Health information on social media: Blessing or harm?

From clinical practice to public health campaign, promotion and protection of health and well-being, prevention of ill-health and prolonging life through organised societal efforts are the ultimate goals of public health (FPH, 2017). These goals have been enshrined in public health domains as health improvement, health protection and service improvement with evidence–based practice as one of the core values to improve global health outcomes. The effects of social media on global health outcomes in the 21st century can never be overemphasised. Advent of social media in the ICT–driven century has positively shaped health industry in many ways, including transfer of healthrelated data among healthcare professionals to improve both individual and community health practices, sharing of preventative information, and facilitation of healthcare support structures to track patients post diagnosis. However, the numerous challenges created by unrestricted and misinformed messages on social media about health issues signal a huge threat to prevention of ill-health, promotion and protection of health worldwide.

From basic non-invasive surgical procedures such as conventional chiropractic manipulation to more complex invasive ones such as bariatric surgery, gastric and coronary revascularisation, the ubiquities of seemingly unauthorised video recording and sharing of these procedures on social media are at an alarming rate. It is not uncommon, especially in the developing countries to see members of the surgical team holding handheld devices with unauthorised filming of the surgical procedures. This practice aside being unethical can also break the sterile nature of the surgical environment, raises the risks of contamination and consequently results in more complicated outcome for the patients. Filming, streaming and sharing of surgical procedures and other classified health related information without consents of concerned individuals do not only constitute infringements on the autonomous right of those persons, but is also antithetical to ethical principles of health profession around the world. The four-basic ethical principles guiding health practices are; respects for individual or patient to make choice base on personal values and believes (autonomy); obligation not to inflict harm intentionally (non-maleficence); equitable treatment of persons (justice) and; provision of benefits to others (beneficence). It is therefore important that all stakeholders in heath sectors such as health policymakers, professional bodies and society at large make concerted efforts against the flagrant abuse of these ethical principles. As obtainable in the developed nations, ethical and legal issues in health should be among the core prerequisites for medical and allied health students under training in the developing countries as many of these trainees have been seen unethically filming medical procedures. This will go in long way of producing more ethically conscious health professionals in the nearest future.

Furthermore, more worrisome among the negative effects of social media is widespread of ‘far from the-truth’ information about certain health conditions. Nowadays, rumours about various causes and treatment regimens for conditions such as cancer, human papilloma virus (HPV) and HIV/ AIDS circulate faster and wider on social media than evidence–based health reports from competent and reputable health organisations. According to the survey by The Independent – a UK–based newspaper (2017) – more than half of the cancer related posts on Facebook social media platform in 2016 were found by health experts to be a hoax or fake. In the reports of Dr Rachel Orritt – the health information officer for Cancer Research UK, three of the most circulated, ‘shared’ and ‘liked’ five news articles on social media about HPV in 2016 were discovered to be fake (The independent, 2017). In addition, “Shared Count” (A web analysis tools to know how much an information is liked or shared on social media) revealed that, treatment of cancer with Dandelion plant posted by a US registered healtheternally.com website and linked to a renowned scientist was the most popular article on Facebook shared among 1.4 million users in 2016. However, contrary to the stated claims on the website, when the scientist mentioned in the article was contacted, he said to know nothing about the article as the recruitments for the trial on the plant was still ongoing and serious experimental procedures were yet to start on the plant! The website has though been brought down, yet, the false information about dandelion plant still trends on many social media platforms such as Facebook and WhatsApp.

To gain credibility, most of the fake health related articles often got falsely attributed to reputable research institutions across the globe. In 2013, packaging of food and drinks in the plastic or polythene containers was reported to be one of the causes for stomach cancer by an online article attributed to Johns Hopkins research centre in US as “Cancer updates from John Hopkins hospital, US”. However, researchers at Johns Hopkins on their website disclaimed the article and gave point-by-point evidence based refutations of all information linking packaged food in polythene products to stomach cancer (Snopes, 2017). The examples are few among many false health reports on social media.

The devastating effects of wrong health information are more grievous than many infectious diseases of public health concerns. According to global population review of 2017, about 25% of total global population of 7 billion have access to internet with high tendency of using social media. In relation to this data, it is therefore indicated that about a quarter of the world population will be predisposed to various health risks of different magnitudes through misinformation on health-related issues on social media. A major challenge that health professionals and agencies now face is the ability to respond publicly and in a timely manner to the spread of misinformation and health-related rumours during public health events. Social media and cancer hoax Cancer is a group of diseases characterised by abnormal cell division to form lumps or masses of tissues called tumours (except in leukaemia where abnormal division of cells take place in the blood stream). The cancerous tumours grow and interfere with body systems, it can also release hormones that alter body function. According WHO (2017) cancer is the leading cause of death worldwide and responsible for estimated death of about 8.8 million. The common types of cancer in men are prostate, lung, colorectal, stomach and liver cancer, while breast, cervix, stomach, lung and colorectal are commonly found among women. Tobacco smoking has been identified as the most important risk factor for cancer and account for about 22% of cancer related death worldwide. Late-stage presentation, poor diagnosis and inaccessible treatment are the main drive for rise in cancer cases in low and middle-income countries. Findings from research show that about 30 to 50% of cancers can be prevented by avoiding predisposing risk factors and adherence to evidence based prevention strategies.

Prior to the advent of social media, there was limited information about treatment, prevention and ongoing clinical research on cancer. Today, on social media platforms like twitter, Facebook, WhatsApp and so on, real-time information on health and other issues can reach millions of users in seconds. Aside general audience, healthcare researchers also derive immense benefits from the emergence of social media. In minutes, findings from ground-breaking research on cancer by oncologists can be shared or presented to many followers through twitter or similar platforms. However, the rate at which health hoax spread on social media is faster than evidence based health facts. Associating packaged food in polythene products with cancer, freezing drinking cold water in plastic bottle as the cause of cancer and different claims of cancer treatment are among contemporary cancer related medical hoax on social media

Cancer and packaged food in polythene or plastic containers

The articles highlighting eating hot food packaged in plastic or polythene bags as one of causes of cancer have been trending for long on social media and have also find their ways to front pages of many dailies. In these articles, it has been claimed that Bisphenol A (BPA) and dioxins; two chemicals in plastic and polythene products do leak into hot food, disrupt hormone level in the body and subsequently results in stomach cancer. However, there is no convincing scientific evidence supporting this believe. In the manufacturing of polythene bags, the raw materials were heated to a temperature of about 200 degrees Celsius while the temperature of most hot food use to be below 80 degrees Celsius. It is therefore difficult for the chemicals of high temperature to be released into the food of lower temperature. This lack of association between cancer and hot food in plastic or polythene bag has been corroborated by findings from many research. In 2016, the European Food Safety Authority (efsa) conducted a full scientific review of Bisphenol A. Findings from the review showed that there was no health risk associated with Bisphenol A. Furthermore, in the findings of experiment reported by Cancer Research UK, the level of chemicals that moved into the food when plastic water bottles were heated for many hours to a high temperature above 60 degrees Celsius under experimental condition were smaller than the level that constitutes health risk to humans.

Warning against freezing water in plastic bottles, placing bottled water in the car and heating with plastic in microwave ovens as potential causes of cancer are other commonly found cancer hoax on social media. In contrary, freezing of water in plastic bottle works against the release of chemicals and therefore reduces the chances of any chemical being released into the water. This fact is also in line with findings by researchers at Sidney Kimmel cancer centre at Johns Hopkins University in the United States of America.

With thousands of healthrelated myths and hoax appearing on social media daily, people are exposing to information that put their health at higher risks. Every week there are thousands of medical breakthroughs and wonder drugs on social media. These stories do provide faster and more effective solutions than conventional medicine, however there is no reliable evidence on many of these social media health stories. Although sieving through to know truthful information on social media can be tasking, yet there are certain questions that should be asked to know the authenticity of the news. The questions include What is the evidence for this stated causes or claims?

What does the research show? What is the statement of other scientists about this claim? Is there any reliable source for claim? Knowing right questions to ask is the first important step toward culture change on social media health myths and hoax.