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Neither Words nor Images: Health Departments' and Hospitals' Use of Twitter During COVID-19 Had Limited Racial
Poorva Sheth1, Chloe Thompson, Avi Bhavsar
1Saint Louis University School of Medicine, St Louis, Missouri (Ms Sheth); Saint Louis University College for Public Health and Social Justice, St Louis, Missouri (Mss Thompson, Bhavsar, and Smith and Dr Rozier) and Emory Health, Atlanta, Georgia (Ms Thompson).
Objective:
To determine the degree to which hospitals and state health departments used written content or visual representation on social media to draw attention to racial disparities during the COVID-19 pandemic.
Study Design:
A retrospective analysis, using Twitter content (words and images) between May-June 2020 and May-June 2021 from organizations in the 5 states with the largest documented racial disparities in COVID-19-related mortality.
Main Outcomes:
All tweets and retweets (n = 6790) were coded along several lines. For May-June 2020 and May-June 2021, posts were coded as pandemic related (yes/no) and disparities related (yes/no). Open-coding methods categorized pandemic-related content into content areas, including COVID-19 education, hospital or public policy, and addressing misinformation. After self-identifying their own race/ethnicity, survey respondents (n = 100) coded pandemic-related Twitter images (n = 198) as including individuals of a similar race/ethnicity (yes/no).
Results:
In May-June 2020, health departments posted more pandemic-related content than hospitals (μ = 204 and 71 tweets, respectively; P = .03), including more about health disparities (μ = 14.3% and 2.11% of tweets, respectively; P = .03). Between May-June 2020 and May-June 2021, content addressing health disparities decreased for both groups (47% decrease for health departments and 69% decrease for hospitals). Black respondents were more likely to feel represented in images from health departments than in those from hospitals (44.3% and 23.7% of images, respectively; P = .05). Both hospitals and health departments were more likely to use images where White respondents felt represented (hospitals = 76.1% of images; health departments = 59.7%) than images where respondents from racial/ethnic minorities felt represented (hospitals = 19.3% of images; health departments = 21.4%) ( P ≤ .001 for hospitals; P = .004 for health departments).
Conclusions:
Health education ideally comes in a variety of ways. Hospitals used social media for this purpose less than health departments, and neither group increased such content during the COVID-19 pandemic even as evidence of racial disparities grew.
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