Introduction by Croakey: The upheaval at Twitter has profound, wide-ranging implications for Aboriginal and Torres Strait Islander people’s health and wellbeing and for public health, emergency responses, public discourse, policy development and rural health, according to health leaders.
They told an online meeting hosted by Croakey this week that the concerns surrounding Twitter merit serious consideration and systematic responses by governments and policymakers, and also advocacy efforts by civil society and the health sector.
Participants shared diverse ways that Twitter has been used to promote public health, build communities and provide a platform for showcasing Aboriginal and Torres Strait Islander excellence in public health.
Melissa Sweet writes:
Elon Musk’s disruptive takeover of Twitter has sent shockwaves across the health and community sectors, where the platform has been a powerful tool for community-building, advocacy, engagement, research dissemination and connection.
About 40 people attended a snap online meeting convened by Croakey this week, which was chaired by Professor Megan Williams, who is Wiradjuri through her father’s family, Chair of Croakey Health Media and an academic at UTS Sydney.
Participants shared stories about the difference that Twitter had made for them and their work, as well as a collective sense of apprehension, grief and loss about where the platform is heading.
Despite these concerns and interest in alternative platforms such as Mastodon, many participants were resolved to stay with Twitter as long as possible, to ensure public health voices remain active on the platform.
“We need to keep our voices in the mix,” said Croakey editor Dr Ruth Armstrong. “And we need to keep moving, and we need to keep contributing, and we need to keep being a force for public health on Twitter.”
On a similar note, Dr Summer May Finlay, a Yorta Yorta woman, senior lecturer at the University of Wollongong and a contributing editor at Croakey, said she planned to stay on Twitter until it became intolerable “or literally carked it”, because of its ongoing value.
At least one participant said they were considering taking a break from social media after finding the changes at Twitter distressing, with the effect of reducing their professional engagement and personal enjoyment in the space.
“We’ve all got our own personal worlds here and I’m feeling an anticipated sense of loss as well, which I’m struggling with,” said this person, who asked not to be quoted by name.
Declaration of interest
As this image below indicates, Twitter has been an essential platform for Croakey, for our journalism and the development of our business model.
As a small independent media organisation of modest means, Twitter has allowed us to be incredibly efficient at sourcing news from diverse leads across Australian and globally, with the ICYMI column being one such example.
It’s been important for dissemination and also for innovation and development of our professional practice, through engagement, listening and impact.
For example, Twitter has been integral to the Croakey Conference News Service, Twitter festivals, the CroakeyGO walking journalism, special projects such as #JustJustice, and also our commercial arm, Croakey Professional Services.
Our rotated, curated Twitter account @WePublicHealth, modelled on the successful @IndigenousX account, contributes directly to our Croakey coverage of important health issues.
That said, we’ve already experienced the adverse consequences of Twitter’s market dominance, when Twitter bought and then closed down the app Periscope, which had been an important element of our conference reporting.
The impact of Twitter’s troubles upon our sustainability remains an open question.
Aboriginal and Torres Strait Islander peoples’ health
Twitter has been embraced by Indigenous people in Australia and globally, as evidenced by initiatives such as @IndigenousX, Dr Summer May Finlay told the meeting.
“Reflecting on the impact that Twitter has had on Indigenous conferences is enormous and what a loss it’s going to be,” she said.
“For example, with covering things like the Lowitja [Institute] conference, we were able to really get out messages to Indigenous people and into the world more broadly that wouldn’t have necessarily been seen by a mainstream audience.
“On a personal level, I have certainly been able to connect to like-minded Indigenous people, and it’s become like a really supportive community in a whole bunch of ways. For our research, in particular, but also for personal stuff as well.
“From a public health point of view, we know that Aboriginal and Torres Strait Islander people do public health really, really well, and it has been a fantastic way of being able to showcase the really good work for a broader audience. I honestly, I don’t think there is another platform…that’s really had the same impact.”
Finlay said Twitter had also been “a fantastic” platform for Aboriginal and Torres Strait Islander people to be able to critique policies, research, and the media.
She gave as an example of its impact the engagement of Federal politicians, including then Minister Ken Wyatt, with the #JustJustice project. “These are people that we wouldn’t have reached otherwise, had we not been on Twitter,” she said.
“So if Twitter doesn’t continue in its current form, and it’s not a platform that, you know, necessarily we want to participate in, or it does implode on itself completely, it’s really going to be quite a loss for the Aboriginal and Torres Strait Islander community.”
Professor Megan Williams said it was important to keep the futures of young Aboriginal and Torres Strait Islander people in mind when envisioning alternatives to Twitter going forward.
“I think we’ll always look back and know what a transformative time Twitter’s been for us, you know, Aboriginal people about research, research translation and models of care and conveying our excellence,” she said.
“We’ve really been able to feel that power and convey our excellence so clearly. We’ve really got to be thinking hard about what next and we’ll spend a bit of time doing that.”
Dr Tim Senior, a non-Indigenous GP who works in the Aboriginal community controlled sector and is a contributing editor at Croakey, said Twitter had been important for the development of his professional practice.
“The Aboriginal and Torres Strait Islander voice on Twitter particularly has been really striking and…the Indigenous X accounts and so many really good Aboriginal Torres Strait Islander Twitter users…have taught me so much from a sort of a broad range of Countries across what we now call Australia,” he said.
Professor Kathy Eagar, Director of the Australian Health Services Research Institute at the University of Wollongong, spoke of her personal experience with Twitter’s power in shaping and setting agendas.
“I’ve done a lot of tweeting, as people know about aged care, about elder abuse, about COVID in aged care… the interesting thing for me is how often I’m contacted by journalists in the mainstream, to do follow up stories,” she said.
“Tweeting consistently, advocating for an issue has actually ended up being very powerful in the mainstream media, much more so than I realised when I started.
“I often have that comment back from Ministers and others, ‘Oh, I saw your comments on Twitter about that’.”
Eagar gave the example of tweeting out a journal paper that she had published on staffing ratios while the aged care Royal Commission was underway.
“So I tweeted it that night and senior counsel quoted it the next day in the Royal Commission, and that’s because they had a team scouring Twitter for feedback … and it was shaping the Royal Commission issues,” she said.
“I found that a very powerful case study in how Twitter can be used to shape an agenda – not just disseminate information.”
Public health roles
Alison Barrett, managing editor at Croakey, highlighted the importance of Twitter for emergency responses, amid bushfires and floods of recent years, as well as for sharing news and evidence on public health, including COVID.
Like other participants, she highlighted concerns about Musk’s Twitter becoming a vehicle for increased misinformation and disinformation, with “huge implications for public health”.
Digital health researcher Dr Becky White underscored these concerns, pointing to the problems that can be predicted to arise from changes to the blue tick verification process.
Kristy Schirmer, principal of Zockmelon Health Promotion and Social Media Consulting, said Twitter remains the most important platform for public health.
She teaches that social media platforms are tools for public health – to connect with people of influence including politicians, journalists, academics and others – and also a setting for health, where there can be positives (such as connections made, education, information), and negatives for health (trolling, disinformation).
“Viewing platforms in this way is helpful for public health practitioners,” she said.
Dr Amy Coopes, rural doctor and a Croakey editor, said she had been reflecting on the significance of Twitter’s upheaval, especially in the wake of the shootings in Colorado Springs.
While some were downplaying Twitter’s importance as “just a social media platform and another one will just step into the vacuum”, Coopes said she felt there were much broader implications to consider.
“There’s a culture wars kind of thing happening and the signals that are being sent into the public square by Elon taking over Twitter, and then in…emboldening a dog whistling to the far right, the Trumpites, putting Trump back into a position where he’s got like a soap box – it emboldens people to do things like what we saw in Colorado Springs,” she said.
“So I think it’s really disturbing. And I really worry about…the implications for civil society and discourse around this issue, and I think that is a massive problem for public health.”
Coopes also stressed the importance of communities that had built up on Twitter.
“There’s such a community that’s built up over many years and communities of practice and alliances, professional and otherwise, that have been so important and so valuable,” she said.
This had been especially important during the recent difficult years of the pandemic, where Twitter, while it could be a polarising space, also had contributed to cohesion and networks.
Dr Tim Senior said Twitter had many different functions, included in providing real-time reports – for example, from COP27 – and its use in fostering and developing communities.
“I think that’s sort of a misunderstood thing, that it’s not just broadcasting, it’s actually an interactive community and so the loss of that is potentially massive,” he said, adding that no other platform could fill this role quickly.
Rural health connections
Coopes, who live-tweeted the discussion, joined the webinar from Wiradjuri Country on the border of NSW and Victoria, and also stressed the importance of Twitter’s connectivity for rural communities.
It had helped amplify their voices in times of crisis, like fires, flooding and COVID, and this was especially important when mainstream media’s capacity was so depleted.
“Twitter in particular was such a kind of place to organise and to share information and I think that’s really important in dispersed rural communities…where they don’t sort of get much of a look in necessarily,” Coopes said.
“I think it’s been a real force for good and I wonder how we’re going to organise as a…community of people who are passionate about climate action when we have lost this space.”
Sustainable food systems advocate Lisa Brassington agreed that there was no other platform to replace Twitter, whose important features included its accessibility for rural communities. As it is a low data platform, it can be accessed in poor data areas.
“Our farmers use this not only for mental health, connectivity; if you’re bogged on farm, you’ve broken an axle, you do a shout out on Twitter and someone from 3,000 kilometres away gets online and helps you out,” she said.
Brassington said efforts were being made to develop alternative ways to keep farmers connected for the sake of their mental health and wellbeing. “There’s a lot of people at the moment scared of isolation,” she said.
Sharon Friel, Professor of Health Equity at ANU, said the potential implications for social and health inequities globally were “quite phenomenal”, and she stressed the importance of having such conversations as the Croakey webinar.
The risk of Twitter becoming even more of a “rabid, toxic tabloid space” was really concerning, while the impact upon Twitter employees was a reminder of the power of Big Tech and their influence over working and living conditions.
On the other hand, Twitter had been “incredibly helpful” for coalition building, Friel said, and for raising awareness of issues that people may not otherwise have connected to public health, such as some of the social, environmental, political determinants that Twitter has enabled us to communicate very quickly.
What to do?
Participants suggested multiple responses, ranging from pushing for regulatory action to developing new platforms for public health using federated models like Mastodon.
“The Twitter situation is indicative of a wider structural issue – a massive regulatory failure,” said Friel. Governments, including the Australian Government, had avoided regulating Big Tech/digital platforms, she said, adding: “This could be an opportunity to advocate for Big Tech regulation.”
She suggested that a coalition between public health and the ‘just’ tech people might be able to advocate for such regulation, and that the Office of Best Practice Regulation (which was re-named on 18 November to the Office of Impact Analysis) would be worth approaching.
Public health physician Dr Tarun Weeramanthri said civil society and peak bodies needed to be involved in these discussions, that these were matters beyond public health’s responsibilities alone.
Professor Kathy Eagar suggested a multi-pronged strategy, including staying on Twitter and continuing to tweet, while also exploring setting up a public health or Croakey server on Mastodon or another federated social network, or simply joining Mastodon.
Professor Megan Williams suggested the research community could also contribute; for example, by action research projects to trial federated platforms or develop other possibilities.
Kristy Schirmer agreed about the need to remain on Twitter.
“As a public health community, we still need to know what’s going on the setting of Twitter, so I don’t think we can actually kind of just agree collectively to leave,” she said.
“I think we need to have people there to kind of see what’s going on, so that we can advocate. I am thinking about with what’s going on with Twitter currently, who is benefiting from that and who has been harmed and who is missing out from that.”
(Read The Guardian: As Twitter burns we must not forget it is people that create social movements, not apps)
Schirmer said the conversation hosted by Croakey could be used to develop advocacy tools to persuade decision makers and regulators to act.
“We need to have a decent verification system for accounts on social media, the ability to report misinformation and disinformation, the ability to manage people who are trolling, which is usually racist and gendered and all of the things, so all the things that harm, you know, harm people on social media on these settings,” she said.
“So when we’re thinking about what we can do as a kind of community, these are some of the things that I’m thinking about.”
Jennifer Doggett, health policy analyst and a Croakey editor, said she thought it a really challenging issue for parliamentarians, because many aren’t very educated about the issues, it’s not something they’ve grappled with before and it cuts across a number of different portfolio areas.
Also, there was a general reluctance in governments to begin regulating in areas where they hadn’t previously done so.
It was important to educate MPs about the issues involved, and Doggett suggested they would be interested in related concerns for democracy.
“The lack of media diversity, the collapse of something like Twitter, the monopolies from the digital platforms – they are all a risk to democratic processes and some of the fundamental aspects of our democracies as we’ve seen in the US over the last three or four years. So I think that is one issue that will really resonate with them, and that’s what we should be pushing with them,” Doggett said.
Schirmer suggested LinkedIn as “the next sort of most sensible option for most of us”.
Many participants had started Mastodon accounts, and some had applied for beta testing for Bluesky, a new platform being developed by Twitter co-founder Jack Dorsey and colleagues.
Croakey will explore ways to stay connected with tweeps and in the meantime, we recommend these extensive Twitter lists and using the hashtags #TwitterResistance and #RegulateDigitalPlatforms. Croakey is also on Mastodon: @CroakeyNews@newsie.social
Quick tips from Mitchell Ward
Excellent article on the in-and-outs of joining Mastodon by Jeff Jarvis
Twitter – > Mastodon cross poster
Debirdify – allows you to search the people you follow on Twitter for possible Mastodon accounts:
The Conversation: What the world would lose with the demise of Twitter: Valuable eyewitness accounts and raw data on human behavior, as well as a habitat for trolls
The New Yorker: What fleeing Twitter users will – and won’t – find on Mastodon
Mashable: All of your burning Mastodon questions, answered
More from Twitter
(Editor’s note on 24 November: This post is being updated with further related commentary and tweets).
See Croakey’s archive of articles on digital platforms and health