Men's Understandings of Social Marketing and Health: Neo-Liberalism and Health Governance

Article excerpt

Social marketing for health has become a core component of UK government strategies to improving wellbeing and tackle inequalities amongst diverse populations, including men. Social marketing strategies adopt the methods of commercial marketing to promote social good through encouraging behavioural change in individuals. These methods have been employed with men in the UK as part of a wider movement to improve male health. Drawing on original empirical data collected with 50 unemployed men in the UK, this paper and considers men's responses to social marketing strategies and their own understandings of health, its determinants and personal responsibility. Data presented illuminates men's critical stance towards social marketing for health and its imperatives for behavioural change in the face of wider societal determinants of wellbeing which shape both their health behaviours and experiences. Critical discussions of the use of such strategies as part of neo-liberal models of health governance are offered.

Keywords: social marketing, men's health, determinants of health, responsibility, neo-liberalism

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Our public health problems are not, strictly speaking, public health questions at all. They are questions of individual lifestyle--obesity, smoking, alcohol abuse, diabetes, sexually transmitted disease. (Tony Blair, 2006)

Social marketing is: the systematic application of marketing, alongside other concepts and techniques, to achieve specific behavioural goals, for a social good. (French & Blair Stevens, 2005)

Your asking the wrong people who are on benefits aren't you really? You can't afford choice. (Research participant)

In the above quote, UK Prime Minister (1997-2007) Tony Blair neatly summarises what have become, in the UK and beyond, prevailing neo-liberal ideologies which position responsibility for health and its management with the individual. These ideologies have infiltrated recent public health work, promoting individual responsibility for the management of health and wellbeing and focusing upon what has been described as the "politics of behaviour" (Furedi, 2006). Where once, the aim of public health was to improve environments, strengthen communities or tackle inequalities (Ashton & Seymour, 1988), newer strategies emphasise the role of the individual in determining their own health (Rose, 2001), typically focusing upon the promotion of behavioural change. Perhaps nowhere else are these imperatives so apparent than in social marketing strategies which have recently become a key aspect of UK government public health policy at national and local levels (French, 2009). These strategies are indicative of newer forms of health governance which move beyond the provision of services to integrate health as a core aspect of the lives of individuals and communities and elevate it to a core goal of self actualisation within late modern western "health societies" (Kickbusch, 2007).

Social marketing aims to promote "social good" (National Social Marketing Centre (NSMC, 2007) using the methods of commercial marketing. These methods include: a customer/consumer orientation, setting of behavioural goals for a social good, use of a marketing mix to achieve those goals, audience segmentation to target customers effectively, and use of the concepts of "exchange" and of "competition" (Robinson & Robertson, 2010). Social marketing for health typically targets individuals and communities (the sick, but more often, and most significantly for this research and discussion, the "worried well"), with the aim of encouraging behavioural change, often with populations deemed to be "at risk"; for example (male) smokers (see Figure 1).

These objectives are achieved through a complex "mix" of methods which includes recognising the relationship between product, price, place and promotion characteristics in intervention planning and organisation (Lefebvre and Flora, 1988). …