Thomas Jasen Gardner
LSC 625 RISK COMMUNICATION
Fall 2011
Professor Dominique Brossard
Social Media and Risk Communication for African-Americans
Black
health care risk communication has been analyzed using the theories and
values assigned to rational actors. The failure of this theory leads to
a stereotype of blacks living in an avatar world called Taxonomy of
Ignorance, when these health communication methods are ignored,
confusing and do not invite participation. This paper will show that if
health departments theorize communicating health risk by using social
media, we will teach values that effectively communicate health issues
to low-income cultures.
This is a risk communication problem
motivated by incomplete knowledge or flawed understanding. If public
health departments understand how to better communicate health risks to
blacks, there is reason to believe that the community will have a
positive risk perception of health practitioners. Nonetheless, complex
risk problems find publics at a distinct disadvantage, regardless of
levels of interest and commitment. Risk assessments are difficult to
understand, value issues poorly defined and governmental agencies
distrusted.
(1)
Inadequate health care for
African-Americans in the U.S. has focused on the social disadvantage of
uninsured health-care, infrequent medical visits, and access to local
health care. But the field of health-care communication has focused on
traditional media to help black people understand the consequences of
inadequate health care. We do not live in a homogeneous society where a
single form of risk communication about health care is understood by all
demographics. The use of mass media for public health information has
been called into question because of a failed series of risk
communication attempts targeted at black residents. The messages have
not been effective in reaching a target audience with the highest number
of preventable diseases, paralysis, and deaths. This suggests that some
individuals in top leadership positions are unaware of the severity of
illness in the black community or they just don’t care.
(2).
Communicating
risks with social media is a two-way exchange. With social networking,
health organizations can inform target audiences of possible medical
risk, and gather information from and for those affected by the risk.
The Pew Internet Project
(3) estimates that 79% of American
adults use the Internet and many of them not only gather and share
health information with social media, but also make health decisions
based on what they find online. And many people, once they find health
information online, talk with someone about it offline.
For blacks
in the United States, health disparities can mean earlier deaths,
decreased quality of life, loss of economic opportunities, and valid
perceptions of social injustice. For society, these disparities
translate into less than optimal productivity, higher health-care costs,
and social inequity. Racial/ethnic health disparities are reflected in
leading indicators of progress toward achievement of the national health
objectives as set by the national health campaign. In 2002, blacks
trailed whites in health care. Inadequate health care is represented in
a lack of insurance, vaccination against influenza and pneumococcal
disease, women receiving prenatal care, and participating in structured
exercise.
Blacks also had substantially more years of potential
life lost than whites for homicide, stroke, perinatal diseases, and
diabetes. Death rates from all causes for seniors between 65-74 and
75-84 are higher among Black seniors than any of the other racial and
ethnic groups. Preventable health issues with the right care include
hypertension; coronary artery disease, stroke, end stage renal disease,
dementia, diabetes, and certain cancers are the leading causes of early
death among the black population. These are intolerable and underrated
risks to the black community living in America.
(4)
Social
media can help dissolve the barriers that inhibit risk communicators
from performing their civic duty for low-income communities. Social
networking between members in the community, government bureaucrats, and
public health care medical professionals can help to enable the human
connection in health. Such associations can help reinstall lost trust
and patient confidence with individuals who feel alienated from society.
Heuristics gained from history of the black experience and medical
research makes cooperation unpredictable. Because of that history, there
is reason to believe that open transparency with meta-data from a wide
array of genres, that include manuscripts, publications, community data,
laboratory and field notes, instrument calibrations, grant proposals,
public lectures, power point slides, patent applications, theses, and
dissertations will help increase positive relationships between health
care professionals and the low-income population. These types of
contextual data, available on social media, will help neighborhood
skeptics and other reactionaries to utilize their own expertise and
identify any potential problems for the social media campaign.
(5)
In
a nutshell, social networking or Web 2.0, is how social media can help
health care organizations share information and knowledge about risk
perceptions. Internet based networks such as e-mail, Facebook, blogs,
Twitter, YouTube and Wordpress provide interpersonal interaction between
people and organizations. However, before we begin, let us admit that
there is a paradigm shift from the mainstream gatekeepers of information
to Internet interpersonal sources.
Web 2.0 describes the
interactive, collective intelligence of today’s Internet experience.
Web-based information technologies, such as social media, enhance public
health practice through the accelerated dissemination of health
promotion and disease detection information. In 2008, CDC
(6)
participants who received smartphone reminders about applying sunscreen
applied the sunscreen an average of 56% of the time, compared to 30% of
participants who received no messages.
7
In
Chicago, teenagers can receive weekly-automated unique personalized
texts about sex education and in Colorado, teens can even text or tweet
anonymously with questions about contraption methods and disease
prevention. Local and state health departments can duplicate these and
other micro-marketing techniques successfully used for corporate
propaganda.
Unlike advertisers, you can enlist members from
grass-root organizations to help tailor your messages to specific
audience segments. These proven methods are directly reaching a culture
threatened by genocide from unconscious or conscious systematic
institutional discrimination in healthcare. In addition, you are
directly reaching an audience that relays on internet search engines
that frequently mischaracterize searches for health issues. Your direct
interpersonal interaction can replace and discredit Google and other
internet search engines that present a misdiagnosis of a searched health
term.
AIDS.gov and CDC are deploying contests, blogs, and social
network profiles to empower people to become health advocates. This is
clearly an example of how local health departments can successfully use
social media to decrease illness and premature deaths in low-income
communities. A variety of social media tools can be used to reinforce
and personalize messages, reach new audiences, and build a communication
infrastructure based on open information exchange.
Fully 65% of
adult Internet users now say they use a social networking site like
MySpace, Facebook or LinkedIn, up from 61% one year ago. This marks the
first time in Pew Internet surveys that 50% of all adults use social
networking sites. Because of the digital divide, blacks comprise the
majority of smart phone users online. Smartphones cost less then
computers and Internet access is with satellite connections that are
cheaper then cable installation and monthly costs. The multi-component
use of Smartphones, blogs, Facebook and Twitter should be considered in
areas where stronger quasi-experimental designs and higher message
exposure through several communication channels is a part of the
campaign strategy. Integrating individual behavioral interventions with
social media monitoring can demonstrate widespread efficacy about
healthcare issues.
African Americans are the most active users of
the mobile Internet. Smartphones, laptops, Kindle, and iPads are
frequently used for social media connections. Nearly 48% of African
American adults have gone online using a mobile device, compared with
28% of white adults. Compared to African-American men, African-American
women are much more likely to get health information online. Fully 59%
of black women have sought online information on health and medical
issues, compared to 45% of black men who sought online information for
health and medical issues.
(8)
Social
media is not new. Our mothers talked face to face over the back yard
fence about the new medication; while at the water cooler, your
co-workers suggest ways to lower your blood pressure. When my sister
used our homes landline phone, I over heard her talk about new
experiences with women’s health issues. Like cave drawings; the phone,
the pencil, and the computer are tools designed for and used with human
ingenuity for human benefits.
The relationship between traditional media and social networks is non-combative.
(9) There
is a complex bi-directional relationship among different agendas
between mainstream media and social networks. In fact, mainstream media
has adopted social media as an extension of its news, business and
information dissemination. However, the ability of blogs, Tweets, and
Facebook to shift agendas is more flexible then mainstream media. In
addition, you will notice that most health blogs focus on highly
specialized topics that cater to a segmented audience. Social media also
allows two-way communication. The social media audience gets an
opportunity to influence content by engaging with other audience members
or interacting with the writer. In addition, social media serves as a
translator, interpreter and a swift dissemination of breaking health
news and alternative medical information to people not online.
The
pervasiveness and ubiquity of social media resources provide
individuals with access to many information sources that facilitate
self-diagnosis and provide means for nontraditional biosurveillance of
disease symptoms, preventive care, etc. Bloggers appear to be the best
sources to disseminate information to Facebook and Twitter. Their
conversations increase rate responses about health issues and encourage
health professional interventions. It is hoped that they can trigger a
ripple effect that spreads public health communications about
vaccinations, quarantine, or defining a fever or chickenpox symptoms.
Health bloggers participating in a public health campaign needs to have
influence in the community and the ability to disseminate medical
information quickly. U.S. word mining surveys show that in 2009, nearly
10 million blogs, Facebook pages, Twitter posts, chat room discussions,
e-mail, and cell phone texts initiated communication about health
issues. Trust and credibility of bloggers, Facebook pages, and Tweets
is based on the social definition of trust, empathy, and expertise
. (10)
Black
health care miscommunication has been analyzed using the theories and
values of rational actors. This leads to a stereotype of blacks as
ignorant upon ignorance when expert communication methods do not work.
Research suggests that outrage/anger and a spiral of silence contribute
to avoidance of information processing. Because a health risk campaign
did not involve public participation, this negative point of view might
be motivated by incomplete knowledge or flawed understanding. If we
understand how to better communicate health risks to blacks maybe they
will change their risk perception of health practitioners. If the theory
of communicating through interpersonal interaction is utilized, then
using social media to teach self-efficacy will help communicate health
issues to a culture that is the last receiver of risk communications.
Low-income
and minority population specialized needs are often ignored by public
health practitioners and politicians. These groups may not have the
economic power or cognitive capacity to demand services guaranteed under
a social democracy. Because these groups have fewer resources, low
education levels and receive less information from health officials
about preventive health care or current vaccinations, they are prone to
higher levels of illness and death.
Current risk communication
materials may be written at a literacy level above that for many low-
income people, thus it may be difficult for some of them to understand.
Poverty, as the root cause of numerous other problems, may influence the
low-income populations’ perception of medical risk; trust in the
system, and personal motivation to obtain information. These factors, in
addition to various other contextual situations, usually result in low-
income individuals experiencing serious consequences before, during and
after a health emergency. Designing an effective risk communication
system can prevent the consequences from a lost of life. Risk
communication should be designed to address the unique situations that
exist in low- income communities.
11 For many low-income
populations, getting health care is considered a low probability event
with high consequences. Thus, other pressing issues such as,
institutional racism, paying bills, insuring winter heat, family dramas,
low wages, bad schools, inferior housing, no insurance, and no jobs in
their communities may take precedence over personal responsibility about
vaccinations, dental care or high blood pressure medication.
(12) People
who are at high risk for society’s aliments may be unable to cope with
new risk information. Their heuristics may distort, ignore or not even
process the information when cautioned about increasing health risks.
Or without health risk information, they may believe that the health
threat is irrelevant or insignificant to their lifestyle.
With 37%
to 52% of Americans seeking health-related information on the Internet
each year, the value of such tools for public health monitoring and risk
communication is becoming a dominant source for health related
information. Blacks can clandestinely access health care using social
media without feeling intimidated, incompetent, and insecure. Web 2.0
describes the interactive, collective intelligence that blacks can use
to obtain health warnings about diet, smoking, and other invisible
dangers. Web-based information technologies, such as social media,
enhance public health practice through the accelerated dissemination of
health promotion and disease detection information.
(13)
Public
health officials aim to meet the wants, needs, and interests of
consumers when developing campaigns to promote health services. But this
daunting task means identifying and utilizing costly communication
channels for diverse constituents. For instance, New York City spent $3
million dollars to convince voters that for health reasons, sugar and
caffeine drinks do not belong in public schools. The referendum lost
because Coke spent $30 million to defeat it. There is reason to believe
that if social media were used as a communications channel, people would
have been better informed about the public benefits behind the
referendum. In addition, social media campaigns can be the cost of
volunteers or a mid-level city employee social media manager. The $3
million dollars would have been better spent for the fruit and
vegetables school officials wanted to promote. Nonetheless, many health
campaigns have patted themselves on the back for reaching rational
actors through mainstream media, but have done poorly with providing
frequent messages as well as reaching the target audience that would
benefit the most from health data.
(14)
Social media
can remedy this disassociation, and form a partnership with public
health and government agencies that begin the trust building process
among members of low-income populations. Grassroots organizations could
help introduce health care officials as a source of reliable
information. These organizations can help supply e-mail addresses and
cell phone numbers for medical alerts, medical appointments and links to
community shared medical information on Facebook and blogs. They can
also help create, produce and introduce health campaigns by organizing
community meetings that cooperatively create persuasive techniques that
are effective in changing and reaffirming behavior.
Psychographics
of tailoring and targeting messages to a particular audience maximizes
the cognitive processing of information. With social media, message
targeting directed at subgroups of populations could focus on blacks.
Group members that process enough similar characteristics and
motivations will be influenced by the same message delivered by health
officials. To influence health behaviors, the target audience must
receive persuasive messages using language that is part of the culture,
geography, income, family, personal preference in music and a multitude
of other interconnected variables.
Some health behaviors are so
embedded in individuals’ social relationships and physical environment
that changing even one health behavior in one individual may require a
lifestyle change. It maybe hard to walk by a fast food joint on every
neighborhood corner or challenge your child not to eat starchy school
lunches. Tailoring a message to individuals is a process where
persuasive messages evolve from the characteristics of identified coping
styles. These styles are created from the personality, lifestyles,
attitudes, opinions and interests of targeted segment. Another narrative
of a persons risk assessment is formulated from a person’s network of
neighborhood, church, school and work. Television is also a factor in
health risk perceptions. Soap operas, reality shows, sitcoms, dramatic
TV movies, and commercials present a framework that has an unconscious
or conscious manipulation of false or exaggerated information.
It
is possible that the only recourse is to present communication in a fear
appeal context. The extended parallel process model increases the
perception of severe threats if behavior is not changed. This stimulates
efficacy related thoughts that stimulate attitude, intention or
behavior changes to reduce the threat. White Witte (
15)
believes that fear messages maybe rejected when threat outweighs
knowledge of threat. The lack of control, dread and/or fatal
consequences predicted will influence risk perception. Witte also
writes that these individuals with fear control responses to risk
communication have negative discriminating values that have higher
levels of defensive avoidance; message minimization and they also
perceive that others are trying to manipulate their behavior.
However
Lieberman writes that subsequent defensive avoidance of fear messages
could be changed if preexperimental belief differences are relevant,
especially if the participant does not have prior knowledge. This
unbiased systematic processing can be manipulated with fear tactics of
gruesome images and uncompromising text show to be effective tool for
behavior change. It would be reasonable to assume that an audience that
thrives on horror and conflict entertainment thrives on fear/danger
values.
Word of mouth was traditionally the model used to process
information and amplify information among subgroup members. Word of
mouth is how people confirm trust in health officials by using social
network. Word of mouth on the Internet includes commenting on someone’s
Facebook page by linking information relevant to his or her health
needs. Retweeting someone’s Tweet question about vaccinations while
tweeting the answers is to engage with reluctant partners. Writing blogs
that offer statistical data mixed with narratives that also offer links
to other relevant health websites shows sincere concern about supplying
relevant information.
Social media has added to the mix of ways
people talk to each other. Social media supplies a critical need for a
rapid means of detecting, assessing, evaluating health care needs and
identifying disease trends (e.g. flu, measles). The constant
connectivity of modern social networking formats allows people to share
information with each other. People can share risk information anywhere
at anytime where any thought ignite opinions, questions, or suggestions.
This can be done while driving, in the middle of class with an iPad,
smartphone, or laptop on Twitter, Facebook, texting or with email.
Health care officials can reach this audience segment rapidly with
health information and get a quick response about symptoms and
medication effects by accessing any search engine on anyone’s electronic
device.
Micro-blogs such as Twitter are considered noninvasive
information sharing platforms where you can produce, consume and
reproduce knowledge and information without the formal constraints of
personal embarrassment or social inhibition. Social media is typically
available to the young and old with different health needs.
The
second most reason for being online in Wisconsin, according to
UW-Extension, is to search for health information. Researchers have
concluded that while online, people are motivated to find risk reduction
conversations on health issues, popularity of health ailment antidotes,
lowering medical costs, easy information about health symptoms risk
perception and inspiration for life. It can thusly be reasoned that
public health care professionals can persuade behavior changes with the
opportunities for interactivity on social networking sites. These sites
are becoming increasingly important as a wider group of people use
social media for on line expression and as a motivator for information
seeking purposes.
(16, 17)
The effectiveness of using social media platforms can be evaluated with open source specialized algorithmic software
. (18)
Patterns of dissonance with successful micro-blogs, go from mediocre
sentiment, to mainly positive with minor negative points and then
towards messages with strong affirmative feelings and maybe a micro
negative word or two. One of the successes of micro-blogs is that the
140-character limit is a familiar length for quick information
processing. The posts have much in common with natural language
exchanges. However a successful communication pattern with targeted
segment requires constant interpersonal interaction to gain trust and
certainty from followers.
The effective use of social media for
risk communications is considered pioneering research among social
scientists. To create an effective message, preproduction research
should determine audience characteristics, current behavior pattern, and
selection of communication channels. Most health campaigns concentrated
on pretesting messages with a target audience for feedback and
effectiveness in changing behavior. It is reasonable to assume that
research is faulty when almost half of the formative campaigns were
theory based messages rather then specifically designed message contents
for an audience segment. Because some black people like rap music then
all black people must like rap music so we will have rap music messages
on the classic music station, is a stereotyped cultural theory used
often by risk communicators.
(19)
This
explains why nearly 47% of black survey participants indicated they
were not confident that public health officials would do a good job
during an emergency and 83% did not feel the same officials would treat
them fairly. Lack of trust among low-income populations may be a barrier
to using traditional risk communication systems. This limits their
ineffectiveness in reducing racist health factors when depending on an
unstable information environment for behavioral change.
(20)
This
is a research problem motivated by incomplete knowledge or flawed
understanding. If we understand how to better communicate health risks
to blacks maybe they will change their risk perception of health
practitioners.
Risk management is people management. We are a
crisis management society. We should respond before a crisis instead of
reacting to failed policies. Responding to social science forecasts
instead of reacting to a technician’s aggregate data will increase the
bottom dollar. Preventive health care is by far cheaper then surgery and
hospitalization.
The exaggeration of health risks in the media
plays havoc on citizens who relay exclusively on traditional media for
knowledge and information about risk perceptions. Those who are
uncertain will seek out additional information that increases their
knowledge from traditional media sources. The needs and habits of the
press shoehorn health coverage for black Americans into predictable
patterns of personal negligence and undesirable lifestyle regardless of
other variables. There is reason to believe that social and economic
stories about public health, public schools, and public jails are code
words for incompetent and socially deviant blacks.
21 Because
blacks
rely partly on TV talk shows and newspapers for sources of knowledge,
we should examine the effect of false fiction about health issues.
Usually they receive preventive information too late or not at all from
public health officials. In addition, blacks were exasperated with the
contradictory and often incorrect information that reached them. Because
of the mental noise from misinformation and prior experiences, health
information should be increased to blacks via social media.
For
instance, media initially reported that all blacks have AIDS. They later
retracted that with news reports that black drug addicts and
homosexuals are more likely to have AIDS. No immediate mention was made
of the AIDS epidemic among white homosexuals. Conversely, expensive
medication was made available to the white community, long before it
became affordable to the black community. These types of omissions are
what Dudo noted. There is reason to believe newspapers are not the best
distributors of health warnings. When despite high death rates, American
newspapers waited 2 years before reporting extensively on risk
information about Avian flu. The right to know requirements of specific
health issues is way laid by newspaper and business profit imperatives.
(
22) Newspapers typically did not commonly
report on lynching unless the level of sensationalism increased
circulation among white subscribers. But for blacks searching for loved
ones, the benefits and risks of lynching information was unevenly
distributed in the press. The lack of personal control over involuntary
risks such as lynching or vaccination availability should require
different communication techniques based on the amount of emotional
stress a particular risk generates.
Risk communicators who focus
on mass media ignore the potentially potent amplification of social
media. The social networks simple delivery of data and information, in a
local colloquial message is easily explained by family, friends,
co-workers and neighbors, which helps to share messages about health
risks among the same social groups. These discussions on Facebook,
blogs, Tweeter, YouTube, LinkedIn, and Flick help people decide about
information in an environment that has somewhat extended face-to-face
conversations.
Social media can share quantitative risk information, risk reduction, risk comparisons and the symptoms of illness.
(23)
Social media can reduce emotionally unfounded stress with imagery,
knowledge, attitudes, beliefs, and specific environments that evoke
positive frames of health related aspects. Thematic framing will occur
in social media because its context allows for the formation of informed
risk judgments.(
24). Social media is an arena where the
growing social imperative that those possessing special health knowledge
of health risk will communicate it to potential risk bearers through
blogs, email, FaceBook, you tube and tweets.
(25) Low
levels of self-efficacy correspond to helplessness and panic, which can
interfere with the processing of risk-related information. (Dudo) Mass
media typically presents health information in an episodic news frame as
a single specific event driven issue based in sensational and emotional
dialog. This type of reporting inhibits cognitive understanding of
issues and leads to unfounded preconceived beliefs.
Social media
allows the thematic news frames that synthesize events that provide
participants with useful background knowledge surrounding a health
issue. Only 20% of newspapers provided preventive and symptoms
information, while over half of the newspapers promoted episodes of
sensationalism about health information with no redeeming factors.
(26, 27)
.
Only 47% of ethnic Americans believe the mass media is doing a good job for society with respect to biotechnology.
(28) There is reason to believe that similar surveys about health information might yield the same results. Priest
(29)
suggests there might be a relationship between knowledge and trust. But
the genetic knowledge correlations show that increased knowledge does
not indicate an increase in trust. That might explain why even college
educated middle and upper class blacks have the same feeling of dread
when seeking medical advice from health care professionals and
government bureaucrats. The number of black deaths despite social status
and economic demographics is noticeable even to the most objective
observer. This maybe why Priest
(30) concludes that mass
media and other forms of public discourse should play a crucial role in
conveying new information about health in a positive framework.
This
could be a major reason social media should be included in relating
risk information from health care institutions. They could be the
dependent social actor most relied upon for deciphering simple
explanations and sophisticated health problems. The sociocultural matrix
of black lifestyle details which institutions have a trust gap with the
black community. Democrats, government, religion, public schools, and
public institutions have recently been mired in controversy about their
credibility. Black audiences who are actively engaged in measuring the
truth level of these institutions believe these stoic institutions do
not earn trust. Social and psychological factors determine personal
choices between voluntary and involuntary risk perceptions. It was
reported that black men should volunteer for prostate cancer
examinations because of the high rate of cancer among older black men.
Then news came out that costly prostate cancer examinations were not
only unnecessary, but could provoke prostate cancer symptoms. The
pharmaceutical companies benefited, the medical hospitals benefited, but
black men did not benefit from this intrusive cancer screening. The
massive discrepancies between expert risk assessments and public
perceptions over risk communication methods are a “crisis in
confidence.”
The informativeness or “signal potential” of a health
related event is unfamiliar to lay people and they may amplify the
suspected risk of vaccinations or kidney dialysis machines as harbingers
of further health mishaps. “I was fine until I went to the hospital,”
is a common comment in the black community. The signal value of a
negative event at a hospital that is amplified by the mass media
reinforces that risk perception.
(31) The measures of risks from “higher order” impacts have a higher cost-benefit analysis when preventive care is considered a risk.
The
media’s strong focus on sensationalism shapes the concerns of blacks.
Mass media typically “overemphasizes dramatic events” and this
interferes with rational public attitudes and behavior. When government
health officials try to intervene with correct information, blacks
perceive trust is how authoritarian abuse sensitive circumstances. It is
reasonably assumed that neither government nor health professionals are
concerned about black health care as much as they care about the
profits derived from prescribing unneeded medication or completing
unnecessary surgeries.
32 Even when mass
media allows medical personnel to “keynote” a positive spin on
responsible patronizing care for blacks, the factual summaries of
improper health care are already amplified.
It is also considered
that the perspectives of opposition groups to medication or surgery is
not prominent in the mass media. Blacks needs to learn of negative and
positive consequences of private and public health care. The richest
and powerful institutions in society restrict susceptible information
that may offset profits.
The liberal media only validate credible
public health criticism when unexplained hospital death takes place.
This death trend rumor is common among blacks that are seen as having
“irrational public fears” based on irrelevant community knowledge and
cultural ignorance. Blaming the victim, instead of the oppressor may
represent Marx theory about the mainstream press being used by
government and corporations to keep the downtrodden down and out.
(33) However,
Johnson concurs that expert opinions about laypeople’s risk perception
should not be the only criteria to evaluate heath concerns. Still, he
believes that laypeople’s inexperience with risk probabilities seem to
overestimate the frequency of low probability about dramatic hazards
compared to risk management estimates. This taxonomy of ignorance does
not consider multiple levels of community knowledge that is shared.
Blacks
originally focused on the trustworthiness and recreancy of
institutional empathy. Health organizations and government have been
entrusted with a specialized responsibility. But the psychometric
emotional judgments of blacks have come to believe that these
authorities have misused their power or failed to merit the trust
necessary to prescribe health care measures. Whether the events are
unintentional or indirect, health professionals must trust public
opinion and engage in a responsible respectful manner. While the Marxist
perspective of media bias has not been substantiated, there is a
widespread cultural conviction that white newspapers mask black issues
that are not sensational to white readers. This was evident with lead
poisoning from water pipes. The Wisconsin state journal reported an
official as saying that it was very doubtful that anyone had drunk any
of the lead contaminated water. But later studies showed that the black
community had been exceeding EPA levels of lead consumption for several
years. The community’s cognitively available heuristic makes risk
probability of lead poisoning an exact science for black public opinion.
(34)
Once again, public participation
did not include the entire community. The question is, where were
health officials with relevant data that confirmed or dismissed the
fears that the bodies of black children had high levels of lead from
water contamination. Unless health officials are prepared to challenge
the conclusion of developers, industries, and factory farms, the
low-income public will continue to distrust health information from
government sources with defensive processing mechanisms.
(35)
An
assessment of individuals who need tailored messages will help create
personal information contained with persuasive messages. Others may
depend on previous negative experience as a shortcut to an informed
opinion. Their risk perception is based on heuristics from personal
experience, family member or a neighbor’s testimonial. Systematic
behavior could be changed if resources for further information were
shared with laypersons. Their fear
[tt1] of the unknown may translate into a cognitive search for additional knowledge. Peters
(36)
indicates that an increase in public perceptions of knowledge and
expertise on the part of citizen groups will result in a larger increase
of trust and credibility in risk perceptions.
In a social
democracy, all participants have the opportunity to learn about options
to receive health care and the expected consequences of poor health
care, vaccinations, and medicine. But blacks are typically the last to
receive risk information or the least likely to be exposed to it through
traditional mass media.
37 Risk is seen as a social and
cultural context in black communities. Risk management activities and
priorities should reflect social values and lifestyle preferences for
communicating risk. The social amplification of risk in the black
community may start with individual perceptions gained from social
communication. Policy makers and health regulations have not been fair
and equitable in providing health care to black Americans. This
objective social theory includes a shared value about the competence of
medical personal when caring for black citizens. The black history of
medical care in America has empirical validity and social relevance to
the current mistrust of health practitioners. This history donates a
possibility that an undesirable state of reality may occur as a result
of human activities.
Their deep anxieties about inadequate and
second-class health care are linked to numerous realities. For example,
the immortal cells of Henrietta Lacks are an example of how innocent
blacks seeking health care were used as guinea pigs to advance the
careers of researchers and doctors. After many years, harmful chemicals
in drinking water from black communities were reduced only after white
communities also showed an increase in harmful chemicals in drinking
water. The black community relied on the inadequate assessment of state
officials while the white community offered professional assessments
from privately paid toxicologists and epidemiologists.
(38) This
is reason to believe that a stigmatizing characteristic perceives the
victims of inadequate health care are responsible for their own fate.
It seems to be the social responsibility of risk managers to conceal
hazards from blacks.
This is why we must not exclude how
environmental conditions influence health conditions. Physical
environments also affect health status. The places where we live and
work can present hazards in the form of toxic agents, microbial agents,
and structural hazards in the form of toxic agents, microbial agents,
and structural hazards. Toxic agents from occupational products,
environmental pollutants, chemical contaminates of food and water
supplies, and components of commercial products have been associated in
particular with skin diseases, cancers, allergies, and other diseases of
various organ systems. For example, radon and carbon monoxide are noted
to be responsible for pulmonary and cardiovascular conditions. In some
cities, urban children at a bus stop inhale more toxic chemicals then a
worker at a hazardous factory.
In grid/group typology, these are
stratified individuals who have the fewest or least socially valued
skills. The many deaths of African Americans is a reason to believe they
are the most vulnerable in American’s social system for proper health
care. The hierarchical authority of government bureaucracy limits
public resources and types of care to a partial segment of this
population. Layperson’s experience can also make them skeptical of
expert facts. This social context shapes justification. Treating these
reactions as wrong misconstrues the contingent place of facts in
knowledge. Ideologies and the opinion of people within a community
affect the traditional salience between physician and patient.
(39)
Thus,
scientific expertise may not be taken at face value as a means to
resolve questions of risk. Social trust in risk manager is important,
especially when personal knowledge of the risk is low. There is reason
to believe that existing patterns of trust and distrust for the rational
actor paradigm may not apply in low-income communities.
40
Trust in a social structure implies that health organizations are doing
a good job for society. This dimension of social trust implies that
the agency has shown competence in attending to the health care of
blacks and that politicians, government and health agencies are
motivated by compassion and empathy. Using the examples above, there is
reason to believe that there is a magnitude of trust gaps when illness
and death rate among blacks have remained high for decades.
Public
[tt2] participation might remedy how risk messages are conveyed. According to Kasperson
, (41) institutions
are late with involving the public with activities aimed at informing
and involving the public. While he was talking about environmental
injustice, the theory could be applied to public health agencies waiting
until proper procedures are in place before increasing opportunities to
assess a health risk of mental illness and kidney damage from paint
lead poisoning or slowly rating increased asthma symptoms from the local
asbestos factory. Because of the technical perception of acceptable
levels of personal harm; the expert risk communicator is viewed as
having a compromised mandate or a lack of technical competence or any
moral credence with regard to African-Americans. The proposition of
communicators who mismanaged trust has established their questionable
integrity by their continuous inactions. Administrators and bureaucrats
censored relevant risk information that is also weakened or jargoned up
for prospective risk bearers.
(42)
While
social scientists suggest there are almost 40 ways to communicate
issues to the public, they do agree that public hearings are
unrepresentative of the population most effected by the risk assessment
discussed. These meetings solve agency goals for public arenas but do
little to educate and inform the public with its alienating environment
of technical language and white men wearing intimidating suits. With the
deciphering skills of scientists, blacks could bargain with government
agencies and industry analysts for better prevention methods and
survival rates because they understand the lingo that is forced upon
them. To help the entire community understand complex issues, workshops
should be provided to address concerns.
Once again, understanding
[tt3] the health issues that affect blacks requires the community to be part of the communication campaign at the beginning.
Different
communication channels use strategies that get the attention of
different social groups in a community. While studies on individual
behavior are redundant little research is done on risk perceptions
formed within sub-social groups. With social media, individuals, social
groups and the communities can enlarge their analytical and
communication capabilities by presenting information in a colloquial
language that is compassionate and empathetic. England and Wales provide
medical, lifestyle information, and online health tools to participants
using social media. Its user base increased in 2008 to 24 million
unique users, with an average of seven million visitors per month.
(43)
Like
many organizations that use social media, the British public health
service could not measure the effectiveness of social media on
increasing knowledge about health issues. However, there are software
programs called “mashups” that can mine, categorize, filter, and
visualize online intelligence about specific searches for health care
information (e.g. cancer, diet). Healthlink uses similar software to
find online global searches for ongoing infectious disease threats and
epidemic outbreaks. Because of open software, public health officials,
government bureaucrats, general public, clinicians, and patients can
also create a mapping technology that not only has search term
surveillance, but can identify geographic address of search source.
As
an example of real time internet, the Distributed Surveillance
Taskforce for Real-time Influenza Burden Tracking and Evaluation is a
group of state and local health departments that use the Internet to
share, integrate, and analyze health data across city, county, state and
regional areas. Other Web-based surveillance networks monitor social
media, cell phones and other electronic communication devices for health
related key words.
Because search engines may not produce the
desired information for self-efficacy, organizations should work with
grass root organizations to help amplify health care information. The
serious questions about the social value of health information
organizations, government and health professionals should deliver online
information directly to stakeholders via social media.
(49) Efforts
to promote informed patient decision-making have become increasingly
common. In general, these efforts have focused on providing disease
specific facts. The rational underlying this approach is
straightforward: to make informed decision requires information. If
people lack key facts, their decisions cannot be informed. The solution
is to provide factual information using social media.
Risk
generally creates uncertainty, which motivates people to seek
information in order to deal that uncertainty. Social media is a
prominent information source where collective intelligence is shared and
further information is generated from interactive engagements. In
addition, social media users can override information from the
gatekeepers of traditional media. Online citizen journalists have the
ability to create news content about health related issues before
newspapers can go to press. Bloggers can shape public policy by
revealing information usually withheld from the public by mainstream
newspaper conglomerates. Facebook is a visualization tool where people
express opinions, share photos and highlight events about emerging
health issues. This is interpersonal communication where medical experts
and people with similar ailments underscore vaccination and other
health preventive measures. Discussions about such things as diarrhea
and salmonella or product recall can provide real time answers from
experts on Facebook. Tweeting “My Bobby is ill this morning,” can create
further discussion that might include Grandma’s chicken soup or a
suggested doctor visit. “Aunt Nellie got the fever and died last spring”
opens an opportunity to openly discuss genetics and inherited
illnesses. This relationship can only be established if an employee or
volunteer monitors your websites for at least a few hours a day.
Software mining data will help establish when is the best time to share
general knowledge about health issues, in order to get more specialized
questions answered by experts.
REFERENCES:
1. Kasperson, R. E. (1986). Six propositions on public communication of risk. Risk Analysis,6, 275- 281.
2.
Dudo, A., Dunwoody, S., & Scheufele, D.A. (in press). The emergence
of nano news: Tracking thematic trends and changes in U.S. newspaper
coverage of nanotechnology.
Journal of Mass Communication Quarterly.
3.
Dudo, A.D., Dahlstrom, M. F., & Brossard, D. (2007). Reporting a
potential pandemic: A risk-related assessment of Avian Flu coverage in
U.S. newspapers.
Science Communication 28(4), 429–54.
4. Rubin, D. M. (1987). How the news media reported on Three Mile Island and Chernobyl. Journal of Communication, 37(3), 42- 57.
5. The Pew Internet Project
6. Ethnogeriatric Curriculum Module. Health And Health Care Of
African American Elders
http://www.stanford.edu/group/ethnoger/african.html#II
7.
Pepe, A., Mayernik, M., The use of microblogging for field based
scientific research. Institute for Quantitative Social Science, Harvard
University, Cambridge, MA.
8. Center for Disease Control.
Department of Health and Human Services. Safer, Healthier People.
Morbidity and Mortality Weekly Report
Centers for Disease Control and Prevention
1600 Clifton Rd, Mail Stop E-90, Atlanta, GA 30333, U.S.A http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5401a1.htm
9. Center for Connected Health.25 New Chardon Street, Suite 400 D. Boston, MA 02114
10. Kapp, J. M. , LeMaster ,J. W.,Lyon, B., Zhang, B., Hosokawa, M. C., (2009)
Updating Public Health Teaching Methods in the Era of Social Media
Public Health Reports / Volume 124
11.Noar,
S.M., Palmgreen, P., Chabot, M., Dobransky, N., & Zimmerman, R.S.
(2009). A 10- year systematic review of HIV/AIDS Mass Communication
Campaigns: Have we made progress?
Journal of Health Communication, 14, 15-42.
12.
Witte K. (1995). Generating effective risk messages: How scary should
your risk communication be? In B.R. Burelson (Ed.), Communication
Yearbook 18 (pp. 229-254). Thousand Oaks, CA: Sage.
13.
Schmid, K., Rivers, S., Latimer, A. ,Salovey, P. NIH Public Access.
Targeting Or Tailoring? Maximizing Resources To Create Effective Health
Communications.. Health, Emotion, And Behavior Laboratory Department Of
Psychology, Yale University.
14. Jansen, B., Zhang, M., Sobel, K.
Abdur Chowdury Twitter Power: Tweets As Electronic Word Of Mouth. In
February 2009 Published By The Journal Of The American Society For
Information Science And Technology, 60(11):2169-2188, 2009
15.
Pelat, Camille More Diseases Tracked by Using Google Trends, Institut
National de la Santé et de la Recherche Médicale, Unité Mixte de
Recherche S 707, Faculté de Médecine Pierre et Marie Curie, Site
Saint-Antoine, Porte 807, 27 rue Chaligny, 75571 Paris CEDEX 12, France;
email: pelat@ u707.jussieu.fr
16.Noar, S.M., Palmgreen, P.,
Chabot, M., Dobransky, N., & Zimmerman, R.S. (2009). A 10- year
systematic review of HIV/AIDS Mass Communication Campaigns: Have we made
progress? Journal of Health Communication, 14, 15-42.
17. Rowel,
R., Sheikhattari, P., Barber, T., Evans-Holland, M., (2009) A Guide to
Enhance Risk Communication Among Low-Income Populations
Funded by the Maryland Department of Health and Mental Hygiene
18.
Rubin, D. M. (1987). How the news media reported on Three Mile Island
and Chernobyl. Journal of Communication, 37(3), 42- 57.
19. Kasperson, R. E. (1986). Six propositions on public communication of risk. Risk Analysis, 6, 275- 281.
20.
Dudo, A.D., Dahlstrom, M. F., & Brossard, D. (2007). Reporting a
potential pandemic: A risk-related assessment of Avian Flu coverage in
U.S. newspapers. Science Communication 28(4), 429–54.
21. Dudo,
A.D., Dahlstrom, M. F., & Brossard, D. (2007). Reporting a potential
pandemic: A risk-related assessment of Avian Flu coverage in U.S.
newspapers. Science Communication 28(4), 429–54.
22. Kasperson, R. E. (1986). Six propositions on public communication of risk. Risk Analysis, 6, 275- 281.
23.
Dudo, A., Dunwoody, S., & Scheufele, D.A. (in press). The emergence
of nano news: Tracking thematic trends and changes in U.S. newspaper
coverage of nanotechnology. Journal of Mass Communication Quarterly.
24.
Priest, H.P., Bonfadelli, H. & Rusanen, M. (2003). The “trust gap”
hypothesis: Predicting support for biotechnology across national
cultures as a function of trust in actors. Risk Analysis, 23 (4),
751-765.
25. Priest, H.P., Bonfadelli, H. & Rusanen, M.
(2003). The “trust gap” hypothesis: Predicting support for biotechnology
across national cultures as a function of trust in actors. Risk
Analysis, 23 (4), 751-765.
26. Slovic, P., (1992) Perception of
Risk: Reflections on the Psychometric Paradigm CHAPTER 5. Social
Theories of Risk.. Praeger publishers, Westport ct.
27.
Freudenburg WR, Coleman CL, Gonzales J, Helgeland C. (1996). Media
coverage of hazard events - analyzing the assumptions. Risk Analysis,
16, 31-42.
28. Freudenburg WR, Coleman CL, Gonzales J, Helgeland
C. (1996). Media coverage of hazard events - analyzing the assumptions.
Risk Analysis, 16, 31-42.
29. Schmid, K., Rivers, S., Latimer, A.
,Salovey, P. .NIh Public Access. Targeting Or Tailoring? Maximizing
Resources To Create Effective Health Communications.. Health, Emotion,
And Behavior Laboratory Department Of Psychology, Yale University.
30.
Peters, R.G., Covello, V.T., McCallum, D. B. (1997). The determinants
of trust and credibility in environmental risk communication: An
empirical study. Risk Analysis 17(1): 43-54.
31. Renn, O. concepts of risk: a classification chapter 3 Social theories of risk. 1992. Praeger publishers, Westport ct.
32.
Slovic, P., (1992) Perception of Risk: Reflections on the Psychometric
Paradigm CHAPTER 5. Social Theories of Risk.. Praeger publishers,
Westport ct.
33. Johnson, B.B. (1999). Ethical issues in risk communication: Continuing the discussion.
Risk Analysis 19 (3). 335-348.
34.
Priest, H.P., Bonfadelli, H. & Rusanen, M. (2003). The “trust gap”
hypothesis: Predicting support for biotechnology across national
cultures as a function of trust in actors. Risk Analysis, 23 (4),
751-765.
35.Kasperson, R. E. (1986). Six propositions on public communication of risk. Risk Analysis, 6, 275- 281.
36. Kasperson, R. E. (1986). Six propositions on public communication of risk. Risk Analysis,
6, 275- 281.
37. Use of the NHS Choices website for primary care consultations: results from online and general practice surveys.
38.
Brownstein, J, Freifeld, C., Madoff, L. Digital Disease
Detection-Harnessing The Web For Public Health Surveillance The New
England Journal Of Medicine
39. Ladwig, P., Anderson A.A.,
Brossard, D., Scheufele, D.A., & Shaw, B. (2010) Narrowing the nano
discourse? Materials Today, 13(5), 52-54.
(??) Westerman, D.,
Spence, P., Van Der Heide, (2011) A social network as information: The
effect of system generated reports of connectedness on credibility on
Twitter. Computers in Human Behavior. Journal homepage:
www.elsevier.com/locate/comphumbeh
(??)
Liberman, A., Chaiken, S. (1992) Defensive Processing of Personality
Relevant Messagesl Pers Soc Psychol Bull 18:669, Personality and Social
Bulletin, psp.sagepub.com/content/18/6669
(//) McGinnis, J.,
Williams-Russo, P., Knickman, J., The Case for More active policy
attention to health promotion. Health affairs, volume 21, number 2
2002 project Hopte. The People to People Health Foundation, Inc.
[tt1]More info about how people learn or ignore information.
[tt2]Info about public participation.
[tt3]Data about early community involvement
