The commercialization of childhood and children’s well-being: What is the role of health care providers?

The African proverb “It takes a village to raise a child” is a common and evocative means of arguing for the necessity of community involvement in child rearing. Care for children has to extend beyond the immediate family. It also reminds us that children’s experiences beyond the family – in the neighbourhood or community – can have a powerful impact on their growth and development.

These days, the village raising our children has been transformed by the unprecedented convergence of sophisticated, increasingly miniaturized screen technology and unfettered commercialism. As a result, children are bombarded from morning to night by messages designed not to make their lives better, but for the sole purpose of selling something. Health care providers have long known to look beyond the child to the influence and values of the family, neighbourhood and peer group. But now we have to consider the influence and values of the commercial world as well. The results of the convergence of leaps forward in technology and steps backward in corporate regulation is unprecedented in the lives of children and, while we do not know yet what kind of adults this generation of screen-saturated, commercialized children will become, there is mounting evidence that its impact may be harmful. Commercialism is a factor in many of the public health and social problems facing children today (1). Childhood obesity (2), discontent about body image (3), eating disorders (4), sexualization (5), youth violence (6), family stress (7), underage drinking (8), and underage tobacco use (9) are all linked to advertising and marketing. So is the erosion of creative play (10) – the foundation of learning, creativity and the capacity to make meaning of life (11). The underlying message of commercial marketing – ie, the things we buy will make us happy – is a major factor in the acquisition of materialistic values, which has been linked to depression and low self-esteem in children (12).

BEYOND COMMERCIALS: MARKETING TO CHILDREN IN THE 21st CENTURY

The marketing environment in which kids are growing up today is significantly different from that experienced by their parents as children. In 1983, corporations spent US$100 million annually on direct advertising to children in the United States alone (13). Now, it is estimated that they spend approximately US$17 billion annually (14).

Today, huge corporate conglomerates own television channels, radio stations, Web businesses and film studios, and successfully insert screen time into the lives of an increasingly younger audience. The American Academy of Pediatrics recommends no screen time for children younger than two years of age (15), yet 40% of three-month-old babies in the United States regularly ‘watch’ television and DVDs for an average of 45 min per day (16), and 19% of babies younger than one year of age have a television set in their bedroom (17). There is very little research available on the impact of screen time on babies, but the research that does exist suggests that there is little evidence that children younger than two years of age learn anything useful from screen time (18). One study (19) suggests that content viewed may have an impact on language learning, but others (20–22) show that screens are simply not an effective means of promoting language development for children younger than two years of age. There is also some evidence that screen time may be harmful for babies (18). Studies suggest that early screen use can be habituating (23), and is negatively associated with cognitive development (24), regular sleep patterns (25) and language acquisition (26). The more babies and toddlers engage with screens, the less time they spend in creative play and interacting with parents – two activities known to be educational (27).

Television is still the primary venue for advertising to children, but Internet marketing through computers and hand-held devices such as MP3 players is escalating, as is text message marketing on cell phones. Nick.com, the Web site belonging to the internationally popular children’s cable television channel Nickelodeon, took in US$9.6 million between July 2004 and July 2005 – more advertising revenue than any other Web site (28). In fact, as digital technology becomes more sophisticated, television and the Internet are merging to become a whole new interactive media and marketing experience for children. Although children see thousands of commercials each year on television alone, modern marketing methods extend well beyond the traditional 30-second ads. The marketing industry is still creating television commercials aimed at children, but companies are expanding their reach through a variety of other techniques.

Product placement

Products inserted into the content of media programs – known as ‘product placement’ – is technically illegal in television programs created specifically for children (29). However, it is prominent in programs that children like to watch. For instance, American Idol, which is often rated among the top 10 most popular programs for two- to 11-year-olds, is rife with Coca-Cola product placement (30,31). Products are also routinely inserted into the content of Web sites, movies, songs, books, video games and other media for children. In extreme cases, product placement has morphed into ‘advergaming’, in which entire Web-based games revolve around a product. For example, children can visit www.candystand.com and go bowling with Life Savers, or visit the General Mills Web site (www.millsbury.com) and go virtual snowboarding in the Reese’s Puffs Cereal snow-boarding championship (32).

Brand licensing

Probably the most popular method for marketing to young children is brand licensing, in which a media image is sold to other companies to market toys, food, clothing and accessories. Most children’s media characters have become tools for marketing other products. Approximately 97% of children younger than six years of age in the United States own something – such as a doll, stuffed animal, action figure, bedding or clothing – that features the image of characters from the media (33). It is increasingly difficult to find any products for children – from food to toys – that are unadorned with media characters and logos. Today, even children’s books are often media linked. As a result, children’s play, reading, art and music are primarily shaped by precreated characters, plots and themes. What were once tools for self-expression are now designed to constantly remind children of media programs and their products, teaching them to value that which can be bought over their own creations.

360° branding strategies

Companies that target children are forming partnerships and using multiple media platforms to surround children with marketing. In the fall of 2008, Lego partnered with McDonald’s, Sony and Warner Brothers to market a violent video game and fast food to young children by promoting the Lego Batman video game through Happy Meal toy giveaways (34).

McDonald’s used cell phones to market McFlurries by having 600 of their California franchises urge kids to text-message to receive a cyber coupon for a free McFlurry. They were urged to download free ringtones and cell phone wall-paper, and to pass on information about the promotion to their friends. McDonald’s advertised the text message address through ads on buses and billboards, and through a guerrilla marketing technique known as ‘wild posting’, which involves plastering print ads on structures such as bus kiosks or construction site barriers. The company even used skywriting to promote the “Text McFlurry 73260 ” message (35).

THE ROLE OF GOVERNMENT

There is no getting around the fact that government policies, or lack thereof, have contributed to the current situation of raising children in the middle of a marketing maelstrom aimed directly at them. Around the world, policies created and policies defeated by conservatives, progressives and centrists have enabled marketers to target children, as have policies endorsed and condemned by the extreme right and left.

Prohibiting marketing to children may seem extreme; it isn’t – but marketing to children is extreme. The United States regulates marketing to children less than most other industrial democracies. Quebec bans marketing to children younger than 13 years of age (36). Sweden and Norway ban television marketing to children younger than 12 years of age (37). Greece prohibits ads for toys on television between 07:00 and 22:00; ads for toy guns and tanks are not allowed at any time (38). In the Flemish-speaking areas of Belgium, no advertising is allowed within 5 min of a children’s television program shown on a local station (38). Advertising regulations proposed by the European Union ban commercials suggesting that children’s acceptance by peers is dependent on their use of a product (39). Finland bans advertisements that are delivered by children or by familiar cartoon characters (40). The French government recently prohibited all vending machines in middle and secondary schools (41), and recently banned television programming that targets children younger than three years of age (42). In Britain, the BBC stopped using its beloved cartoon characters to market unhealthy food to children in 2004 (43). A few years later, Ofcom, the British regulatory agency, banned television junk food advertising on children’s shows and on adult programs popular with children (44).

HEALTH CARE PROVIDERS AS ADVOCATES

Given the potential harms of commercialized culture, it is certainly important for health care providers to educate parents about the potential negative effects of media and marketing on children, and work with parents to limit children’s access to screen media. In fact, the Canadian Paediatric Society recommends that paediatricians inquire about children’s media use and that children watch no more than 1 h to 2 h a day of television (45). But while education and interventions with individual families are important, they can only go so far in limiting the effects of an unhealthy society. Working to limit children’s exposure to child-targeted marketing is not effective enough. Limits need to be set on marketers’ access to children as well. Toward that end, health care providers need to move beyond their offices and become public advocates for policies that restrict and/or prohibit advertising and marketing to children. For instance, Canadian organizations such as Edupax, the Canadian Centre for Policy Alternatives, and Canadians Concerned About Media Violence have taken public stands against media violence marketed to children and in-school commercialism. In addition, the Canadian Paediatric Society and its individual members should join with municipal bodies such as the Toronto Board of Health, and organizations such as the Ontario Public Health Association, the Toronto Elementary Teachers Association, and the Center for Science in the Public Interest, and become part of a growing movement to extend Quebec’s ban to the rest of the country.

CONCLUSION

Children have a basic right to live in environments that promote their social, emotional and intellectual well-being. They have the right to grow up, and parents have the right to raise them, without being undermined by greed. While health care professionals need to help parents monitor and restrict children’s exposure to corporate marketers, they can also play an important role as advocates for limiting marketers’ access to children.

The village raising our children is dominated by a marketing-driven, media-saturated culture that has a powerful negative impact on many aspects of children’s lives. It is unrealistic to think that staying cocooned within our classrooms, offices or health centres is adequate to the task of mitigating the impact of marketing that targets children. Professionals concerned with the health and well-being of children need to join together with parents and social advocates to effect policy changes that will stop the commercial exploitation of children.