CMAJ • May 12, 2009; 180 (10). doi:10.1503/cmaj.090696.
© 2009 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Figures Only
Right arrow Full Text (PDF)
Right arrow Online Extra
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wilson, K.
Right arrow Articles by Keelan, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wilson, K.
Right arrow Articles by Keelan, J.

Salon

Coping with public health 2.0

Kumanan Wilson, MD MSc and Jennifer Keelan, PhD

Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario

The scope of the Web today is hard to fathom. ... In fewer than 4000 days, we have encoded half a trillion versions of our collective story and put them in front of 1 billion people, or one-sixth of the world’s population. ... What we all failed to see was how much of this new world would be manufactured by users, not corporate interests." 1

This statement by the founding editor of Wired reflects 2 interrelated phenomena of the Internet: the rapidity of its growth and the amount of information produced by users for free. It is the latter fact, that is at the heart of the second generation of Web services: Web 2.0. These services fuel an individual’s desire to connect with others and communicate their views, and allow online collaboration and sharing of content. Web 2.0 applications have grown dramatically in number, size, popularity and influence to include sites such as Wikipedia, YouTube, political blogs such as Daily-Kos and HuffingtonPost and the social networking sites MySpace and Facebook.

Web 2.0 facilitates both expert and general public communication of health-related knowledge, which can be particularly problematic for public health authorities. De facto, it juxtaposes vetted scientific opinion against information from critics, crusaders and conspiracy theorists, which undermines the critical foundation of trust between public health officials and the public. 2 This trust is necessary for activities that sometimes require restrictions on individual liberties or impositions on individuals for the benefits of the population.

Antivaccination postings illustrate some of the challenges of this new medium. The usual public health response to concerns about vaccination has been to disseminate well-researched evidence that refutes the claims. To an important extent public health officials have also tried to not bring too much attention to claims made by vaccine critics because of fear that a public debate and subsequent airing of those views, regardless of scientific merit, might lend credence to the claims. However, with the Internet and Web 2.0 these strategies are no longer appropriate. YouTube is now being used by a community of individuals concerned about vaccination to communicate their messages. 3 MySpace blogs contain a significant number of posts with antivaccination content. Anti-vaccination viewpoints linking autism to mercury are also being posted on popular blogs such as the HuffingtonPost. By leveraging these new media, vaccine critics have overcome the structural advantage held by traditional public health in communicating their viewpoints. The consideration of public figures, such as actress-activist Jenny McCarthy, as equivalent an authority, in some media, to top public health officials, and the infiltration of the language and logic of vaccine critics into political discourse is a testament to their success. 4


Figure 126
View larger version (53K):
[in this window]
[in a new window]

  		FIGURE. Image courtesy of Fred Sebastian

 
The use of Web 2.0 reflects an evolution in medical counterculture movements. Individuals with beliefs outside the mainstream used to have difficulty finding likeminded individuals. But when they did, their ability to hold onto their viewpoints and reject criticism was strengthened. Now, Web 2.0 provides those with alternative beliefs a virtual environment where they can hear their viewpoints echoed and become more confident that their assertions are correct. This interaction also has the potential to sway others.

Although troubling to many in public health, the use of the Internet for these purposes simply cannot be ignored. Web 2.0 is here to stay and will almost certainly influence health behaviours. Health is a logical area in which individuals will want to seek opinions from others and communicate their experiences. In this new era, public health officials need to learn how to more effectively listen to these messages and, simultaneously, develop more lively and engaging messages themselves to communicate with the public.


Figure 226
View larger version (19K):
[in this window]
[in a new window]

  		FIGURE. No caption available.

 

Footnotes

Dr. Wilson is supported by the Canada Research Chair in public health policy.

Have you got an opinion about this article? Post your views at www.cmaj.ca. Potential Salon contributors are welcome to send a query to salon{at}cmaj.ca


REFERENCES

  1. Kelly K. We are the Web. Wired 2005;13(8). Available: www.wired.com/wired/archive/13.08/tech.html?pg=2& (accessed 2009 Apr. 17).
  2. Hesse BW, Nelson DE, Kreps GL, et al. Trust and sources of health information: the impact of the In-ternet and its implications for health care providers: findings from the first health information national trends survey. Arch Intern Med 2005;165:2618-24.[Abstract/Free Full Text]
  3. Keelan J, Pavri-Garcia V, Tomlinson G, et al. YouTube as a source of information on immunization: a content analysis. JAMA 2007;298:2482-4.[Free Full Text]
  4. Carey B. Into the fray over the cause of autism. New York Times 2008 Mar. 4. Available: www.nytimes.com/2008/03/04/us/politics/04autism.html (accessed 2009 Apr. 17).



eLetters:

Read all eLetters

Embrace, don't cope
George Klima
CMAJ, 6 Nov 2009 [Full text]
This Article
Right arrow Figures Only
Right arrow Full Text (PDF)
Right arrow Online Extra
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wilson, K.
Right arrow Articles by Keelan, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wilson, K.
Right arrow Articles by Keelan, J.