Public Health 2.0: Electric Boogaloo

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Using Twitter, researchers were able to predict influenza in their population. The red line is predicted rates, the black line is the actual rate. The vertical line separates training from predicted data. Click image to view PDF (Culotta, 2010)

I love conferences and seminars. Having someone who is passionate about an issue get up and present is one of the best ways to learn about something new, and can really bring something to life. But what’s perhaps most interesting is not how effectively someone can communicate an issue, but it’s in the break immediately afterwards. Do people leave to discuss the topic that was just presented? Do they leave thinking about what you said? In my mind, that’s one mark of a good presenter: they make you think about the issue so deeply that it dominates the conference lunch immediately afterwards.

I had this experience last week. As part of an introductory epidemiology course, the students were allocated to a side and had to “debate” an issue. One of the topics was “Vaccination campaigns can be helped by social media,” with the two teams arguing accordingly. That got me to thinking: How is social media used by public health professionals? And can it be used effectively?

Public Health 2.0 is a take on the idea of Web 2.0, where the users are what drive content. Its been documented in a CMAJ article here and another article in JAMA here. I should say up front that I’m a huge fan of social media and have blogged about it for science specifically, inspired by this Scientific American article by @NerdyChristie. I think it has the potential to be a great tool for outreach and engagement, and it’s a hugely misunderstood and under-utilized.

The fact is that most people turn to the internet when they have a health concern, and this shows no sign of abating in the future. We can use this to our advantage: flu trends have been monitored using Twitter by Aron Culotta at Southeastern Louisiana University, and has also been used as the basis of Google Flu Trends. Scientists interested in using this as a research tool could potentially study this further to evaluate whether it predicts visits to the ER or doctors offices.

Another advantage of social media is that it is incredibly responsive. A natural disaster like Hurricane Sandy can hit, and social media can spread and be responding quicker than traditional media outlets by mobilizing the public, such as in the case of this story. At a broader level, those in public health or those looking to broaden their reach can use Twitter/Facebook and other forms of social media to engage with their public. The Centers for Disease Control does a great job with this with their regular “Twitter chats.” They did one after the movie Contagion came out, and it was a great way for them to build on the buzz the movie had generated. Other organizations and health units can use Twitter to publicize information about upcoming flu shot clinics, meetings or events, as well as engage people who have questions by providing them with accurate and valid information.

But there are problems.

The primary problem is the amount of false information out there; we can’t possible start correcting it all. This ranges from the innocuous, to information that is patently untrue. Tackling this is not only time intensive, but it also requires you to convince people that you may not want to engage. As said by by Wilson and Keelan:

The use of Web 2.0 reflects an evolution in medical counterculture movements. Individuals with beliefs outside the mainstream used to have difficulty finding likeminded individuals. […] Now, Web 2.0 provides those with alternative beliefs a virtual environment where they can hear their viewpoints echoed and become more confident that their assertions are correct.

Another concern is how much time this can take up. Public Health departments and organizations often don’t have the resources to have a dedicated social media person or have anyone who has time to spend to these resources in addition to their regular position. The combination of having to deal with potential headaches, in addition to how time intensive using social media can be results in many people deciding to not to use it.

So is it worth it? This will change depending on your perspective. The “bad information” is going to be out there, and it’s not enough to sit back, let it exist and hope people will seek out our sites for more information. We need to be proactive and put our information out there as well and engage people when they have questions. While this may be difficult, the alternative is to put our heads in the sand and hope it goes away. Which it won’t. If anything, it’ll get magnified and enhanced and then we have to deal with that monster once it’s even worse.

So how do we go about tackling this? How do we even open this Pandora’s box? One way we can learn is by learning from those who have implemented it well. The CDC has a very detailed social media guide where they outline how to develop and implement an effective social media strategy, and more and more conferences have a social media component – including workshops and panel discussions. If you’re in a larger institution, like a hospital or university, they may even have guidelines in place you have to follow that take the guesswork out of it. Health units could copy this approach and modify it to suit their own goals and objectives.

I’m interested to hear from our readers. Do you use social media? Why or why not? For those who don’t – what stops you? For those who do – do you have any advice or thoughts for those on the fence?



Hesse et al.(2005) Trust and Sources of Health InformationThe Impact of the Internet and Its Implications for Health Care Providers: Findings From the First Health Information National Trends Survey. Available at:

Culotta. (2010). Detecting influenza outbreaks by analyzing Twitter messages Available at:

Wilson and Keelan (2009) Coping with public health 2.0 Available at:

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