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How can social media support knowledge exchange on the social determinants of health?

By Pemma Muzumdar (she/her) on November 03, 2013

Pemma Muzumdar (she/her), MPH

Knowledge Translation Specialist

Pemma is racialized as Brown. Through various roles with the six National Collaborating Centres for Public Health, Pemma has worked at the nexus of public health, knowledge translation, and systems change for the past 12 years. She is passionate about public health system renewal, building a culture of equity in public health organizations, and supporting public health to address root causes of health inequities. At the National Collaborating Centre for Determinants of Health, her work and leadership is focused on: operationalizing values such as reciprocity, solidarity, and social justice through a range of program and policy approaches (e.g. those informed by critical race theory, intersectionality, decolonization); disrupting racism and White supremacy; analyzing opportunities for public health to respond to the inequitable climate crisis; and framing messages about the structural and social determinants of health. Pemma co-leads the Health Equity Collaborative Network (a group of health equity-focused public health staff from across Canada) and co-produces Mind the Disruption, a podcast about building a healthier world for everyone. She completed her Masters of Public Health at the University of Waterloo in 2010. 

[email protected]

This blog was written by Cameron Norman and Pemma Muzumdar for the National Collaborating Centre for Determinants of Health.

Social media and public health

My humanity is bound up in yours, for we can only be human together
-- Desmond Tutu

Social media represents more than a set of tools and technologies that connect people to information and each other. Rather, social media represents a simultaneous return to the roots of health promotion and a paradigm shift in health communications. Social media tools may enhance public health efforts to engage the public, collaborate across sectors, and exert influence. This blog, along with a webinar and online conversation, will look at social media and its emerging role in supporting public health to exchange knowledge on the social determinants of health and take action to advance health equity.

Social media communication is mobile, fast, scalable, non-hierarchical, non-linear, narrative-based, and collaborative. Unlike traditional communications media, social media channels are designed for conversation rather than broadcast, and users - individually and collectively - are placed at the centre of the message and the medium, and are responsible for generating content. Messages no longer flow from one to one or one to many, but rather from many to many. Every participant has equal voice, and has an equal opportunity to use it. What’s more, a range communication channels are always at play: a photo and message from Instagram may be included in a Wordpress blog; compressed to a tweet and published on Twitter; fed into a LinkedIn profile, shared in a YouTube video; posted on Facebook; captured in a storify story; and the list goes on.

By placing organizations, networks and individuals on equal ground, social media can create opportunities to engage multiple sectors on issues related to the social determinants of health and health equity, and can offer a complementary online environment within which public health professionals can share thoughts, resources, and follow opportunities for further exchange.

In their review of social media and public health, Schein, Wilson and Keelan (2010) describe the social media landscape as being characterized by interactivity, user-generated content and multi-directional communication flows (p.4); all of these characteristics challenge the model used in many public health communications. That being said, engaging others in dialogue fits with the central tenets of health promotion practice.

Starting and participating in conversations related to the social determinants of health, health equity, and public health

Social media creates a hybrid space where interactions can be highly personal. Information can also be personalized; modified for and directed to specific individuals, organizations, and networks. Participating in social media is akin to having intimate conversations in public. Thus, many of the same conventions we would use in our conversations apply. This means creating a space for give-and-take, sharing, and a willingness to hear other perspectives.

General rules for participating in conversations

1) Have something to say, be authentic, and share what you know.

• A strategy is critical for using social media effectively. This does not mean prescribing each message or limiting flexibility to respond in conversation. Rather, it means knowing why you are having certain conversations. Are you starting a conversation to encourage the use of evidence? Share a resource? Invite discussion around a possible area of tension? Inform a specific group? To learn from, or with, others? Or, is it a combination of the above, as they may happen simultaneously? Being strategic will help you to “speak” with an authentic voice across social media channels.

2) Give and take, conversations are not one-sided.

• You may want to start the conversation by sharing what you know, and also including a question, or an invitation to comment “What do you think?”, “How might we do X?” or “How has this affected you?” are all questions that elicit different kinds of reactions to which social media is well-suited.

3) Whenever possible, make connections: hyperlink, mention, and tag.

• To better connect related posts, as well as to help others users follow relevant information, make an effort to learn conventions such as hyperlinking words within text, mentioning organizations and individuals when appropriate, and embedding tags into your social media posts. Further details are provided in the next section.

4) Sensitize yourself to the needs of your organization, if relevant, as well as your audience

• Make sure your organization has a policy for how to handle the sharing of material and what constitutes an endorsement or what is considered to be a personal perspective vs. an organizational perspective. Ask some questions about what can be shared across your accounts and your networks like those asked in a post on Public Health and Social Media.
• Start and end when appropriate. Throughout the process assess how things are working relative to expectations. Social media strategy requires ongoing developmental evaluation and iterative steps to creating, re-creating and sharing messages and conversations on a timeline appropriate to the conversations being had.

Tracking conversations related to the social determinants of health, health equity, and public health.

The introduction of the hashtag (#) as a tracking mechanism on Twitter is one of the most widely used tools within social media. When you click on a hashtag, you are directed to a a page that contains all other tweets that have been similarly “tagged”.

Colleen Young promotes the #hcsmca hashtag to denote healthcare social media canada in all of her (and her peers') related posts to allow people across networks to track conversations. Although the hashtag originated as a means to denote Twitter topics, it is often used with other tools such as Instagram, Facebook, Youtube more often because it is easily searchable and distinguishes it from other text.

Certain hashtags are specific to the social determinants of health (#sdoh), health equity (#healthequity), and public health practice (#publichealth). Social media postings, particularly on Twitter, often have character limits, and must remain concise. To save space, hashtags are often used to replace the words they represent. For example, one would say “check out this #sdoh resource” instead of “check out this resource related to the social determinants of health”.

Examples of how hashtags can be used within conversations

Capturing (documenting) conversations

Tools such as Storify and Tweetchat (the website) can be used to aggregate comments and posts organized through a hashtag. Specific media objects (e.g. pictures, websites, other  social media posts) can be included and curated - selected, edited, and/or placed in a specific sequence - to create ‘storylines’ that show the flow of conversation. These are really collections of artifacts gathered from the conversation stream that can be used to preserve learning, generate further conversation, and assist in the identifying next steps and follow up actions.

Example of a "storify" story

Interested in this topic? Participate in a related webinar and online conversation

As with all social media, this above commentary is intended to spark a larger conversation. The authors of this blog post, Cameron Norman and Pemma Muzumdar, invite you to join them for two related online events:

1. November 7-14, 2013, participate in a Health Equity Clicks online conversation
2. November 12, 2013 at 2:00p.m.-3:30p.m EST, participate in a webinar

Together, we’ll explore the following questions:

• How is your organization using social media to exchange knowledge related to the social determinants of health & health equity?
• What are the challenges and opportunities associated with using social media to support SDH interventions and programs?
• What do public health practitioners need to capture and evaluate the use of social media in their social determinants of health-related efforts?

For further information, please contact Pemma Muzumdar.

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Methods & tools