Public Health 2.0: Re-Mixing Public Health

Public Health 2.0: Social Innovation and the Rise of OpenHealth Jody Ranck, DrPHPrincipal Investigator, Public Health InstituteAugust 2009

"We need to convert the social safety net into a

social safety network

through the creation of smarter communities that areinformation-rich, interconnected, and able to provide opportunities for all citizens." -Rosabeth Moss Kanter & Stanley Litow“Innovation is something everyone wants more of, but nobody is toosure what it means exactly”-John Gapper

Some Social Media Factoids to Digest:

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-25% of Americans have watched a video in the last month, ontheir phones-there are over 100 million videos on YouTube and YouTube is the2

nd

largest search engine on the web-Facebook added 100 million new users in 9 months, if it were acountry it would be the 4

th

largest in the world-the Dept. of Education found that online students out-performedface-to-face teacher-student learners-Wikipedia is more accurate than Encyclopedia Britannica-1 of 8 couples who met in the US last year met online-there are 1.5 million pieces of content on Facebook-80% of the “tweets” on Twitter are from mobile devices The list could go on. Something has shifted in how we communicate.Public health professionals can no longer dismiss social media as theplayground of teens. Those who do may soon find themselves largelyirrelevant to the public(s) that constitutes public health. Networks andcommunication tools are central to how societies organize themselves.We’ve seen text messaging both overthrow despotic rulers as well asincite ethnic violence. Mobiles are changing the way resource poorcommunities access services, obtain market information and improvetheir livelihoods. The challenge is this—publics around the globe are

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See “Social Media Revolution”:http://www.youtube.com/watch?v=sIFYPQjYhv8

ahead of public health in their ability to use these tools to innovate.We’re playing catch up again. Innovation in the field of public healthtoo often has meant innovation in the life sciences and medical deviceworld. We need to rapidly develop our thinking around socialinnovation and innovation systems that can move beyond thetraditional confines of biomedical and healthcare innovation. Thenature of the web in this point in time is evolving rapidly toward the“network as platform” model where the more people use the platformsand applications the better they become.

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This means that peoplecontributing content, data, and insights act as a form of sensor forwhat is going on around us. Furthermore, there are more physicalsensors and mobile devices that enable us to “see” what waspreviously invisible and make connections to health outcomes. Youraverage smartphone now contains numerous sensors such asmicrophones, cameras, motion sensors, GPS, etc. As Tim O’Reillyobserves, even Apple’s iPhoto ’09 has pretty good facial recognitionfeatures. During the summer of 2009 we have witnessed a dramaticincrease in augmented reality applications that take additional layersof data and add them to the physical space in front of our eyes viamobile devices. The call for better open data polices and frameworksis accelerating in government circles with efforts to track stimulusspending and the creation of new jobs. This paper will provide someinitial thoughts as well as attempt to map an emerging landscape of tools, technologies, and innovation insights as an initial step towardsdeveloping frameworks for social innovation in public health. Theunderlying rationale for this paper is first to provide a preliminaryoverview of some of the technological changes that are happening andmake the connections to public health and why we need to becomemore engaged with technology debates. Furthermore, how can wedrive the politics of technology deployment to make sure that the righttechnologies get into the right hands, the data measure the rightthings to drive better health outcomes, and generally to think morestrategically about social media, mobiles, sensors, visualization toolswithin the context of intentional innovation policies for public health.

Introduction

: This paper will explore the emerging landscape of innovation in public health through the lens of social media, mobilesand design and the possibilities that may evolve from the tools andethos of social media (or web 2.0 as these tools are often referred). The emphasis is going to be on social innovation, or innovations thathave the effect of changing social practices. My objective is to shiftthe emphasis in how we talk about innovation from a focus merely on‘things’ or new technologies and to think about the complex networksof people, technologies, and nature (eg. microbes) that come together

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Tim O’Reilly (2009). Web Squared: Web 2.0 Five Years On.Web2Summit.com

to form an “assemblage” of elements that produce new socialoutcomes, namely preventing disease, ameliorating the negativeconsequences of global climate change and addressing the socialinequalities and determinants of health. As Ilona Kickbusch (2008)has recently noted, innovation in health and healthcare all toofrequently refers to the innovations in biotechnology andpharmaceuticals that deliver medical value rather than social value.Furthermore, she notes, we are undergoing a major shift in respect tohealth and its role in society. Health is no longer, if it ever was, afunction of the delivery of medical care despite the almost obsessiveconcern with medical care in “health reform” debates. The boundariesof what constitutes health are broad and fluid and increasingly wemust think well beyond the health sector to account for the socialdeterminants of health and the range of factors that influence healthoutcomes. Yet rarely do we do this in practice or in a manner that issustainable and actually brings sectors from outside of health in arobust manner. The innovations that are occurring on mobile platformsin low-resource contexts are making those who espouse ludditeperspectives on technology in public health increasingly irrelevant.However, we must also be cautious to think critically about theconsiderable amount of hubris that Silicon Valley-influenced techno-libertarianism often mobilizes in the political economy of hype andhope to create new markets. The underlying rationale for the way of thinking about innovationproposed here will attempt to provide a way of thinking about healthand tools to more readily enable us to see and make the connectionsthat can encompass this rather complex and challenging thing calledhealth. The purpose of social innovation in this context is aboutdeveloping the next generation of public health tools, practices andpolitics that can respond to the ever-growing demands that thepublic(s) demands of public health professionals, calls for thedemocratization of knowledge, expertise and more participatorypractices of public health. There is a need to create more innovativeapproaches to health that enable new voices and knowledges to be atthe table, and to catalyze development of approaches that can addressthe complexity and global nature of public health challenges. We mustnow recognize that ‘global health’ doesn’t mean public healthelsewhere. While much of the paper will provide examples of technology or social networking platforms being used today, I want thereader to think beyond the technology. Think of the examples insocio-technological terms. Too often, in my experience, when wemention new technologies, particularly social media, in a public healthsetting the first questions are focused on technologies used by teensand therefore considered irrelevant to public health or the view thattechnologies are artifacts that the poor lack. An additional concern