VOLUME V ISSUE 7

CULTURE
WHAT DRIVES
DECISION-
MAKING
IN HEALTH
CARE?
HEALTH
MARKETING

AND ACCULTURATION
HISPANIC
CAREGIVERS
HOW TO
REACH
HISPANICS
WITH HEALTH
MESSAGING
THE FUTURE OF
HISPANIC
HEALTH
2 THE AXI S AGENCY | CULTURE MAGAZI NE
Despite recent progress in improving Hispanics
access to quality health care, according to
the Agency for Health care Research and
Quality, ethnic disparities continue to persist
with Hispanics falling further behind other
ethnic groups.

More than 30 percent of Hispanics in the U.S.
lack regular access to health care. The CDC
shows that Hispanics are about twice as likely
as non-Hispanic blacks and three times as
likely as non-Hispanic whites to lack access to a
regular health care provider. We know Hispanics
are a growing community and as such we need
to explore not only their access to health care,
but also their sources of health information and
knowledge of key diseases. Studies show that
those most likely not to see a doctor are men,
the young, the less educated and those with no
health insurance. We also know that foreign-
born and less acculturated Hispanics are even
less likely to go for medical treatment. At the
same time, more than eight in ten Hispanics
report receiving health information from media
sources such as television and radio, according to
a Pew Hispanic Center study. About seven in ten
Hispanics also report they received information
from a doctor in the past year. The question
remains, however, how many Hispanics obtaining
health information from media and other sources
are acting on this information?

The Afordable Care Act could be the key to
help uninsured and underserved Hispanics
get access to regular health care through the
laws expansion of Medicaid and the creation
of the health insurance exchange marketplaces
that provide tax credits to help people with
a moderate income purchase coverage. By
understanding whats in the law, Hispanics can
make better health care choices for themselves
and their families. The ACA represents an
important milestone toward the ultimate goal of
changing the disparities in health and health care
in the U.S.
Armando Azarloza
President
AXIS
THE CHANGING
LANDSCAPE OF
HEALTH CARE
THE AXI S AGENCY | CULTURE MAGAZI NE 3
Clorox Nurses Network
Case Study
Kaiser Permanente
Case Study
A New Beginning
16
18
20
Covered California
Case Study 14
8
HOW TO REACH
HISPANICS
WITH HEALTH
MESSAGING
THE FUTURE OF
HISPANIC HEALTH
HISPANIC CAREGIVERS
HEALTH MARKETING
AND ACCULTURATION
WHAT DRIVES
DECISION-MAKING
IN HEALTH CARE?
4 6 8
12 10
THE FUTURE OF
HISPANIC HEALTH
PREVENTIVE CARE
Preventive care is a gateway to health.
It includes a collection of services that can
quite literally save a life and greatly improve
the quality of life. Preventive care allows
physicians to focus on the patients total
well-being, imparting the knowledge and
recommendations they need to live happier,
healthier lives. Preventive care is also the
stage of care where patients are likely to
gain a better understanding of basic health
practices and disease management.
Traditionally, Hispanics have been less
likely to receive preventive care, in great
part due to lower incidence of health
coverage, but also due to lower health
and health care literacy. The ACAs
emphasis on preventive care will make a
signicant diference in the future health
of Hispanics especially as it pertains to
diabetes and obesity, conditions which
disproportionately afect this population.
Diabetes is the fth leading cause of
death among Hispanics in the U.S. and the
leading cause of heart disease and stroke.
Hispanics are almost twice as likely to
develop type 2 diabetes compared to the
Non-Hispanic population. At present, it
is estimated that 10 million Hispanics (20
and older) have diabetes and many more
are undiagnosed. Many are at risk for the
disease, but dont take steps to prevent
it. Particularly distressing is the projected
future of this disease. It is estimated that
nearly half of all Hispanic children born in
200 wil develop diabetes.
Access to regular preventive care,
including check ups and screenings, will
help Hispanics recognize and understand
their diabetes risk as well as get diagnosed
and treated. More importantly, it will help
them understand pre-diabetes - that
addressing it with a simple diet and
exercise can greatly reduce their risk
of it developing into type 2 diabetes.
Obesity is also of major concern in the
Hispanic community. About a third of
Hispanics (18 and older) are obese and
another third are overweight. Moreover,
close to 40% of Hispanic children and
teens are considered obese or overweight,
putting them at greater risk for diabetes
and heart disease. Unfortunately, many
Hispanics tend to underestimate their
weight and do not consider themselves to
be overweight or obese, as dened by the
CDC. Often gorditos (an endearing word
in Spanish for chubby) are simply deemed
cute and a woman with curves is naturally
considered womanly. Of particular
concern is that these individuals are less
likely than non-Hispanics to understand
the health risks of being overweight.
4 THE AXI S AGENCY | CULTURE MAGAZI NE
The Afordable Care Act (ACA) is making quality, afordable health care coverage accessible to
an estimated 10 million uninsured Hispanics. This previously unprecedented access for the group
with the least access (nearly 1 in 3 uninsured) has the potential to write a whole new future for
the Hispanic community due to its emphasis on preventive care and provisions for heightened
cultural competency.
By: Alice Rivera
About a third of
Hispanics (18 and
older) are obese and
another third are
overweight.
Greater access to preventive care will
help Hispanics better manage their
health conditions and prevent them from
worsening or developing complications.
With 34% of Hispanics under the age
of 18, heart disease is less prevalent in
this younger community versus other
ethnic groups. However, when one
takes into consideration the higher
prevalence of obesity and diabetes in the
community, their cardiovascular future
seems uncertain. The ACAs emphasis
on afordable preventive care can help
transform this future.
CULTURAL COMPETENCY
Hispanics in the health care system
often report feeling as if their doctors
dont understand or listen to them,
dont spend enough time with them,
and dont explain things so that they
are easy to understand. Language barriers
might be partially at fault here, but there
are also cultural barriers. Almost one in
four Hispanics report having received
poor quality medical treatment and
attribute it to their nancial limitations,
their ethnicity, or the way they speak
English. With the new inux of Hispanics
into the health care system under the
ACA, it becomes even more critical that
the health care system is prepared to
address the needs of Hispanics in a
culturally sensitive manner.
This is why the ACAs provisions
for diversifying the health care
workforce (which sufers from an
underrepresentation of Hispanics) and
strengthening its cultural competence
stand to make such a diference in the
Hispanic community.
Marketers should note that cultural
competency goes far beyond language.
To better provide efective health care
solutions, medical practitioners and
marketers need to understand Hispanic
family dynamics and the cultural
traditions and mindsets that afect their
attitudes and behaviors towards health
and health care.
Understanding family dynamics begins
with recognizing that Hispanics make
health care decisions as a family unit.
This is compounded by the fact that
Hispanic families tend to be larger, with
more children living in the household, and
they are more likely to serve as caregivers
to elderly parents or other relatives,
who may also live in the household.
Health practitioners and marketers that
recognize and leverage the Hispanic
familys involvement in the care of an
individual will experience greater success
with this community.
THE FUTURE
The market is abuzz with health and
wellness dialogue. It is taking place in
the media, at community forums and
among families and friends. And as tends
to happen in the Hispanic community,
word of mouth will also play a role. As
more and more Hispanics embrace this
world of preventive care and discover
better health opportunities, others will
follow. This groundswell of education
and understanding will have an impact
beyond those directly afected by the
ACA to include those that have been in
the health care system, but may not have
been optimizing their use of preventive
services or getting the right attention.
This is how the ACA stands to benet
the Hispanic community at large. The
immediate and most logical beneciaries
are the newly insured, but those already
insured will also benet from the
improvements in the system with better
access to afordable preventive care
services and culturally competent care.
We are witnessing the beginning of
a movement that will revolutionize
Hispanic health and wellness. This
movement will rst improve Hispanics
management of chronic health
conditions as well as their ability to
remain healthy. But then, with more
Hispanic young adults and kids
entering the system, new health care
traditions will be established from an
early age. This new attitude toward
health care will push the market to a
tipping point where quality care is the
norm, where diabetes and obesity are
better managed and where Hispanics
in general have a better quality of life.
5 THE AXI S AGENCY | CULTURE MAGAZI NE
Greater access to
preventive care
will help Hispanics
better manage their
health conditions
and prevent them
from worsening
or developing
complications.
6 THE AXI S AGENCY | CULTURE MAGAZI NE
Many factors have historically inuenced Hispanics
health and wellness decisions and behaviors.
Marketers should learn to recognize these factors,
and develop strategies to overcome the roadblocks
that, in many instances, they represent.
Marketers face a challenge of striking a balance
between General Market norms and what Hispanics
learn from their families and individual countries of
origin. Lets examine some of the key factors and
traits to consider:
When compared to the General Market, Hispanics,
in general, share a low level of health literacy.
Recent immigrants in particular tend to be less
knowledgeable than their more acculturated
counterparts.
Hispanics are at a greater risk for a number of
chronic illnesses and diseases. This holds true
despite Hispanics having lower mortality rates
than the overall population.
Hispanics have the highest uninsured rates (32%)
of any racial or ethnic group. This contributes to a
lack of adequate health care.
Hispanics have a permissive attitude towards
dening healthy. The General Market tends to
look at health through the lens of deprivation,
while Hispanics tends to be more permissive in their
dietary allowances. For example, while soda may
be completely eliminated from the General Market
home, Hispanics tend to see sugary beverages as
just one element in an otherwise healthy diet and










part of being a kid.In addition, Hispanics see a
little extra body fat and curves as a sign of good
health; theres less emphasis to have visibly dened
abdominal muscles or size 0 frame.
Hispanics exhibit a diferent approach to exercise.
Attitudes towards physical activity and body
image are also diferent. While the General
Market tends to follow strict tness regimens
(gym memberships, personal trainers, etc.) and
pursue adrenaline-lled activities (mountaineering,
snowboarding, etc.), Hispanics are less intense
about conquering Mother Nature. Instead, theyre
more focused on activities that provide general
mobility, whether its simply going for a walk or
playing with their kids at the park.
Superstitions and home remedies can play a
major role. This is true especially for older, less
acculturated Hispanics. Although many younger,
acculturated Hispanics see home remedies as
antiquated, these healing methods are culturally
approved and also provide a low-cost alternative
to modern medical care.
Hispanic attitudes towards health and wellness impact a range of categories,
from fast food to pharmaceutical, and understanding the Hispanic point-of-
view is becoming increasingly critical to the success of American business.
This article will highlight some of the factors that have historically inuenced
Hispanics and provide key takeaways for marketers interested in reaching out
to the U.S. Hispanic market.
WHAT DRIVES DECISION-
MAKING IN HEALTH CARE?
By: Dennis Demori
Superstitions and home
remedies can play a major
role. This is true especially
for older, less acculturated
Hispanics.
THE AXI S AGENCY | CULTURE MAGAZI NE 7
CULTURAL INFLUENCES
GETTING PERSONAL
When it comes to the health care experience, Hispanics want
a more personal relationship with doctors than Non-Hispanics.
But, only 40% of Hispanics say their doctors understand their
needs and make them feel at ease vs. 55% of Non-Hispanics.
Hispanics are also signicantly less likely to report that doctors
discuss benets and side efects with them (29% vs. 53% of
Non-Hispanics).
Its important for Hispanics to be able to feel comfortable with
medical professionals. For some Hispanics, this comfort level will
come from being able to communicate in Spanish, but it can also
stem from cultural awareness and sensitivity. To supplement
these doctor/patient relationships, Hispanics rely heavily on
other front-line medical professionals, like nurses, pharmacists
and support staf.
WAITING TOO LONG
Culturally speaking, Hispanics tend to be reactive when it comes
to pursuing medical care. They use very little, if any, preventive
care and are less likely to regularly visit doctors before diagnosis.
They also delay their use of medical care when chronic, disease-
related symptoms (warning signs) occur.
There are multiple reasons why Hispanics delay care, ranging
from machismo (the attitude of males wanting to be seen as
strong instead of weak) to fatalism (the idea that our fates are
predetermined and our actions have little impact on outcomes
in life).
WERE ALL IN THIS TOGETHER
Hispanics are heavily inuenced by a seless, collectivist way
of thinking that places the familys needs before that of the
individual. Group activities are dominant, responsibility is shared
and accountability is collective. One example of this attitude is
in the way Hispanics approach taking care of the elderly. Nursing
homes are seen primarily as a General Market method for
elderly care that Hispanics are much less likely to use. Instead, a
number of Hispanics identify as caregivers. These caregivers are
actively involved in many aspects of care beyond medical help,
which include managing nances, grocery shopping, providing
transportation and acting as translators.
Hispanics rely heavily on word of mouth when it comes to
health-related information and guidance. Its not necessarily
because of a lack of trust in doctors (Hispanics tend to trust
authority gures), but because Hispanics tend to place high
value on the opinions of friends and family. Still, this reliance
on social networks can pose problems when Hispanics combine
or substitute professional medical advice for the passionate,
opinionated counsel of a family member.
CONCLUSION
The U.S. Hispanic market is a dynamic, diverse and growing
segment that provides a unique opportunity for marketers who
are able to efectively connect with them. The information in
this article provides a broad and simplied overview of Hispanic
attitudes towards health and wellness. Marketers wishing to
successfully target Hispanics will surely benet from a much
deeper and comprehensive understanding of the many health
and wellness cultural nuances in this group.
Its important for Hispanics to
be able to feel comfortable with
medical professionals.
THE AXI S AGENCY | CULTURE MAGAZI NE 8
By 2020, an estimated 1 in 5 Americans will be Hispanic. This growth,
coupled with the impact of the Afordable Care Act (ACA), will
dramatically change the Hispanic health and wellness landscape.
Historically, pharmaceutical companies and health insurance providers
have not focused on the U.S. Hispanic market. But we are already seeing
shifts in the health care sector as providers look to secure their fair share
of the 10 million Hispanics newly eligible for insurance. Their new eforts
to reach this population are evidenced by increased investments in highly
targeted advertising, health fairs and even community ofces designed to
cater to Hispanics.
By: Alice Rivera
HEALTH MARKETING
AND ACCULTURATION
THE AXI S AGENCY | CULTURE MAGAZI NE 9
For pharmaceutical marketers of both
prescription (Rx) and over-the-counter
(OTC) medications and products, this
underdeveloped segment ofers billions of
dollars in incremental growth opportunity.
Hispanics represent about 9% of total
adult prescriptions sales in the U.S. and
11% of total OTC sales. Combined, these
sales total over $19 million today but the
opportunity is much greater. Reaching
census parity would see combined Rx and
OTC sales of over $33 million to Hispanics.
With more Hispanics entering the health
care system and the revitalized emphasis
on health and wellness in the market due
to the ACA, more than ever Hispanics
represent a key growth opportunity for
marketers in this sector.
Making the opportunity for marketers
even greater is the fact that 83%
of Hispanics report getting health
information from the media, and the
vast majority of those report having
acted on that information by changing
their health habits, deciding how they
treat a condition, or seeing a health
professional. Moreover, Hispanics are 3
times as likely to trust information from
drug manufacturers vs. Non-Hispanics,
and the vast majority agrees that Rx ads
encourage better communication with
doctors. This makes Hispanics prime
candidates for health messaging.
As marketers embark on initiatives to tap
into this opportunity it is very important
to note that the Hispanic market is far
from homogeneous. One of the most
important characteristics to examine
is acculturation and the diferences
between the more acculturated and
the less acculturated. These diferences
come into play signicantly, as Hispanics
level of acculturation impacts their
attitudes and perceptions about health
and wellness, and should be taken into
consideration when messaging to them.
For example, level of acculturation seems
to inuence Hispanics perception of their
own weight. Less acculturated Hispanics
are more likely to underestimate their
weight or not consider themselves
overweight when in fact they are.
Conversely, more acculturated Hispanics
are more likely to have a more accurate
perception of their weight. Therefore,
in marketing diet aids to the less
acculturated, messaging will need to
take into consideration that they rst
need to see and better understand the
problem and its consequences, before
they take steps to remedy it.
Similarly, level of acculturation has been
shown to impact understanding of health
conditions. For example, diabetes is the
health issue Hispanics in general are
most concerned about, but only the more
acculturated tend to be knowledgeable
about the disease. In marketing products
that help manage this condition,
marketers need to be aware that less
acculturated Hispanics will need, and
appreciate, more general and background
information to better understand the
benets of their product. Paradoxically,
even though more acculturated Hispanics
are more knowledgeable about diabetes,
those with the condition are less likely
than their less-acculturated counterparts
to practice the healthy diet their condition
requires. In their case, it might be more
important to emphasize specically the
serious consequences of not maintaining
a healthy diet.
Understanding acculturation can help
marketers develop more powerful
messaging that truly speaks to the heart
of each segment thus maximizing the
efectiveness of any campaign. The key
to understanding acculturation is to
recognize that it is not as simple as a
persons ability to speak English, but it is
a dynamic combination of many cultural
variables that paint multidimensional
proles of the Hispanic population.
Important to note is that when it comes
to health and wellness, these proles are
further impacted by the fact that until
now more than a third of the Hispanic
population has been uninsured, and thus
some of their perceptions and ideas about
health and wellness have been formed
without the benet of having quality
health care. What remains clear is that
Hispanics, both the less acculturated
and the more acculturated, represent a
tremendous growth opportunity in the
health sector and the time to reach out
to them is now.
Hispanics level
of acculturation
impacts their
attitudes and
perceptions about
health and wellness
and should be taken
into consideration
when messaging
to them.
THE AXI S AGENCY | CULTURE MAGAZI NE 1 0
With the introduction of the Afordable Care Act (ACA), more than 10 million previously uninsured
Hispanics are now potentially entering the ranks of the insured, with all the corresponding benets.
The implementation of the ACA also means there is more demand for patient education, and
disease awareness and prevention than ever before among Hispanics.
By: Alex Vitale
HOW TO REACH HISPANICS
WITH HEALTH MESSAGING
The industry has to have a deep
understanding of where Hispanics
seek health-related information.
As a result, the pharmaceutical and health & wellness industries have
a phenomenal opportunity at their doorstep to grow their Hispanic
consumer base and develop long-term relationships with this coveted
segment. For insurance and pharmaceutical companies - and others
operating in the health & wellness sector - it is now a critical business
imperative to take a long overdue look at their Hispanic marketing
plans and assess how they will establish and develop this long-
term relationship with the Hispanic consumer. Its expected that the
implementation of the ACA will involve a gradual transition over several
years, yet for insurance and pharma companies aiming to successfully
position themselves for long-term commercial success, the time to
reevaluate their Hispanic marketing plans is now.
In order to construct or rene engaging and culturally-relevant Hispanic
marketing eforts, the industry has to have a deep understanding of
where Hispanics seek health-related information as well as what kinds
of approaches and messaging best resonate with them. What are the
most efective media channels? Where do Hispanics turn to for health-
related information? What are the language and other considerations
that we need to take into account?
THE AXI S AGENCY | CULTURE MAGAZI NE 1 1
HEALTH PROFESSIONALS
Primary care physicians and other health
professionals are the number one source
Hispanics turn to for health-related
information. 71% of Latinos report getting
information from a medical professional in
the past year.
Prior to the passing of the ACA, studies
indicated that Hispanics with access to
health insurance preferred to obtain health
care information directly from a medical
practitioner, while for those without health
insurance, television was their primary
source of information. However, with
millions of previously uninsured Hispanics
now having access to health coverage as a
result of the ACA, the role of the medical
practitioner as a provider of information will
become that much more important.
Marketing drugs and products directly to
medical professionals via a direct marketing
efort could prove valuable in building brand
awareness among their Hispanic patients.
FAMILY CONTACTS AND COMMUNITY
WORD OF MOUTH
Family, friends and word of mouth are
essential sources of information for
Hispanics on health-related topics,
including symptoms, preferred doctors,
and treatment preferences. Regardless of
language preference, Hispanics rely more
heavily on word of mouth for health-related
information than Non-Hispanics; 57% said
friends and family are a primary source of
information vs. 41% of Non-Hispanics.
To capitalize on the value of word of mouth,
marketers should consider community
outreach eforts and partnerships with
grassroots Hispanic organizations that
can help their brands solidify their
positioning in the community. Participating
in community health fairs, neighborhood
forums and church events are some
examples of how brands may build a robust
and positive reputation in the community
while directly inuencing family, friends
and community leaders.
MEDIA
83% of Hispanics report obtaining at least
some information about health and health
care from (both English and Spanish-
language) television, radio, newspapers,
magazines or the Internet in the past year.
Studies show that television is
an especially powerful conduit of
information; 68% of Latinos report
obtaining health information from this
medium in the past year.
51% of Hispanics report getting
information from print media over the
past year.
Radio also is an important source of
health care information for Hispanics, in
particular Spanish-speaking ones, with
40% obtaining health information from
this medium.
35% of Hispanics report getting
information from the internet over
the past year. The internet including
social media, of which Hispanics are avid
users is a medium that Hispanics are
increasingly turning to for information.
A Google study of Spanish-language
search found tremendous unmet need
for Spanish-language health content.
Spanish-language online health
queries grew an average of 588% per
subcategory from 2006-2011. Google
searches on salud grew 272% for the
period while health searches rose only
29%. Savvy marketers will take notice
of this nding and will develop more in-
language and in-culture digital content
to meet this need.
Studies show
that television is
an especially
powerful conduit of
health information.
ACCORDING TO VARIOUS SOURCES, INCLUDING UNIVISION RESEARCH, NIELSEN, AND
THE PEW HISPANIC CENTER, THE TOP THREE SOURCES OF HEALTH INFORMATION FOR
HISPANICS ARE PROFESSIONALS, FRIENDS AND FAMILY, AND THE MEDIA.
HISPANIC CAREGIVERS
By: Amelia Jimenez
By 2050, the U.S. population above age 65 is projected to increase
from one-seventh to one-fth of the total population. The Hispanic 65+
demographic is projected to follow suit, growing at an even faster pace
from 7 to 20% during the same period.
THE AXI S AGENCY | CULTURE MAGAZI NE 1 2
Hispanic elderly rely on family caregivers
much more than on outside support or
medical care. The majority of Hispanic
caregivers (83%) care for their own family
members, including 23% who care for their
mother and 13% who care for their father.
Savvy marketers will take into account the
inuential position of family caregivers
and recognize that theyre often the key
decision maker when it comes to matters
involving their subjects health. Current
eforts on behalf of marketers to target
caregivers have been inefective. Hispanic
caregivers consistently report a greater
need for health-related services yet are
lacking in formal support when compared
to Non-Hispanic White caregivers. They
are the most likely to want help and
information, but the least likely to seek
it; 65% have not searched for solutions
to caregiving challenges.
Companies looking to reach Hispanic family
caregivers should provide accessible and
culturally-relevant information, training
and support that are: easy to understand,
family-based, and community-based.
Content marketing, recommendations,
and community education events will be
welcomed by Hispanic family caregivers.
They believe training on caregiving skills
would be helpful (80%), but most (53%)
cannot aford professional help, citing a
household income of less than $30,000.
Reaching Hispanic family caregivers is
best achieved through a variety of
channels. Consider that only 29% have
searched for information online. They
are also more likely than non-Hispanic
caregivers to use other sources, such as
books, brochures, radio, TV, or community
organizations. However, although Hispanic
caregivers know helpful information is
out there somewhere they admit to
not knowing how to access it. They most
commonly look for information from
professionals (81%), family and friends
(66%), government agencies (49%), and
disease-specic organizations (37%).
As they reach out to Hispanic caregivers,
marketers need to fully understand family
dynamics and ensure that their approach
is culturally relevant. Hispanics value
lial obligation, reciprocity, and respect
for the elderly, and believe caregiving is
a rewarding duty. In contrast, Hispanics
believe the Non-Hispanic populations
abandon elders to external care services.
Hispanic caregivers generally mistrust
outside help, and need to retain a sense
of control and involvement. They want
services that address the care recipients
needs and rarely mention their own needs
as caregivers.
For many Hispanic family caregivers
(25%), lack of time is an important
challenge. Two-thirds of them are
married, and theyre also more likely to
have children in the home than Non-
Hispanic White caregivers. Brands should
recognize and acknowledge this important
challenge and emphasize the time-saving
conveniences of their propositions, and
how these will allow caregivers to do a
better job.
Marketing information should be in Spanish
or bilingual, as even highly acculturated
immigrants often prefer discussing family
care in Spanish. 78% of Hispanic family
caregivers believe having services in Spanish
is important, yet many are unsatised with
the quality of available Spanish-language
information. The information must also
be easy to understand, given that 65% of
Hispanic family caregivers have a high
school education or less and 31% have low
health literacy.
Hispanic caregivers value taking care
of their family members but may not be
able to aford necessary resources and
also face unique challenges, including
lack of information. Marketers seeking to
benet from the growing elderly Hispanic
population should become relevant to
caregivers by addressing these issues. As
marketers raise awareness about how their
products and services help the elderly, its
also important to emphasize that these,
in turn, also help caregivers provide better
care. Marketers seeking to establish a
relationship with Hispanic caregivers should
reach out to them through professionals,
community organizations, events, and
multiple mediums to provide simple, easy to
understand and accessible information and
recommendations. Education and awareness
would likely increase sales, as they are
positively correlated with using health
maintenance, preventive medicine and
community-based long-term services.


THE AXI S AGENCY | CULTURE MAGAZI NE 1 3
As they reach out to
Hispanic caregivers,
marketers need to
fully understand
family dynamics
and ensure that
their approach is
culturally relevant.
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17.5 h x 12 w 70 h x 48 w
17 h x 12 w 68 h x 48 w
16.25 h x 10.625 w 65 h x 42.5 w
Job info
None
Notes
Art Director
Copywriter
Account Mgr
Studio Artist
Proofreader
Kim Beylin
None
A Moncure
E Whitaker
L Beliz
Approvals
Fonts
Karbon (Medium, Regular, Bold)
Images
91589.LIZ.TS.psd (CMYK; 300 ppi; 100%),
CC_Vert_CMYK_Logo.eps (174.81%), 91589.
MASTERBUTTON.SPANISH.SHAD.psd (CMYK;
554 ppi; 54.12%), 91589.MASTERBUTTON.
SPANISH.psd (CMYK; 554 ppi; 54.12%)
Inks
Cyan, Magenta, Yellow, Black
Fonts & Images
Saved at None from LANDLA-DMX1135 by Printed At
Liz R.
Recibe ayuda gratis en persona
CoveredCA.com/espanol
La fecha lmite
es el 31 de marzo.
Asegrate.
Y t?
TM
Les digo a mis amigos,
ustedes estn locos si
no se inscriben, porque
es tan accesible.
S:10.625 (42.5)
S:16.25 (65)
V:12 (48)
V:17 (68)
T:12 (48)
T:17.5 (70)
The historical passage of the Afordable Care Act will make
the dream of health care coverage a reality for many more
Americans. In California, more than 7 million residents
are without health insurance and, of that number, well
over 50% are Hispanic. Covered California is charged with
implementing the federal health care law and creating a
new insurance marketplace in which individuals and small
businesses can get access to health insurance.
To fulll its mission of increasing the number of insured,
improving health care quality, lowering costs and reducing
health disparities, Covered California, partnered with
The Axis Agency along with its sister agency Weber
Shandwick to create a fully integrated marketing and
advertising campaign.
1 4 THE AXI S AGENCY | CULTURE MAGAZI NE
CASE STUDY
CASE STUDY
28.5 x 44.5 30 x 46 30.5 x 46.5
1019589_CC_CStore_30x46.indd
2-13-2014 7:30 AM Hendel, Rick (LAN-DLA) / Whitaker, Eric (LAN-DLA)
1
Job Client
Built At Output At
Scale Bleed Trim Viewing Live
1019589 Covered California
25% 400%
1 = 4 46.5 h x 30.5 w 186 h x 122 w 46 h x 30 w 184 h x 120 w 46 h x 30 w 184 h x 120 w 44.5 h x 28.5 w 178 h x 114 w
Job info
None Notes
Art Director Copywriter Account Mgr Studio Artist Proofreader
Mark Marcelo None A Moncure E Whitaker L Beliz
Approvals Fonts Minion Pro (Regular), Karbon (Bold, Regular, Medium)
Images 91589.MyronCStore.psd (CMYK; 150 ppi; 100%), CC_Vert_CMYK_Logo.eps (431.49%), 91589.MASTERBUTTON.SHAD.psd (CMYK; 229 ppi; 130.5%), 91589.MASTERBUTTON. psd (CMYK; 229 ppi; 130.5%)
Inks Cyan, Magenta, Yellow, Black
Fonts & Images
Saved at None from LANDLA-DMX1135 by Printed At
TM
Health care for all.
Log on today, and find someone in your community
who can walk you through every step of enrollment.
Now I dont worry
about the cost of care.
I just get it.
Myron P.
Enroll by March 31
st
CoveredCA.com
Are you?
T:30 (120)
T:46 (184)
CAMPAIGN OBJECTIVE IS TO INCREASE
HEALTH CARE ENROLLMENT OF
UNINSURED CALIFORNIANS BY:
Quickly raising awareness of the new
Covered California brand as the ofcial
objective source for nding afordable
health care coverage.
Educating audiences who are very
diverse - about the new insurance rules.
Driving uninsured Californians to the
Covered California site to nd, compare
and enroll in coverage.
AGENCY DEVELOPED A THREE TIERED
MESSAGING APPROACH:
Welcome & Bienvenidos establishes
the voice, and role, of Covered California -
a sort of health care usher, welcoming
you in and guiding you along to a life of
greater security and possibility.
That Covered Feeling & Tengo un plan
reects on the emotional impact that
afordable health care will give to those
who now nd it within reach.
Hes Covered, Shes Covered & Estn
Cubiertos is a reection on the past by
a community that didnt have health
insurance then but does now.


Covered California Enrollment. Individuals who selected plans
Enrollment by Ethnicity
THE AXI S AGENCY | CULTURE MAGAZI NE 1 5
Mixed Race 6
%
Native Hawaiian
and Other Pacic Islander <1
%

American Indian
and Alaska Native <1
%
Other 3
%
White
35
%
Asian
21
%
Latino
28
%
Unknown(non-Latino)4
%
Black/African-American 3
%
The Spanish-language advertising campaign is currently running in 11
markets across the state. The campaign includes television, radio, print, out
of home, direct mail, digital and collateral.
1,395,929
Subsidy eligible 1,222,320
Not subsidy eligible 173,609
88%
12%
Covered California
Enrollment
Individuals Who Selected Plans
1 6 THE AXI S AGENCY | CULTURE MAGAZI NE
More than half of Hispanic adults in the
United States dont have regular access
to a health care provider. Hispanics
rely on alternate resources for health
information, like online tools and advice
from friends and family members.
To U.S. Hispanics, nurses are more
relatable than doctors, thanks to their
longer interaction with families as doctors
get busier and busier. Whether at schools,
workplaces or clinics, nurses often
diagnose medical issues and emotional
problems before family doctors, act as ER
nurses and educate parents and children
on seasonal health issues.
STRATEGIC APPROACH AND CAMPAIGN OBJECTIVES
Considering that nurses are usually the rst point of contact for Hispanic
families looking for health advice in their own language, and in response
to the lack of health and wellness information available to Hispanics,
The Clorox Company partnered with the National Association of Hispanic
Nurses (NAHN) to create the Hispanic Nurses Network.
The Axis Agency was instrumental in establishing the relationship
with NAHN and in nurturing this relationship throughout the duration
of the campaign.
The programs objectives included:
Positioning Clorox as a company that understands Hispanics and
their health & wellness needs
Introducing Clorox as a trusted ally on family health by providing our
target audience with practical ways (product and health education)
to keep their family healthy
Encouraging the target audience to try Clorox Clean Up and
Clorox Disinfecting Wipes instead of other cleaners for cleaning
and disinfecting
CASE STUDY
CASE STUDY
THE AXI S AGENCY | CULTURE MAGAZI NE 1 7
TARGET AUDIENCE
Our main target audience was Hispanic,
unacculturated and semi-acculturated women
ages 18 to 34 with children.
OUR APPROACH RED DE ENFERMERAS HISPANAS
(HISPANIC NURSES NETWORK)
The Clorox Hispanic Nurses Network provided U.S.
Hispanic moms and their families with a new resource
for health and wellness matters. The Network
consisted of four Spanish-speaking nurses, one
each in Miami, Los Angeles, Chicago and New York,
who acted as health care advocates sharing health
information and educating Hispanics on how to keep
their homes healthy via social media platforms and
through traditional media interview opportunities.
LAUNCH ANNOUNCEMENT AT HISPANICIZE IN MIAMI
To announce the launch of the Hispanic Nurses
Network, Axis engaged NAHN and leveraged Cloroxs
existing partnership with health advocate and
expert, Dr. Aliza Lifshitz. The Axis Agency negotiated
a sponsorship for one of the most important U.S.
Hispanic marketing and social media events of the
year, Hispanicize, which included a special press
conference and announcement of the Clorox Hispanic
Nurses Network as part of Hispanicizes conference
activities. Key Hispanic mommy bloggers and media
attended the conference, which was followed by a
local media tour in Miami with Dr. Aliza Lifshitz and a
member of the Hispanic Nurses Network.
SOCIAL MEDIA ENGAGEMENT CONVERSATIONS
WITH HISPANIC MOMS AND BLOGGERS
As part of the Clorox Hispanic Nurses Network, monthly
live chat sessions via Facebook were scheduled, engaging
the audience to ask health-related questions and
interact with the nurses. During the sessions, the nurses
provided seasonal health information in Spanish and
answered questions to participants. Additionally, tips
from the Hispanic Nurses Network posted on Clorox
Latinos Facebook page to generate ongoing awareness
throughout the year.
To create additional social media engagement with our
target audience, Axis partnered with Hispanicizes sister
company, Latina Mom Bloggers, to help coordinate and
promote the Facebook live Q&A chats.
CAMPAIGN RESULTS
The Clorox Hispanic Nurses Network launch
announcement garnered nearly 8.5 million media
impressions and increased brand awareness among the
close to 800 Hispanic inuencers and bloggers engaged
at Hispanicize 2012.
Additionally, the live Q&A chat sessions generated nearly
12 million impressions through blogger promotion and
in-studio session follow with new sentence: And over
400 Latinas were engaged in the live chat sessions.
On average, over 1,700 Facebook fans were exposed to
each biweekly branded health tip which posted on Clorox
Latinos Facebook page.


CASE STUDY
1 8 THE AXI S AGENCY | CULTURE MAGAZI NE
Kaiser Permanente (KP) is one of the nations
largest not-for-prot health plans, serving
9.1 million members.
In July of 2013, The Axis Agency hit the
ground running to develop KPs new Spanish-
language multi-channel advertising campaign
for ve key regions across the U.S.: California,
Colorado, Georgia, and select Northwest and
Mid-Atlantic areas.
CASE STUDY
THE AXI S AGENCY | CULTURE MAGAZI NE 1 9
With the objective of educating Latinos
on the importance of health coverage and
KPs role in providing afordable options to
quality health care, Axis set out to reach two
important target audiences 1) the health care
reform eligible and 2) the employer-based
enrollment elegible.
In August 2013, Axis launched a new
multi-channel marketing campaign which
included TV, radio, digital, events, direct
mail and social media. Axis also collaborated
with KPs internal marketing team, for
the development and translation of their
Spanish-language consumer website,
vivabien.com, and member communications
collateral material.
In just a few months, Axis succeeded in
reaching a number of milestones. We
developed original Spanish-language
television creative that attained high marks
in key measurements (including likeability
and relevance) and launched KPs rst
Spanish-language Facebook page, which
reached 10,000 Likes after the rst
three weeks our companion targeted
Facebook campaign. Results to date
include 26,388 Likes.
Moreover, to increase awareness and
engagement among Latino consumers at a
grassroots level while supporting KPs
prospect targeting strategy in anticipation
of 2013s open enrollment period, we designed
and activated a community-based events
series targeting Hispanics in key markets
throughout Northern and Southern California.
Attendees received complimentary health
screenings and health-related materials, as
well as information on KPs oferings in their
language. The events series was a great
success with over 50% of booth visitors lling
out KPs lead generation cards.
- You clearly cannot. When you reach this point, buddy, you
gotta ask for help. You have to go to the doctor.
- Well, going to the doctor is not something I look forward to.
- Whys that?
- Because.
- Because? You remind me of a child. Come on. Why do you fear
going to the M.D.?
- What are you talking about? I love McDonalds. You know that
at one time they had a Double Big Mac ofer? Four patties,
man. That was good!
- Forget about all that stuf. Do the kale thing.
- The kale thing? I am not a turtle. Im a man.
- A dead man in the making. And dead men are worth a sigh.
- Why do you care?
- What do you mean?
- You heard me. Why?
I grabbed his arm.
- Because.
A long pause. Our eyes were locked. They slowly lled up with
tears. He smiled and nodded.
- Ok, he said.
- So right now, youre going to pick up the phone and call my
doctor.
- And what do I tell him?
- That you want to schedule a full body check-up for this week.
- I dont know about that.
- Ok, ne. Ill call him.
I scheduled a visit for the following day. My doctor saw him and
recommended several treatments that would bring him back to
the land of the living.
- Man, I have a long way to go, he said that night after taking
several pills.
- Yes. And I will make sure you dont derail, stall or park.
- Deal.
He shook my hand, while his kids and his wife nodded
approvingly.
What can I say? Es mi hermano.
20 THE AXI S AGENCY | CULTURE MAGAZI NE
Call him sedentary, if you will. Hes never been to a gym.
He doesnt run, jog or walk fast. Heck, he does not even
stretch. He is 27 pounds overweight, has high-cholesterol,
skyrocketing blood pressure and is riddled with ailments. He
smokes, drinks and shoots guns. A couch potato supreme,
he is in his mid-40s and told me that his body feels a bit
worn out. Last year, he had a herniated disc in his lower
back. One day, he tried to stand up from his ofce chair and
couldnt walk anymore. I drove to his work and took him to
the hospital. He had to get two epidural shots, plus a bunch
of muscle relaxers and painkillers. The doctor attributed this
misfortune to genetics, and probably because he sat at work
for too long. Six months ago, he was diagnosed with type
2 diabetes. Its all the crazy Korean BBQs we have every
weekend. That marinade is sweet! Add the booze and the
Crpes Suzette and it all makes sense, he told me after
pricking his nger and getting a reading of 196. To which I
countered, It all makes sense? What are you doing?
Youve got four young kids. Do you want to die? Because
to me, it looks like your lack of self care is driving you
straight to the grave. He shook his head, took a long puf
from his cigarette and said, Man, you know me. This is
how I roll. I can take care of myself.
A NEW BEGINNING
By: German Libenson
DIABETES
African American adults are twice
as likely than non-Hispanic white
adults to have diabetes.
Hispanic adults are 1.7 times more
likely than non-Hispanic white
adults to sufer from diabetes.
CANCER
Hispanic women are 1.6 times
more likely to be diagnosed with
cervical cancer than non-Hispanic
White women.
African American men are 2.5
times as likely to die from
prostate cancer, as compared
to Non-Hispanic white men.
21
Health Facts
HEPATITIS
Among all ethnic groups in
2011, African Americans had
the highest rate of Hepatitis B
and Hispanics had the second
highest rate of Hepatitis.
HIV/AIDS
Racial and ethnic minorities
accounted for 70% of the
newly diagnosed cases of
HIV infection in 2011.
African Americans accounted
for 44% of all HIV infections
casesnon-Hispanic white men.
SOURCE: MinorityHealth.hhs.gov
HEART DISEASE
African Americans are 1.4 times
as likely as non-Hispanic whites
to have high blood pressure.
In 2010, African Americans are
30% more likely to die from heart
disease, as compared to non-
Hispanic whites.
STROKE
African American adults are twice
as likely than their white adult
counterparts to have a stroke.
Hispanics are 30% more likely to
have a stroke than non-Hispanics.
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