Page 268 - The Handbook of Persuasion and Social Marketing

244 The Handbook of Persuasion and Social Marketing

and Wallack (1996, p.179) argue that social marketing campaigns are un-
likely to improve long-term health status “given the seemingly insur-
mountable and ubiquitous cues influencing individuals to maintain
unhealthy habits.” Siegel and Lotenberg’s (2007) public health marketing
book catalogs many socioeconomic correlates of personally self-destruc-
tive behaviors. And if the environment is a root cause, then the solution is
to change the environment. To accomplish this, public health advocates
should concentrate on social change through the political process, rather
than relying solely on traditional social marketing.
The target is the individual the marketer or agent is seeking to influ-
ence. In downstream marketing, the target is the individual who is either
currently engaging in a particular behavior or has the potential to engage
in it. For example, downstream remedies would target cessation/mainte-
nance messages toward individuals already engaged in a destructive/pro-
social behavior while prevention/uptake efforts would target individuals
who are not currently engaging in the behavior. In upstream marketing,
the target is not individuals (although ultimately these actions should ben-
efit individuals); rather, the target is the organizations that have the power
to influence the environment in which individuals make their decisions.
The most important organizations typically targeted are government offi-
cials, government agencies, for-profit corporations, and nongovernmental
agencies.
The ultimate behavioral change goal is the same for both forms of mar-
keting—to get a person to either take or not take a specific health action
(e.g., get immunized, stop smoking, not start smoking). The distinction is
that in downstream marketing, the goal of inducing a person to “do the
right thing” is the explicit goal. In upstream marketing, the goal is to in-
duce one or more target organizations to alter the environment in which
people make their decisions. For example, a government official may be
targeted to vote for a change in a drunk driving law or to pass funding for
immunization programs. Presumably, by promoting such changes in the
environment, penalties or costs deter the negative behavior and/or in-
creased opportunities encourage the desired behavior.
Downstream marketing views the process in terms of individual “deci-
sion making” without regard to any possible motivation, opportunity, or
ability related to the targeted pro-social behavior. Decisions are not as-
sumed to be rational, free of bias, or made with forethought. Recognizing
this varying nature, decision making is often framed in terms of how indi-
viduals will respond to the stimuli and choices that they encounter in their
environment. Downstream marketing has emphasized that the way to
change behavior is to alter these stimuli in order to change the related