The Think Before You Pink Project
Karuna Jaggar
September 20, 2019

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Karuna Jaggar has been executive director of Breast Cancer Action since 2011 and has a lifelong commitment to social justice. Throughout her 15-year career in nonprofit leadership, her work has focused on women’s rights and on eliminating socioeconomic inequities. Jaggar began her career working with women’s microenterprises internationally and in the United States, providing self-employment and business training, funding and support for low-income women. Prior to joining Breast Cancer Action, Jaggar was executive director at the Women’s Initiative for Self Employment. She has served on the Board of the California Association of Microenterprise Opportunity, where she chaired the Policy Committee. She holds a master’s degree in economic geography from the University of California-Berkeley and received her bachelor’s degree in philosophy from Smith College.

With Breast Cancer Awareness Month upon us, Karuna joins us to talk about the Think Before You Pink project, including its history and goals.

Listen to the podcast to hear Karuna talk about:

  • how the Think Before You Pink campaign started
  • how she defines “pink washing”
  • reactions to the campaign
  • four questions Breast Cancer Action asks people to consider before buying anything with a pink ribbon on it

Running time: 28:46

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Show Full Transcript

Jamie DePolo: Hello! Thanks for listening to the Breastcancer.org podcast! Our guest today is Karuna Jaggar, executive director of Breast Cancer Action, an organization that focuses on systemic interventions that address the root causes of breast cancer to produce public health benefits, including its Think Before You Pink campaign. Jaggar has been executive director of Breast Cancer Action since 2011 and has a lifelong commitment to social justice.

Throughout her 15-year career in nonprofit leadership, her work has focused on women’s rights and on eliminating socioeconomic inequalities. Jaggar began her career working with women’s microenterprises internationally and in the United States, providing self-employment and business training and support for low-income women. Prior to joining Breast Cancer Action, Jaggar was executive director at the Women’s Initiative for Self Employment. She has served on the board of the California Association of Microenterprise Opportunity, where she chaired the Policy Committee.

She holds a master’s degree in economic geography from the University of California Berkeley, with a special emphasis on women, gender, and sexuality, and received her bachelor’s degree in philosophy from Smith College. With Breast Cancer Awareness Month upon us, Karuna joins us to talk about the Think Before You Pink campaign, including its history and goals.

Karuna, Welcome to the podcast!

Karuna Jaggar: Thank you! It’s really nice to be here with you.

Jamie DePolo: So, in case anyone is not familiar with Think Before You Pink, can you tell us how the campaign started and when it started?

Karuna Jaggar: Think Before You Pink is a project of Breast Cancer Action. Breast Cancer Action was founded in 1990, which is right about the same time that the first companies were putting pink ribbons on products for breast cancer awareness. I’m happy to tell you that story in a moment.

But what was happening is, during those first 2 years or so of Breast Cancer Action’s history, more and more pink ribbon products were flooding the market and our members had questions about that. They wanted to know, where was all that money going? And so, I think it really emerged from a follow-the-money project that was really looking at the transparency and accountability a lot of this pink ribbon fundraising. And basically, folks were not satisfied.

You know, a lot of companies were making a lot of money in the name of awareness, and often pennies on the dollar at best would be donated to any breast cancer program. And folks thought there was too little to show. And so, by 2002 we had launched the Think Before You Pink campaign, and the idea is Think Before You Pink calls for accountability and transparency. It helps the public think about how they can evaluate some of these pink ribbon promotions.

We provide critical questions that folks can ask about any particular ribbon promotion, and over the years we’ve targeted a number of multi-million-, even billion-dollar companies, really urging them to go beyond simple marketing, which is what many of these pink ribbon promotions end up being, and really taking steps to demonstrate their commitment to ending the breast cancer epidemic.

Jamie DePolo: Excellent. Now, did Breast Cancer Action coin the term, “pink washing,” or was that already in use when you started this campaign?

Karuna Jaggar: Yes, we did coin that phrase. For us, pink washing is really a spin on that phrase “green washing,” right? The idea behind green washing is that you have companies that tell you how much they care about the environment but are not actually taking steps to ensure their practices are sustainable. Similarly, you’ve got all these companies that are telling us how much they care about breast cancer and women’s health, and yet all too often, the products that they’re pushing may contain chemicals that might increase the risk of the disease. So we call that pink washing.

Pink washing is not simply pink ribbon promotions, of which there are many, it’s specifically the hypocrisy of companies telling us how much they care about breast cancer while their product or service might increase risk of the disease.

Jamie DePolo: Now you sort of touched on this in your first answer, but if you wouldn’t mind telling us specifically what are the goals of the campaign? Is it transparency to get these companies to show where the money is going, and does it also involve getting companies to perhaps be a little more responsible if you will in promoting products tied to breast cancer?

Karuna Jaggar: Our work is to address [the] breast cancer epidemic, and to do that we find that we’re really challenging this cancer industry, which is when companies that are contributing to risk of the disease are working hand-in-hand with nonprofits that are supposedly working on behalf of patients but all too often are really just providing cover for companies and letting them get away with some of these hypocritical business practices.

So you know, everybody cares about breast cancer, and they should. We have a public health crisis on our hands. The incidence of breast cancer has increased over the decades. You know, it was 1 in 20 women 50 or 60 years ago. Today, it’s 1 in 8 women over the course of her life will get breast cancer. That’s a marked increase in incidence that you cannot explain that just from the BRCA mutation. Everybody is thinking about these hereditary risk factors, but combined family history accounts for maybe 10% of breast cancers, so the majority of breast cancers are not linked to any known risk factor. They’re being driven in part by these systemic exposures to synthetic chemicals that are disrupting our hormone systems and are in other ways carcinogenic. And these aren’t things that individual people can just shop their way out of.

So given that’s our analysis of the cancer industry and the kind of cancer economy, and given the ways that we keep pushing the burden onto individual women to prevent their own breast cancer, kind of shaming and blaming women in ways that are completely unfair. We are always looking at the systemic root causes, so when you have a company that’s telling you how much they care about breast cancer, we think, “Great! We need you to clean up your business practice and actually demonstrate that you are willing to do the work to help turn the tide on this epidemic.”

So I think about last year’s Think Before You Pink campaign which was called Help Put the Brakes on Breast Cancer, targeting Ford Motor Company. Ford Motors runs the Lawyers in Pink program, again telling us how committed they are to women affected by breast cancer. Well, this past year, Ford decided to stop selling passenger cars in the U.S. and instead double down, you know, go full throttle so to speak, on their trucks and SUVs, which are their highest-emitting vehicles.

We know that auto exhaust drives the risk of breast cancer, and this is bigger than individual lifestyle choice. An individual person may ride public transportation or bicycle everywhere, but we’re all breathing that auto exhaust that is increasing the risk of breast and other cancers. And so when you have a company like Ford building their brand by telling us how much they care about breast cancer and at the same time, their business practices are going in exactly the wrong direction… In 2018 they announced that they would be launching a new diesel F150. The F150 is the country’s most popular vehicle, and introducing a diesel model is taking us in exactly the wrong direction. So we called on Ford to go to an all-electric fleet that would actually turn the tide on the breast cancer epidemic.

So, going back to the goals of the campaign, for us it is about urging companies to take the steps to make sure that they’re not driving up the risk of breast cancer, and calling for accountability and transparency so that companies aren’t just exploiting people’s good intentions. We’re not saying that pink ribbons are inherently wrong and that no companies can ever do the right thing. What we’re saying is, show us. Show us that this is not just a publicity stunt. Show us that this is more than marketing. Show us by actually taking the steps to ensure your business practices are not driving up risk of the disease.

Jamie DePolo: What would you say some of the achievements, the results, are? Have companies responded to this, and how have they responded?

Karuna Jaggar: [There are] a number of companies that have changed their business practices in response to the Think Before You Pink campaign. One of the best examples is Yoplait, which has been making yogurt and putting these pink lids on that folks can mail back to the company in order to generate a donation. Unfortunately, Yoplait, in the early 2000s, was using dairy that was produced with this synthetic growth hormone called rBGH, and there were concerns about the links between rBGH and breast cancer risk. So, in response to our campaign, which we called “Put a Lid on It,” Yoplait, and then later, Dannon, decided to go rBGH-free in their yogurt, which was a really wonderful [achievement]. It meant that two-thirds of yogurt produced in the U.S. was rBGH-free. So that’s a great example.

Another example is Kentucky Fried Chicken was producing “Buckets for a Cure.” I know that sounds shocking, but in 2010 or [2011] that was actually … they thought it was a good idea. So we launched the “What the Cluck?” campaign, calling out the hypocrisy behind encouraging people, particularly in low-income communities of color, to eat this fried chicken in the name of breast cancer, and the hypocrisy of those health harms associated with that food. So we’re really pleased that KFC stopped that campaign early. They ended up stopping after 6 weeks. I think that’s another example of a win.

You know, Komen was producing a perfume that they called Promise Me that contained hormone disruptors and other chemicals of concern. So here you have the world’s largest breast cancer charity that commissioned the perfume. They actually asked the manufacturer to make them a perfume just for Komen, and independent laboratory testing found these chemicals of concern including hormone disruptors. Breast cancer is a hormone-driven disease. We know that hormone disruptors can impact the efficacy of treatment, so we were outraged. I reached out immediately to their CEO and let them know about the results of the independent laboratory testing. We called on them to recall that perfume, and while they didn’t recall it, they did end that production rather than carrying it on as planned.

So those are some of the kind of real-world impacts where we feel we’ve kind of been able to help companies stop putting these products out into the marketplace that have chemicals of concern. Other ways that I would measure the campaign’s success really does have to do with changing the way people think about breast cancer marketing. Just in 2011 when I came to the organization, people were still calling and asking, “Isn’t any money for breast cancer good?” — suggesting that the end justifies the means. We don’t get those questions anymore. I think the public is much more discerning about not just breast cancer marketing but other charitable marketing and saying, “Hey! This needs to be more than a publicity stunt.” How is the company really demonstrating their commitment to the issue?

So I think pink washing is now largely a household name. Most people really do understand what pink washing is, and we can help them think about how they can go beyond pink washing and ask some specific questions to make sure that their purchase is having the impact. As I said, people care about breast cancer, so we’re not suggesting that [there are] no companies doing anything good. We’re really wanting to make sure they’re being transparent around how they’re doing good.

Jamie DePolo: And is that typically the way Think Before You Pink works? You launch sort of an initiative each year focusing on maybe what you see as the most egregious marketing campaign of that year, or is it something that’s ongoing all the time?

Karuna Jaggar: A little bit of both, although October is Breast Cancer Awareness Month, and there are a number of special breast cancer promotions in October. More and more companies are doing breast cancer marketing year round, so things like our critical questions for consumers are always available.

We do launch an annual campaign in October that coincides with Breast Cancer Awareness Month, which we call “Breast Cancer Industry Month” in recognition of the profiteering off of the disease. But something like the Buckets for a Cure was actually launched in the spring, and so our “What the Cluck?” campaign was not just during October. It was actually launched in the spring when KFC first created the pink ribbon buckets of fried chicken.

Jamie DePolo: Now, I’m curious about what the reaction has been to the campaign, both from people who’ve been diagnosed with breast cancer, as well as the corporations. And I would invite anyone who is listening, if you have comments you can email us at podcast@breastcancer.org and tell us what you think about pink washing and/or marketing of specific breast cancer products during October. But back to you, Karuna. What has the reaction been to the campaign?

Karuna Jaggar: Well, like all things, it makes different people have different reactions, and I think the trend or the response has changed over trends. When we first began following the money and when we first launched Think Before You Pink, more people tended to say, “Isn’t any money for breast cancer good? Isn’t this ultimately a good thing?” We just don’t get those questions anymore. More people see that too many of these pink ribbon promotions are really publicity stunts or marketing campaigns that benefit the company more than they benefit any breast cancer organization.

All too often, you see companies spending much more to promote their donation than they’re actually donating. I have a number of examples of that. One of them were these pink fracking drill bits from a few years ago. So, Baker-Hughes is the world’s second largest oil servicing company, a multi-billion-dollar international company, and they were making a donation of $100,000 to the Susan G. Komen Foundation. Meanwhile they were making 100 drill bits, these were drill bits that were going to go into the ground, hoping to trademark pink. And they were shipping those around the world in containers that included mammography screening brochures.

The theory was that if they put these brochures into the container with the drill bit, then the roughnecks — and that’s their word for it — the roughnecks out in the field would take these brochures back home to the women in their lives. Well, they produced promotional videos and all kinds of promotional materials about these donations that far exceeded the $100,000 donation to [Susan G.] Komen, and we see that over and over again. I think the public has really begun to look past the pink ribbon to see what’s really happening.

And I’ll also say that an individual person’s relationship to the pink ribbon often changes over time. So it’s not uncommon that when someone is first diagnosed they’re sort of thrown into the deep end of the breast cancer world and the breast cancer community. At the very beginning, they might actually feel some sense of a kind of solidarity by seeing another pink ribbon out there. But many times, the more time someone spends as part of the breast cancer community, the more questions they have about companies profiting off the disease. About the messages the companies are giving, which are not at all evidence-based. Despite the popularity of the phrase “early detection saves lives,” the fact of the matter is women are more likely to be overdiagnosed and overtreated than to have their lives saved as a result of a mammogram. Essentially the mortality rates have remained relatively unchanged. We’re just not seeing the promised benefit for all those mammograms. Still, more than 40,000 women die each year from breast cancer, and it’s a number that is hardly changed from 1990, when Breast Cancer Action was founded.

So more women, as they learn the facts of breast cancer, see that companies are putting out often really misleading information about the disease, including information about the 5-year cure rate when we know that for hormone-positive breast cancer, half of all recurrences are going to happen after that 5-year mark. We know that as many as 20, possibly even 30% of all breast cancers — even those detected early — will go on to metastasize. And so, it’s those women who are feeling misled and betrayed by some of this kind of cheerful ribbon marketing, that the relationship with the pink ribbon changes. They begin to feel let down by companies that are just selling, essentially, cheerful stories and easy answers that aren’t working. In order to sell these pink ribbon products, companies tell us that the pink ribbon products are going to make a difference, and that can be very misleading.

Jamie DePolo: I agree with you about the sort of change in perspective on the pink ribbon. Two of my friends have metastatic breast cancer, and I’ve talked with them about it and I’ve watched them kind of go through that, and Breast Cancer Awareness Month is very tricky for them because they feel that there is a lot of awareness. What one said to me flat out was, “Lots of people are aware of breast cancer. What we really need is the cure.” So I agree that that relationship can change because, as you said, when you are first diagnosed, it can be comforting to kind of use that to seek out other people and get support. That is helpful, but I think that people who’ve been diagnosed with metastatic disease, sometimes it gets to be a more complicated relationship.

Karuna Jaggar: I would just add to that that, you know, so many women feel that the pink ribbon gets tied to this cheerfulness. I mean, the history of the pink ribbon is really interesting. It’s a history of a cooptation of a grass roots tool. So when the pink ribbon kind of emerged from this peach-colored ribbon, similar but slightly different, Charlotte Hailey was a woman living in southern California. She was alarmed at the number of women in her family and community who were diagnosed with and dying from breast cancer. So at a time when we had yellow ribbons for the troops and red ribbons for HIV/AIDS, she launched this peach-colored ribbon calling for more research funding to prevention. And SELF magazine and Estee Lauder… she got some media attention.

Charlotte Hailey got media attention, and SELF magazine and Estee Lauder reached out to her to see if they could partner with her. She wasn’t interested. She said that it was too corporate for her. And so, Estee Lauder and SELF magazine’s lawyers suggested that all they needed to do was change the color. So they did focus groups, and they found that pink was feminine and cheerful and soothing and soft, and basically everything that breast cancer is not. And when the peach ribbon was turned pink, that focus on prevention was changed to these really corporate profit and these sometimes donations to breast cancer organizations, but sometimes not.

And that story, that association with “stay strong, fight hard, be positive, smile more”… I think Estee Lauder’s campaign just a year or two ago said things like “Smile more.” And it’s so condescending, and it’s sort of a double blame-and-shame women. Not only did they not live, make all the right choices, but they got breast cancer, and the implication [is that] they didn’t have the right attitude to their breast cancer. And I think that is really harmful, and it’s important that we really acknowledge the full breadth of experiences with breast cancer and that there’s space for a full range of emotions, including anger and of course grief and sadness.

Jamie DePolo: Now, on the website, to sort of wrap up, Breast Cancer Action has four questions on the Think Before You Pink page, four questions that you ask them to consider before they buy anything with a pink ribbon on it. I thought it might be helpful if you could kind of go over those questions with us so if people are interested, they can have those in their mind.

Karuna Jaggar: We have four questions to ask before you walk for breast cancer and four questions for conscious consumers. So if you see a pink ribbon on a product there are quick things you can do. Let me say that I have been that person before I came to Breast Cancer Action.

If you are looking at two olive oils and one of them has a pink ribbon on it, your first impulse might be, “Well, I might as well buy the pink ribbon one,” and you assume that some money is going to get donated to a breast cancer organization. Well, that’s the first question — is it? Often, companies will put a pink ribbon on something and that’s the extent of their supposed support. There’s not necessarily a financial contribution. So the first question is, how much money from this purchase is going to go to a breast cancer organization?

And the next question is, what organization and what programs will your money fund? And that really speaks to the fact that so many breast cancer organizations are doing more awareness work. Here we are in 2019. You’d be hard-pressed to find somebody who isn’t aware of breast cancer. Often that awareness can include a lot of misinformation and misleading information. So what’s the work that you think is most important? Are those the programs that your purchase is funding?

Third question is, is there a cap on the donations, is there a maximum, and has it already been met? One of the problems with the transparency around these donations is that sometimes a company like Reebok will be selling athletic wear, and they’ll say that a portion of this purchase will go to whatever organization up to a maximum. How do you know if that maximum has been met, because if it’s already been met, your purchase is going to go straight back into the company’s bank account.

And the fourth question is, does the product put you or someone you love at an increased risk of breast cancer? This really gets back to that pink washing question, the question about those chemicals in the product that may increase the risk of the disease. If you’re not able to answer each of these questions to your satisfaction, you don’t have to despair because you can still go ahead and make a donation to the breast cancer organization of your choice that you feel is doing the work that’s most important.

Jamie DePolo: That makes good sense, and I realize that it could be difficult to figure out some of those, as someone’s standing in a store, as you said, with two bottle of olive oil in their hands. But maybe you decide on your purchase and then you go home and you do some research.

Karuna Jaggar: Yes, and I think it’s reasonable to ask companies that are asking us to buy their products to make that information available. It shouldn’t be that hard. That’s part of what Think Before You Pink does. How much of this money is going to go to any breast cancer organization, any breast cancer program? What is that work? How do I know that my purchase is going to result in a donation, and is this product safe? Folks shouldn’t have to work too hard to get those answers, and if they do, I think that’s important feedback for the company. That’s part of what our Think Before You Pink campaign does. It really asks how they can partner with the breast cancer community to help people understand where they can make a real difference.

Jamie DePolo: Karuna, thank you so much. This has been very interesting and informative. I really appreciate your time.

Karuna Jaggar: Thank you for having me!

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