Recent public health policy and practice in the UK and beyond has promoted behavioural and lifestyle change as key methods for health improvement and the reduction of inequalities. These methods contrast with more upstream and structural interventions intended to address environmental and material determinants of health. A current exemplar of this approach is the use of social marketing. These changes represent a shift from the social to the individual as the target of public health interventions and raise a number of critical questions for health social scientists concerned not only with health improvement but also equity and social justice. Further, they can be identified as part of broader social and economic shifts that posit the individual as responsible for the management of their own bodies and selves in late modern societies characterised by ‘government at a distance’ and the repeal of welfare. This paper offers a review of shifting paradigms of public health and considers the implications of newer modes of health governance such as social marketing and their role as a modern form of health governance.