Lessons About Subsistence Consumers-Patients from The Wall Street Journal
Source: Emerging Lessons By Madhubalan Viswanathan, José Antonio Rosa And Julie A. Ruth. WSJ. Oct 20, 2008.
The subtitle, For multinational companies, understanding the needs of poorer consumers can be profitable and socially responsible, limns the focus of the article. My contention is that the concepts available from this piece, while targeted to multinational companies dealing with “people in developing nations like India who earn just a few dollars a day and lack access to basics such as education, health care and sanitation,” are also applicable to healthcare provided to low income and low health literacy patients by clinicians in, say, northern Illinois.
To illustrate, I’ve listed a few excerpts from the article. It’s the usual drill – translate the following into healthcare-ese (e.g., change words like “consumers” to words like “patients”). Even if you haven’t done this before, don’t worry – it’s easy.
… One of the key observations we made is that low-literacy consumers have difficulty with abstract thinking. These individuals tend to group objects by visualizing concrete and practical situations they have experienced.
… Being anchored in the perceptual “here and now” also interferes with the ability of low-literacy consumers to perform mathematical computations, especially those framed in abstract terms. For example, when we asked low-literacy shoppers in the U.S. to estimate whether they had enough cash to pay for the groceries in their cart, many needed to physically handle cash and envision additional piles of currency or coins to accurately estimate the cost of goods in their cart; when the sensorial experience of counting cash was taken away, they often were at a loss.
… One of the most potentially detrimental results of concrete thinking, however, is the difficulty that low-literacy consumers have with performing price/volume calculations. They tend to choose products based solely on the lowest posted price or smallest package size, even when they have sufficient resources for a larger purchase, because they have difficulty estimating the longevity and savings that come from buying in larger volumes. Some base purchase decisions on physical package size, instead of reported volume content, or on the quantity of a particular ingredient — such as fat, sodium or sugar — but without allowing for the fact that acceptable levels of an ingredient can vary across product categories or package size. They tend to think in pictures, so any change in visual cues such as sign fonts, brand logos or store layouts can leave them struggling to locate a desired product category or brand. Price displays can cause confusion because of the many numbers presented, such as original prices, discounted percentages and discounted prices.
… When shopping in familiar stores, many low-literacy consumers buy only the brands they recognize by appearance or have purchased previously. While this approach reduces the incidence of product purchases for which the consumer has no use, it precludes the adoption of new and improved products as a category evolves and improves over time.
… To win and enhance customer loyalty in developing markets, manufacturers and retailers need to understand the difficulties faced by low-literacy consumers and create shopping environments that make them feel less vulnerable. Here are a few ways that companies can help customers make better purchases and avoid embarrassment:
- Display prices and price reductions graphically — a half-circle to indicate a 50% markdown, for example, or a picture of three one-dollar bills to indicate a purchase price of $3. Price products in whole and half numbers to make it easier for low-literacy consumers to calculate the price of, say, two bags of rice. These pricing practices are critically important in marketplaces where general stores and kiosks are being replaced by self-service stores, where there is less interaction between customer and store owner.
- Clearly post unit prices in common formats across stores, brands and product categories to make it easier for low-literacy consumers to perform price/volume calculations.
- Include illustrations of product categories on store signs to make it easier for low-literacy consumers to navigate new or refurbished stores. Similarly, use graphical representations of sizes, ingredients, instructions and other information to communicate product information more effectively in shelf and other in-store displays.
- Put the ingredients required for the preparation of popular local dishes in the same section of the store. This would be helpful to low-literacy consumers who often envision the sequence of activities involved in fixing specific dishes to identify the ingredients and quantities they need to purchase. The same can be done for other domestic tasks.
- Incorporate familiar visual elements — such as color schemes or font types — into new store concepts or redesigned brand logos to minimize confusion and anxiety among low-literacy shoppers and increase the likelihood that they will try new products and stores.
- Create a friendly store environment by training store personnel to be sensitive to the needs of low-literacy shoppers and by verbally disclosing and consistently applying store policies. In addition, allow employees to form relationships with consumers by learning their names and offering small amounts of individualized assistance. This is particularly important for global brands and companies entering markets where foreigners are mistrusted or have accrued a history of mistreating people.
This is yet another case in which those of us in the healthcare community can learn (and borrow) from methodologies developed by those in other fields.