Expressions of sentiment toward racial minorities on Twitter—positive or negative—can gauge cardiovascular health in the states from which they originate, University of Maryland public health researchers have found.

In a new study published in the Journal of Racial and Ethnic Health Disparities based on tens of millions of race-related tweets, epidemiology Assistant Professor Quynh Nguyen and colleagues showed that people living in states with the highest number of racist tweets—including Mississippi, Louisiana and Michigan—had elevated rates of high blood pressure, diabetes, obesity, stroke and heart attack.

These below-average outcomes were seen for both non-Hispanic black and white people, according to the study.

By contrast, states with the greatest number of positive tweets about racial minority members, including Utah, North Dakota and California, had a lower prevalence of cardiovascular disease. 

Many recent scientific studies have linked being chronically exposed to racial discrimination and poor health; the new study is innovative in its use of social media data to characterize racism in the broader social environment. 

“We’re trying to capture what may be invisible, but still affects people’s lives,” said Nguyen, who led the study. “Using Twitter data allows us to look at not just people’s individual experiences of discrimination, but the broader context of the social environment. Understanding area-level characteristics gives us a broader way of characterizing and examining the influence of discrimination on health.” 

Nguyen and colleagues collected a random sample of tweets across 48 states in the contiguous United States and the District of Columbia. Using big data analysis, they categorized more than 30 million race-related tweets from 2015 to 2018 by positive, negative or neutral sentiments and by state. They linked the state-by-state tweet data with cardiovascular disease risk factors reported through the telephone-based survey Behavioral Risk Factor Surveillance System conducted annually by the Centers for Disease Control and Prevention. 

One novel aspect of the study was its finding of adverse health outcomes not only among minority group members, but among white people as well. 

“Although whites are not the recipients of discrimination against minorities, racial hostility may still behave like a stressor and be linked with worse outcomes,” Nguyen said. “A social environment characterized by more negativity may be bad for population health overall.”