‘Soda politics’: Yale students explore storytelling and public health

Students in the School of Public Health’s (YSPH) “Soda Politics” course are watching an advertisement. In the ad, celebrity Kendall Jenner poses at a photo shoot as a group of protesters walks down the street. At first hesitant, Jenner is eventually drawn into the crowd and then eases tensions by giving a police officer a Pepsi — an act met with cheers, high fives, and hugs.

“What’s the story?” asks Neal Baer, the course instructor.

Baer knows a lot about stories. A pediatrician by training, he has spent more than 30 years in the entertainment industry, writing, producing, and serving as showrunner for several television series, including “Law & Order: Special Victims Unit,” “E.R.,” and “Under the Dome.” He understands the power of a good story, the damage a bad one can cause, and how to engage a wide audience — all of which, he says, can be important tools for public health.

The course is based on the book “Soda Politics: Taking on Big Soda (And Winning),” which Baer pitched to author Marion Nestle (and later wrote the afterward for). In the class, he and his students examined how soda, a product made from inexpensive ingredients, became a multibillion-dollar industry and how it has affected public health along the way.

“It’s a really fascinating way to understand not only the economics of an industry, but its impact on health, philanthropy, storytelling, the environment, and more,” said Baer. “The course is about looking at a company or an organization through different lenses to understand its impacts. We’ll be using health, environmental, governmental, philanthropic, advertising, economic, and storytelling lenses.”

After watching the Pepsi commercial, the class discussed the spot — the use of celebrity and sexuality, the careful casting, the pointed lack of any signifier about what the “protest” is about — as well as the public criticism that followed.

The nine students conducted deep analyses of other advertisements as well, looking at who was cast, what music was used, what shots were included — everything about the kind of story being told and its intended audience.

“You’ll never look at advertisements the same,” Baer tells the class.

Soda is a leading source of sugar in American diets. Sugar-sweetened drinks have been associated with weight gain, obesity, type 2 diabetes, heart disease, kidney diseases, non-alcoholic liver disease, tooth decay and cavities, and gout, according to the Centers for Disease Control and Prevention. And the burden is not spread equally, as evidence shows sugar-sweetened beverages are consumed at higher rates by lower-income populations and communities of color.

The course involved scrutinizing the drivers of these differences. Students examined how commercial messages are used in different communities. And in one assignment, students assessed a two-block area of New Haven to see where and how often soda is advertised.

Richard Rodriguez ’22 M.P.H. is a dentist interested in public health policy, and prior to the course, he had already been thinking about how public health hasn’t invested in marketing in the way that the corporate world has. “I’ve been looking at the specific ways in which companies try to sell their products and thinking about how we could apply those principles to convince people of the importance of public health,” he said.

When studying ads in the course, Baer pointed out all of the details and the intent that went into each example, said Rodriguez. And he learned that even though many television ads are only 30 seconds long, they are still very influential. “Within those 30 seconds, every single second, every millisecond, has intention, and learning that was fascinating to me,” he said.

The students also looked at scientific studies — some that showed negative consequences of drinking soda and some that showed no relationship — and discussed what factors might be at play. And each student took on a study focused on their own interests, such as issues related to labeling or environmental impacts, and presented their findings to the class.

“As a showrunner, I have to know about the cinematography, music, wardrobe, makeup, hair, writing, budget, and publicity of my show. And I put together all of these elements to tell a story,” said Baer. “That’s what I try to do when I teach. I don’t just do a straightforward lecture or a straightforward seminar. It’s an integrated approach using the world.”

After wrapping up the discussion of the Pepsi ad, the class conversation moved through a number of topics, including diabetes and its cost to society, why demonstrating the health impacts of soda is more difficult than doing so for cigarettes, whether warning labels are effective, soda taxes and the measures soda companies have taken to stop them, government corn subsidies, and how much water is required to make soda.

And that was during just one class session.

Baer asks students how practitioners of public health should deal with the problems soda presents. One student turns to communication, saying that those in public health sometimes assume too much health literacy. “We need to learn to communicate better and to larger groups, not just one-on-one with patients,” he said.

Baer has seen first-hand the impact communication can have on public health issues. While he was working on “E.R.,” the show featured storylines about emergency contraception and the link between human papillomavirus and cervical cancer. In a study, he and his colleagues showed that those episodes increased viewers’ awareness around those issues.

“I think it’s really important to tell stories that are grounded in science,” said Baer. And he has brought that perspective to his collaboration with YSPH’s Humanities, Arts, and Public Health Practice at Yale (HAPPY) Initiative, an interdisciplinary effort focused on health and the humanities. “This idea is the foremost element of the HAPPY Initiative. How do we draw on the humanities and arts to tell stories grounded in science that can make a difference in promoting public health?”

As they moved through the topics of the class session, the students kept returning to the power of storytelling.

The World Health Organization has defined public health as “the science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society.” Rodriguez believes the public health field has done a good job with the science. “But less so when it comes to art,” he said. “We can’t rely solely on numbers, but if we can use numbers as a starting point and then think about the stories we want people to take away from them, I think we will move forward in a more progressive way and achieve our goals more widely.”

Baer guided the class through pointed questions throughout the session, and when students offered potential solutions, he’d point out possible pitfalls. Often there were several. And he shared them not for the sake of discussion, but because they’re real challenges affecting public health today. Baer doesn’t let a conversation end with an easy answer because there aren’t any in the real world.

The students seem up to the task.

Baer says his hope is not that the students walk away from the course with a particular opinion about soda, but that they see the value in assessing a topic like soda from every different angle. “So looking not just through, say, a social justice lens or an economic lens or an environmental lens. Because often there’s impact across multiple areas,” he said. “I want them to use this multifactorial approach in thinking about any kind of industry or organization.”

For Rodriguez, at least, the class hit the mark. “It’s changed my entire outlook on industry influence.”