Cultural Fluidity and Healthcare Marketing–The New Reality


The face of America is changing. For healthcare marketers, this new reality is creating unprecedented challenges in strategy: First, how do you connect with diverse populations when the cultural hallmarks that have long defined them are no longer valid? And how do you stay relevant when minority influences are becoming mainstream, transforming culture and consumption patterns?

Cultural fluidity is the new reality. Healthcare marketers are now faced with an opportunity and a challenge. Traditional strategies, which focus on speaking to consumers within the market majority and then filtering for ethnicity, have become outdated and ineffective. Businesses outside healthcare are light-years ahead in terms of reaching diverse populations and are effectively setting new standards in messaging while reaping the benefits. Likewise, healthcare marketers must find commonalities between ethnic segments and the mainstream market in order to meet consumers on their own terms.

Health systems and others in the integrated healthcare ecosystem must deploy messaging that reflects a more sophisticated understanding of the diverse populations within their communities. These may include bilingual caregivers who were born in the U.S. but whose parents are native to Mexico. Or the elderly African Americans who suffer from a higher rate of hypertension and associated complications than their white peers. An over-reliance on stock photos showing people of color or simply translating copy into Spanish will no longer cut it when it comes to messaging effectively.

The New Americano

The current demographic trends underscore the fact that we are experiencing a mainstream transformation. Non-Hispanic whites no longer dominate the census results. Look at the findings: The U.S. will be a minority-majority country by 2045, a time when Caucasians will represent slightly less than 50 percent of the population. Non-Hispanic whites may represent 60 percent of the population today, but by 2060, that number will shrink to 43 percent. By that time, Hispanics will represent nearly a third of the country.

Driving these changes are young people. Pew Research reveals that 17 percent of all U.S. newlyweds in 2015 were mixed or interracial, a five-fold increase from 50 years ago. The most common pairing is between a white spouse and a Hispanic. Babies of color are already the majority; one in seven U.S. infants were multiracial or multiethnic, nearly triple the amount since 1980.

The Millennial generation is leading the change in diversity. Nearly half (44%) of the largest living generation in the U.S. today is non-white and over one-fifth (22%) is Hispanics. But in some of the most diverse areas of the U.S., Hispanic Millennials are already the majority. In Los Angeles, Hispanics make up 54% of the Millennial population while Asians comprise 11.5% of this group. Importantly, many Millennials are already in their 30s, having children and making healthcare decisions for themselves and their extended families.

Cultural Fluidity

We are already seeing how these demographic shifts are permeating our culture. BTS, a Korean boy band, reached No. 1 on the Billboard 200 chart. “Despacito” was already a mainstream hit in 2017 with only Spanish lyrics well before Justin Bieber added his English intro to send the song charting into the stratosphere. In 2018, songs featuring Cardi B, Demi Lovato and Selena Gomez singing in both Spanish and English topped the Billboard charts. Black Panther, Coco and Crazy Rich Asians, all films featuring diverse casts or themes, smashed box office records. Even more telling, Nielsen reports that multicultural Millennials spend over $65 billion each year and influence more than $1 trillion in total CPG and entertainment spending.

The influence of multicultural Millennials on mainstream culture now runs deep. Because the majority of English-speaking Hispanics are bilingual, it is not uncommon to find a Latino household where adult caregivers enjoy watching a favorite telenovela with a senior parent, as they hit their phone to place an Amazon order in English, while listening to mainstream Top 40 radio.

How many healthcare organizations are reaching these consumers with a cohesive brand narrative across both general market and ethnic media channels? The answer is not many. Clearly this suggests an opportunity to reach diverse populations in real time as they play a greater role in healthcare purchasing decisions. Hispanics, like other non-white groups, are not monolithic in their tastes, beliefs, interests and passions. Cultural identity no longer flows in one direction, from the majority population down to diverse pockets in the community. Rather, it is fluid, moving across many cultural influences pulled from different ethnic cultures and experiences. LGBTQ groups are not excluded from this fluidity movement. They are an important part of the mix for many healthcare organizations and major consumer brands as well.

Cultural Infusion

Back to those Hispanic caregivers. To reach them, hospitals, payers and others have traditionally lumped them into a catchall multi-cultural strategy, which did nothing to address their individual needs or challenges. But with cultural influences transforming the mainstream, healthcare marketers have a new imperative to go beyond that approach. Communication strategies must be established that reflect the nuances of the multigenerational, bilingual homes in the communities they serve. Messaging should be created to address the health disparities that challenge ethnic communities. This includes increased rates of diabetes in Hispanics or high blood pressure among African Americans. The most effective approaches look at diverse communities for what they have in common, then fine-tune the messaging by tailoring to their respective nuances.

We call this the Cultural Infusion℠ approach. Cultural Infusion takes into account the social determinants, education levels and mindsets of the various ethnic groups targeted by healthcare marketers. For example, some groups may have a more fatalistic attitude about their health and not fully understand the implications of an A1C number. Or they may live in a food desert, without easy access to more healthful meal options. The messages for these audiences must still be based on a core human truth, but adding educational and grassroots awareness efforts for these populations is a crucial component for success.

What people share, of course, is the desire for wellness, freedom from pain, and the chance for a long and purposeful life. But how will varied cultural experiences influence these desired outcomes and a consumer’s healthcare journey related to coverage and care? The answer will depend on the group you’re talking to. However, one thing is certain. With the fusion of general market and multicultural audiences in America, a more sophisticated approach to address consumers in a culturally authentic way will give a tremendous advantage to those healthcare marketers who choose to embrace it.

David Maricich is president and COO of Maricich Health, located in Irvine, California. Visit

The culturally diverse team at Maricich Health collaborates with health systems, payers and other healthcare marketers to find core human truths that will resonate cohesively across diverse audiences. Learn more about our Cultural Infusion approach and how we can help you reach diverse populations within your market area.