Why Are Healthcare Consumers So Angry on Social Media?

Maureen Marshall will present "Empathetic Civility in an Uncivil Social World: Responding to Public Comments on CDC Social Media Channels" at the Mayo Clinic Social Media Network 2018 Annual Conference. To learn more from Maureen and other expert speakers, please join us!

Check any of your social media feeds and, between the family photos, silly videos, weather alerts, and traffic reports, you’ll see posts with angry, even crude and hateful comments. Of course, people have strong feelings about topics like religion and politics and, depending on the diverse mix of your friends/followers, you may see a broad range of political rants. But you also are likely to see some strongly worded posts about health care and public health. Why are health care consumers so angry on social media?

In my experience, health care topics are a lightning rod for discussion on social media channels. My work life exposes me to lots of healthcare and public health messages. Many people respond to those posted messages with a broad range of highly emotional comments. While many remarks are emotional in expressing fear, confusion, pain, or gratitude, others are surprisingly and pointedly angry.

I’m tasked at my job with monitoring public-health-focused social media posts and sometimes responding to questions. Admittedly, the topic I frequently monitor —vaccinations across the lifespan—has been controversial for decades. In fact, opposition to vaccination has existed since the introduction of smallpox vaccine in the early 1800s. The current conversation about vaccines can quickly ramp up to disrespectful and even be threatening. The meanness is not just from those opposing vaccines; those championing vaccination post crude comments too.

The slings and arrows waged on social media are not limited to vaccination posts….check Twitter at any point in the day and you will see what I mean. Nastiness on social media is at an all-time high and health care consumers seem angrier than ever. I have identified three underlying reasons I believe explain their ranting.

Frustrated with Health Care System

While nine-in-ten people who saw a health care provider in 2016 said they felt listened to and cared about, 15-23% reported they felt hurried and were confused, according to a 2017 Pew Research report. Some subset of that group seems to be frustrated and unheard. Their frustration spills over, in part, in their comments on social media. Some go to Facebook to lament and see friends and friends of friends empathize or even amplify the personal feelings. Some post their complaints on a provider’s or organization’s feed; if they feel unheard there, some expound in additional posts and intensify the emotional content. They also may jump to a forum and expand the reach and volume of their frequently negative comments. Rather than relieving the frustration, such online activity seems to amplify it.

Freed by Anonymity

There is good and bad in the freedom and anonymity the Internet provides. Anonymity provides protection to speak about personal topics. But it also provides a curtain behind which people can comment without fear of repercussion. Some people post hurtful comments they would never say face to face. If blocked, a person can create a new social account and return to continue posting within a conversation. A New York Times journalist recently departed Twitter, noting it has become “a place where people who are understandably upset about any number of things go to feed their anger, where the underbelly of free speech is at its most bilious.”

Fed by Internet Searches

According to Pew Research Center, nine-in-ten adults in the U.S. are online. Pew previously found that, when using search engines (one of the most popular online activities), Internet users say most or all the information they find is accurate. But several search engines are for-profit entities supported by advertising dollars and serve advertising-related content within, even atop, search results. Continued use of search engines whose algorithms serve content based on previously clicked (and so inferred successful) search results will serve similar content. This can lead a user down a rabbit hole of similarly focused content and like-minded comments.  After several searches, someone can feel like an expert. And their social media channel provides a platform where they can post claims or opinions as facts, take umbrage at rebuttal or rejection of their posts, and begin—or continue—emotional comments within social posts.

So, Respond with Facts

Arriving on my or your organization’s social media channel feeling frustrated, relatively anonymous, and confidently knowledgeable, many health care consumers are posting emotional, even hateful comments. An emotional comment begs an emotional response. However, as health communicators, we must show restraint and respond with facts. Admittedly, facts and links to credible sources may not change a mind or even prompt second thoughts. But facts, stated in plain language and supported by science-based studies, are the foundation for emotion-free review and, hopefully, reconsideration.

I can’t step away from the angry social media comments (without a job change) and I don’t want to. Working in health care-focused social media provides a great opportunity to educate, offering easily accessible, science-based health information. The harsh and hateful comments are tough to read, but I’ll continue to read them and respond, when appropriate, with science-based facts.

If you too are reading and responding to similarly emotional posts, I suggest you have an armor of thick skin, an arsenal of facts, and an abundance of empathy.

Maureen Marshall is a health communication specialist with CDC’s National Center for Immunization and Respiratory Diseases. Her focus is implementing clear communication of health messages for the public and for health professionals through digital channels. She has a BA in English from Seton Hill University and an MS in Technical and Professional Communication from Southern Polytechnic/Kennesaw State University.

Views expressed here are her own and do not necessarily represent the views of her employer.

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A very good question, one we DEFINITELY need to talk about.
Discussing healthcare on social media: Navigating the meanness:
How do we respond to angry and abusive comments on social media? With facts and compassion.

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