A few years ago I began researching health equity and social determinants of health (SDoH) mainly as result of my intentionality to join the diversity and inclusion conversation inside healthcare organizations.

The more and more I have researched, the more conversations I have shared with thought leaders, the more my interest has grown. I have specifically become intrigued by the intersection between SDoH and the use of social media inside healthcare organizations.

First, I feel like it is important to share one the explanations I have found surrounding SDoH. Dr. Beth Snow is an Adjunct Professor at Simon Fraser University in Health Sciences and shares the following:

“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 peaked my interest which caused me to dig in and learn more; specifically spending lots of time seeking out these intersections. So far, I found little research regarding SDoH and healthcare social media; but recently connected with Sume Ndumbe-Eyoh, MHSc from National Collaborating Centre for the Determinants of Health in Nova Scotia, Canada. She shared her recently released research entitled “Public health use of digital technology to advance health equity” and was recently punished in the Journal of Public Health Policy.

Health organizations use social media as an “effective way to expand their reach, foster engagement, and increase access to credible, science-based health messages.” This creates the opportunity for ongoing dialogue, knowledge exchange, and the integration of social media into public health activities. Public health is using social media to mobilize knowledge and enhance the use of research evidence; inform, educate, and empower people about health issues; assess public perception; increase rapid access to public health messaging during emergency and non-emergency situations; mobilize community partnerships and action; and collect surveillance data. Social media allows messages to be audience specific and distributed more widely, and promotes the democratization of knowledge and information.

This struck me and honestly excited me; researchers like Sume Ndumbe-Eyoh and are now creating thought leadership explaining that healthcare communicators should be looking beyond healthcare marketing and communications walls when leveraging social media, we should use it as an opportunity to empower our communities “inform, educate, and empower people about health issues.”

This research indicates a specific goal, “to assess how digital technology, including social media, was being used to support action on the SDH and health equity. Furthermore, we were interested in how public health used these tools for knowledge translation, relationship building, and in specific public health roles to advance health equity.”

Why is this important? To me…it is important as a communicator that social media is more than just marketing and public relations; for healthcare organizations it is knowledge transfer and providing access to information across all social, demographic, and geographic corridors. Social media can and should be used to bridge gaps; giving individual patients access to information previously restricted based on traditional boundaries.

I think about two case where I have seen these opportunities:

1) Greenville Health System’s Private Community for Healthy Way, a Secret Facebook Group.

This community’s mission is as follows: “The Private Community for Healthy Way is created to provide you with a safe and convenient place for support in working towards your healthy lifestyle. You can come here to ask questions, seek advice from the dietitian, and share your thoughts with other members of the group.”

This group is being used to connect dietitians with cancer patients who live in geographic areas that create a barriers for regular appointments. This group allows patients to share recipes with each other and ask questions to the the certified dietitian who manages this private group. Before joining the group, patients are required to sign a release form and understand that Facebook information can be shared even though it is called a secret group. But, it allows patients to use their mobile phone to access the group and quickly connect with other patients and the dietitian to have almost instant conversations.

2) Mayo Clinic’s use of YouTube Strategy.

Mayo Clinic does a wonderful job titling many of their videos using the disease specific name with a physician talking about this specific disease or condition. This allows those searching for information to easily find information about a specific disease, connecting the patient with a physician talking about this disease answering basic questions. I think of the many patients that just received a very specific diagnosis and want to learn more about the medical terms surrounding their disease. Mayo Clinic has embraced the opportunity to engage audiences regardless of where they live, regardless of their socio-economic status, regardless of their gender and religious beliefs to find information as it relates directly to their health…immediately. Social media connects patients with information.

These are only a few the connections I have found over the last ten years, but leads me to think about one of the conclusions Sume Ndumbe-Eyoh’s shared in her research:

Social media was second only to websites as a source of information on the SDoH and health equity in the 2016 survey, and its ranking is on the rise when compared to the earlier survey. This indicates that social media platforms are becoming an increasingly important source of information for public health practitioners and researchers. The use of primarily visual social media tools like Instagram and Pinterest was very low and there is room here for significant uptake in public health. Engaging with these tools is important, especially given the proliferation of seemingly health enhancing content on these platforms. Given the rise in social media use, it is essential to populate these spaces with timely, credible, and reliable information.

Healthcare organizations need to begin looking at their social media goals and re-aline with their commitment to the community they serve. I have a few questions for those healthcare organizations we serve:

  1. Is your healthcare organizations using social media as the “catch-all” for healthcare marketing and public relations messages?
  2. Have you considered using social media to provide content to the community that positions your healthcare organization as a thought leader and is that content “timely, credible, and reliable information”?
  3. Should social media become strategic goal when addressing health equity in the community?

Many healthcare organizations struggle with the use of social media and even block access within the walls of their organization. Many organizations share concerns with HIPAA and privacy, workplace productivity, and even IT related concerns. Are these healthcare organizations truly commitred to best practices in health equity and addressing all the communities they serve and their social determinants of health? Is social media an opportunity or a barrier to addressing these issues?

Sume Ndumbe-Eyoh’s research also shares:

While many organizations support social media use, practices such as blocked sites and ambiguous or slow organizational approvals may restrict access and use. Investing in clear enabling policies will allow organizations to expand their reach, and foster interactions and engagement. Moving forward, the adoption and evaluation of social media usage will need to be faster and more flexible than is currently the case.

I even conclude that Sume Ndumbe-Eyoh’s statement above extends all the way to the arena of engaging communities on social media by having a clear strategy to address positive, negative, and neutral social media comments and reviews. I wonder, how many healthcare organizations take their reviews seriously?

As a partner with the Social Health Institute, we have been researching healthcare organizations and their social media review scores. So far we have reviewed eight states and found the following:

8 States / 1061 Hospitals
– 198,650 Facebook Reviews with an average of 4.17 out of 5
– 54,776 Google Reviews with an average score of 3.04 out of 5
– 9,227 Yelp Reviews with an average score of 2.81 out of 5

In my home state, this is what we found:

South Carolina – 60 Hospitals
– 7329 Facebook Reviews with an average of 3.92 out of 5
– 54,776 Google Reviews with an average score of 2.87 out of 5
– 9,227 Yelp Reviews with an average score of 2.83 out of 5

I wonder how many healthcare organizations are reviewing their Facebook, Google, and Yelp reviews? I wonder how many are reaching out to the individuals who are taking the time to write a review and trying to discern if the review is a credible statement? I wonder, are we ignoring the idea of health equity by not engaging with the consumer when they leave reviews in the public domain?

I have so many questions and excited about this new intersection of health equity, SDoH, and social media.