http://hints.cancer.gov

briefs

N U M B E R 1 9

U.S. Social Media 

Use and Health 

Communication

Characteristics of Internet and 

Social Media Users

Surveys routinely find that more than two-thirds of U.S. adults use 

the Internet, and about 60 percent of those online say they use the 

Internet to look for health or medical information. Although studies 

continue to show that ethnic minorities and those who are older, 

less educated, and less healthy are more likely to be non-Internet 

users, a more nuanced picture of this “digital divide” is beginning 

to emerge, particularly with the advent of social media and mobile 

technologies. 

Advances in Internet technology heralded the advent of new 

social media applications that facilitate user-generated content 

and the ability to interact and collaborate online, transforming 

communication patterns from being unidirectional and passive 

to active and participatory. HINTS data from 2008 show that 27 

percent of Internet users participate on some type of social media 

platform. Involvement on social networking sites (SNS) such as 

Facebook, MySpace, and Twitter has been especially remarkable, 

quadrupling between 2005 and 2009, and these sites have become 

leading channels for communication about business, politics, and 

health. Among the HINTS respondents from 2008, 23 percent 

said they used these types of SNS sites, with 7 percent saying they 

were bloggers and 4.6 percent indicating they participated in online 

support groups. 

These social platforms are thought to hold health-enhancing 

potential, and many public health practitioners and organizations 

have begun using them for health education, interventions, and social 

marketing. However, there is little research on the impact these new 

technologies have on population health, and the studies that have 

been conducted have produced conflicting results.

0%

5%

10%

15%

20%

25%

Social Media Use Among Internet Users

(HINTS, 2008; n=5,078 [69%])

Participated in Social 

Networking Site

Participated in Online 

Support Group

Written in a blog

23%

4.6%

7.1%

Age Plays a Significant Role in Internet and 

Social Media Use

Studies using HINTS data from 2008 confirmed prior research 

showing that as a group, people 65 years old and older are much less 

likely to use the Internet than are those in any other age group, with 

about two-thirds of them reporting they do not go online. People in 

the next younger age group (55–64 years old) were nearly twice as 

likely to use the Internet. That trend continues as age declines, with 

Internet use at its highest level (85 percent) among younger adults 

18–24 years old.

Usage gaps are even more pronounced with respect to social 

media, with just 8 percent of Internet users in the oldest age group 

using such platforms compared with more than three-quarters in 

the youngest age group. There are also differences in the types of 

platforms used by those in various age groups. For example, Internet 

users age 18–24 were the least likely to use online support groups 

(OR=.98), but were the most likely of any group to be bloggers 

(OR=19.11) and to use social networking sites (OR=47.85). Across 

all age groups, the odds of participating in social networking and in 

blogging decreased as age increased.

Although social media use is growing and may hold promise for 

health professionals to communicate with target populations in 

new and interactive ways, HINTS research suggests that careful 

consideration must be given to the differing needs and traits of 

various audiences, particularly those related to age. 

Social Media Use by Age

(Internet Users; HINTS, 2008)

 Online Support 

 Bloggers 

 Social Networking

0

10

20

30

40

50

60

70

80

18-24 25-34 35-44 45-54 55-64 65+

Quick Facts

•	 More	than	one-quarter	of	U.S.	adult	Internet	users	

participate in social media.

•	 The	only	consistent	predictor	of	social	media	use	is	

younger age.

•	 People	age	65	and	older	rarely	report	using	social	

media platforms of any kind.

•	 Despite	inequalities	in	Internet	access,	use	of	social	

networking sites does not vary significantly by race, 

ethnicity, or social group.

In this HINTS Brief, we explore sociodemographic and health-related factors associated 

with current social media use in the United States. 
Influence of Health Status on Social Media Use

In addition to age, HINTS 2008 research reveals that several health-related factors must be taken into account when 

considering differences in social media participation.

For example, those who perceive themselves as less healthy, experience psychological distress, or have a personal experience 

with cancer are more likely to have participated in an online support group. In addition, individuals who have been diagnosed 

with cancer at some point in their life are much less likely to use social networking sites than are those who have no personal 

history with the disease; similarly, family members of cancer survivors are much more likely to use SNS than are cancer 

survivors. The same is true of blogging, although to a much smaller degree. HINTS data also show that SNS use is associated 

with higher levels of psychological distress, even when controlling statistically for the influence of other variables. This anxiety 

is not seen with general Internet use, suggesting it is uniquely associated with these social applications. 

How Can This Inform Your Work?

HINTS data suggest social media presents opportunities for communicating with the public about health topics and may hold 

potential for narrowing the existing health disparity gaps. As new communication programs and eHealth interventions are developed, 

several factors must be considered, including:

•	 Age of the target population: Younger age is the single most important predictor of social media use, indicating that 

communicating about health through social media platforms can be expected to have the broadest reach and impact with 

younger generations, while they currently are likely not suitable for connecting with those age 55 and older. 

•	 Race/ethnicity of the audience: Once on the Internet, people with low levels of education and racial/ethnic minorities 

are just as likely to use social networking sites. Social media may provide opportunities to reach traditionally underserved 

populations. 

•	 Type of social media platform: Online support groups continue to be useful for people who are in poorer health and 

those who have experience with specific diseases such as cancer—either personally or through a family member or friend. 

•	 Message to be communicated: Social media may permit information to reach a wider audience than traditional media, 

but where targeted messages are needed, these platforms may not be the most effective option.

The National Cancer Institute (NCI) fielded the first Health Information National Trends Survey (HINTS) in 2002 and 2003, surveying 

6,369 Americans. Subsequent surveys followed in 2005 (5,586 Americans surveyed) and 2008 (7,674 Americans surveyed). HINTS was 

created to monitor changes in the rapidly evolving field of health communication. The survey data can be used to understand how 

adults use different communication channels to obtain health information for themselves and their loved ones, and to create more 

effective health communication strategies across populations.

HINTS Briefs provide a snapshot of noteworthy, data-driven research findings. They introduce population-level estimates for 

specific questions in the survey and summarize significant research findings that are a result of analyzing how certain demographic 

characteristics influence specific outcomes. Many Briefs summarize research findings from recent peer-reviewed journal articles using 

HINTS data.

For More Information on Cancer

•	 Call	the	NCI Cancer Information Service at 1-800-4-CANCER

•	 Visit	http://cancer.gov

•	 Order	NCI	publications	at	https://cissecure.nci.nih.gov/ncipubs/

•	 Visit	Facebook.com/cancer.gov and http://www.youtube.com/ncigov

References Used in This HINTS Brief

Chou WS, Hunt YM, Beckjord EB, Moser RP, Hesse BW. Social media use in 

the United States: Implications for health communication. J Med Internet Res. 

November 2009. 11(4):e48.

Kontos EZ, Emmons KM, Puleo E, Viswanath K. Communication inequalities and 

public health implications of adult social networking site use in the United States. 

J Health Commun. 2010.15 Suppl 3:216-35

August 2011