Humor in Social Media Health Communication: A Systematic Review of Strategic Uses and Effects

Social media has become an important venue for health communication. Although prior research has examined the effects of humor, evidence on the mechanisms through which humor shapes communication effectiveness in social media health communication remains fragmented and has not been systematically synthesized. This systematic review examines how humor functions as a communication strategy in social media health communication designed by healthcare professionals, health organizations, and researchers. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 32 empirical studies were identified and synthesized. Findings indicate that humor is primarily used in two ways: as a content-level strategy to enhance audience engagement and as a psychological persuasive appeal in health message design and dissemination. Across studies, humor not only enhanced platform-level engagement but also influenced affective responses, attitudes, cognitions, and perceptions, which in turn shaped health-related behavioral intentions. Importantly, the effectiveness of humor was also contingent upon contextual and audience characteristics. This review integrates fragmented evidence into a conceptual framework that clarifies the pathways and boundary conditions of humor-based health communication on social media. It also highlights key limitations associated with the use of humor in health messaging and outlines directions for future research. Overall, this study provides theoretical insights and practical guidance for the strategic use of humor in digital health communication.