Health marketing refers to social marketing in the health field; that is, the application of strategies and techniques originally developed for commercial marketing to change human behaviors for social benefits, such as better health behavior, reducing littering in public places, and elimination of racial prejudices. Health is the most important field for targeting social marketing because good health is a prerequisite for any human activities. We believe that the idea of marketing is very important for public health in contemporary Japan, which is why we established the Japanese Association of Health Marketing in 2021.
Major problematic diseases in public health have changed with the times. In addition, Japanese people’s awareness of society and politics has also changed. Before World War II, many people died from acute infections because of undernourishment, poor hygiene, and lack of antibiotics. In addition, Japanese people were insufficiently aware of the value of democracy. As a result, Japanese people have incomplete control over their government’s powers. During this period, police stations were under the control of the Ministry of the Interior, while health centers were under the control of the Ministry of Health and Welfare, which had become independent from the Ministry of the Interior in 1938. Based on health regulations, both ministries restricted people’s movements to manage the spread of infectious diseases in Japan.
During the postwar economic expansion (1945–1973), society became richer, nutrition and hygiene improved, antibiotics and vaccines became widespread, and deaths from acute infectious diseases decreased significantly. However, occupational accidents and pollution were caused by the newly highly developed mining and manufacturing industries. Therefore, occupational health became the biggest public health issue in Japan. To prevent occupational accidents and pollution, companies were obliged to educate their workers and provide health examinations to comply with safety, labor, and work regulations. The Japanese political system became democratic after World War II, but the executive government officers and doctors remained somewhat authoritarian.
During Japan’s low-growth period after 1974, the number of industrial accidents and pollutions decreased with the improvement of the occupational health management system and technology in addition to the change of Japan’s industrial structure from the mining and manufacturing industry to the service industry, and from domestic mining and manufacturing to international mining and manufacturing. However, measures against lifestyle-related diseases such as cancer, cerebrovascular accidents, and heart disease have become critical issues. Unlike acute infectious diseases, occupational accidents, and pollution, it is difficult to enforce people’s compliance with regulations through restricting their movement in addition to providing education to prevent lifestyle-related diseases. In the prevention of lifestyle-related diseases, there are often no symptoms at the time when countermeasures are required. This makes it difficult for people accept the risk and spontaneously change their behavior. Thus, behavioral changes based on strategic marketing methods and techniques are necessary. After thoroughly investigating people’s ideas and characteristics through marketing research, we should determine the behavioral changes to be promoted in addition to the target market and then implement an appropriate marketing strategy, such as the 4Ps (product, price, place, promotion) or 4Cs (concept, cost, convenience, communication).
In the current medical and public health fields, is education or marketing more important? Can medical institutions enforce any compulsory measures (such as refusal of medical treatment) for patients who do not follow medication instructions? Can government agencies force citizens to exercise to maintain and improve their health? It is theoretically possible to enforce these measures for medication and exercise if the government creates laws and penalties. However, this is unrealistic in the current political situation. In addition, the public may consider the idea of “educating” patients and citizens to reflect the arrogance of health-care professionals. Therefore, a suitable communication strategy (e.g., marketing) is necessary to match patients and citizens’ thinking, feelings, individuality, and everyday feelings to encourage them to take initiative to manage their own healthy behavior. As mentioned above, marketing rather than education is needed in current medical and public health settings. However, the need for marketing is not well known in health-related institutions, which are usually operated by nonprofit organizations in Japan. It is necessary for the Japanese medical community to learn to use marketing strategies to address the public.