Introduction

The context behind what a community is and how it exists is rapidly changing with the advancement of technology in accordance with social media platforms, which is how people choose to socialise in the present day. Communities developing online are causing a rise of debates of what a true “community” looks like and how it participates in society. Social media communities provide a platform for individuals with similar diseases and disorders to connect and provide peer support, share personal experiences and information. Social media communities allow members to present themselves as they feel comfortable such as sharing their identity or remaining anonymous. Despite the risk of misinformation and the community’s level of success being dependent on the involvement of professional physicians, trust resides within the community and the shared information and experiences. Communities have formed with members connecting over diseases with minimal research, becoming reliant on the sharing personal stories and creating a voice for marginalized disorders. The vocalization of sharing experiences creates extensive databases that can encourage researchers to embark on marginalized diseases and disorders. Social platforms such as Facebook and Reddit minimalise habitual factors such as geographical and socioeconomical barriers that limit one’s access to resources and creates greater opportunity for more belonging individuals to find and participate within the community in hope to gain information and support. Social media platforms such as Facebook provides a safe space for communities of various health disorders and diseases to share personal experiences, medical treatments, symptoms and emotional support, creating a sense of belonging and trust, and participating in additional information dissemination within the online social communities which contributes to health and behavioural changes.

How Online Health Communities Exist

Online health communities exist within the platforms of social media, like Facebook, and are typically made up of patients and caregivers with particular health diseases and disorders (Chen, 2023.), who are looking for people with the same disease to share experiences and receive support. Facebook provides these community members with a favourable space to further understand their own health status (Chen, 2023). The presence of advanced technology such as the smartphone has allowed for the existence of “citizen journalism” (Mulligan, 2023), which is the ability of anyone with access to a smartphone or social media to provide a voice for repressed and marginalised groups within society (Mulligan, 2023) and tend to possess highly levels of a sense of belonging and community (Mulligan, 2023) on an online platform. Citizen journalism provides the opportunity for all minorities to find one another and develop a community with the intention to help, inform and support one another. The successful factor that lies within online health communities is trust, as without trust and continual participation between members, the success of the community would diminish (Husain, Weise & Hammedi, 2022). Community members differ in backgrounds as the social platforms present on Facebook thrive in diversity thanks to the high level of accessibility as factors that tend to place limits on communities such as geographical location, socioeconomical status, gender and age lack influence on the participation of online communities have little presence. This lack of restrictions enables participation of vulnerable and minority groups to be active and gain a sense of belonging within the online communities (Husain, Weise & Hammedi, 2022). A vast majority of the population choose to use a social media platform to connect with members of various health communities in which they share information, provide recommendations on healthcare providers and spread awareness throughout all stages of the diseases and disorders (Kline et al., 2023). Neely & Feng (2023) explain that online health communities allow for members to acquire valuable information regarding their health conditions and receive social support from community members through “peer to peer” (Neely & Feng, 2023) online interactions which positively benefit members by increasing awareness, improving members mental health and level of connectedness, producing a greater sense of community. Patients tend to seek additional information and support on online health communities before and after appointments with physicians, which impacts members health literacy and decision-making (Lu, 2023). When patients do seek information, it’s often when there is a strong sense of social presence within the online community that creates an atmosphere of trust and support from other members (Lu, 2023). This strong sense of online community doesn’t require face-to-face interactions to grow and conserve relationships as the continual social presence aids in the longevity of the continual use of online health communities present on Facebook (Lu, 2023).

Impacts on the Members of Online Health Communities

Online health community members are performing the action of seeking information which is an important step in solving a patient’s problem (Zhang et al., 2024), however, in the medical communities past it wasn’t as easy for patients to gain access to information regarding their diseases and disorders. Prior to the development of social platforms like Facebook, groups were disadvantaged if they were linked to poor income, education, and a minor race and or ethnicity (Reynolds et al., 2023). Facebook has created a “favourable environment” (Chen, 2023) for online health communities’ to develop and be at access to a larger population as social media is accessible to everyone, especially to groups such as the youth and those that belong to a low socioeconomical status who are not familiar with traditional medical methods (Reynolds et al., 2023). Facebook is becoming the most popular social platform that patients are taking advantage of to develop their communities (Husain, Weise & Hammedi, 2022) and seek information regarding their health, this creates positive influence on their behaviours that affect their health (Reynolds et al., 2023). Facebook has the ability to alter the perspective on diseases and disorders such as obesity by providing more accessible information to help inform communities of their health and suggest behavioural changes that can assist members of the obesity community to help their health. A media review was conducted on Facebook which took place over 6 months to perform data collection through Meltwater software (Mazonde & Goldstein, 2023), which aimed to do just that. This media review saw that obesity was only perceived as the stigmatizing image that obesity was the individuals fault caused by poor lifestyle habits such as an unhealthy diet and not exercising (Mazonde & Goldstein, 2023), only shaming and unhelpful posts existed that provide no social support which is the necessary important factor to help inform and encourage patients to improve their health (Yue, 2023). Mazonde and Goldstein (2023) discovered that online social and behaviour can change the way a disorder and disease is communicated, enabling a more supportive base for communicative interventions to aid prevention and shift the way that these illnesses are looked at to a more supportive tone to encourage positive change. Facebook has also provided a safe and supportive space for the diabetes community to exchange information regarding diet, medications, glucose screening and physical exercise, and seek and provide social support (Zhao, Zhao & Song, 2022). It’s believed that those who self-identify with a disease or disorder have increased their participation within an online social support group (Rutvij et al., 2022), this then encourages the seeking of information that has led to community members participating in behavioural changes that has improved their condition of their illness and health which is stimulated from peer support on social media platforms like Facebook, proving that social media is an important source of social support for patients (Zhao, Zhao & Song, 2022).

Social Media Communities Risk Misinformation

It’s proven that social media platforms provide a support base for online communities to form and thrive, but it can also be argued that these communities are at risk of misinformation (Bizzotto, Gert-Jan & Schulz, 2023). Misinformation is likely to occur on social online platforms as they’re mostly relied on volunteers within the communities to install regulations within the group, and not relying on credentialed health experts to approve shared information within the community (Bizzotto, Gert-Jan & Shulz, 2023). The lack of expert physicians’ participation within the communities put members at risk due to most of the information being shared is based on other members experiences which exposes another mistake in health, assuming “universal human experience” (Camit, 2021) which is diminishing the voice of marginalised communities, disregarding cultural struggles placed on their experiences (Camit, 2021). The communities at most risk to misinformation is those of chronic and marginalized diseases, in particular, mental health diseases that are likely to fall under the “illusory truth effect” (Bizzotto, Gert-Jan & Shulz, 2023) that explains the more individuals are exposed to consistent misinformation, the more inclined they are to believe it (Bizzotto, Gert-Jan & Shulz, 2023), placing patients who are already fragile from poor health conditions in greater risk of mistreatment. For communities sharing the interest of anxiety, social online health communities can contribute to their members anxiety through information seeking that ultimately stresses them further and raises their anxiety as they’re unsure how to regulate their disorder (Forgie et al., 2021). With 80% of internet users using online social groups to seek information regarding health statuses, there’s higher risk of becoming victim to information that lacks credibility and polarized information that becomes available through personalized algorithms that comes from suggested and recommended content on social media (Forgie et al., 2021). The ability to share personal stories with information and treatments puts community members at risk to mistreating their own individual health condition which can be caused from “problematic single-person narratives” (Forgie et al., 2021) and confirmation bias which is when information is trusted due to its belief consistency and not believing information if its belief appears inconsistent (Forgie et al., 2021). Such bias can place patients in danger to social influence and peer recommendations that ultimately might not be suitable to every patient’s health situation, this negatively impacts the patients’ health behaviours that might encourage change due to peer pressure and a desire of a sense of belonging to a group for support (Forgie et al., 2021). Although the general success of an online health community is dependent on the participation of professional physicians, and the consistency and quality of contributions made by the community members (Chen, Jin & Yan, 2023), social online platforms provide immense emotional support (Lu, 2023) for patients who reside with similar diseases and disorders, proving that social media platforms can provide a sense of community.

Conclusion

Online health communities provide a strong sense of belonging to patients of similar diseases and disorders, creating a safe space for patients to connect, share personal stories and experiences with fellow community members. Although these online health communities can be at larger risk of receiving misinformation, they understand that they should rely predominantly on physicians’ advice and not be biased towards information provided by other patients’ experiences on the online community. Facebook provides a safe space for a larger community of patients with different backgrounds to migrate and share resources under a discretionary or exposed identity, with minimal shame and embarrassment present within the online communities. Social media’s high levels of accessibility minimize exclusion of minority groups and creates a sense of belonging to those of insignificant health disorders and diseases that may have felt lonely in a community sense. Facebook has homed the existence of online health communities that share information amongst its community that assist members in understanding their own health statuses (Chen, 2023) and creates a sense of belonging through social and emotional support (Lu, 2023) that is generated within these groups. Online health communities that exist within Facebook have proved that communities can exist within an online social platform and can be successful in creating an interactive and supportive community without face-to-face communications (Lu, 2023). Facebook has successfully increased connectedness, awareness of disorders and diseases and provided social support (Neely & Feng, 2023) to patients by giving the ability to seek information that has encouraged them to make purposeful behavioural changes to aid their health conditions and receive social support when doing so (Neely & Feng, 2023).

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