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65 Laura Bush’s Fashion Choices and the Heart Truth Initiative erika cornelius smith MUSEUMANDLIBRARYPRESIDENTIALBUSHW.GEORGE white house history quarterly
66 IMAGESGETTYSPREAD:THISIMAGESALL on december 3, 2006, President George W. Bush and First Lady Laura Bush hosted a White House reception in advance of the Kennedy Center Honors. Mrs. Bush selected a brilliant red Oscar de la Renta gown for the occasion, inspired by the dramatic red of the Kennedy Center’s interior. Yet Mrs. Bush was not alone in her good taste. Three other women attending the reception selected the same gown and greeted the first lady as they moved through the receiving line. The women laughed off the faux pas, even posing for a photograph together, but the first lady chose to change before the awards ceremony. Despite its short-lived appearance for the honors ceremony that December evening, Mrs. Bush’s red gown was later featured in the official White House holiday photograph and traveled the country as part of the Heart Truth Red Dress campaign.1Inthebeginning months of her tenure as first lady, Laura Bush’s everyday fashion reflected a con servative, subdued style. She adopted a mixture of slim and tailored pantsuits in muted colors and earthy greens or oranges, as well as the occasional wool tweed suit. Dallas fashion designer Michael Faircloth, whose clothes were worn by the first lady on more than one occasion, observed that “she was always very conscientious about not wanting white house history quarterly
white house history quarterly the American public still lacked a broader under standing of women’s health risks. In 2000, stud ies emerged reporting that one in three American women’s deaths were due to heart disease. Not enough women—or their doctors—were sufficiently aware of these emerging statistics about women’s heart health.4 A separate survey conducted by the American Heart Association in 2000 showed that only 34 percent of women knew that heart disease represented their most likely cause of death. Most believed breast cancer was their greatest health concern.5 Heart disease was not something they took seriously or personally; rather, they predomi nantly viewed it as a “man’s disease.”
67 clothes to speak loudly” because she believed there were other things that were “more important.”2 This approach to fashion remained constant throughout her eight years as first lady with two exceptions: fashion for formal occasions and fashion as a tool forWhenadvocacy.Laura Bush arrived at the White House as first lady, like most Americans she believed cancer was the leading cause of death among women in the United States. This belief was due, in part, to a concerted public health campaign to raise aware ness of cancer risks following President Richard Nixon’s 1971 State of the Union Address, in which he asked for $100 million to find a cure for cancer.3
fellowshipanAcceptinghonoraryfrom the American College of 2004.whatdiseasewomenDresssheBushFirstCardiology,LadyLauraexplainsthatwearsherRedpintoremindthat“heartdoesn’tcareyouwear,” opposite top After posing at a White DressthebringinwouldbutceremonybeforedecidedZubinSpielberg,Mrs.PresidentDollyLloydRobinson,tochosen.gownOscarwearingthreediscoveredLauraCenter2006recipientsreceptionHousewithoftheKennedyHonors,BushthatguestswerethesamedelaRentathatshehadFromleftright,SmokeyAndrewWebber,Parton,andBush,StevenandMeta.Shetochangetheaward(below),thereddresslatertravelanexhibittoattentiontoHeartTruthRedcampaign. right First Lady Laura Bush wears Tours.SpringaheadtowelcomespantsuitunderstatedanasshethepresstheEastGardenofthe2004Garden
The Breast Cancer Detection and Demonstration Project (BCDDP) launched the next year, followed soon after by the open, national discussion of the diagnosis and treatment of First Lady Betty Ford and Vice President Nelson Rockefeller’s wife, Happy Rockefeller, for breast cancer. Women’s health advocacy organizations sprang into action and grew rapidly throughout the next two decades, raising awareness and funds for research; the Susan G. Komen Breast Cancer Foundation, later renamed the Susan G. Komen for the Cure, became a household name. Despite success in raising awareness about women’s risk for cancer, the medical profession and previous spread
In the same historical moment, women who had experienced heart attacks began to share their sto ries. They learned of one another’s misdiagnoses, inadequate treatment, and social isolation, which motivated them to form a supportive network for women living with heart disease. Brought together by a reporter for MORE magazine, they founded
WomenHeart: The National Coalition for Women with Heart Disease in 1999 as the first national patient-centered organization that would focus exclusively on women’s heart disease. The next year
Sister to Sister: Everyone Has a Heart Foundation Inc. was founded to increase awareness and encour age healthy lifestyles among women.
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The Heart Truth, a name designed to acknowl edge the “hard truth” and urgency of women’s expe rience with heart disease, launched in September 2002 in Washington, D.C., officially as a partner ship among the U.S. Department of Health and Human Services Offices on Women’s Health, the American Heart Association, and WomenHeart. To increase the visibility of the campaign, advocates believed they needed an ambassador who could connect with American women and speak from a national platform. Dr. Elizabeth Nabel of the NHLBI approached the office of First Lady Laura Bush.American first ladies have often used their plat forms to promote health and disease awareness, research, and treatment. Scholars have docu mented Eleanor Roosevelt’s advocacy for access to healthcare as part of her broader commitment to universal human rights, the impact of Betty Ford’s candor regarding breast cancer and mental health, Nancy Reagan’s commitment to combating sub stance abuse and investing in stem cell research, and Hillary Rodham Clinton’s work to expand access to basic health care through policy reform. This work is not simply an extension of their hus bands’ agendas but often stems from their own value judgments, personal experiences, and polit icalByambition.7thesummer of 2002, Laura Bush drew approval ratings consistently above 60 percent. When surveyed, Americans described her as “hon est,” “confident,” “intelligent,” and “caring.”8 Even before she became first lady of the United States, she amassed a record of advocating on behalf of women’s and children’s health issues during her time as first lady of Texas and as a member of the Governors Spouse Program of the National Governors Association. She consistently supported the Susan G. Komen Foundation because of her family’s personal connections to the fight against breast cancer; both her mother and grandmother were survivors.9 This personal commitment to women’s health and the power of the first lady’s “velvet pulpit” enabled Mrs. Bush to become an effective ambassador for the Heart Truth.10
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As these movements garnered more support and gained momentum, they turned to public advocacy. WomenHeart was determined to put women’s heart health on the National Heart, Lung, and Blood Institute’s (NHLBI) national agenda. In 2001, the NHLBI, WomenHeart, patients, research ers, public health leaders, health communicators, health care delivery experts, and other women’s health advocates participated in the Women’s Heart Health Education Strategy Development Workshop.6 Their subsequent partnership with Ogilvy Public Relations Worldwide unfurled a blueprint for what would become the Heart Truth campaign and a new powerful symbol for women’s heart disease—the Red Dress.
In January 2003, Laura Bush joined the American Heart Association Valentine Luncheon and Fashion Show as an honored guest. Her remarks emphasized the importance of self-care, the staggering reality of women’s susceptibility to heart disease, and the steps toward prevention advised by medical professionals. She cited com pelling statistics amid more personal stories, at one above Laura Bush greets event organizers in front of The Red Dress Project exhibit in Bryant Park, during New York Fashion Week, 2003. The dresses on display were later auctioned to benefit Association.AmericantheHeart 70 white house history quarterly
in New York in February 2003. Nineteen leading fashion designers, including Ralph Lauren, Vera Wang, and Oscar de la Renta, contributed dresses to an exhibit displayed at Bryant Park.
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far right Laura Bush and Oscar de la Renta pose beside a dress of his design during the 2004 Fashion Week in New York City. Mrs. Bush donated the red dress to The Heart Truth Road Show that toured the country to help inform women about heart disease.
point teasing, “If my mother-in-law Barbara Bush, who is 77, can swim 88 laps at a time, the rest of us can surely walk 30 minutes.”11 Two weeks later, on Valentine’s Day in February 2003, Laura Bush began her role as a national ambassador for the campaign by appearing on all three network morn ing shows wearing a symbolic Red Dress pin, reiter ating the same information about women and heart disease. She continued throughout the year with local awareness-raising events across the country, national press conferences, media interviews, and events at the White House. The Heart Truth cam paign team also appealed to leaders in the fashion industry to help promote the Red Dress symbol.
Women’s heart disease was integrated as the sig nature “cause” of Mercedes Benz Fashion Week
The events of February 2003, between the first lady’s media appearances and New York Fashion Week, brought the Red Dress to life and gave the campaign a powerful media platform. The national conversation continued through October of that year with a special issue of Glamour magazine dedicated to reminding readers that “Heart Disease Doesn’t Care What You Wear—It’s the #1 Killer of Women.” The issue included images of twenty-four celebrities wearing red dresses by renowned fash ion designers, such as Oscar de la Renta and Vera Wang, many of whom had designs featured in February’s Fashion Week. Swarovski crystal com pany designed its own version of the Red Dress, the first of which was featured in Glamour’s inaugu ral partnership issue.12 Editors directed readers to messages provided throughout the magazine and integrated statistics that reinforced the serious impact of heart disease for women: There’s a disease that kills nearly 1,400 women a day, but you probably don’t think about it, and neither does your doctor. We want to change all that. . . . We think we’re safe because right Mrs. Bush is joined by heart disease survivors (top, near right) as President Bush signs an American Heart ProclamationMonth in the East InFebruaryRoom,2,2004.2006,shelookson(bottom,nearright)asPresidentBushsignstheproclamationintheOvalOffice.
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Scenes from the John F. Kennedy Center for the Performing Arts as Laura Bush and Nancy Reagan unveil the Heart Truth’s First Ladies Red Dress Collection exhibit.
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in Kansas City on television, where she heard Mrs. Bush describe the symptoms of a heart attack, how they differed among women from men. Later that night, Cullen woke up concerned she was experi encing the symptoms of a heart attack and imme diately sought medical help. She became a local advocate for women’s heart health following her episode and felt compelled to share that First Lady Laura Bush’s words saved her life.15
Glamour also positioned First Lady Laura Bush as a powerful figure leading a team advocating on behalf of women: “Take care of yourself!” That’s First Lady Laura Bush speaking, and she’s talking to you. Her new cause is critical to women’s health, and she’s got a powerful team on her side. “I want to thank all the people who are lending their voices to educating American women,” says Mrs. Bush. On the next 10 pages you’ll see who’s joining her in the heart-health crusade and learn what you can do today to save your life tomorrow.14 The impact of the campaign was felt almost immediately. Women across the United States wrote to the first lady to tell their own stories. One of the very first women to do so was Joyce Cullen, who shared that she watched a Heart Truth event
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The momentum of the Heart Truth Initiative continued through 2004, when President George W. Bush proclaimed February as “American Heart Month” and National Wear Red Day ceremonies were held at the White House. Olympus Fashion Week introduced the 2004 Red Dress Collection, and it became a traveling exhibit throughout the spring of 2004. The Heart Truth Road Show, spon sored by the NHLBI and Johnson & Johnson, trav eled to shopping malls on a five-city tour that began in Philadelphia, then toured through Chicago, San Diego, Dallas, and Miami, where it ended in May.
First Lady Laura Bush is joined by heart 2007survivordiseaseJoyceCullenduringtheFashionWeekinNewYork.CullencreditedMrs.Bush’sadvocacywithsavingherlife.
The installations, designed by Hargrove Inc., the official general contractor for three presidential Inaugurations prior to 2004, included information about heart health and free screenings. Fifteen cus tom dresses were displayed atop a central runway, we’re female. We think we’re safe because we’re young. How could so many women be so wrong about heart disease? The facts should be common knowledge by now, but somehow, we’ve failed to grasp that heart disease claims the lives of 500,000 women each year, more than all types of cancer combined.13
Laura Bush takes the opportunity to speak AmericanaboutHeartMonthduringherweeklyradioaddressfromtheWhiteHouse,February1,2008. day.16 Kathy Kastan, who served as a past president of WomenHeart, credited the first lady’s ability to reach a national audience: “In spite of what’s going on—the war in Iraq, the administration’s approval ratings—she’s still getting through [to people]. Her impact is from policymakers down to the average woman, and that’s huge.” Medical professionals echoed Kastan’s perspective. “My patients say, I saw the First Lady on TV, and I made an appointment,” confirmed Nieca Goldberg, MD, medical director of New York University’s Women Heart Program. Sharonne Hayes, MD, then director of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minnesota, added, “She has a way of connecting with her audience: She admits she used to smoke and that it was very hard to quit. I can honestly say [the campaign] would not have been such a success without her stewardship.”17 In his introductory remarks for the unveiling of the First Ladies Red Dress Collection, then Secretary of Health and Human Services Michael surrounded by three stations for heart disease risk factor screenings, information stations, and a video wall of presentations. By 2005, the national Heart Truth campaign inspired local initiatives across the country and beyond. In February, Mrs. Bush shared at an event that Airman First Class Shay Guesnier and women in her unit were wearing Red Dress pins even while deployed to Iraq. In May, Mrs. Bush joined with former First Lady Nancy Reagan to unveil a very special edition of the Red Dress Collection, one that featured dresses worn by seven of America’s first ladies. The First Ladies Red Dress Collection, displayed at the Kennedy Center for the Performing Arts, included Nancy Reagan’s red lace Oscar de la Renta, which she wore when President Ronald Reagan was presented with the Order of the Bath in England 1989; the red evening gown worn by Lady Bird Johnson when celebrating her 80th birthday; favorite gowns worn by Rosalynn Carter and Betty Ford; Barbara Bush’s red dress from a State Dinner; Hillary Clinton’s red Valentine’s Day dress; and Laura Bush’s red dress from her visit to the Bolshoi Ballet in Moscow in 2003. By 2010, the collection grew to include dresses and suits representing fourteen former first ladies and twelve celebrity dresses from the annual New York Fashion Week collections.Asambassador for the Heart Truth campaign, Laura Bush used the power of her office to con tinue promoting awareness about women’s risks for cardiovascular disease until her last days in the White House. She continued to make public appearances at health facilities across the country and on morning talk shows, from Rachael Ray to CBS This Morning. In 2007, she once again joined former First Lady Nancy Reagan for a special exhi bition of the Red Dress Collection at the Ronald Reagan Presidential Library, where she partic ipated in a panel discussion on women’s health as well. Laura Bush also utilized the presidential Weekly Radio Address in February 2008 to remind listeners about the importance of women’s heart health.The campaign’s success was measured by the NHLBI and leading health advocates, who noted the number of women dying of heart dis ease decreased sharply. One report estimated the awareness campaign contributed to reducing the number of women who die each year from heart disease by 17,000, or forty-seven lives saved every 74 white house history quarterly
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8. Pew Research Center, “Laura Bush’s Changing Image: No Longer Just ‘Nice,’” posted July 2, 2002, U.S. Politics and Policy, Pew Research Center website, pewresearch.org.
12. Jennifer Wayman, Terry Long, Beth Ann Ruoff, Sarah Temple, and Ann M. Taubenheim, “Creating a Women and Heart Disease Brand: The Heart Truth Campaign’s Red Dress,” Social Marketing Quarterly 14, no. 3 (2008): 40–57.
13. Wendy Naugle and Daryl Chen, “It’s Time to Save Your Life,” Glamour, October 2003, 207–08.
14. Cindi Leive, “Take Care of Yourself,” Glamour, October 2003, 201. 15. “Mrs. Bush’s Remarks in Recognition of American Heart Month,” February 15, 2006, Office of the First Lady. www.georgewbushwhitehouse.archives.gov.
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3. Ulrike Boehmer, “A History of AIDS and Breast Cancer Activism,” in The Personal and the Political: Women’s Activism in Response to the Breast Cancer and AIDS Epidemics, ed. Ulrike Boehmer (Albany: State University of New York Press, 2000), 8–9; Richard M. Nixon, “Annual Message to the Congress on the State of the Union,” January 22, 1971, online at American Presidency Project, www.presidency.ucsb.edu.
5. Allison H. Christian, Wayne Rosamond, Anthony R. White, and Lori Mosca, “Nine-Year Trends and Racial and Ethnic Disparities in Women’s Awareness of Heart Disease and Stroke: An American Heart Association National Study,” Journal of Women’s Health 16, no. 1 (2007): 68–81.
11. “Remarks by Mrs. Bush American Heart Association Lunch and Fashion Show,” January 29, 2003, Office of the First Lady, www. georgewbush-whitehouse.archives.gov
4. Terry Long, Ann M. Taubenheim, Jennifer Wayman, Sarah Temple, and Beth Ann Ruoff, “The Heart Truth: Using the Power of Branding and Social Marketing to Increase Awareness of Heart Disease in Women,” Social Marketing Quarterly 14, no. 3 (2008): 3–29.
Leavitt shared his belief that “art has the power to teach and the power to change.” By linking the Red Dress, an iconic feminine fashion symbol, to a health campaign that aims to create awareness around the risk of heart disease among women, and amplifying that message with the power of the Office of the First Lady, the Heart Truth initiative saved the lives of thousands of American women.
6. National Heart, Lung, and Blood Institute, Women’s Heart Health: Developing a National Health Education Action Plan (Bethesda, Md.: U.S. Department of Health and Human Services, National Institutes of Health, 2001).
16. Sharonne N. Hayes et al., “Taking a Giant Step Toward Women’s Heart Health: Finding Policy Solutions to Unanswered Research Questions,” Women’s Health Issues 25, no. 2 (2015): 429–32.
For her part, Laura Bush acknowledged, “I realized the degree to which I had a unique forum as first lady. People would pay attention to what I said.”18 notes
7. Myra Gutin, “Using All Available Means of Persuasion: The Twentieth Century First Lady as Public Communicator,” Social Science Journal 37, no. 4 (2000): 564–75.
2. Quoted in Noelle Walker, “Dallas Fashion Designer to First Lady Laura Bush Give Nod to New First Lady Fashion,” published January 20, 2017, NBC Dallas–Ft. Worth, online at www.nbcdfw. com/news.
1. Laura Bush, Spoken from the Heart (New York: Scribner, 2010), 378–80.
10. Erika Cornelius Smith, “Speaking from the Velvet Pulpit: The Media Relations of Laura Bush,” in Media Relations and the Modern First Lady, ed. Lisa M. Burns (Lanham, Md.: Lexington Books, 2020), 221–44.
18. Both quotations in Sady Doyle, “The Secret Inner Life of Laura Bush,” Atlantic, May 2010.
17. All quotations in Leive, “First Lady’s Quiet Victory.”
9. Cindi Leive, “The First Lady’s Quiet Victory,” Glamour, January 2008.