Challenges for Health in a Networked Society

In February, I had the great fortune to visit the Robert Wood Johnson Foundation as part of their “What’s Next Health” series. I gave a talk raising a series of critical questions for those working on health issues. The folks at RWJF have posted my talk, along with an infographic of some of the challenges I see coming down the pipeline.

They also asked me to write a brief blog post introducing some of my ideas, based on one of the questions that I asked in the lecture. I’ve reposted it here, but if this interests you, you should really go check out the talk over at RWJF’s page.

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RWJF’s What’s Next Health: Who Do We Trust?

We live in a society that is more networked than our grandparents could ever have imagined. More people have information at their fingertips than ever before. It’s easy to see all of this potential and celebrate the awe-some power of the internet. But as we think about the intersection of technology and society, there are so many open questions and challenging conundrums without clear answers. One of the most pressing issues has to do with trust, particularly as people turn to the internet and social media as a source of health information. We are watching shifts in how people acquire information. But who do they trust? And is trust shifting?

Consider the recent American presidential election, which is snarkily referred to as “post-factual.” The presidential candidates spoke past one another, refusing to be pinned down. News agencies went into overdrive to fact-check each statement made by each candidate, but the process became so absurd that folks mostly just gave up trying to get clarity. Instead, they focused on more fleeting issues like whether or not they trusted the candidates.

In a world where information is flowing fast and furious, many experience aspects of this dynamic all the time. People turn to their friends for information because they do not trust what’s available online. I’ve interviewed teenagers who, thanks to conversations with their peers and abstinence-only education, genuinely believe that if they didn’t get pregnant the last time they had sex, they won’t get pregnant this time. There’s so much reproductive health information available online, but youth turn to their friends for advice because they trust those “facts” more.

The internet introduces the challenges of credibility but it also highlights the consequences of living in a world of information overload, where the issue isn’t whether or not the fact is out there and available, but how much effort a person must go through to manage making sense of so much information. Why should someone trust a source on the internet if they don’t have the tools to assess the content’s credibility? It’s often easier to turn to friends or ask acquaintances on Facebook for suggestions. People use the “lazy web” because friends are more likely to respond quickly and make sense than trying to sort out what’s available through Google.

As we look to the future, organizations that focus on the big issues — like the Robert Wood Johnson Foundation — need to think about what it means to create informed people in a digital era. How do we spread accurate information through networks? How do we get people to trust abstract entities that have no personal role in their lives?”

Questions around internet and trust are important: What people know and believe will drive what they do and this will shape their health.

The beauty of this moment, with so many open questions and challenges, is that we are in a position to help shape the future by delicately navigating these complex issues. Thus, we must be asking ourselves: How can we collectively account for different stakeholders and empower people to make the world a better place?

thoughts on Pew’s latest report: notable findings on race and privacy

Yesterday, Pew Internet and American Life Project (in collaboration with Berkman) unveiled a brilliant report about “Teens, Social Media, and Privacy.” As a researcher who’s been in the trenches on these topics for a long time now, none of their finding surprised me but it still gives me absolute delight when our data is so beautifully in synch. I want to quickly discuss two important issues that this report raise.

Race is a factor in explaining differences in teen social media use.

Pew provides important measures on shifts in social media, including the continued saturation of Facebook, the decline of MySpace, and the rise of other social media sites (e.g., Twitter, Instagram). When they drill down on race, they find notable differences in adoption. For example, they highlight data that is the source of “black Twitter” narratives: 39% of African-American teens use Twitter compared to 23% of white teens.

Most of the report is dedicated to the increase in teen sharing, but once again, we start to see some race differences. For example, 95% of white social media-using teens share their “real name” on at least one service while 77% of African-American teens do. And while 39% of African-American teens on social media say that they post fake information, only 21% of white teens say they do this.

Teens’ practices on social media also differ by race. For example, on Facebook, 48% of African-American teens befriend celebrities, athletes, or musicians while one 25% of white teen users do.

While media and policy discussions of teens tend to narrate them as an homogenous group, there are serious and significant differences in practices and attitudes among teens. Race is not the only factor, but it is a factor. And Pew’s data on the differences across race highlight this.

Of course, race isn’t actually what’s driving what we see as race differences. The world in which teens live is segregated and shaped by race. Teens are more likely to interact with people of the same race and their norms, practices, and values are shaped by the people around them. So what we’re actually seeing is a manifestation of network effects. And the differences in the Pew report point to black youth’s increased interest in being a part of public life, their heightened distrust of those who hold power over them, and their notable appreciation for pop culture. These differences are by no means new, but what we’re seeing is that social media is reflecting back at us cultural differences shaped by race that are pervasive across America.

Teens are sharing a lot of content, but they’re also quite savvy.

Pew’s report shows an increase in teens’ willingness to share all sorts of demographic, contact, and location data. This is precisely the data that makes privacy advocates anxious. At the same time, their data show that teens are well-aware of privacy settings and have changed the defaults even if they don’t choose to manage the accessibility of each content piece they share. They’re also deleting friends (74%), deleting previous posts (59%), blocking people (58%), deleting comments (53%), detagging themselves (45%), and providing fake info (26%).

My favorite finding of Pew’s is that 58% of teens cloak their messages either through inside jokes or other obscure references, with more older teens (62%) engaging in this practice than younger teens (46%). This is the practice that I’ve seen significantly rise since I first started doing work on teens’ engagement with social media. It’s the source of what Alice Marwick and I describe as “social steganography” in our paper on teen privacy practices.

While adults are often anxious about shared data that might be used by government agencies, advertisers, or evil older men, teens are much more attentive to those who hold immediate power over them – parents, teachers, college admissions officers, army recruiters, etc. To adults, services like Facebook that may seem “private” because you can use privacy tools, but they don’t feel that way to youth who feel like their privacy is invaded on a daily basis. (This, btw, is part of why teens feel like Twitter is more intimate than Facebook. And why you see data like Pew’s that show that teens on Facebook have, on average 300 friends while, on Twitter, they have 79 friends.) Most teens aren’t worried about strangers; they’re worried about getting in trouble.

Over the last few years, I’ve watched as teens have given up on controlling access to content. It’s too hard, too frustrating, and technology simply can’t fix the power issues. Instead, what they’ve been doing is focusing on controlling access to meaning. A comment might look like it means one thing, when in fact it means something quite different. By cloaking their accessible content, teens reclaim power over those who they know who are surveilling them. This practice is still only really emerging en masse, so I was delighted that Pew could put numbers to it. I should note that, as Instagram grows, I’m seeing more and more of this. A picture of a donut may not be about a donut. While adults worry about how teens’ demographic data might be used, teens are becoming much more savvy at finding ways to encode their content and achieve privacy in public.

Anyhow, I have much more to say about Pew’s awesome report, but I wanted to provide a few thoughts and invite y’all to read it. If there is data that you’re curious about or would love me to analyze more explicitly, leave a comment or drop me a note. I’m happy to dive in more deeply on their findings.