28 September 2015

A note on social media campaigns

I've previously noted my disdain for "awareness" campaigns, of most any type. They are usually harmless. For instance, a childhood cancer campaign involves changing profile photos to those of superheroes. This is fairly benign. Kids usually like superheroes (so do adults, obviously). And there isn't usually a way to do a lot of early detection and interdiction for children and cancers, so we're stuck trying to figure out how to treat it (or if we should, which is even more horrifying to contemplate). So any campaign "increasing awareness" is liable to fund useful research somewhat more rather than funding more "awareness campaigns".

They also are not typically that helpful. It is better that some number of young people are aware of the existence of Boko Haram or the LRA and their activities in Africa. But that has little to say about what we can or should do about those as problems. It was likewise amusing (if typically wasteful) that some number of people learned something about ALS through dumping buckets of ice water on themselves. Whether or not that will materialize into a substantive improvement in the well-being of the people afflicted with it, or future persons, is much less clear. I at least credit people their intentions may be good even if their efforts are shallow and unresponsive to the deeper issues at stake.

Where I see some more recent annoyances is the yearly campaigns involving weird status games on facebook and "breast cancer awareness". Firstly, the status games themselves can involve some insensitive and even harmful postings. Posting a fake pregnancy announcement, a fake sexuality announcement, a fake marriage announcement, and so on, these are not things sensible people should do. Whether or not they "have good intentions". These are potentially quite harmful and at least annoying to say: couples who have experienced infertility or miscarriages, couples that are no longer couples, and maybe people who are in the closet about their sexuality (or gender for that matter). I'm not saying you can't post it, but I am saying I'm going to look askance at the people who do as though they have a problem. Because it seems to me that they might need a few explanations about the nature of reality.

In general, few people are concerned with toilet-related mishaps that they should be shared either. While I'm sure a percentage of the public thought those were amusing, they weren't very interesting amusements. For instance, that video of the Massachusetts man freaking out at seeing a sunfish, that was indirectly interesting, on top of being a series of crazy accented speech and expressions that lends itself to being easily copied for more ordinary purposes than ocean going voyages and the encounters those lend themselves to. Despite these flaws, I do not think people are posting such things maliciously and with the intention to cause grievous harm or annoyance to people like me.

Where I think the biggest problem here is that "breast cancer awareness" is already well past the saturation point. Much of the empirical evidence on treatment and detection of breast cancer suggests that any benefit from "additional awareness" is getting cancelled out by unnecessarily worrying people and of course, the unpleasant varieties of treatment that we subject women to upon detection. We are all pretty aware by this point that women have breasts, and some women tend to get breast cancers. So this kind of awareness should not be a major concern for charitable work or social awareness campaigning and the like. Many of these public campaigns are effectively more about this "awareness" activity than they are about the treatment and detection of cancer.

What is of more pressing concern is likely research into better screening methodologies (genetic screening data for example seems promising), and research into better and more effective treatment for those cases that require treatment, in particular for advanced cases. These are not things that can be directly provided through "awareness", and in some cases are not really available or fully in use yet. What happens by increasing awareness, but without any accompanying campaign to donate to such research as would be needed to make our work in this area more effective, is that a lot more people are aware of what we already do and are presented with the social requirement to enter into it out of habit. Which isn't that helpful at all. Indeed, I think it may be quite harmful on balance. I'd say we could use much less awareness of mammograms and for many women breast cancer screening in general (possibly cancer screening of any kind for many is a waste of time and money).

The false positive rate is way too high to be a useful test for many women which we use it on. There are specific cases where it may be quite useful, but the general public isn't going to know that when they, as people have quite vigorously in the past when discussing the flaws of this processing during debates surrounding the ACA, will insist on receiving such treatment in spite of its general futility. The general practice of screening some millions of women in this way annually seems to be saving perhaps one life in a thousand and subjecting several dozen, perhaps as many as a hundred other women per thousand to the kinds of worrying and stress over medical matters that isn't provided by checking WebMD every time you have a medical problem and nearly as many women as those who die of breast cancer without treatment are subjected to unnecessary (and expensive, both in money and well-being) forms of treatment for no apparent reason what so ever. That seems like a tremendous waste of a general awareness campaign to expend vast amounts of human energy and effort upon. A more focused campaign rather than general call saying something like "hey what about breast cancer!" would be much more constructive.

As I said with the ALS ice bucket campaign, this is a serious problem. Some thousands of women will be afflicted by breast cancer every year. Some thousands will die of it. We should have some level of seriousness in our social response to this, even if there is some humor injected into it. It should also be less about demonstrations of awareness, which unlike ALS, I think we're quite well aware of this as a problem as a society, and more about direct demonstrations of concern and aid to the problem as it exists now.
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