Public Health Doesn’t Have a Dissemination Problem. It Has a Marketing Problem.

Every year, taxpayers invest billions of dollars in biomedical and public health research. Scientists publish hundreds of thousands of papers, systematic reviews, and clinical guidelines. Yet only a fraction of those discoveries ever change clinical practice, influence policy, or improve health outcomes. The problem is so well recognized that it has spawned an entire field known as dissemination and implementation science, devoted to understanding how evidence moves from the pages of journals into the real world.

A new paper in Implementation Science represents an important milestone in that effort. Rather than treating dissemination as a vague concept, the authors propose a taxonomy of eight measurable outcomes that evidence should achieve on its journey toward implementation: exposure, comprehension, credibility, salience, perceived fit, leadership endorsement, action readiness, and ultimately, the decision to implement. Their argument is simple but important. If researchers cannot clearly define what successful dissemination looks like, they cannot determine why one dissemination strategy succeeds while another fails.

It’s an elegant framework. It also exposes one of the biggest blind spots in modern public health.

Scientists have spent decades building a science of dissemination while largely ignoring another discipline that has been studying nearly identical questions for over a century

Marketing.

For many academics, that comparison is uncomfortable. Marketing carries baggage. It conjures images of advertising agencies, corporate sales teams, and clever slogans designed to convince people to buy products they don’t need. Science, by contrast, prides itself on objectivity. Researchers often assume that good evidence should persuade people on its own merits.

But history tells us otherwise.

People do not make decisions based solely on evidence. They make decisions based on whether they notice information, understand it, trust it, recognize its relevance to their own lives, believe it applies to their circumstances, and feel capable of acting upon it. Remarkably, these are almost exactly the stages described in the new dissemination taxonomy. Exposure comes before comprehension. Comprehension precedes credibility. Credibility must be established before people judge whether the evidence matters to them or fits their situation. Only after navigating those psychological hurdles do individuals or organizations decide to act.

Anyone who has worked in marketing would find this sequence familiar.

Marketing researchers have spent decades experimentally testing how people process information. They study message framing, source credibility, audience segmentation, emotional appeals, social proof, behavioral nudges, and brand recognition. Entire industries have developed sophisticated methods for answering questions that dissemination scientists are only beginning to formalize. How many people saw the message? Did they understand it? Did they trust it? Did it change their intentions? Did it ultimately change behavior?

The terminology differs, but the underlying psychology is remarkably similar.

That does not mean dissemination science should become marketing. The goals of public health are fundamentally different from those of commercial advertising. Public health seeks informed decision-making grounded in evidence, not simply persuasion. Likewise, marketing alone cannot solve the organizational, policy, and implementation challenges that dissemination scientists study so well. Dissemination science contributes theories of implementation, organizational readiness, health equity, systems change, and policy adoption that extend far beyond traditional marketing.

The mistake would be to assume these fields compete with one another. Instead, they complement one another.

One of the most striking features of the new taxonomy is its recognition that dissemination does not fail for a single reason. A clinician may fully understand a study yet doubt its credibility. A hospital administrator may trust the evidence but see no practical way to implement it within existing workflows. A policymaker may agree completely with the science but prioritize other issues because of political realities. Each failure requires a different solution.

Marketing has been grappling with these distinctions for decades.

Perhaps nowhere is this more evident than in audience segmentation. Researchers often communicate as though there is one audience called “the public.” In reality, every piece of evidence has multiple audiences, each with different motivations and constraints. A physician wants concise clinical guidance. A legislator wants economic impact. A health department director wants feasibility. A patient wants clarity and reassurance. Effective marketers instinctively tailor messages to these different audiences. Scientists, by contrast, often publish a journal article and assume the work of communication is complete.

It isn’t.

Publication is not dissemination.

Dissemination is not implementation.

And implementation is not impact.

These are distinct stages that require different expertise.

Ironically, scientists themselves demonstrate the importance of marketing every day. When applying for grants, they carefully tailor proposals to the funding agencies’ priorities. When submitting manuscripts, they adapt their writing to the expectations of journal reviewers. When presenting at conferences, they simplify complex findings for broader audiences. Researchers already know how to adjust messages to different stakeholders. They simply don’t call it marketing.

Perhaps they should.

The future of dissemination science will not be found by replacing rigorous implementation frameworks with advertising techniques. Nor will it be achieved by pretending communication is somehow separate from science itself. The most effective public health efforts will combine both traditions. Dissemination science can identify where evidence stalls on its path toward adoption. Marketing science can help explain why and provide tools for overcoming those barriers through better audience understanding, message testing, behavioral insights, and continuous evaluation.

The ultimate goal of public health is not simply to generate knowledge. It is to improve health.

If evidence never reaches the people capable of acting on it, even the best science remains little more than words on a page.

The new dissemination taxonomy is an important step toward understanding how evidence travels. The next step may require public health to embrace an idea that has long seemed uncomfortable: that great science deserves great marketing. Not because public health should sell ideas like consumer products, but because understanding how people receive, trust, and act on information has always been at the heart of both disciplines. Dissemination science and marketing science offer something far more powerful than either field alone: a roadmap for ensuring that discoveries don’t simply advance knowledge—they improve lives.