JMIR Publications

ABSTRACT

Background:

Web 2.0-empowered social media platforms have been applied to promote health interventions and facilitate community engagement, especially during a crisis or emergency like COVID-19. COVID-19-related health inequalities were reported in some studies, showing the failure in public health and communication. Studies investigating the contexts and causes of these inequalities pointed to the contribution of communication inequality or poor health literacy and information access to engagement with healthcare services. However, no study exclusively dealt with health inequalities induced by the use of social media during COVID-19.

Objective:

The objective of this review was twofold: (i) to identify and summarize COVID-19-related health inequalities induced by the use of social media and the associated contributing factors; (ii) to characterize the relationship between the use of social media and health disparities during the COVID-19 pandemic.

Methods:

A systematic review was conducted on this topic in light of the protocol of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Keyword searches were performed to collect papers relevant to this topic in multiple databases: PubMed (which includes Medline (Ovid) and other sub-databases), ProQuest (which includes APA PsycInfo, Biological Science Collection, and others), ACM Digital Library, and Web of Science, without any year restriction. The retrieved publications were selected based on the predefined selection criteria. Of the 670 articles collected, 442 were first removed for being duplicates, other document types, and not written in English. After reviewing the titles and abstracts of the remaining articles, 212 were determined to be irrelevant to the topic of this review and therefore excluded. The full texts of the remaining 16 articles were reviewed, and 6 were removed for being irrelevant to this study. The 10 articles left were subjected to the quality analysis and the final synthesis and discussion.

Results:

Of the 10 articles, 1 was further removed for not meeting the quality assessment criteria. 9 were finally eligible and selected for this review. In these studies, we found not only four broad categories of COVID-19-related health inequalities induced by the use of social media, including health inequalities due to misinformation, health inequalities due to health information inaccessibility, disproportionate attention for COVID-19 content, and higher odds of having psychological distress, but also the associated factors and recommended resolutions.

Conclusions:

It was the first systematic review on this topic. The findings synthesized from the selected studies highlighted the great value of studying the COVID-19-related health knowledge gap, the digital technology-induced unequal health information distribution, and the resulting health inequalities, thereby providing empirical evidence for understanding the relationship between the use of social media and health inequalities in the context of COVID-19 and suggesting practical solutions to such disparities. Informed by this review, researchers, social media and health practitioners, and policy-makers can join hands to take full advantage of social media to promote health equality while minimizing social media-use-induced health inequalities not merely in public health crises like COVID-19 but in usual times as well.