Social media is ever present in today’s society, and levels of interest in the use of social media to support action to promote and protect health, alongside understanding and protecting against potential harms is growing. To help harness social media to support health we need to better understand who, and how, people engage with the platforms available to them, and the impact of those actions.
In 2018 in Wales, Public Health Wales in collaboration with Bangor University, carried out a nationally representative survey amongst adults (aged 16 years and above). The household survey was delivered face to face and collected the views from over 1,200 people on their access and use of digital technologies, including social media, and demographics and levels of health and wellbeing.
Our findings were surprising. Overall, 77% of the adult population in Wales reported using social media, with 65% using it on a daily basis (weighted to the demographic distribution of the Welsh population). The most frequently used platforms were Facebook, followed by WhatsApp, and YouTube. Of those remaining, approximately 10% had access to the internet but did not engage with social media, and a further 10% did not have access to the internet at all.
Digital exclusion (not having access, skills or digital literacy needed to use internet enabled technology) has been highlighted before in Wales and across the UK, and is recognised to be higher amongst older populations those in more deprived areas, and in poorer health. Given the increasing reliance on internet and technology across society, digital exclusion could be considered as a new social determinant of health. The continued efforts of many organisations such as Digital Communities Wales to support everyone to have the opportunity, skills and capability to engage with online platforms is essential – ensuring a progress on digital is not inadvertently widening inequalities.
Back to our survey – where our findings challenged the preconception that social media is only for the young. We found that, amongst those who do have access to the internet, use did decrease with increasing age but a high proportion of the older age groups were using social media – 76% of those aged 60-69 years and 60% aged 70+ years. We also found higher engagement with social media amongst women than men – but differences across platforms. For example, more women used social networking, photo content and messaging platforms, whereas a higher proportion of men used video content platforms.
When considering differences by health status, we found that people with lower self-reported health and those who engaged in health-harming behaviours (smoking, inactivity and/or high levels of alcohol consumption) were less likely to engage with social media. Many studies have explored how social media offers people the opportunity to communicate and interact with others and find and receive information about health conditions – but not all may be interested or able to engage.
Collectively, these findings highlight the importance of understanding the audience, where they are (or not) on digital platforms, to inform and target relevant information.
Lastly, we found that engagement in social media was similar across deprivation quintiles (see figure below), with the exception of Twitter and Whatsapp which had a lower level of engagement in those least affluent. The potential for social media to reach more deprived populations has also been reported elsewhere, and warrants further exploration to better understand how we can use social media to reach and engage all communities in health.
Back to my question – can social media offer a way to engage across social groups?
Possibly.
First there is the challenge of digital exclusion, recognised to be higher in more deprived areas, older populations and those in poorer health. There remains the need to overcome structural, educational and behavioural barriers contributing to digital exclusion. Should this be achieved then our findings pose some interesting areas for further exploration, given that we found no difference in engagement in some social media platforms across deprivation groups.
However, in this short blog I have somewhat simplified a complex challenge, and one that includes questions of trust, quality and reliability of information online, better understanding the relationship with well-being, and the need to build in evaluation – all in a fast-paced environment.
There remains much to learn about the role of social media in health, both beneficial and harmful. But as public services move to digital channels, continued efforts are needed to understand and address inequalities in access, alongside recognising that social media may offer a platform to reach a wider audiences and engage differently with populations about health.
Written by Dr. Alisha Davies FFPH PhD Head of Research & Evaluation, Public Health Wales
NOTE:
This report is the second in a series called Population health in a digital age, the first published in 2019 and explored the use of digital technology to support and monitor health in Wales. Both reports and infographics are available here
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