Hospitals’ BLM Support: Brief, Shallow on Twitter

A majority of top-ranked hospitals tweeted at least once in support of the Black Lives Matter (BLM) movement after the murder of George Floyd. However, that support was shallow, according to a recent analysis of these hospitals’ Twitter accounts.

While 74.4% of Twitter accounts for 90 of Newsweek‘s top hospitals — some facilities from the same system were represented by the same Twitter handle — used a hashtag in support of the BLM movement, that amounted to only 274 tweets out of the 281,850 they posted in total from 2009 to 2020 (0.097%).

Only four tweets out of those 274 (1.5%) were published before George Floyd’s murder, Yulin Hswen, ScD, MPH, of the University of California San Francisco, and colleagues reported from their retrospective longitudinal cohort design study in JAMA Network Open.

Other categories didn’t fare much better:

• Black support garnered a total of 244 tweets (0.086%) from 42 handles (46.7%) since 2013
• Black health got 28 tweets (0.0099%) from 15 handles (16.7%) starting in 2018
• Social justice had 40 tweets (0.014%) from 21 handles (23.3%) since 2015

This, the authors wrote, reflected a 10-year trend among hospital systems, which have lacked social media discourse surrounding the Black community.

For the 67 handles that tweeted in support of the BLM movement, 26 (38.8%) had published only one tweet in this category. Of the 42 handles that posted tweets under the category of Black support, 10 (23.8%) had only one tweet. In the Black health category, 13 out of the 15 handles that tweeted in support also had a single tweet each, and 13 out of the 21 handles that tweeted something related to social justice had just one tweet each.

This research was done at a time when the COVID-19 pandemic — which has disproportionately impacted Black Americans — and police violence against Black individuals in the U.S. painfully coalesced.

“It is imperative for hospitals to acknowledge themselves as safe spaces, run by clinicians and staff who care about social justice issues impacting the health of the Black community,” Hswen and colleagues wrote. “Without the promotion of activism for the [BLM] movement, Black patients may perceive hospitals as uncaring and unsafe, possibly delaying or avoiding treatment, potentially resulting in serious complications and death for those with COVID-19.”

In order to separate tweets into the four categories they identified, the researchers isolated the posts — both original tweets and retweets — that included key hashtags related to the Black population and the BLM movement. Tweets that contained hashtags from more than one category were placed into multiple categories, and the authors manually reviewed each grouping.

The earliest tweet collected was published on May 3, 2009, and the most recent was published on June 26, 2020; the date of George Floyd’s murder — May 25, 2020 — was investigated as a point of interest. The median date of all tweets from the BLM category was June 5, 2020 (interquartile range 3 days). The most common hashtags among this group of tweets were #GeorgeFloyd and four variations of #BlackLivesMatter, including two forms of #whitecoatsforBlacklives.

“Of the small percentage of tweets that had Black community or social justice labels, the earliest tweets are at least 6 years later than the earliest tweet published in the data set,” the authors noted. “This, along with the median dates within a year of collection, indicate that these discussions are relatively recent.”

Additionally, researchers found that, while some hospitals acknowledged the disparate impact of the COVID-19 pandemic on Black communities, most tended to tweet about Black health and COVID-19 separately.

Hswen and colleagues acknowledged that their dataset was limited, as it was only based on hashtags and not on text. However, they added, the use of hashtags is essential when showing support of a social movement on social media, and hospitals tend to hire social media managers with this knowledge.

That their sample only included the top 100 hospitals ranked according to Newsweek posed another limitation. Their results, therefore, may not be generalizable to all U.S. hospitals. Notably, the authors did not include community- or minority-based hospitals as a point of comparison.

“Health organizations that thoughtfully address social justice issues online may be able to build trust and bolster uptake of their services among these groups and help to improve their health outcomes overall,” the researchers concluded.