I am, as the saying goes, "actual millennial trash". This means I don't buy diamonds or eat cereal for breakfast and that people seem to be obsessed with how, where, and why I use social media. Why what is called a generation of "entitled narcissists" refers to itself as "trash" and "garbage" I don't know, but it amuses me just as much as attempts to appeal to my generation through social media amuse me.

It seems that social media has become so vital a platform for reaching my generation that in addition to businesses using it as an advertising outlet (see: my favorite example of this, the Denny's tumblr account) various health organizations have also incorporated it into their health communications campaigns. Some excel at this, but others leave me staring at the computer and crying in silent laughter at how horribly they miss the target.

dress: Matilda Jane Clothing cardigan: taken from my mom's closet socks: H&M shoes: Dr. Martens

In a departure from work outfits - and fitting in with this post I think - I'm sharing a Sunday brunch outfit. The wrinkles are part of my "I'm a grad student and everyone else in this restaurant is still hungover" aesthetic. This kind of outfit is generally what I put together when I get dressed in 5 minutes right after I wake up, which seems like a pretty millennial thing to do when a lot of us are working multiple jobs and involved in many different activities while also constantly keeping up with current events and networks on social media.

I'd like to start with the campaign that inspired this post, The Real Cost. One day I was scrolling through my tumblr dashboard as usual and happened upon a sponsored post from a blog titled "Know the Real Cost". For those who don't know, tumblr is a microblogging platform, and half of its user base is under 25 years old. The dashboard is the curated "front page" for a user, where followers view content posted by the users they follow (like the homepage of Facebook or the Twitter feed). Since tumblr's buyout by Yahoo in 2013, sponsored posts now show up on users' dashboards. These posts are not from people users are following, but from whatever companies decide to pay for advertising space on tumblr.

The Real Cost is an FDA-run campaign aimed at youth ages 12-17 who are open to trying smoking or who are already using tobacco products. In short, its goal is to prevent teenage tobacco use. It does this through a series of commercials, a website (where you can play a game where you shoot teeth to show the damage cigarettes can cause), an instagram, a Facebook page, and this rather hilarious tumblr.

Actual image from knowtherealcost.tumblr.com

The photo above is what originally attracted me to the page, and it was from the tumblr that I discovered that The Real Cost is run by the FDA and they hired someone who thought that this image appealed to ages 12-17 and would help prevent smoking. Obviously, I'm outside the target demographic, but the fact that this image exists made me struggle not to laugh out loud at my computer in a public place. On the one hand, I'm glad that the FDA is still trying to prevent tobacco use among teens and is doing so through social media, especially after the failure that was the My Anti-Drug campaign. On the other hand, how does this image and others like it on the blog prevent tobacco usage? I don't care if a cat with an eyepatch is judging me, or if a cookie loses chocolate chips, or if smoking will make me look old enough to get a senior discount. Actually, the last one might be a positive because then my rebellious and at-risk 12-17 year-old self could potentially get away with purchasing cigarettes and maybe alcohol by myself.

This blog and others like it make it clear that those trying to reach that tricky millennial demographic are making real attempts to do so, but for the most part are just barely missing the target. In the case of this tumblr, the FDA is clearly trying to use meme culture and internet culture at large to appeal to millennials, but ends up just sounding like a middle aged parent trying to sound hip and using slang incorrectly. Cat memes are pretty much only used on Facebook nowadays, and even then for the most part they are used either ironically or by Facebook "wine moms". The same goes for cake wrecks, and while "MFW" and "MRW" ("my face when" and "my reaction when") are still en vogue, whoever is running this tumblr seems to have missed that now those captions are generally coupled with either ironic or extremely literal photos.

Maybe I'm being overly critical. After all, their online pages are only part of the overall campaigns, and it's clear that much more money is being spent on video content. Still, I think if an organization like the FDA or the CDC is going to use social media to reach millennials, they might want to spend a little more time on research, or failing that hire an actual millennial who spends a lot of time on their target websites within their target communities. There's not much data on the efficacy of The Real Cost, other than that 89% of its target audience was aware of the campaign's existence within its first six months, but I hope that unlike My Anti-Drug, this campaign and others like it will at least not encourage its target audiences to smoke.1,2

Thankfully, divisions of the Department of Health and Human Services do have some social media campaigns that I think are really well done. This Free Life, another smoking prevention campaign run by the FDA and targeted towards LGBT young adults aged 18-24, has a tumblr and website that come much closer to hitting the mark. They use real people and real experiences, as well as pop culture figures. I've been told those drag queens are contestants on RuPaul's Drag Race - which I don't watch because I'm not a fan of reality shows - but I know is really popular amongst the campaign's target demographic.

from @ActAgainstAids on instagram

The fantastically named "Doing It" campaign, which is part of Act Against AIDS and run by the CDC, is aimed at encouraging HIV testing among adults, and posts punny images to instagram like the one above, as well as equally punny tweets under the Twitter handle @TalkHIV. I especially like that they often reframe HIV testing as an issue of personal health responsibility and a sign of respect in a relationship in an attempt to destigmatize HIV/AIDS. One of my favorite CDC-run social media accounts is the Twitter account @CDCSTD, which also does this, in addition to posting STD facts. On May 4th, that account - and individuals within the CDC - post hilarious and punny Star Wars themed tweets that also relate to health.

Unfortunately, I couldn't find any data on the effectiveness of any of these social media campaigns, although it's entirely possible that they're too new for there to be any data. However, I can say that I love the use of social media by individuals, especially CDC director Dr. Tom Frieden and Surgeon General Dr. Vivek Murthy. Both tweet health facts, but they also engage with the public. In particular, during the Step It Up! Challenge late last month, which had the goal of encouraging Americans to walk more, Dr. Murthy tweeted his step count and challenged others to get in more steps than him. However, their follower counts are currently 104k for Dr. Frieden and 82.7k for Dr. Murthy. For a better visualization of the scale of Twitter fame, Kim Kardashian has over 48.9 million followers, NASA has 19.7 million, and the director of the upcoming third Thor movie, Taika Waititi, has a follower count of 95.4k. I know there are much more important things these men have to do than tweet, but it's still interesting to see what kind of a social media presence they have. After all, both men are the faces of public health in the United States.

Social media seems to be here to stay (well, except for Vine...) and I believe its use by the Department of Health and Human services is an important part of health communication, but I hope it grows to be more effective than it is currently. I understand budget constraints are difficult to deal with, and in that respect health organizations will likely always be at a disadvantage when it comes to things like tobacco prevention campaigns, and I understand that there are certain rules when it comes to using social media as a method of health education and communication. Still, I also believe there are ways to use social media wisely for maximum impact, and there is still much room for improvement. I suspect it may be difficult for the FDA and CDC to get young social media and marketing minds - after all, they have student loans to pay off and there's money to be made working for companies like Buzzfeed and YouTube - and it's expensive to hold focus groups and spend time doing lots of marketing research. I still like to think there's hope for HHS and its divisions when it comes to reaching young people. After all, they are at least trying.

1. Duke JC, Alexander TN, Zhao X, Delahanty JC, Allen JA, MacMonegle AJ, Farrelly MC. Youth's Awareness of and Reactions to The Real Cost National Tobacco Public Education Campaign. PLOS One. 10(12): e0144827. doi: 10.1371/journal.pone.0144827
2. United States Government Accountability Office. "Contractor's National Evaluation Did Not Find That the Youth Anti-Drug Media Campaign Was Effective in Reducing Youth Drug Use". http://www.gao.gov/new.items/d06818.pdf