title: The "long tail" and public health: new thinking for addressing health disparities.
abstract: The prevailing approach to improving population health focuses on shifting population means through a few targeted and universal interventions. The success of this approach for eliminating health disparities depends on an assumption about the distribution of demand for such interventions. We explored whether long tail thinking from business might yield greater progress in eliminating disparities. We examined 2011 to 2013 data from 513 state and local health agency representatives in 47 states who used an online system to create 4351 small media and client reminder products promoting colorectal cancer screening. Products in the long tail were more likely to target minority groups with higher rates of colorectal cancer and lower rates of screening than Whites. Long tail thinking could help improve the public's health and eliminate disparities.
authors.affiliation: Matthew W. Kreuter, Debbie J. Pfeiffer, Maggie Fairchild, Suchitra Rath, Balaji Golla, and Chris Casey are with the Health Communication Research Laboratory, Washington University in St. Louis, St. Louis, MO. Peter Hovmand is with The Brown School, Washington University in St. Louis.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Kreuter
authors.forename: Peter
authors.initials: P
authors.lastname: Hovmand
authors.forename: Debbie J
authors.initials: DJ
authors.lastname: Pfeiffer
authors.forename: Maggie
authors.initials: M
authors.lastname: Fairchild
authors.forename: Suchitra
authors.initials: S
authors.lastname: Rath
authors.forename: Balaji
authors.initials: B
authors.lastname: Golla
authors.forename: Chris
authors.initials: C
authors.lastname: Casey
mesh_terms: D002755:Choice Behavior; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008403:Mass Screening; D009864:Ontario; D016730:Program Development; D015980:Public Health Practice; D017010:Reminder Systems; D014481:United States; D035862:Vulnerable Populations