1. News
Mixed uptake of social media among public health specialists
Public health organizations are starting to use social media. Some specialists say they hold untapped potential for public
health. Ben Jones reports.
Sari Setiogi was worried. In the wake of WHO is among the public health organi- for the public health crowd”, while the
the Japanese earthquake back in March zations using social media to disseminate Wall Street Journal’s health blog has a
2011, panic about the effects of a possible health information and counter rumours. business focus.
radiation leak at the Fukushima nuclear But should public health be making more CDC has uploaded 243 videos to
plant had caused a number of rumours use of such media? video-sharing site YouTube, and Shelly
to spring up on social networking site Using social media may seem easy Diaz, a social media expert at the CDC,
Twitter. but users say it is time-consuming and says social media are a key means of
Chief among them was the miscon- can backfire when health messages be- getting the agency’s message across to
ception that drinking iodized wound come distorted, such as when they are online visitors. For example, one CDC
cleaner and consuming large quantities retweeted. That can jeopardize organi- Facebook page is targeted at parents of
of iodized table salt would reduce the ef- zational reputations and undermine the teen drivers. “We spend a lot of time and
fects of radiation (rather than potassium credibility of their information. we have a whole team of people working
iodine tablets taken before exposure, on social media. It’s not investment free”,
which is recommended). Setiogi learned she says. “We need a message that can be
that people had started stockpiling salt in nimble. Social media allow us to upload
China. One person had built up a five-
year supply. It was time for her to act.
Setiogi, a communications officer at
the World Health Organization (WHO) in
“ People retweeted
our message and the
number of messages
messages quickly.”
Not all public health organizations
have embraced social media as enthusias-
tically as the CDC. Rajiv Rimal, associate
Geneva, knew she had to combat the wild- telling people to professor in the Department of Health,
fire spread of such rumours with some well buy the salt went Behavior and Society at Johns Hopkins
chosen advice. At the same time, WHO’s
China Country Office and other public
health agencies in China worked hard to
raise awareness inside the country itself.
down.
Sari Setiogi
” University, contends that social media
hold untapped potential for public health.
He notes, though, that some public health
organizations have found innovative
The joint efforts paid off. “[For our ways to use these media. “Locating the
part] we tweeted asking people not to eat “Due to the nature of social media presence of flu geographically based on
excessive amounts of table salt because and the interaction on social media people’s search terms” during the H1N1
it leads to hypertension, and within a platforms, we can be sure of what we say influenza pandemic in 2009, he says, was
couple of days we’d heard people had but we just can’t be sure how it will be “a really cutting edge use”.
run back to the shops and asked for re- changed by others”, says Yousef Elbes, This year Google, the Internet search
funds for the salt!” Setiogi says. “People a multilingual manager responsible for engine, launched a similar web-based
retweeted our message and the number disseminating health information via tool called Google Dengue Trends to
of messages telling people to buy the salt the Organization’s multilingual web monitor for dengue fever. The CDC also
went down.” site. “When it comes to public health, provide “widgets”, which are small pieces
Social media – networking web sites information must be accurate, timely of html code that users can upload to
such as Facebook, Twitter, QQ in China, and reliable.” their own web sites. That way they can
blogs, e-mail fora and video-sharing web Elbes says that it is possible to protect receive the latest CDC statistical updates,
sites – have only been around a few years. sound public health information and which is particularly useful during an
advice via social media. “You have to pro- outbreak.
vide the correct information but then you The two-way nature that sets social
must have mechanisms in place to follow media apart from traditional media also
up and respond, reply and retweet if the presents opportunities. Public health
messages are getting distorted.” organizations can monitor these media
WHO has a Facebook page, a Twit- to find out people’s health concerns and
ter feed and a section in YouTube, as interests, as well as to find out “what has
do the Centers for Disease Control and been pushed out to them”, Rimal says.
Prevention (CDC) in the United States of He believes that social networks can be
America, several health ministries, uni- used to change people’s behaviour, for ex-
versities that offer public health courses, ample, in selecting the right sunscreen for
and many scientists and health writers. children based on both evidence-based
There are popular blogs on health mat- recommendations and on “what other
ters, such as Covering Health, run by the mums are using”.
WHO
Association of Health Care Journalists While getting evidence-based health
for journalists. Another blog, the Pump information and messages out to the pub-
Sari Setiogi Handle, describes itself as “a water cooler lic via social media may seem simple, the
784 Bull World Health Organ 2011;89:784–785 | doi:10.2471/BLT.11.031111

2. News
challenge is in listening and responding what they just had for breakfast. But to-
to questions and rumours in a timely way. day Twitter is an important tool to share
“Using social media [at WHO] came information and frame policy debates”,
about because of lessons learned from the Love says. “In a meeting or conference,
H1N1 [2009] pandemic response”, Setiogi tweets can reach the people in the front of
says. “There were a lot of rumours circu- the room, the back of the room and people
lating but we didn’t listen. We didn’t know who are not even in the room. You can
what people were talking about and what comment on events in real time, even if
information they wanted from WHO. you are not physically attending. It changes
After that, we started changing our ap- our sense of whose voices are being heard.”
Courtesy of Knowledge Ecology
proach to social media.” Two years on, in For Rimal social media are still
October of this year, WHO had about 255 underused, especially in linking large
International Online.
000 followers on its Twitter feed and 30 groups of people with common inter-
000 ‘fans’ on its Facebook page, numbers ests. “Social media help people who are
that increase every month. concerned about similar issues to come
together, to work together, to have a
unified voice. That is an area that public
“ Social media
help people who are
concerned about
health has not really adapted to yet, in
terms of mobilizing social networks to
promote a particular cause.”
In countries with low internet band-
Thiru Balasubramaniam, who runs the Geneva
office of Knowledge Ecology International, blogs
at the General Assembly of the World Intellectual
Property Organization (WIPO) in 2011
similar issues to come width, e-mail is easier to use for virtual
together, to work networking than social-networking web
together, to have a sites. One e-mail discussion forum, example, there are more than 900 videos
unified voice. “ HIFA2015, aims to promote ‘health on YouTube expressing a wide range of
information for all’ with a focus on the views on vaccination and many blogs and
Rajiv Rimal
developing world. “Social media can web sites suggesting the links between
bring large numbers of people together smoking and lung cancer are myths.
to discuss, explore, learn around a focus Social media and the web give people
For activists, social media can be an of common purpose”, says HIFA2015 a forum to express their views, but these
inexpensive and quick platform for their coordinator Neil Pakenham-Walsh. are debates that may never reach a con-
campaigns. Jamie Love, director of NGO Rimal stresses the importance of clusion. For public health specialists this
Knowledge Ecology International, reaches “source credibility”. “Where the infor- can be difficult ground. “Once you start
wider audiences than ever before using his mation is originating from – whether interacting with social media, you have
Twitter feed, where he has more than 2000 it comes from one’s friends, companies to be ready to carry the work forward”,
‘followers’, to publicize his web page. But trying to sell a product or public health says Elbes of WHO. “You can’t just start
he understands why some health profes- agencies – becomes that much more and stop.”
sionals are wary of using social media. critical”, he says. Not every user will check A recent editorial in the British
“Some professionals may think that sources and many will be confused by the Medical Journal called widely-available
Twitter is just for extroverts who share multitude of conflicting information. For health information “fundamental to
global health improvement”. Measuring
the success of public health campaigns
is often hard enough. But measuring the
impact of social media beyond counting
the number of retweets or using web-
based tool Klout, which measures online
influence, would require more time and
a new method.
Diaz says the CDC recently surveyed
its Twitter followers, asking if they were
likely to make changes to their health
behaviour based on the information they
received via the CDC twitter accounts.
“Most said that was likely”, Diaz says.
WHO/Harold Ruiz
“Theoretically, you can establish
evaluation metrics for virtually any-
thing”, says Elbes of WHO. “But when
it comes to public health, it’s extremely
difficult to measure the impact, be-
cause it takes years to see the impact
Scientists studying the H1N1 influenza virus on health.” ■
Bull World Health Organ 2011;89:784–785 | doi:10.2471/BLT.11.031111 785