Social Media and Social Determinants of Health

Given my interest in Public Health and the social determinants of health, and the fact that I’m currently taking a class on digital marketing, including social media, the National Collaborating Centre for Determinants of Health (NCCDH) ¹I had initially put the incorrect National Collaborating Centre here, but fixed it on 2 December 2013. Thanks for bringing this to my attention, Pemma! recent webinar called “Public health, social media, and the social determinants of health” caught my attention.

Social determinants of health (SDoH), much discussed among practitioners and academics in the field of Public Health, refer to the those things outside of the health care system, that affect people’s health. These determinants – things like povery, education, gender, ethnicity, employment, and the communities we live in – affect our health a lot more than the healthcare system does. In fact, they are estimated to account for about ~75% of our health, whereas healthcare only accounts for about ~25%. So it makes sense that if we want to have a better understanding of what’s affecting people’s lives, we have to understand what their lives are like. And given that so many people are on social media, it makes sense to use these tools to reach people where they are at. This can be in terms of both reaching out to people to provide information and resources that might help them (broadcasting, but in a targeted way), but also to *listen* to what people are talking about – what’s important to them and what’s affecting them. And, to not only talk and to not only listen, but to engage in meaningful conversation with people.

A lot of the things that were discussed on the webinar resonated with what we’ve been discussing in class (the full set of notes that I took are after the jump). Here are my key takeaways (many of which are things we talked about in class, but it was interesting to see them in the context of social marketing for health) from this webinar:

• We often spend a lot of time “preaching to the choir”. Social media gives us a chance to listen to the conversations of groups who we don’t traditionally talk to – we can learn from them and engage in dialogue to better understand their side of things and perhaps to find where we have common ground.
• Think about *why* you want to engage – what do you hope to achieve – and based on the objective, ask *what* are the best tools to achieve those objectives.
• How can you add value (e.g., interpretation, analysis, and/or context), rather than just being part of the echo chamber?
• Think about what your target audience is looking forward – what words would they search for when they are looking for what you have to offer. They probably won’t search for “locations of Public Health unit”, but they might search for things like “what vaccines should my kids get?” or “need help with breastfeeding”. You need to make sure that you make yourself findable in the ways that people will search for the things you have to offer.

I also really liked this video that one presenter shared from his organization, Upstream:

It’s catchy with a clear message, not too long (as people tend not to want to sit through very long videos), easy to share (because it’s on YouTube) and calls you to action – go to their website to learn more and get involved.

A few more links:

• the webinar description
• webinar blog posting

My Notes from the Session – probably only of interest to me, but you are welcome to check them out if you like

Presenter: Cameron Norman (@cdnorman)

• social media embodies innovation – not just because it’s technology-based, but because it connects us and it’s about conversation
• unlike traditional web methods (or prior to the web), it’s not about talking to (broadcasting) – it’s about talking with (engagement) and listening to people
• people share about where they are and what’s important to them
• social determinants of health -> going into people’s lives and seeing what’s important to them
• the fundamentals get lost because we often get caught up in the technology (as Paul says “beware the shiny objects!”)
• if you are interested in the innovation space, you see how much upheaval there’s been (Facebook has a billion users, but it replaced myspace and Friendster, and it can disappear too)
• as an organization and as an individual, to what extent do you use your social media tools for:
  • broadcasting?
    • It’s OK to do this sometimes. I share things that people might be interested and I get feedback from people. But note that this is the same thing we’ve done before (broadcasting), just in a different channel. And we are assuming that people are listening to us because they are interested.
  • listening?
    • homophily – birds of a feather. we have the opportunity on social media to people who aren’t the people we usually talk to. People in different communities and sectors that we might not usually hear from. Think about who you are following and who you aren’t following? Whose following you and who isn’t?
  • conversation?
    • actually engaging in dialogue
    • often in Public Health practice, we engage people on our own terms, not on the communities’s terms
    • it’s hard to get to some of  communities physically – can’t just show up in a neighbourhood, but you can show up on social media
• makes sense to use social media as a tool for work in social determinants of health
• but don’t forget that there are still lots of people not on social media
• journalists are going to social media because that’s where the audience is
• transmedia = working across several different platforms – e.g., journalists taking questions from Twitter on TV
• people are looking for information in different ways
• think about:
  • where your audience is
  • how you want to connect with them
  • what tools can you use to do that
• health literacy – how do you communicate to your audiences? how do they communicate? (academics? PH practitioners? communities?)
• social media is a tool – it’s not good or bad (match the tool to the task at hand – e.g. you wouldn’t eat soup with a fork or salad with a spoon)
• “*why* do you want to have a discussion about the social determinants of health?” is a more important question to think about then choosing Twitter vs. Facebook
• organizations often fail at being genuine in the conversation
• same rules of conversation apply as in the real world – give and take, people engage differently – when you talk about meaningful stuff, you can get into awkward situations, say the wrong thing – but have opportunity to correct, clarify, etc.
• hashtags (or good keywords) will help people find you – people might not think “I need to connect with the Public Health unit today”, but might go search for information they need (e.g., where do I get my flu shot? or how can be more healthy in how I eat?) and it happens to be you that they find if you use the words they are looking for
• storify lets you bring the story of a conversation together
• mobile is big right now (phones, tablets)
• it’s not just the people you are talking to, but also the people *they* are talking to (network thinking) – not just about how many followers you have, but getting the right people at the right time and things spread through their networks

Presenter: Pemma Muzumdar (@Ask_Pemma)

• following events in multiple channels (e.g., watching TV news, watching my Twitter stream, tweeting about the story using the hashtag the news is suggesting)
• at conferences, you need to know:
  • what hashtag to follow
  • what people to follow
  • what is it useful to say (e.g., “I like this presenter” is not very useful, but “This presenter just suggested resource X and here’s the link” (useful to those who couldn’t make it to the conference or to save other conference goers from having to go find the link)

Presenter: Ryan Meili from Upstream

• author of A Healthy Society: How a Focus on Health Can Revive Canadian Democracy
• as a family physician, learned how much the social determinants of health were factors in what he was trying to do (e.g., want patient to take medication – can they afford them? can they get to a pharmacy that has it? etc.)
• social determinants of health are the stuff of politics  (Meili even ran for political office)
• “Upstream is a movement to create a healthy society through evidence-based, people-centred ideas.”
• using social media and offline experiences to make connections between organizations who are working this space, as well as individuals interested in this – build a network of people who are thinking in this way – we also want to “infect” the language – want to see people talking about “upstream” from various different parts of society
• when someone “likes” your page:
  • it’s an invitation to connect
  • it’s very passive, easy to do
• when people “like” our posts, we send them a message “Thanks for liking the page. What drew you to us?” – start a connection
• if they keep liking”, e.g., housing posts, send them your housing report
• Nation Builder – primarily being used for politics, but now being used for other stuff (track interactions, organization your network and your audience)
• want to translate social determinants of health from something that’s talked about among academics and politicians and make it real

Question Period

• Don’t forget the journalists! They are professional storytellers. How do we connect with journalists and how can we use social media to do this?
• What’s the evidence for social media?
  • evidence from a research standpoint, involves replication and controls, but social media does not lend itself to control and because of rapidly changing context, doesn’t lend itself to replication
  • some people will do case studies, but hard to publish (people don’t see them as “strong evidence”)
  • we need to document what we are doing and how it goes [my thoughts: sounds like some Developmental Evaluation is needed!]
• What are we trying to achieve and what tools do we need to get there?
• Some great analytics tools to breakdown your followers and ask “who should be in my follower list?” Analytics frames can help. What we know about demography, etc. – Is my online activity matching the profiles and if not, why not? Might be that those groups not using this technology or using it in the same way. But can find those people who you are missing and follow who they are following.
• Don’t be afraid to “fail”. Try things out!
• Think about what people are looking for and how you can provide that.