What Would it Take to Make Social Media Healthier?

New research outlines steps to combat disinformation on social media and restore its credibility as a public health tool.

Social media apps on a phone screen

Nearly 4.3 billion people worldwide use social media, a number that is expected to grow to 6 billion within five years. Photo from iStock

By Michael Penn

Published July 5, 2023, last updated on July 6, 2023 under Commentary

Social media is so often plagued by disinformation that it’s easy to overlook its positive effects. Even during the COVID-19 pandemic, when vaccine denialism and dangerous fallacies flooded platforms, millions of people around the world relied on those same channels for timely knowledge on the virus and how to avoid it. In fact, several research studies have shown regular social media users were better informed about the virus and more likely to follow public health guidelines.

Those contradictions run through a new analysis of the uses and misuses of social media in public health campaigns. The study, led by a Duke undergraduate student and involving health experts in seven countries, describes a complicated picture of harms and benefits from social media consumption and proposes recommendations to reduce the influence of disinformation.

“There’s been a lot of framing of social media as inherently flawed and doomed to damage public health,” says Zain Jafar, a Duke senior who led the research. “While there’s certainly basis for that viewpoint, we wanted to challenge that notion and illustrate that given social media’s reach and spread, it can be used in powerful ways to benefit public health.”

The research, published July 3 in the journal Health Promotion Perspectives, argues that the harms associated with social media platforms are not inevitable, but instead stem from choices that both social media companies and users make that tend to reward outrageous content. But simple steps by platforms, governments and users themselves could help reverse that trend, the authors assert.

There are a lot of concrete steps social media companies can take to mitigate these problems, but that might not happen without sustained pressure.

Zain Jafar — Duke senior

Jafar notes that social media companies have access to tolls such as viral circuit breakers, which Facebook deployed in 2020 to interrupt the uncontrolled spread of unverified information. Practices such as the timely flagging of misleading posts and “prebunking,” which involves giving users facts before they are exposed to disinformation campaigns, are also proving effective at dismantling the influence of false or deceptive health claims.

But many platforms have been slow to embrace such controls, which may undercut their commercial interests in promoting viral content. “There are a lot of concrete steps social media companies can take to mitigate these problems, but that might not happen without sustained pressure,” Jafar says.

Some countries are effectively exerting that pressure through increased government oversight, says Jonathan Quick, M.D., an adjunct professor of global health at Duke who advised Jafar on the research and is the second author on the study. He cites the European Union’s Digital Services Act, which requires social media companies to police illegal content on their platforms, as one positive step that could enforce more transparency and accountability on social media channels.

The study also calls for more efforts by governments and social organizations to educate users about the potential dangers of overreliance on social media, including the links between social media use and heightened anxiety, isolation and depression.

Jafar, who is pursuing a self-designed major focused on health equity and healthcare reform, began the research while working as a teaching assistant in Quick’s first-year Duke course on global health epidemics. He and Quick solicited ideas and guidance from coauthors in India, Mexico, South Africa, Zimbabwe, Australia and the United Kingdom, reflecting the increasingly global reach of social media’s biggest players. Their analysis points out, for example, that nine of the 10 countries with the most Facebook users are in the Global South.

That global footprint underscores the need for multinational approaches to social media regulation and moderation, notes Quick. And while those efforts have been slow to take root, particularly in the United States, he and Jafar remain cautiously optimistic that the collective will is building for more proactive reform.

“Social media is here to stay, and it’s an essential tool for 21st century global and public health,” Quick says. “As with a lot of high-impact innovations, it can be used for good or for ill. This paper shows us the possible steps to making it more effective and less harmful for all.”