‘Long tail’ thinking can help eliminate health disparities

Brown School study applies a business model to public health

“Long tail” thinking in public health might yield greater progress in eliminating health disparities, according to a new study from the Brown School at Washington University in St. Louis.


The long tail strategy is one many new businesses employ, recognizing that selling small quantities of many niche items can be more profitable than selling a few blockbuster items.

The concept was popularized in Chris Anderson’s 2006 book, “The Long Tail: Why the Future of Business is Selling Less of More.”

Understanding how and why businesses profit from this long tail of niche products has the potential to transform thinking about strategies to improve the public’s health, said Matthew W. Kreuter,
PhD, associate dean for public health at the Brown School, the Kahn
Family Professor of Public Health and senior scientist in the HCRL.

The implications for long tail thinking are particularly profound for helping reduce health disparities – the inequalities in health outcomes that disproportionately affect the long and diverse tail of niche populations whose needs may not be adequately addressed by approaches designed for the general population, Kreuter said.

Focusing collectively on the universe of disparity niches may yield significant population health benefits. But it would also require new approaches and new tools.

To test the effectiveness of long tail thinking for public health, Krueter and researchers from the Brown School’s Health Communication Research Laboratory (HCRL) and Social Systems Design Lab examined data from more than 500 health agencies in 47 states who used the HCRL’s Make It Your Own (MIYO) system to create small media and client reminders that promoted colorectal cancer (CRC) screening.

MIYO products in the long tail were significantly more likely to target racial and ethnic minorities with higher rates of CRC and lower rates of screening, researchers found.

“Long tail thinking and advances in technology have opened a promising new path to achieve progress for vulnerable populations,” said Kreuter, who also is a scholar in the university’s Institute for Public Health.

The findings were published online Oct. 16 in the American Journal of Public Health.

To read the study, visit here.