Brian G. Southwell (Col '95) researches public understanding of science and evaluates large-scale mass media campaigns. His new book, Social Networks and Popular Understanding of Science and Health: Sharing Disparities, looks at the ways people learn and share information about health and science and finds that some people never get exposed to seemingly widely available information. The following is an excerpt from the book's introduction:

In June 2012, the United States Supreme Court announced a milestone decision regarding health policy, upholding major tenets of the Patient Protection and Affordable Care Act (Affordable Care Act). The Act ensures increased access to health coverage for many Americans and introduces new protections for people with health insurance. Ironically, the ways that news about the Court’s decision spread among people underscores the information inequality facing the nation. As this landmark decision was announced, many citizens learned about the news directly from television or radio reports or over the Internet. Despite prominent broadcast by media outlets, many other people first learned about the news from coworkers they passed in the hall or colleagues at a meeting who had happened to hear the news. Yet other people tried to make sense of the complex legal decision by talking with friends or family members. Some Americans, however, did not hear the details of the Court’s decision at all that morning, and neither did anyone they happened to see that day.

Within hours of the Court’s decision, some people were actively debating the nuances of the health care policy itself or forecasting the impact of the decision’s framing on the 2012 presidential election. Others were able to solicit expert advice as to whether the decision had any direct impact on their use of health care services or on their pocketbook. Other people did not enjoy the benefit of chatting with neighbors or friends about what the decision meant. For some people, this lack of conversational focus on health policy was an active choice. Given the opportunity to talk about any topic during a work break, last night’s sports scores or the latest celebrity scandal likely seemed much more appealing than the subtleties of an individual mandate to purchase health insurance.

For some people, however, forces had been set in motion prior to that morning that ensured that the social network in which they reside would not actively interact to share, discuss, or forward news about the Court’s decision. Chances are that those people went to sleep the night following the historic decision with little more than a vague awareness that something in Washington, D.C., had happened that day involving President Obama and health insurance. The social amplification of understanding and opinion that quickly unfolded that day for some people left others relatively in the dark and undisturbed.

Polling conducted soon after the health care decision revealed the extent to which prevalent broadcast of health and science news does not necessarily result in widespread understanding. Within weeks of the Court’s ruling, a striking gap in public understanding came to light. Nearly half of survey respondents were confused as to the basic facts of the decision. About one third of respondents were unaware of the details of the case and about another 15 percent actually reported that the Affordable Care Act was overturned by the Supreme Court. Many different factors likely produced that unevenness in understanding. One set of possible factors, nonetheless, involves the people with whom respondents interact (or do not interact) regularly. While social network interaction certainly cannot account for all aspects of this uneven state of knowledge, a dearth of health policy knowledge within a person’s immediate network may contribute to this gap or to the echo chamber effect that polarized, ideologically charged network discussion may have had on erroneous interpretation of news coverage. Consequently, the importance of social networks is a main focus of this book.

The example of information sharing regarding the Affordable Care Act begins to show how the effect of social network interaction on information spread is not solely dictated by the sheer volume of information broadcast from a central source. In other words, social network interaction is not merely uniform rippling following a stone cast in the information pond. It appears that some ponds are more receptive than others; that is, some networks are primed to engage broadcast news, whereas others are not.

Consider a news example contemporary to the Affordable Care Act that may be, scientifically speaking, even more fundamental and profound as an advance in human knowledge: the announcement in summer 2012 of evidence consistent with the existence of the Higgs boson, what many journalists dubbed the “God particle.” The discovery generated substantial news coverage in Europe and around the world. Subsequently, some social networks simmered with not only general references to the news but also jokes and puns and commentary. An example that bounced around Facebook involved a Higgs boson disrupting a Catholic church service exclaiming, “Wait! You can’t have mass without me!” The sum effect of such simmering likely kept the news salient for many people. However, without a basic background in physics or access to colleagues who had one, other people apparently did not witness much social interaction regarding the topic at all.

One goal of this book is to document gaps between groups of people in their tendency to share information about health and science. Documenting such disparities is important to correct popular misperceptions regarding the free and unfettered flow of information that supposedly abounds in the present moment. Pundits and scholars talk about the emergence of the information age in the 21st century. Central to such conceptualizations is the grand promise of peer-to-peer sharing. That is, instead of living in a one-to-many broadcast era, we live in an environment in which information can be expressed from many to many 24 hours a day. But the inference that all are sharing equally in this feast does not entirely jibe with empirical reality. While some celebrate the potential of social media and other new peer-to-peer connection technologies for teaching people about science and health in this century, enthusiasm about peer-to-peer information flow requires important caveats. Rather than encouraging equity in what we all know and think about scientific discoveries, household consumer tips, the latest health recommendations or opportunities for medical services, systematic reliance on social networks to spread information may be a recipe for inequity.

As delineated in these pages, an increasing body of research suggests that people are not equal in their tendency to share information with others around them. In general, people do not take advantage of the chance to share ideas with others, a paradox in our current era of apparent information abundance. But it also appears that some people are much less likely than others to share information. Some of the differences in peer-to-peer sharing represent inequity in that information sharing is constrained unjustly by factors outside of a person’s immediate control. This book explains why these information-sharing patterns appear to persist, why it matters to society, and what, if anything, can be done to address these tendencies.

Brian G. Southwell (Col '95) is a senior research scientist at RTI International, a nonprofit research institute headquartered in Research Triangle Park, North Carolina. He is also a faculty member at both the University of North Carolina at Chapel Hill and Duke University. At UNC, he holds appointments in the School of Journalism and Mass Communication and the Gillings School of Global Public Health. At Duke, he is affiliated with the Duke University Energy Initiative. He lives in Chapel Hill with his family.