Page 163 - The Handbook of Persuasion and Social Marketing

Social Marketing as Social Control 155

particular area such that citizens of the jurisdiction are subject to its laws
and decrees.
The slow and steady progression of society from primitive or savage
hordes; to disparate clans or tribes; to the early Greco-Roman states; to
medieval fiefdoms, monarchies, and aristocracies; and finally to the rise of
constitutional democracies or republics where political power is dispersed
more evenly across the citizenry—this latter development identified as the
“responsible state” by Franklin Giddings (1918)—has culminated in a mix
of control systems, the elements of which coexist, sometimes uneasily,
across contemporary society. Although archaic informal control or self-
help is still an important aspect of control in modern societies, over time
it has been pushed aside in favor of more formal systems of control. The
most formal, of course, is legal control, but medical control continues to
expand and is becoming more formalized as it intertwines with aspects of
legal control. For example, with the push toward universal health care
under the direction of President Obama, federal mandates are filtering
down to the previously informal level of health decisions between doctors
and their patients, as well as between insurance companies, hospitals, the
wide panoply of health care workers, and those who receive health care
services.
It is also worth noting that as more and more of the responsibilities of
providing health care have been shifted to employers, everyday decisions
concerning health and well-being are increasingly being made for workers
in the workplace. For example, nurses and other health care workers can
be required to obtain flu shots or face termination of their employment if
they refuse. In this way, workplaces are becoming a key site for all sorts of
control, whether informal, legal, or medical (see Adams, 1982; Chriss,
2010, 2013; Lidz, 2010).

The Tacit Assumptions of Social Marketing

Because health is so highly valued in today’s society, the ethos of medical
control is that whatever can be done to reduce disease, injury, or accidents
should be done. The philosophical principle underlying medical con-
trol—whether at the traditional level of individual case management or the
newer versions of collective or public health—is that of utility. That is, all
things being equal, social policies ought to be geared toward maximizing
happiness (health) and minimizing pain or harm (disease, accidents,
and injuries). Over the years, various public health initiatives have been
introduced into society to try to reduce or eliminate adverse health out-
comes among the citizenry. Some well-known successful public health