news that Pfizer was not only going to pursue a vaccine for COVID-19, but openly communicated that it was lowering its walls and inviting competitors to become collaborators — united as one to save humanity. The resulting Science Will Win campaign took a brand name that often found itself in the crosshairs of negativity and heroicized it to everyone from the industry’s harshest critics (key physicians and opinion leaders) to its biggest skeptics (patients and their caregivers). 

We’re now seeing an overall sea change, where pharma brands have pervasively entered the dialogue — taken into greater account when HCPs are making treatment or prophylaxis decisions and when consumers are now asking for treatment by the manufacturer brand, not product brand, name. In turn, Pfizer has actually become the new culture keeper: the company that put the first truly human face on pharma.

As we cautiously yet optimistically come out of the pandemic, marketers will have to face a true reckoning as they encourage brands to make an impact. We believe that there are five key factors that every marketer should consider when identifying and addressing their Culture Keepers:

·  Teasing out the environment vs. culture: Look at the world your customers are living in and then identify why that world exists. 

·  The cultural polarity that exists: Is the culture positivity- or negativity-driven? The answer forms the very foundation of how we will identify the impact that the Culture Keeper will have on the brand.

·  Determine the Keeper: The Culture Keeper could be an ideology (e.g., anti-vaxxers and vaccination), a person and organization (Susan G. Komen and breast cancer) or simply any force that you believe to be the primary factor constantly shaping and influencing culture.

·  Absolute vs. relative impact of the Culture Keeper: Here we ask how representative the Culture Keeper is of our customers and what their exact level of influence and control is. 

·  Customer engagement dynamics: At a very tangible level, we will need to understand how the Culture Keeper influences brand and customer interactions. Knowing and addressing the Culture Keeper will not serve any purpose unless brands pull through their strategic approach at a customer experience level. 

As marketers now move into this post-pandemic era, accounting for these five factors and identifying the Culture Keeper will be more vital for brand success than ever. It is clear that we are entering an era where cultural influences and influencers will take on a more important role in shaping healthcare, the customer habits that drive it and the end consumer reaction. Identifying and directly addressing these Culture Keepers could hold the key to successfully developing enduring brand strategies that set a foundation for short- and long-term success.