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.
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[tt1]More info about how people learn or ignore information.
[tt2]Info about public participation.
[tt3]Data about early community involvement