This Emergency Will Be Tweeted: What Local Health Departments Need to Know About Social Media

By Frances Bevington, Senior Marketing and Communications Specialist, Public Health Preparedness, NACCHO

With nearly three out of four American adults using social networking sites [1], first-hand reports on social media during unfolding situations present many opportunities for those in the fields of local public health and emergency response. However, local health departments have a long way to go with adoption of social media, with only 8 percent using Twitter and 24 percent using Facebook [2].There are also significant challenges that should not be ignored. For example, the speed at which new information is released can be challenging to keep up with and verify, and pressures official sources of information to release updates and dispel rumors more quickly.


The promise of real-time reporting through social media. With over half of American adults owning smartphones [3], a majority of the U.S. population now carries around a computer in their pocket. The convergence of smart phone use with social media use means that more people are posting about waking up feeling unwell, posting photos of the accident they narrowly avoided, tweeting about the power outage from last night’s storm, or other similar activities. Social media “listening” initiatives hope to monitor this fire hose of data to get ahead of potential pandemics, target response activities, and more precisely allocate resources with technology that is able to perform real-time content analysis and cut through the unrelated chatter. One such initiative is underway at Johns Hopkins University, where researchers have demonstrated that Twitter can be used to guide public health departments in response to influenza outbreaks.

Social media listening can also be accomplished through more low-tech solutions during emergencies by engaging staff and volunteers to monitor and respond through social media channels, as was the case when phone lines were down in New York City after Hurricane Sandy. Many government agencies and volunteer organizations used Twitter and Facebook to respond to requests for accurate information and the FDNY used Twitter to report residents in distress who couldn’t access 911 to dispatchers.

It’s important to recognize the reciprocal nature of social media. The general public looks to the social media accounts of official sources during emergencies for real-time updates of accurate information [4]. San Diego County leveraged heightened attention through social media by “live tweeting” a press conference during a blackout in September 2011. With television and radio stations unable to reach the public without electricity, Twitter became their best option for releasing critical information [5]. Twitter recently enhanced its services for releasing time critical information from credible organizations during an emergency with the launch of Twitter Alerts.

Who are really reading local health department tweets? Official sources of information should be prepared for a surge in interest in social media accounts during a disaster or emergency. The Heroic Project noted a significant increase in followers of Twitter accounts of local agencies (e.g. Boston Police Department, Mayor Tom Menino, and Boston EMS) after the Boston Marathon bombing and suggested that this demonstrated heightened awareness and information seeking in the aftermath of the attack [4]. San Diego County also reported a significant increase in followers as a result of the County’s effective use of social media during the 2011 blackout [5].

However, a study of the Twitter accounts of local health departments revealed that most of their followers on Twitter are health-focused organizations, educational institutions, government agencies, and nonprofits located outside the state [6]. The study also revealed the local health departments with larger numbers of local followers tend to serve larger populations, have a Public Information Officer on staff, and have a greater rate of frequency in tweets, suggesting that those wishing to gain more local followers would be able to do so with more resources dedicated and priority given to social media efforts. With this information in mind, local health departments should examine the audience and listening efforts of their social media initiatives to ensure that they are engaged in an active dialog with local audiences and that they are able to reach their intended audiences with preparedness messages before their social media accounts experience a surge during a disaster or emergency.

Stopping the rumor mill. The speed at which news spreads on social media networks provides an opportunity for misinformation and rumors to gain traction quickly. During Hurricane Sandy, there were enough rumors spreading through social media that FEMA started a rumor control webpage to help police misinformation. After the Boston Marathon bombing, rumors that an arrest had been made started on social media and spread to television news reports, without confirmation from the Boston Police Department. The speed at which false information can spread makes it critical for official sources to ensure the accuracy of the information being released to the public through social media and to make efforts to monitor social media channels and dispel rumors as quickly and consistently as possible.

What’s next? While the promise of harnessing the speed of real-time reporting through social media is exciting, there are significant obstacles to overcome. For example, applications that rely solely on Twitter cannot assume that data collected is representative of the entire U.S. population since only 18 percent use Twitter [1]. Social media also may not be the best method for reaching vulnerable populations like older adults and children that don’t use the platforms. Finally, the growing number of Americans enabling their social media accounts to include location information in their posts [7] has the potential to further enhance data mining of social media for public health purposes but HIPAA and other privacy concerns must be taken into consideration to avoid potential misuse of the information. Social media has already proven its value as a powerful means of providing vital information and two-way communications during disasters and emergencies. Further advancements in the use of social media in risk and crisis communications may lead to better predictive capabilities for potential pandemics, faster response times with more accurate location information, and more finely tuned messages designed to reach specific audiences with just-in-time information.

Resources for getting your local health department started on social media:

  1. Brenner, J. and Smith, A., (2013). 72% of online adults are social networking site users. Pew Internet and American Life Project. Retrieved from:
  2. Harris, J. K., Mueller, N. L., & Snider, D. (2013). Social media adoption in local health departments nationwide. American Journal of Public Health, 103(9), 1700-1707.
  3. Smith, A. (2013, June 5). Smartphone ownership 2013. Pew Internet and American Life Project. Retrieved from:
  4. Sutton, J., Spiro, E., Johnson, B., and Butts, C. (2012). Following the bombing. The Heroic Project. Retrieved from:
  5. Christensen, T. (2013, September). Social media in an emergency. Presented at the NPHIC Symposium, Chicago, IL. Retrieved from:
  6. Harris, J., Choucair, B., Maier, R., Jolani, N., Bernhardt, J. (under review). Are public health organizations tweeting to the choir? Understanding LHD Twitter followership.
  7. Zickuhr, K. (2013, Sept. 12). Location-based services. Pew Internet and American Life Project. Retrieved from:


About Frances Bevington

Frances Bevington is the Senior Marketing and Communications Specialist for Public Health Preparedness at NACCHO. Her work includes emergency and risk communications planning, strategic messaging, and multichannel marketing for the adoption of best practices in public health preparedness. Twitter: @Wilkington

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