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Using Social Marketing for Public Health: Global Trends 7

Trend 2: Integration of Downstream, Midstream, and
Upstream Efforts

Social marketing was once called “an administrative theory” because it was per-
ceived as “essentially source-dominated” (Baran & Davis, 2009, p. 259). The critics
held that social marketing “assumes the existence of a benign information provider
seeking to bring about useful, beneficial social change” (Baran & Davis, 2009, p.
259). These critics failed to see the complete picture of today’s social marketing
theory and practice. In 2006, Andreasen described the expanded roles for social
marketing in his book, Social Marketing in the 21st Century, seeing social marketing
as “about making the world a better place for everyone—not just for investors or
foundation executives” (p. 11). As he elaborated,
the same basic principles [of marketing] that can induce a 12-year-old in Bangkok
or Leningrad to get a Big Mac and a caregiver in Indonesia to start using oral rehy-
dration solutions for diarrhea can also be used to influence politicians, media fig-
ures, community activities, law officers and judges, foundation officials, and other
individuals whose actions are needed to bring about widespread, long-lasting, pos-
itive social change. (p. 11)

“[T]o take social marketing to the ‘next level’ of influence and impact” (p. 11),
Andreasen (2006) outlined a vertical perspective, in addition to the “traditional”
horizontal perspective. As he put it,

[w]e need vertical perspectives to understand where social problems come from,
how they arise on various social agendas, and how they are addressed. A horizontal
perspective then is needed to consider the range of players who need to act and the
kinds of changes that have to happen for the social change process to move for-
ward. (p. 12)
Andreasen’s (2006) thought has actually been put into practice in many social
marketing campaigns. In this book, Chapters 3 and 5 illustrate social marketing
successes for public health in both horizontal and vertical perspectives. The only
difference lies in the different terms used in these chapters. While the horizontal
perspective is called downstream efforts in the chapters, the vertical perspective is
described as upstream efforts. Between these two types of efforts, a third dimen-
sion of social marketing—midstream efforts—is also introduced in Chapter 5.
Midstream efforts are made to reach “those with the ability to influence others in
the target markets’ community,” including family members, neighbors, co-workers,
and friends. Midstream efforts could be as critical as downstream and upstream
efforts for the success of a social marketing campaign. Chapter 3 describes how a
mass media campaign (to reach the main segment of the target audience) and an