On November 12-13, I took part in a Washington D.C., hearing organized by the FDA on how pharmaceutical companies can use the Internet and social media to communicate with consumers. The hearing was a source of excitement in the healthcare industry – the FDA received more than 800 requests for 350 seats.

Over two days, more than 60 speakers – representing pharmaceutical companies, agencies, research firms, search and social media websites along with consumer organizations – shared their thoughts on how companies can responsibly engage consumers online, as well as questions and areas that need clarification from FDA.

Despite the variety of industries and agendas represented, I was surprised by the amount of consistency in the presentations and recommendations. Through the two days of the hearing, a few key themes emerged:

• No one can ignore the explosive power of social media.
  Several speakers shared great data about how often the Internet is used as a source for healthcare information. With patients, caregivers and doctors alike going online for healthcare information, it simply is not an option for pharmaceutical companies to remain separated from this discussion.
• No one company can be expected to monitor the whole of the Internet.
  In our Nielsen BuzzMetrics dataset of health-specific CGM sites, we collected an average of 83,000 messages per day over the past six months. This volume will only continue to grow, and no one can expect to monitor all of it.
• Pharma is ready to listen, but confusion persists.
  Most pharmaceutical companies would like to listen and even respond to consumer feedback online. However, there is confusion among pharmaceutical companies about how and when it is appropriate for them to engage with consumers online, and what responsibilities they have in doing so. This confusion often results in companies holding back on engaging in social media and sometimes even in listening to what their consumers are saying online.
• Adverse events are a red herring.
  Companies that have not done social media listening often have a fear that they will see a high volume of adverse events in online consumer conversation. (And for pharmaceutical companies, there is a requirement that these events are followed up and reported to the FDA.) In fact, the number of adverse events in online discussion is very low and manageable within the reporting systems that pharmaceutical companies already have in place.

This last point was the basis of my testimony at the hearing. In 2008, Nielsen analyzed online healthcare discussion to define the number of adverse events and found that just 4 of 500 messages contain adverse event information, and only 1 of those messages contained all of the criteria that are required for AE reporting.

For me, the key takeaway from the FDA hearing was this: More and more consumers are online looking for information on their health. Some of the information they find online is good, but some is not, and it’s not always easy to tell the difference. Right now anyone can contribute to the online health discussion except the pharmaceutical companies, who are waiting for guidelines from the FDA about how to engage online in an appropriate and responsible way.

There was a sense of hope among attendees at the hearing that the FDA will provide new guidelines on the Internet and social media relatively soon. When that happens, not only do we empower the pharmaceutical companies to interact with consumers online, but we give them a sense of duty to contribute to the conversation in a responsible way. Of course it’s not appropriate for pharmaceutical companies to get involved in every consumer discussion about healthcare online. But where these companies can contribute value to the discussion, let’s empower them to do just that.

Like many of my colleagues in the pharmaceutical/healthcare field, I look forward to watching and participating as the discussion continues to unfold.

The Boehringer-Ingelheim drug, which treats male urinary symptoms due to BPH, offered two creatives last season that were recalled at a rate 42% greater than the average based on all newly-launched prescription drug ads.  These latest installments of Flomax’s direct-to-consumer TV campaign feature men at a baseball game and men playing on a golf course.

“With relevant and consistent visuals that stand out from the rest, the Flomax ads prove that marketers can still be creative and memorable even within the restrictive pharmaceutical category,” said Fariba Zamaniyan, senior vice president at Nielsen IAG, Healthcare.

Cialis (Eli Lilly) and Gardasil (Merck) tied for second on the list with 32% greater recall than the average drug ad launched last season. The ad for Cialis, which treats erectile dysfunction in men, was an extension of its “What are you waiting for?” campaign and featured its iconic outdoor tubs and a variety of male and female couples. Gardasil, which guards against cervical cancer and HPV in women, filled its creative with images of moms and their daughters who “chose” to get vaccinated engaging in a variety of activities such as surfing, shopping and swimming.

Wyeth’s “Wind-Up Doll” TV campaign for Pristiq for the treatment of depression “winded up” the top three.  It was the only newcomer at the top of the DTC ranking this past TV season, with a recall index of 128.

A key takeaway from the rankings, said Ms. Zamaniyan, is that DTC advertising is not just successful when symptoms of the ailment treated by the advertised drug are shown.  Any prescription drug ad, she says, can still be memorable without the display of symptoms and still  connect with the audience while staying within FDA guidelines.

“The bar for creativity shouldn’t be lower for pharma because of the regulations in place,” Zamaniyan argues. “In fact,  it should be higher given the level of investment and volume of competitive activity on the airwaves.” 

Nielsen’s recall index is limited to responses among adults 18+ who correctly recalled the storyline of the ads they were exposed to within 24 hours after airing. Only ads airing during entertainment and sports programs on the five broadcast networks (ABC, CBS, NBC, FOX and CW) on Broadcast prime time,  Evening News, Late Night and Syndicated Prime Access (Jeopardy, Wheel of Fortune, Access Hollywood, Entertainment Tonight, Extra, Access Hollywood) were included in the ranking.  The ads are measured at comparable media weight to control for differing weight levels across the campaigns.

On a unit basis, sales were up 63.1 percent, while equivalized unit volume (a conversion that equivalizes products of varying sizes) jumped 81.9 percent. For the 52 weeks ending October 3rd, dollar sales grew 22.5 percent to $179.7 million, while unit sales were up 17.8 percent. On an equivalized unit volume basis, sales grew 55 percent.

Sales hit a peak in the four week period ending May 16, 2009 as news of H1N1 outbreaks were all over the news. This was the highest period in the three years that Nielsen has tracked sales of the product. Sales subsided during the summer months, but then hit their second highest sales period during the four weeks ending October 3, 2009.

Nielsen tracks the sales of consumer goods in U.S. food, drug and mass merchandiser stores, including Walmart.

Concerned Parents
All through the back-to-school season and amid news of the availability (or scarcity) of a vaccine, online conversations around H1N1 (still commonly referred to as Swine Flu by many consumers online) continue to be among the hottest of web topics. The conversations around the flu are particularly active on parenting and pregnancy sites.  A detailed look at that segment shows that on Oct. 25th 17.5 % of all buzz on parenting/pregnancy blogs focused on the virus.

Jim Mansfield, Customer Development, The Nielsen Company

Contributors: Melissa Davies, Jennifer Wehringer, Gabrielle Gibbs, Dale Norton, Robert Buckeldee, Meghan Palestis, Mike Hudak and Allison Fitzenreiter

SUMMARY: The U.S. Food & Drug Administration’s warning for the use of acetaminophen sent temporary shock waves across online chat rooms, which resulted in cautious consumers holding back purchases. While levels returned to normal about four weeks post announcement, online discussions continue to be significant. In the age of instant communications, marketers need to stay ahead of the curve with tactics that educate consumers quickly, accurately and proactively.

On June 30, 2009, the U.S. Food & Drug Administration (FDA) issued a recommendation and warning for the use of acetaminophen. Citing concerns of potential overdose and liver injury, the advisory committee recommended lowering the daily recommended dose of acetaminophen. The commonly used pain- and fever-reliever is found in several nonprescription cough and cold remedies as well as prescription products.

Pain business is big business. Nielsen reports an estimated $732M was spent on total media for the pain category (excluding online) for the year ending June 2009, with more than half (56%) allocated to over-the-counter brands and the remainder to prescription products. With the widespread use of the drug and strong media attention, Nielsen analyzed consumer reaction to the announcement and the resulting impact on sales.

Rising concerns
Immediate consumer reaction to the news of the FDA advisory committee meeting drove a noticeable spike in both branded and generic online discussions of acetaminophen, as the chart below indicates. A review of online chatter for June and July shows buzz volume for acetaminophen. Branded discussion was also significant, with the most chatter among the brands that are most recognizable to contain acetaminophen.

However, in the two-week time period following the advisory committee’s meeting, more than half (58%) of generic acetaminophen discussions was centered on risk information, while only one-fifth of branded product’s online chatter discussed health threats.

After three to four weeks following the announcement, consumer online buzz began to return to a level prior to the warning.

Interestingly, the online buzz and market impact generated was not combined with any broader overt advertising campaign. Nielsen reviewed commercials that aired for products within the pain category and did not find ads indicating specific safety messages in response to the FDA recommendation. However, Nielsen did find an increase in the mention of acetaminophen in advertisements in the weeks after the announcement.

A review of TV commercial spots of prominent pain reliever brands revealed that a few brands aired new creatives and modified prior advertisements with both a voice over and/or an “acetaminophen free” message. The changes seen in these advertisements took place the same week and continue through the most recent available period in September 2009.

Buyer beware
Immediately after the FDA warning was announced, sales of the entire pain category began to decline. Four weeks post announcement, Nielsen estimated that units declined approximately 0.5% (about 2.3 million units), but dollars increased 0.3%. The statistical model incorporated the promotion trends over the period, which was believed to cause the increase in dollars.

In the nine weeks following the announcement, sales resumed, with units and dollars up 1.3% and 0.8% respectively. It appears that consumers initially reacted and paused purchasing any pain product, but as they became more educated of the risks, purchases resumed (approximately five weeks after the warning). As a reference, the average consumers purchase cycle for pain remedies is approximately 50 days, which is within this analysis period.

To determine the predicted dollar and unit sales impact on the pain category, Nielsen employed a statistical method (multiple linear regression) to account for the multiple market levers that were occurring, which included promoted dollars, percent of promoted dollars, total promotion expenditures, online buzz, and gross rating points.

The analysis showed that some brands were more impacted than others. Two directional themes emerged that manufacturers and retailers should consider as the acetaminophen recommendations evolve. First, the brands and store brand products with the most affiliation with acetaminophen were the most impacted by the warning. Second, some brands with dosage instructions that require the consumer to take fewer pills per day appeared to grow.

Feeling the pain
Were consumers who suffer from pain more “tuned-in” to the news surrounding the FDA recommendation? Nielsen analyzed the reach of broadcast and cable programming among ailment suffers who treat their conditions with either a combination of prescription and non-prescription remedies or just non-prescription remedies—in June prior to the acetaminophen announcement and post-announcement in July.

Seven ailment conditions that are treatable with medications that contain acetaminophen were analyzed: Allergies, Osteoarthritis, Rheumatoid Arthritis, Migraines, Chronic Tension headaches, Joint/Neck/Back pain, and Muscle Pain/Spasms.

Both broadcast and cable reached Adults 18–69 during this time period with a 96.75% reach in June and a 95.43% reach in July. However, across Adult (18–69) ailment sufferers whose conditions can be treated with acetaminophen, reach was slightly higher both before and after the announcement at the end of June. Perhaps the segment of sufferers with ailments that cause pain have an increased media reach due to the elevated awareness of the acetaminophen warnings.

Global implications
Global manufacturers and retailers of acetaminophen should take note as countries outside of the U.S. review the use and dosage recommendation of acetaminophen. As it turns out, there are unique differences with regards to how consumers in different countries ensure the appropriate use of non-prescription medications.

A March 2009 Nielsen study revealed that close to half of all U.S. respondents (48%) said they ensure the proper use of non-prescription medications by reading the instructions on the pack. Only 15% said they refer to the product leaflet in the pack, and 12% consult with their pharmacist. These results compare starkly with consumers in Europe, for example, where (on average across 22 countries) fully one-third (32%) of consumers ensure responsible usage by referring to the product information leaflet in the pack, one-fourth (26%) through a dialogue with their pharmacist and only 16% from reading instructions on the pack.

These findings underscore the importance of understanding regional nuances when marketing in a global landscape. Strategies and tactics must reflect these differences to ensure optimal engagement with consumers and proper education on the benefits and safety of acetaminophen.

Cautious consumers
While the initial consumer reaction to the recommendation caused an increase of consumer generated media (online buzz) and decreases in the purchasing of over-the-counter pain products, these trends were later reversed. However, the consumer reaction to “back to normal” should be cautioned. Although consumers believe acetaminophen products are safe, they did show a strong reaction to a call for caution.

The Internet has enabled instant communication where word travels far, wide and deep. As made apparent with the acetaminophen warning, consumers readily seek out information—even without an overt advertising campaign to support it. Manufacturers and retailers have a responsibility—and an opportunity—to properly educate consumers and healthcare providers (pharmacists, physicians, etc.) via multiple media channels and product packaging that is most appropriate for the target audience.

Insights for manufacturers, retailers, and industry groups
The acetaminophen warning, albeit brief, affected the entire over-the-counter pain category. While consumers did return back to the category quickly, the same rebound may have not occurred as rapidly if the discussion of warnings and risks continued for an extended period of time.

In advance of future acetaminophen recommendations, Manufacturers, retailers and industry groups should consider the development of a consortium-like educational initiative about the safety of over-the-counter pain medications for consumers, pharmacists, physicians, and other healthcare providers. An educated healthcare system will be more engaged to repurchase the pain category vs. one that is less understood.

The 2009 flu season is fast approaching (or has already arrived) and this year, swine flu is expected to figure prominently, but online consumers aren’t yet paying attention.

In fact, online discussions about the swine flu have held relatively steady since a spike in April, when federal and world health officials first warned of the spread of H1N1 or “swine flu.” Even now, amid news that 97% of early September’s flu cases were related to the H1N1 virus and as recommendations roll out about swine flu vaccines, Internet buzz a about the phenomenon remains at less than .5% of all online discussions, down from a peak of 2.5% of all buzz in April, according to Nielsen’s BuzzMetrics service.

The U.S Centers for Disease Control’s weekly FluView report (http://www.cdc.gov/flu/weekly/) notes that more than 90% of flu cases currently being reported are H1N1 cases, though the total H1N1 diagnoses per week has dropped over the past two months. The 2009-10 flu season officially begins Oct. 4.

Slight increases in Internet discussion occurred in late August and early September, fueled by flu outbreaks on college campuses and in schools, warnings about possible business absenteeism this flu season, and ongoing news about the swine flu vaccine – including continued tests of the vaccine, news about vaccine availability and production rate, and even by skepticism about safety of the vaccine and confusion about vaccine recommendations for children.

“We saw really significant volume of discussion about H1N1 after the first alerts were issued in April, and although buzz is relatively low now, I expect that we will continue to see the discussion pick up over the next several weeks,” says Melissa Davies, research director of Nielsen’s healthcare practice. “We may see a convergence of events driving this – with school back in session, the start of traditional flu season, and the H1N1 vaccine becoming available later this fall, people will be hungry for good information about swine flu and how to keep themselves and their families safe.”

Health Insurance

Given the proposal of a public health plan, consumers were asked if they would prefer a less-expensive yet less-comprehensive public health plan subsidized by the government to a privatized insurance plan that offered more benefits and flexibility. It appears that although the private plan was the plan of choice, many of the respondents (40%) could not commit to an answer without further information about what the details of the plan would include. It is imperative that health insurance carriers start to increase their brand awareness, value proposition and targeting efforts so that consumers make the most informed decisions once a public plan becomes available.

When we drill down into the penetration of different medical insurance types, the study notes that overall medical insurance is down slightly, but dental and vision insurance are higher — an interesting finding is that for both vision and dental, it’s the employer-based coverage that is down, but individual coverage is up-so when consumers lose their coverage from work, they fill that gap on their own. Heath Savings Accounts and Flexible Spending Accounts are also both up but not from individual plan purchases. In this case, employers are increasing benefits and stepping up these offerings. The same scenario is also true for critical illness coverage.

Property and Casualty Insurance

With regard to shopping and switching coverage, some consumers kept their options open to new offers, with 46% of the respondents saying they have shopped for auto insurance in the past three years. However, only one quarter of those respondents reported actually switching carriers during that time. In addition, only 16% of residential insurance customers changed carriers in the past three years.

Most respondents stated that they would be willing to pay a little more for auto insurance if it means they get better coverage; with 52% of the participants either strongly agreeing (15%) or agreeing somewhat (37%). Interestingly, 45% of the respondents said they actually did have their auto & home insurance policies with the same insurance company.

And good news for carriers who offer both auto and residential coverage to their customers: 62% of respondents would prefer to have their auto and residential insurance at the same carrier. The majority of respondents surveyed (73% selected 8-10 on a 10-point scale where 10 is extremely likely to recommend) said they would be extremely likely to recommend their primary auto and residential insurance carrier to friends and family. Insurance companies with a referral program will likely benefit from this feeling of satisfaction and goodwill.

Life Insurance

Despite the aging population, the percentage of households with life insurance policies has decreased steadily from 2005. Individual life policies have also experienced declines (i.e., whole, universal life and variable life) but individual term policies remained constant between 2007 and 2009 at 23%. Reasons for this could be that fewer employers are offering life insurance as part of their benefit packages or due to rising unemployment.

Agent recommendations and covering final/funeral expenses topped the list of reasons why individual life insurance policies were purchased. However, future channel preference for both types of policies moved away from the agent. More consumers want to purchase life insurance through direct channels and their employer compared to 2007.

Insurance companies will have to increase relationships with employers, offer alternative direct channel options and provide clear educational materials to make up for the lack of the personal relationship with the agent-particularly when trying to influence the decision to purchase these policies for the first time. With penetration rates for life insurance policies declining, insurance carriers will need to deal with multiple issues to grow this business, including a challenging economy, lack of importance as part of retirement and investment planning.

“While this self-awareness of how they rate their healthy living seems to contradict statistics on
child and teen obesity published by the CDC and other agencies, it shows that there is a foundation
or predisposition for turning awareness into actual healthy lifestyle patterns,” said Steve Seraita, Executive Vice President, Scarborough Research.

Parents Know Best

Using the internet is an integral part of teen activity, but it ranks second as a source for where teens go for health information. 63 percent of teens say that when they have questions about health or nutrition, the seek out their parents or guardians, while half turn to the internet. In both cases, girls are more likely to use either source. Seriata notes that healthcare social marketing efforts designed to reach teens might have an even greater impact if their parents were targeted as well.

When teens do go to the web for information on health, they’re more likely to rely on a search engine than they are a social network.

“Teens are considered to be at the forefront of social networking, but, when it comes to seeking health information, we can see the power of search outweighs that of social networking,” said Seraita.”However, with half of all teens going to the Internet for health information, marketers must create a comprehensive and diversified online marketing plan — otherwise they will miss reaching half of their target audience.”

Download Scarborough’s Teen Health Perceptions Study.

Just as the offline conversation about health care reform is growing in the U.S., we are watching the online discussion grow and evolve as well. In the past month, health care reform discussions have increased by more than 1,000 percent, outpacing the online talk surrounding Swine Flu and the government’s “Cash for Clunkers” program.

President Obama is keenly aware of the important role that bloggers play in sharing information about health care reform. On July 20, the President called for bloggers to help drum up support for his health care bill, causing another jump in online conversation in the days that followed. The White House has also been using Twitter to get the message out to the public. Of the 24 tweets that have been sent out in the last two weeks, 14 have been about health care reform.

Online discussion about health care reform – like offline discussion – is highly polarized. YouTube chronicles of recent protests at various public town hall meetings (which have been at the top of the list for most-cited videos in the last week), may have created an assumption that most citizens are strongly against the reform. However, in the past week there has been a slightly larger Web presence of those in support of reform, although the split is fairly narrow and is similar to other national polls on the topic. The bottom line is that the conversation is growing on both sides of the debate, as the following chart shows.

Much of the conversation centers around sharing the latest information on the health care reform debate, with both sides adding their own spin and attempting to debunk myths and misconceptions. The discussion is also highly charged, with some bloggers engaging in one-on-one arguments that degenerate to insults and name-calling. Some of these conversations are taking a very ugly turn, as we have seen them do in person as well.

While the health care reform conversation is taking place continues to grow in online political blogs and forums, it does not represent a significant share of conversations occurring on health care sites. Although patients may have the most at stake in health care reform, the conversations about this reform tend to be more political in nature and are less prominent in health forums and communities.

As the debate rages, consumers are increasingly turning to the official White House Web site to understand the key issues. In the last month, unique visitors to the health care pages of Whitehouse.gov have increased 390 percent, from 41,000 unique visitors in June 2009 to 201,000 in July. The administration has also established a site specifically dedicated to debunking the health care reform myths, www.whitehouse.gov/realitycheck.

Where do you stand?

SUMMARY: A likely future for the U.S. in the year 2020 and beyond is a country split between the aging Baby Boom still with substantial political, economic, and social power, and a young, fast-growing multi-cultural population with far less political and economic clout. Beyond the clear demographic trends, the starting points for this divide can be seen in the growing generation gap that can be measured in the attitudes and behavior of Americans today.

In 1969, a Gallup poll found 74% of Americans thought there was a generation gap. That gap manifested itself throughout U.S. society in the social and political upheavals of the 1960s and early 1970s. Things

settled after that and 10 years later in a CBS/New York Times poll, only 60% saw a generation gap. Today, 30 years on, a Pew Research Center poll finds that 79% of Americans think there is a generation gap. While the 1969 gap was driven by widely varying points of view between younger and older Americans about the war in Vietnam, race relations, and women’s rights, today’s gap is centered around a different set of issues.

The Pew poll finds that Americans of all ages believe that differences in values make up most of the generation gap. Differences in morality, ethics, politics and beliefs/religion are frequently mentioned by younger people, while older folks are much more likely to say there are big differences around a sense of entitlement—that younger people want everything handed to them. Interestingly, only 8% of 18–29 year-olds and 5% of all other ages, mention differing levels of reliance on technology as being divisive, despite the fact that adoption and use of technology wildly varies across generations.

You’re old when…
Did you ever wonder what life would be like when you grow old? While the perception of “old” varies by age group—18–29 year olds think you’re old when you turn 60!—the generation gap of 2009 is focused primarily on the ability of younger persons to understand the large group of aging Baby Boomers.

Younger people exaggerate both the challenges of growing old and the benefits. For example, 57% of younger persons expect to have some memory loss after the age of 65, while only 25% of those aged 65+ actually experience memory loss. Likewise, 87% of 18–64 year olds feel that older people have more time for hobbies and other interests, while only 65% of persons over the age of 65 actually find that extra time in their lives.

Secular states
Religion plays a more central role in people’s lives as they age—and is a clear dividing issue between younger and older Americans today. Less than half of those aged 18–29 (44%) say religion is an important part of their lives, but that percentage escalates by about 10 points with each increasing age increment—54% of 30–49 year olds agree, 61% of those aged 50–74 feel the same, and 70% of persons 75+ believe.

Similar patterns of church attendance can be seen in the Catholic faith. Many younger Catholics consider religion important, but attendance at Mass falls off substantially compared to older persons. There is, however, a slight increase in weekly Mass attendance for Millennials born after 1981 compared to those born between 1961 and 1981. Around one-third of U.S. Catholics are Hispanic, with many of them concentrated in the younger ages—the up-tick may be due to the influx of younger Hispanics into the church.

The gloom of the boom
For three decades, data from the General Social Survey, conducted by the National Opinion Research Center at the University of Chicago, have shown the Baby Boom generation to have experienced less happiness than other age cohorts—new data from Pew show this is still the case. Their consistent gloomy attitudes have separated them from both preceding and subsequent generations of Americans.

Baby Boomer’s rate their overall quality of life lower than other age cohorts—they worry that incomes won’t keep up with inflation, that it is harder to get ahead today than it was 10 years ago, and that their standards of living don’t exceed that of their parents at the same age. Fewer Boomers expect to be able to live comfortably in retirement than members of other age cohorts.

These findings are surprising considering the fact that Boomers have the highest incomes of any age cohort, the highest home values, and the highest net worth. In today’s recession, however, they also have the most to lose and have been hit the hardest by the collapse of the housing and equity markets. Many are financially stretched still supporting children, their parents, or both.

Why are the Boomers the gloomiest generation? One possible explanation is supported by published sociologist, Yang Yang. Her work suggests that the roots of the issue may lie in the size of the Baby Boom generation. Because of the unexpectedly large size of their cohort, Baby Boomers have had to compete with each other for admission to schools, for jobs, etc., and this added level of competition has increased the level of stress in their lives and lowered their overall levels of happiness.

Technology and media
Whether young people feel it differentiates them from older persons or not, adoption of technology and use of both traditional and new media varies substantially between older Americans and new emerging youth

markets.

Average monthly television viewing time varies strongly by age. Although younger persons still watch a substantial amount of television—over 150 hours per month for persons age 25–34—their viewing is dwarfed by that of older viewers. Persons over the age of 65 watch 38% more TV hours per month than those aged 25–34.

While time-shifted television programming via a DVR accounts for a relatively small share of viewing, the highest levels of adoption are among 25–44 year olds, who watch time-shifted programming 24% more than 45–64 year olds and over four times more than persons aged 65+.

The Internet is a more ubiquitous medium with persons over the age of 35—averaging more than 40 minutes a day from home. Younger persons spend somewhat lower amounts of time online from home in an average day, but are the strongest adopters of other forms of technology—such as the mobile telephone. In 2008, the average teenager sent or received over 35,000 text messages a year—about one message every 15 minutes, 24 hours a day, 365 days a year. That’s 163 times more than the average person aged 65+.

Young persons are also much more likely to have abandoned their land lines in favor of an all mobile life. The chart below shows the distribution of persons by age based on how they make use of land and mobile telephone lines.

The U.S. in 2020 will be a very different marketplace from 2009, and the roots of that change are everywhere. The aging of the Baby Boom is inevitable. And in much the same way as they have redefined what it means to be young and to be middle aged, they will also redefine what it means to be old.

Other demographic trends that will shape the future are also present today—growth in Hispanic and Asian populations, with the highest shares among younger people, and falling fertility rates and falling family sizes. Beyond demographics, the gap between the generations, while clearly defined in differing usage of media and technology, has deeper roots too—in values, outlooks, and political perspectives.

Sources:
Center for Applied Research in the Apostolate (Frequently Requested Catholic Church Statistics) – Georgetown University

Baby Boomers: The Gloomiest Generation (Pew Research Center – Pew Social & Demographic Trends Project June 25, 2008)

Yang Yang—Social Inequalities in Happiness in the United States, 1972-2004: An Age-Period-Cohort Analysis—American Sociological Review April 2009

Growing Old in America: Expectations vs. Reality (Pew Research Center—Social & Demographic Trends Report June 29, 2009)

How Teens Use Media —The Nielsen Company, June 2009

A2/M2 Three Screen Report—The Nielsen Company, 1st Quarter 2009

Looking at 210 Designated Market Areas (DMAs) across the U.S., Nielsen Claritas demographic data shows that just over 800,000 households (roughly 0.7%) earn more than $500,000. Those that make $250,000-500,000 account for an additional 1.6% for a total of 2.3% of homes that could be considered “affluent.”

Where The Wealthy Are

The top 10 most affluent markets (San Francisco, New York, W. Palm Beach, Fl., Washington D.C., Palm Springs, CA, Ft. Myers/Naples, Fl., Boston, Santa Barbara, CA, Los Angeles, and San Diego) identified in the dark green [see full graphic] account for 42.6% of all households in the U.S. earning more than $500,000. These affluent households are twice as concentrated in these markets than the USA overall. In these markets, about 1.5% have incomes $500,000+ and 2.8% have incomes $250,000-$500,000 annually.

… And Where The Uninsured Are

Not surprisingly, many of the same markets that have a large majority of high-income households also tend to be the most insured as identified by the light blue [see full graphic]. San Francisco (with 85% estimated insured) leads the way, whereas Greenville, MS (66%) registers as the least insured metropolitan area.

Markets with the most insured households tend towards the major metro areas of the coasts and the Great Lakes, whereas markets with a higher incidence of uninsured households tend toward the secondary metropolitan areas, small towns and rural markets of the South and interior heartland.

This analysis has been based on a likelihood or a rate for being insured and uninsured rather than an absolute number of households without insurance. So while San Francisco has the lowest rate of uninsured, they will certainly have more uninsured households than Greenville, MS. However, even taking market size into account, Nielsen estimates there are roughly 8.3 million uninsured households in the top 27 high income markets (where 60% of all affluent households are) versus 15.4 million uninsured households in the lesser affluent markets. The gap becomes more apparent when you look at the top 50 high-income DMAs – those top 50 markets contain 81% of households with incomes of $500,000+, but only 34% of the uninsured.

Were a “high income” surtax employed to fund universal coverage, there would likely be a “wealth transfer” from the large, metro markets of the East and West to the smaller, second-tier markets of the deep South, the Mississippi valley, and central plains. [See graphic for side by side comparison].

Learn more about Nielsen Claritas.