ABSTRACT
In June 2009, during the last week of school, a 13-year-old Ruskin, FL, girl named Hope Witsell made a mistake. She used a cell phone to take a photo of her breasts and “sexted” them to a boy named Alex, in whom she was interested romantically. Another girl who was friends with Alex – and who considered Hope a rival for her boyfriend – borrowed Alex’s phone on the school bus. When she found the image Hope had sent, she forwarded the text to other students, who then forwarded it to others. By the end of the day, Hope’s photo had reached students throughout her middle school and at the high school nearby. For the rest of the school year, Hope’s friends had to surround her in the school hallways when she walked between classes, attempting to shield her from the taunts of “whore” and “slut” and from students who would shove Hope into the lockers (Meacham, 2009). Shortly after the end of the year, school officials learned about the photo and called Hope’s parents. They briefly took her to counseling, but after three weeks the counselor told the Witsells that their daughter wasn’t benefitting from the counseling because she did not want to be there. Hope also faced a week-long suspension when school began again in the fall, but the summer break meant she would not be subjected to the taunts and slurs or physical abuse she had endured at school (Meacham, 2009). Being physically separated from her bullies, however, did not end Hope’s torment. Children from the middle school continued to taunt
and insult her via MySpace, where they wrote horrible comments about her on pages called “Shields Middle School Burn Book” and the “Hope Hater Page.” By the time Hope returned to school the following year, the bullying had intensified. She wrote about the bullying in her journal, but never told her parents (“How a Cell Phone,” 2010). On Friday, September 11, 2009, Hope met with the middle school’s social worker, to whom she was referred after another adult saw worrisome cuts on Hope’s legs. The counselor had Hope sign a “no harm contract,” in which she promised to tell an adult if she was thinking about harming herself. On Saturday, Hope’s parents went to work at the post office, came home to cook and share a seafood meal with Hope, and spent a few hours watching television. They invited Hope to watch with them, but she declined, preferring to stay in her room, writing in her journal (Meacham, 2009). One of the entries read, “I’m done for sure now. I can feel it in my stomach. I’m going to try and strangle myself. I hope it works” (Meacham, 2009, para. 65). The next time Hope’s mother went to her room to check on her daughter before going to bed, she found that Hope had killed herself. She attempted CPR while her husband called 911, but it was too late. The honor roll student who had dreamed of attending the University of Florida and then setting up her own landscaping and nursery business had given up hope of overcoming her sexting mistake. Although Hope Witsell’s suicide is often cited as the second case in which a teenager’s sexting led ultimately to suicide, it also illustrates one element of the darker side of the Internet, especially the now ubiquitous and heavily used social networking sites like Facebook, Twitter, Instagram, Snapchat and askFM. These social networking sites, which now play a central role in the lives of many teens and young adults, facilitate cyberbullying, a type of victimization estimated to affect at least one in every five youths at least once in their lives (Tokunaga, 2010). Cyberbullying clearly has negative health effects, but categorizing the overall health impacts of social media, including social networking sites, blogs, forums and online discussion groups, is somewhat complicated by the wide variety of content creators, the content they produce, and the nature of the interactions between content producers and content consumers. Chapter 2 already has dealt with the research on the effects of consumer use of the Internet for health information seeking. For the
most part, that research addresses the content, use and effects of government, organizational and corporate websites that provide health information intended for consumer use. This chapter, in contrast, will focus on content produced by individuals who may or may not intend to encourage those who consume their content to make health decisions based on that content. We will begin with what the research tells us about consumers’ use of social media in relation to health. According to the Pew Research Center’s 2009 study on the social life of health information, consumers frequently access “user-generated” health information (as distinguished from health information provided by a government agency, health advocacy group, hospital, etc.); of the 57 percent of American adults who look for health information online, a group the Pew Center calls “e-patients,” 41 percent have read another consumer’s commentary or recounting of his or her experience with a health or medical issue via a blog, a website or an online news group, and almost one in four (24%) have checked online rankings or reviews of health professionals and health facilities. On the other hand, only a small percentage of consumers create health content online, with 6 percent of e-patients saying they have posted health-related comments or information, or asked health questions. Use of social networking sites for health information acquisition is relatively common. Pew’s 2009 survey showed that 41 percent of e-patients had read another individual’s online discussion of his or her health or medical issues; younger adults (aged 18-49) are more likely than older adults to have read such commentaries (Fox & Jones, 2009). More than one-third of all adults (37%) and almost two-thirds (60%) of e-patients use social media in health-related ways, including obtaining information and advice, giving and receiving emotional or social support and so on (Fox & Jones, 2009). In particular, 23 percent of individuals with a chronic condition (e.g., cancer, heart disease, diabetes) and nearly one-third (32%) of those with multiple chronic conditions reported searching for others who share their health concerns; this compares to 15 percent of individuals with no chronic conditions who report similar searches. Looking online for people with similar health concerns also seems to be common among caregivers for those with a chronic condition and among people dealing with a medical crisis or with some sort of significant health change or issue, such as pregnancy, quitting smoking, and gaining or losing weight (Fox, 2011).
