Volume II, Issue II

COLLECTIVE COLLECTIVE COLLECTIVE COLLECTIVE COLLECTIVE COLLECTIVE COLLECTIVE COLLECTIVE COLLECTIVE COLLECTIVE Sociolog y Research Journal VOLUM E 2 | I S SU E 2

WILLIAM & MARY

The Collective Sociology Research Journal

VOLUME 2, ISSUE 2 Spring 2021 1

Executive Board Editor-in-Chief Robert Metaxatos

Layout Editors Rhea Chesson Judith Hahn Allyson Lowe Laura Tutko

Public Relations Director Jasmine Geonzon

Finance Director Chris Hettwer

Copy Editor Nico Bronson

Review Board Nafisa Ahmed Gus Espinoza Celia Lu Kibiriti Majuto Naomi Marin Gavin Meister Chitra Singh Laura Tutko

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Contents

4 5 12 18 23 27 38 Editor’s Note

Show Us the Receipts: Analyzing the Stop Hate for Profit Campaign and Its Performative Activism Jasmine Geonzon

Proximity to Hospitals by Income in Rural Areas Katie Wenger

Positioning in Holistic Medicine: An Assymmetrical Power Balance Celia Metzger

The Food Desert Saturated With Inequality: An Analysis of the Grove Community Helen Tariku

Social Medusa: Effects of Social Networking Sites and Privacy Settings on Psychological Well-Being Matt Wright

Let’s Contextualize, Not Villainize, Vaccine Hesitancy Carlos Noel

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Editor’s Note Dear Reader, I want to let you in on an open secret: the namesake of The Collective comes from sociologist Émile Durkheim’s writings on “collective representation.” On the occasion of publishing our Spring 2021 issue, I was prompted to revisit the main excerpt in which Durkheim describes collective representation as the “ideal world” both society and its individuals constantly create alongside – though not in place of – mundane life. This process “has the effect of engaging a whole world of sentiments, ideas and images which, once born, obey laws all on their own.”

Whether or not collective sentiments are a ‘good’ thing, they make up society’s institutions. For that reason Durkheim also notes that “[t]he formation of the ideal world is therefore not an irreducible fact which escapes science; it depends upon conditions which observations can touch; it is a natural product of social life.”

Our journal continues to publish student work that observes conditions which are hard to pick apart from collective representations otherwise.

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In Volume 2, Issue 2, you’ll find perceptive observations of relevant social problems. Performative activism for Black lives, access to and power in American healthcare, social media effects on well-being, and a mini-ethnography of a community in James City County make up this issue’s analysis of the “ideal world” which tends to obfuscate deeper societal inequalities. In particular, Geonzon’s qualitative analysis of political contributions made by Fortune 500 companies’ registered PACs to Congressional candidates in contrast with the NAACP’s annual report card reveals exactly how corporations like Facebook engage in performative activism for marginalized populations. Wenger uses population data to ask whether people of lower income in rural areas live farther from the nearest hospital compared to their higher-income counterparts; further exposing health inequities, moreover, Metzger close-reads rhetorical strategies used by a wellness blog post intended to establish its author’s legitimacy as a medical expert while its reader is left disempowered. Tariku’s immersive descriptions of grocery stores in Grove, Virginia and Williamsburg illustrate the former’s history of racial discrimination as well as current struggle with food insecurity. Next, Wright gives us a comprehensive look at the effect of social networking on mental well-being, covering such topics as mood, social comparison, social capital in order to suggest slight alterations in one’s online engagement. And finally, Noel rounds out the issue with a timely op-ed on situating vaccine hesitancy within a sociocultural context of medical mistrust caused by years of racial violence. These essays, considered together, use sociology as a way to pick apart and interpret the social world.

It’s my last issue as editor-in-chief, and this is my final note to you. Since I formally started up The Collective a couple of years ago, we became an active student organization, joined Media Council, and successfully carved out a space for sociological inquiry on campus for a community that is increasingly attuned to the issues contained herein. I would like to thank my members, the Sociology Department, and the friends who have supported our small publication. Ah, how bittersweet! Anyway- sit back, listen to some music, and read along. Sincerely,

Show Us the Receipts: Analyzing the Stop Hate for Profit Campaign and Its Performative Activism Jasmine Geonzon “I would like my ally cookie now,” quips white internet celebrity Caroline Calloway as she winks at the camera. Bragging about reading four of the nine books on civil rights and anti-racism she recommended to her fans, Calloway squeezes in the fact that she ordered the remaining five from Black bookstores as she answers questions on Ziwe Fumudoh’s Instagram Live series "Baited." Fumudoh, a Black writer, comedian, and singer, responds to Calloway’s attempted joke without missing a beat, stating, “[T]here are no cookies in this game” (2020).

This interview comes out of the summer of 2020, in which global attention shifted to the United States and the violence perpetrated against Black Americans at the hands of police. Protests around the world stood in solidarity with the Black Lives Matter movement in its fight against institutional racism, demanding justice for individuals like George Floyd and Breonna Taylor, both killed by U.S law enforcement. In addition to white “allies” like Calloway who are beginning to think critically about race, public displays—meant for individuals and companies alike to signal concern for Black lives—began to flood online feeds, most notably #BlackoutTuesday. Participating individuals posted black squares on their Instagram feed to symbolize solidarity but were largely unaware of its unproductive qualities, blocking individuals from accessing racial justice resources online (Heilweil 2020).

With new pressures to be socially conscious online or face the consequences, virtue signaling has been especially prominent over the last few months. One way companies can indicate their social “wokeness” to consumers is by making public political statements.

In late June 2020, this is exactly what happened as big-name corporations began to decry Facebook for its role in the growth of white supremacist affinity groups and disinformation online. To prove their commitment to this cause, companies joined the Stop Hate for Profit campaign. The Facebook financial model relies primarily on advertiser revenue, making these advertisers a prime target for activists looking to curb Facebook’s hate-profiteering. To minimize Facebook’s profit from these social ills, nonprofits and advocacy groups like Color of Change, NAACP, the Anti-Defamation League, Sleeping Giants, Common Sense Media, and Free Press came

together to start the campaign. Stop Hate for Profit asked companies advertising on Facebook to temporarily pause their July 2020 marketing on the site until Facebook decided to “stop valuing profits over hate, bigotry, racism, antisemitism, and disinformation” (Stop Hate for Profit 2020).

As in the case of the #BlackoutTuesday trend, large online campaigns to spread social awareness may bring about an inverse effect, diverting attention from social justice initiatives to those making public statements of support. Based on the performative nature of acts like posting black squares without providing links to substantive action items, this essay discerns the authenticity in signatory companies of the Stop Hate for Profit campaign.

My primary concern is whether companies that joined the Stop Hate for Profit campaign deviate from their stated goals of countering white supremacy and disinformation online outside of press releases.

By analyzing political contribution data collected from the Federal Election Commission (FEC) and the NAACP’s 2020 Civil Rights Federal Legislative Report Card, this paper argues that participation in the Stop Hate for Profit campaign reflects patterns of performative activism, or “professing support and solidarity with a marginalized group, but in a way that is not helpful” (Kalina 2020:478). Further, stark contrasts can be found between how companies publicly condemn white supremacy and disinformation on Facebook, and how these companies quietly continue to bankroll members of Congress with anti-civil rights records.

BACKGROUND Increasingly crowded markets can make it difficult for consumers to find distinct differences between Corporation A and Corporation B, requiring consumers to consider additional factors aside from the quality or cost of a product. Another factor consumers consider in their purchasing decisions now includes the actions of a corporation and whether they publicly subscribe to social causes. This is known as “corporate social responsibility,” or the belief that corporations have an obligation to foster good relationships with their workers and the local community because of their heightened social position (Bokat-Lindell 2020). In the same way that well-perceived

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social messaging can lead to better engagement contentious social movement organizations with consumers, the opposite can be true as well. that protest the contested social practices of In cases where this messaging does not align other companies or entities at higher orders of with the views of the public, consumers may market organization” (2016:53). choose to reduce their purchases from the brand Corporate-sponsored boycotts give smallor even boycott it altogether (Wilcox 2018:1). er firms a chance to punch up at corporations On top of scaring away customers, this can lead to which social activists take exception. Mcto fluctuations in stock prices, where misaligned Donnell portrays this practice as “a tactic of social messaging can lower stock value by over last resort” with some variation in especially 2% (Beck 2020). Because of the risks involved turbulent times of institutional uncertainty in making social stances, it’s not common to see (2016:54). In periods of greater economic companies publicize views that may be viewed and societal precarity, firms may find their soas more extreme, leading cial position to be in them to adopt “unpopjeopardy, making them ular stances the moment Superficial displays of solidarity more likely to partake they stop being unpopin corporate-sponsored with marginalized groups have boycotts and other radular”(Bokat-Lindell 2020). Though corpoical acts “in an effort to rations may feel inclined come up as an important trend to restore social stability” to make social justice 2016:66). consider in this new era of social (McDonnell proclamations because Within the context of of corporate social rethe COVID-19 panactivism . . . Both corporations sponsibility, the messagdemic, the rise of proand individuals have fallen into tests both in support es they adopt are often considered lukewarm or of and in opposition to uncontroversial so as to the trap of performative allyship, the Black Lives Matter mitigate financial risk. and an largely as a means to quickly ful- movement, Due to its expoupcoming presidential nential growth into fill a perceived social obligation. election, this coalition the highest echelon of of businesses and nonSilicon Valley, among profits putting pressure the likes of Amazon and Google, Facebook on Facebook fits into McDonnell’s findings that has become the subject of academic research periods of heightened uncertainty provide the as well as an unsurprising object of activist necessary conditions for such a rare tactic. There scrutiny. Media scholar Siva Vaidhyanathan are several theories that have attempted to extakes an in-depth look at Facebook and how plain why corporations choose to participate in the site has come to restructure our social resocial activism. One theory finds that engaging lationships, arguing the platform's unreguin activism can be a defensive strategy to shield lated growth works to undermine democratic businesses from critique they may receive for processes. False information can spread like not participating sooner. For example, the wildfire on Facebook due to its standardized aforementioned corporate-sponsored boycotts aesthetic, complicating source evaluation and are a part of a toolkit known as “defensive whether posts come from trusted news sourcperformance repertoires” meant to protect es, personal blogs, or businesses (Vaidhyanathe public image of a brand. Consisting of a than 2018:5). The absence of fact-checking wide range of intensity-levels, defensive perin addition to the site’s algorithms, which formance repertoires have the potential to be maximize user screen-time, the social media more mild in the case of avoiding contentious corporation becomes the prime setting for behavior altogether to more radical behavior “violent ethnic and religious nationalism, like redirecting scrutiny to a much larger tarthe rise of authoritarian leaders, and a sort of get, as is the case for Stop Hate for Profit (Mcmediated cacophony that would hinder pubDonnell 2016). lic deliberation about important issues, thus While Stop Hate for Profit may be unundermining trust in institutions and experts” common in that it includes a wide array of (2018:2). By understanding the more sinister corporations, the act of rising up against the side of Facebook, we can begin to understand one specific corporation is a regularly pracwhy Facebook became the target of multiple ticed social movement tactic. “Naming and justice-oriented nonprofits through the Stop shaming” refers to explicitly calling out specifHate for Profit campaign. ic companies for their shameful activity (BartStop Hate for Profit embodies an unlikely ley and Child 2014:657). Historically, this method of virtue signaling by corporations. tactic was popularized by the anti-sweatshop With a multitude of companies and corporamovement to hold individual corporations retions coming together, “corporate-sponsored sponsible for human rights violations (Bartley boycotts” offer an opportunity to shame anand Child 2014:653). other business entity into bowing to social Research conducted by McDonnell also pressure. According to Mary-Hunter McDonsuggests that corporate partnerships with other nell, this form of boycott is carried out by entities like non-governmental organizations firms choosing to “voluntarily cooperate with (NGOs) offer some degree of protection from

“

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naming and shaming campaigns. Companies engaged in this type of “partnership experience a 56 percent reduction in the number of activist challenges during the following year” (Binns 2017:65). Additionally, NGOs can benefit from these partnerships by accessing managerial and financial resources brought to the table by these corporations. However, these benefits tread a fine line as company tendencies to adopt moderate stances can in turn dilute social messaging and hinder NGO progress (Binns 2017:66). McDonnell points out the tendency for companies to gang up against the most flagrantly offending corporation, including the “second-worst-offender” as part of the boycott (Binns 2017:65). Corporations with bad reputations are more likely to partner with NGOs, since many have been activist targets before and made concessions as a result (65). Indeed, even badly-behaving actors have a stake in participating in activism to ensure they aren’t the target.

Superficial displays of solidarity with marginalized groups have come up as an important trend to consider in this new era of social activism. Peter Kalina (2020) calls this behavior “performative allyship” and emphasizes its unhelpful nature. Because this form of allyship is motivated by the hope for a reward for participating, for example a “virtual pat on the back,” Kalina says this outward performance serves to do nothing of substance (478). Both corporations and individuals have fallen into the trap of performative allyship, largely as a means to quickly fulfill a perceived social obligation. In reality, surface-level activism can excuse oneself “from engaging with difficult conversations to address root causes that actually bring change” (479).

The damage this can have to the larger social movement and its base has also been noted in prior research. The self-interest that drives performative activism draws out contradictions that exist in outward expressions and internal operations. Kalina finds that oftentimes, companies who expressed solidarity with Black Lives Matter historically do not support their Black employees, creating a disconnect between supposedly caring about Black lives while not investing in their employees of color (2020:479). Oscar Holmes IV (2020) finds these trends as especially harmful, since performative activism tends to be less conspicuous form of racism and “not as easily recognized or considered.” Because performance-based allyship takes attention and resources away from “legitimate people and causes,” Holmes considers performative activism another way racism “kills black people” and “exacerbates systemic oppression” (6-7).

RESEARCH METHODS To help measure the extent to which organizations engage in performative activism, Holmes recommends looking at clues that tease apart significant mismatches in “enacted behaviors and activism goals” (2020:6). Using

this groundwork, I look at how public statements of solidarity align with more concealed behavior.

Journalist and author of the newsletter "Popular Information" Judd Legum (2020) was the primary inspiration for the research design. Amidst the outpouring of pro-Black Lives Matter statements given by corporations throughout the summer of 2020, he uses FEC filings to see if the political candidates corporations contributed to also supported civil rights legislation. Legum critically analyzes those tweeting in support of Black Lives Matter and whether such values applied when it came to lobbying efforts. Applying Legum’s research method helped significantly in teasing apart performative activism as it applied to widely public statements versus less visible actions.

My sample of Stop Hate for Profit participants was chosen according to companies who fulfilled a series of criteria. First, the company needed to be sizable and economically significant, which was measured using the 2019 Fortune 500 list. Secondly, companies had to have an active political action committee (PAC) registered with the FEC. Thirdly, since this research focused on how political contributions were made after committing to the Stop Hate for Profit campaign, these PACs needed to have made political contributions between their dated announcement of joining the boycott, mostly within the range of the last week of June and August 31st. Lastly, company PACs had to donate to candidates running for U.S. Congress.

Out of the Fortune 500, only 24 companies joined the Stop Hate for Profit campaign.

Further, only 19 of the original 24 had an active PAC recognized by the FEC. Because some PACs hadn’t donated to U.S. Congressional candidates over the course of summer of 2020, the final count of sampled companies whose contributions were assessed amounted to 14. Next, I analyzed the individual congressional candidates and their commitment to civil rights legislation. To do so, this project adopted Legum’s point of comparison: the annual report card published by the NAACP. Since 1914, the NAACP has graded members of the US Senate and House of Representatives according to how each voting record aligns with the priorities of the NAACP. Members of Congress are evaluated on a traditional grading scale. Percentages between 60 to 100 follow a ten point per letter grade logic: 90 to 100 percent alignment with the NAACP amount to an A, whereas grades 59 percent or lower amount to an F or failing grade. The 2020 report examines the voting histories of Congresspeople between January 3, 2019 and December 20, 2019. US Senators were graded on fifteen different votes, and members of the House were graded on thirty different votes.

The NAACP does exclude certain members of Congress from evaluation such as: the Speaker of the House, presidential candidates, indi-

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viduals with incomplete voting records (e.g., the late Congressman Elijah Cummings), and members serving U.S. territories like the U.S. Virgin Islands. Based on candidates with data available through the 2020 NAACP report, PAC contributions were then analyzed. Using the FEC’s database on PAC disbursements, I examined each recorded donation according to the company, contribution amount, contribution date, recipient, political party of recipient, and the recipient’s NAACP report card grades (letter and numerical grade).

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RESULTS In total, this project analyzed 274 individual donations to Congressional candidates. Simply looking at the total amount of money donated to political candidates among the fourteen companies, their respective political action committees donated a cumulative $470,250. Between the two parties, Republicans received $272,000, while Democrats received $198,250, equating to about $2 donated to Democrats for every $3 donated to Republicans.

Despite a difference of only 34 individual donations separating each party, Republicans raised significantly more money than Democrats. Democrats received 120 of 274 total donations, or 43.8% of the total number of donations, whereas Republicans received 154, or 56.2%. Though the percent of individual contributions logged by the FEC only differs by 12.4%, the actual amount of money contributed to either party ranges significantly.

Only looking at the absolute percentage can give the false impression that both sides of the aisle received similar rates of donations, but total cash raised shows a much larger disparity.

Republicans received 67.8% of the combined $470,250 in donations, while Democrats received just above 32%.

Individual contributions from PACs ranged from $500 to $5000. Out of the thirteen $5000 donations, ten went to Republican candidates, meaning that higher value donations were more likely to go to Republicans over Democrats. While the majority of larger donations went to Republicans, there does not seem to be a trend in which candidates receive the most individual donations. Each of the two members of Congress most donated to received five contributions from various PACs: Republican Richard Hudson (NC-8) and Democrat Richard Neal (MA-1). However, the pattern of seeing larger donations go to Republicans reappears in these two Congressmen, as Rep. Hudson’s five contributions amounted to $14,500 while Rep. Neal’s five contributions amounted to only $10,000.

When further scrutinizing the individual candidates receiving donations themselves, the distribution of A grades and F grades from the NAACP looks to almost entirely overlap with party lines. Among the 154 donations made to Republicans, only one recipient, Pennsylvania Congressman Britain Fitzpat-

rick, received a non-failing grade. Fitzpatrick voted in alignment with the NAACP’s criteria of thirty civil-rights-adjacent legislation seven out of ten times, or a 70% C grade.

This means companies participating in Stop Hate for Profit donated $271,000 to members of Congress with extremely low rates of supporting civil rights legislation. Conversely, 118 out of 120 donations made to Democrats (98.3%) went to Congresspeople with A grades. The outlying grades among the Democratic Party came from Rep. Don McEachin (VA-4), who received an 80% B grade, and Senator Doug Jones of Alabama, who received a 73% C grade.

Breaking up the individual letter grades, we can also see distinct trends. There were 66 individual donations going to candidates, all Republicans, scoring between 0% and 10% according to the NAACP grading scale. These donations added up to $122,000, meaning over a hundred thousand dollars went to candidates with the lowest possible grades. 74 individual PAC contributions went to candidates each scoring a 100% A grade. The 74 perfect NAACP report card scores amounted to $124,750. Just $2,750 separates members of Congress with proven pro civil rights voting records and those with rather dismal voting records. This shows that even when a candidate’s voting record aligns completely with that of the NAACP, civil rights advocacy on Capitol Hill does not translate to greater levels of financial support from the sample of companies who made public statements condemning white supremacy.

Implications for Black Lives The wide-ranging contributions made by companies a part of Stop Hate for Profit echoes the same sentiment expressed by Kalina (2020) and Holmes (2020) in their readings of performative activism. Holmes pinpoints performative activism as one mechanism that maintains the institutional violence against Black men and women that frequently ends in death. Social media campaigns meant to prove social justice literacy end up taking away attention from the work of actual grassroots activists and clog feeds by stopping the flow of important information.

Additionally, the legislation included in the grading rubric follows areas such as voting rights, criminal justice, and healthcare, all of which impact Black Americans in an especially profound way. For example, more than half of uninsured Americans are people of color with low wages, meaning an expansion of the Affordable Care Act, also known as the ACA or Obamacare, would largely benefit this group and reduce treatment disparities. In the United States, 21% of the Black population are uninsured, amounting to over seven million individuals unable to seek medical treatment without paying exceedingly high bills out of pocket. Additionally, while Black people make up 12% of the overall U.S.

population, they make up 15% of uninsured Americans (Kaiser Family Foundation 2013).

The NAACP grading rubric for US Senators includes supporting S.J. Res 52, which aimed to overturn former-President Trump’s move to decrease coverage of the ACA, but the joint resolution failed with fifty-two nays (2020:10). With literal lives on the line, we can see how bankrolling candidates who voted to maintain President Trump’s cuts to ACA protection can work to harm Black lives despite these same companies making outward statements signaling empathy for Black Americans. Idaho Senator Jim Risch, who is tied for the greatest number of individual contributions from Stop Hate for Profit PACs, voted against S.J. Res 52 and the remaining 12 NAACP stances 93% of the time. Despite making it more difficult for Black Americans to receive necessary healthcare, Senator Risch cumulatively raised $7,500 from HP and Boeing. By enabling the careers of politicians supporting policies that disproportionately hamper people of color, these companies can be found complicit for their role in the continued suppression of non-white Americans.

Assessing the Campaign's Success As of July 30th, 2020, more than 1,100 companies of varying size committed to the Facebook boycott. According to the campaign, the ripple effects of the campaign and its amplification of Facebook’s wrongdoings accounted for its “unmistakable success.”

Stop Hate for Profit, instead of marketing itself as a full-fledged movement, called itself a “warning shot across Facebook’s bow” with the potential for growing into a much larger, sustained progression towards accountability within the overall push for racial justice (Stop Hate for Profit 2020). The increased attention towards Facebook resulted in Mark Zuckerberg, Facebook’s CEO, testifying in front of the House Judiciary Committee on July 29th, 2020 (Zuckerberg 2020). Facebook also began meeting with civil rights groups to talk about its path forward following the ad boycott (Hsu and Lutz 2020). This being said, the Stop Hate for Profit campaign succeeded in starting conversations about Facebook’s problematic role in profiting from white supremacy and disinformation online.

Additionally, following the summer advertising boycott, Stop Hate for Profit also sponsored a week of action in the Fall. During this week of action, a plethora of celebrities ranging from Kim Kardashian West to Sacha Baron Cohen participated in an Instagram and Facebook "freeze," pausing their activity on the two social media platforms to spread awareness for the campaign. Though Stop Hate for Profit estimates that the global reach of these celebrities’ posts about the campaign amounted to a billion people, these celebrities’ social media consumption has returned to business-as-usual, without much further engagement with the campaign (Stop Hate

for Profit 2020).

Taking a closer look, however, we can see that the Stop Hate for Profit campaign didn’t make as powerful of an impact as it hoped. While this campaign worked to further muddy Facebook’s already murky public reputation, overall financial operations at the company seemed to be unaffected. The New York Times reports that within the first three weeks of July 2020, Facebook’s ad revenue grew 10% relative to the year before (Hsu and Lutz 2020). Additionally, the July buycott appeared not to make a substantial dent in the company’s third quarter earnings, failing to change the platform’s overall trajectory (Frier 2020). Mark Zuckerberg himself has also seen a substantial increase in his net worth since the start of the COVID-19 pandemic’s derailment of daily life in the United States. The Institute for Policy Studies found that Zuckerberg’s net worth grew from $54.7 billion in March 2020 to $101 billion in October later that year (Collins 2020). An increase of 85% or $46.5 billion, Zuckerberg follows a trend of U.S. billionaires getting increasingly rich as many working-class Americans face substantial economic strife as a result of the ongoing pandemic.

CONCLUSION The landmark 2010 Supreme Court case Citizens United v. the FEC ruled that corporations are entitled to the free speech privileges of the First Amendment, allowing them to donate unlimited sums of cash to political causes (Duignan 2020). This ruling gives corporations the same rights allotted to people in the US Constitution. What followed was the proliferation of corporate PACs able to preserve business interests by funneling money into political candidates vowing to keep these interests in mind while voting.

Analyzing the Stop Hate for Profit campaign reveals the tendency for corporations to act in their self-interest when it comes to political contributions, even when publicly exclaiming that they stand in solidarity with the Black Lives Matter movement. These public statements can mislead the general public into thinking a company is more socially-conscious than it really is. While many individuals may not think about the concealed behavior of corporations, like those part of Stop Hate for Profit, taking a deeper dive tells a more obscured story indicative of a corporation’s true moral compass. Both the celebrities and the companies who joined Stop Hate for Profit benefitted from the quick public relations boost, or even the “ally cookie” in the words of Caroline Calloway. However, the campaign doesn’t necessarily translate to making an explicit commitment to de-platforming hate and disinformation, especially with the boycott’s short duration of one month.

While public statements made by companies appear to show support for the movement towards racial justice, this research finds that the

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Stop Hate for Profit campaign served to pay lip service rather than to make tangible changes in the course of Facebook’s growth. Much like the Black Lives Matter Plaza dedicated by Washington DC mayor Muriel Bowser juxtaposing the city’s heightened police presence, press releases and tweets dedicated to Stop Hate for Profit can be easily undercut by looking at political contributions made days after these posts were published (Nirappil 2020).

Invoking the same trend of performative activism described by Holmes and Kalina, these acts serve to do more damage to the greater movement by taking up limited space and resources.

Given the tight timeline of this project, there is still much room for additional research to enrich the findings presented here. As mentioned, companies like Starbucks partook in the ad boycott but their lack of a corporate PAC excluded them from my sample. With additional resources, it would be interesting to see if CEOs or other high-profile corporate executives personally donated in line with their companies’ words. Creating a cross-temporal analysis of FEC data would also provide a compelling point of comparison to further discern if the Stop Hate for Profit changed how companies spent their money before and after the campaign. Finally, the breakdown of FEC contributions by company is difficult to ascertain given the wide range of donations made by some companies versus others. For example, comparing Boeing, which made over 90 contributions, simply cannot be compared to Pepsi’s four individual donations. Expanding the range of time of the dataset could make up for such large differences from company to company.

Be it for a global pandemic, a national election, or catastrophic weather events, finding information online—specifically on Facebook—is a growing trend that doesn’t appear to be stopping anytime soon. While the Stop Hate for Profit campaign lit a flare into the media landscape to signal Facebook’s harm to democratic processes, public health, and marginalized communities, a better route to holding Facebook accountable must be more robust than simply suspending advertising on the site. While corporations may be helpful in further amplifying this message, this research shows that companies can still have an active role in maintaining racial power dynamics in the larger scheme. Companies cannot be at the helm of social movements and take over the role of long-lasting interpersonal activism, because against the logic of the Citizens United ruling, corporations are not people.

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Vaidyanathan, Siva. 2018. Anti-social Media: How Facebook Disconnects Us and Undermines Our Democracy. Oxford, England: Oxford University Press.

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Proximity to Hospitals by Income in Rural Areas Katie Wenger The current study seeks to fill a gap in the existing literature by investigating whether people of lower incomes live farther away from the nearest hospital, especially in rural areas.

Using census data, I evaluate the distance to the nearest hospital for people with incomes below the poverty line, between 100% and 200% of the poverty line, and above 200% of the poverty line. The results do not show meaningful differences in distance to the nearest hospital for people of different income levels. However, they demonstrate that people in rural areas live much farther on average to the nearest hospital than people in urban areas.

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ute drive—from the nearest hospital, compared to 5.6 miles (12 minutes) for suburban residents and 4.4 miles (10 minutes) for urban residents (Lam, Broderick, and Toor 2018).

Many rural hospitals have closed in the last few decades, reducing access for the surrounding communities. Between 2013 and 2017, 64 rural hospitals closed, more than double the number in the previous 5 years (US GAO 2018). Nine percent of rural counties lost their hospital-based obstetric services between 2004 and 2014, leaving a total of 54% of rural counties without them (Hung et al. 2018).

These closures increase distances to hospitals and contribute to health disadvantages for LITERATURE REVIEW

rural people. Residents of isolated rural arLiving within a reasonable distance of a hoseas are less likely to visit providers, especially pital is essential for health in emergency sitspecialists, than urban residents (Chan, Hart, uations. For example, when suffering a heart and Goodman 2007). Further, people in rural attack, patients are more likely to survive if areas with the same type and severity of trauthey live closer to the nearest hospital (Balammatic injury are 14% more likely to die from urugan et al. 2016; Ferrante et al. 2008; Wei their injury than those in nonrural areas, likeet al. 2008; Buchmueller, Jacobson, and Wold ly due to longer distances to trauma centers 2005). As one study demonstrates, the decile (Jarman et al. 2016). The already limited acof communities in Arkansas with the longest cess to hospitals in rural areas raises the quesdriving times to the nearest capable hospital tion of whether access is even more difficult have a 26% higher mortality rate from heart for rural people of low socioeconomic status. attacks than those in the bottom decile (BalBecause hospital emergency departments amurugan et al. 2016). Similarly, after hospital must accept all patients and people of differclosures in the Los Angeles area, communities had ent incomes have unequal health insurance 6.5% more deaths coverage, hospitals from heart attacks which serve poorand 11 to 20% er populations are Rural residents are at particular risk for more deaths from more likely to close. long travel times to the hospital . . . The Studies show that unintentional injuries at home for evfinancial factors are already limited access to hospitals in ery additional mile important for dethey were located rural areas raises the question of whether termining whether from a hospital hospitals remain in (Buchmueller,Jaoperation or close access is even more difficult for rural cobson, and Wold (Graddy and Ye people of low socioeconomic status..

2005). Further, for 2008; Hsia, Kelleach additional erman, and Shen 5 miles someone 2011; Liu et al. lives from a hospital, the odds of death from a 2011). Many poor people lack health insurance, traumatic injury increase by 8% (Jarman et al. creating a financial drain on hospitals when their 2018). Additional studies show that increased emergency departments treat them (Ossei-Owdistance to the nearest hospital leads to higher usu 2017). Hospitals are more likely to close in mortality rates from traffic accidents (Bertoli states that have not expanded Medicaid because and Grembi 2017) and other emergency conmany of their low-income residents remain unditions (Nicholl et al. 2007). Living far away insured (Lindrooth et al. 2018). Even for those from the nearest hospital can have serious with Medicaid, reimbursements for treatments health consequences in emergency situations. are often lower than with private insurance, Rural residents are at particular risk for straining hospitals’ budgets. Studies of non-rulong travel times to the hospital. Rural Ameriral areas find that hospitals which serve a higher cans live an average of 10.5 miles—a 17-minproportion of patients on Medicaid are more

likely to close (Liu et al. 2011; Hsia, Kellerman, and Shen 2011). In rural areas, hospitals are more likely to close their obstetric departments in counties with lower average incomes (Hung et al. 2017). Financial concerns increase the risk of hospital closures in low-income communities.

Furthermore, these economic factors likely incentivize hospital systems to build new sites in wealthier rather than more disadvantaged communities. Studies show that certain types of healthcare facilities tend to locate in communities with higher socioeconomic levels, suggesting that hospitals may follow the same pattern. For instance, urgent care clinics are more likely to be located in areas with higher average incomes. According to Sidney T. Le and Renee Y. Hsia (2016), 39% of ZIP codes with urgent care clinics have mean incomes in the highest quartile, compared with 22% in ZIP codes without clinics. This trend likely results from unequal insurance coverage: more people in the ZIP codes with clinics have private health insurance, whereas more in those without clinics have government-funded insurance or no coverage (Le and Hsia 2016). Similarly, freestanding emergency departments are more likely to locate in regions with higher incomes. In Texas, the average household income in areas with freestanding emergency departments is $91,563, versus $66,825 in areas without (Dark, Xu, and Ho 2017). Certain healthcare facilities follow economic incentives to locate in higher-income rather than poorer areas, and hospitals experience similar incentives.

The empirical question remains of whether people of higher socioeconomic status tend to live closer to hospitals. Nationwide, areas with higher average incomes are more likely to have access within 60 minutes to hospitals with trauma centers, while near-poor people in both urban and rural areas are more likely to have difficult access (Carr et al. 2017; Hsia and Shen 2011). Also, in Kentucky, people who experience long travel times to the nearest hospital have lower incomes and education levels than those who live within 15 minutes of the nearest hospital (Hare and Barcus 2007). However, Jeremy Ader et al. (2019) do not find a significant difference in driving times to the nearest hospital between low- and higher-income stroke patients. Overall, the literature on distance to hospitals by income is inconclusive and incomplete. Studies do not examine differences in distance for people of different economic classes on a national scale, across both urban and rural areas.

Having reviewed the current literature on proximity to hospitals by rurality and socioeconomic status, I will investigate whether higher-income residents of rural areas live closer to the nearest hospital than those with lower incomes. I hypothesize that they do because hospitals follow economic incentives and pressures to build new sites in areas with more financial resources and close sites in ar-

eas with fewer resources. At the same time, it is unclear whether hospitals locate or close in response to the economic characteristics of the surrounding areas, or whether the demographics of these areas change in response to hospitals’ presence. The current study adds to the existing literature on hospital proximity by evaluating census data of the entire US population to compare distances to hospitals by income level.

DATA AND METHODS To evaluate a possible disparity in proximity to hospitals by income in rural areas, I compare the average distance that people in different income categories live from the nearest hospital. I also examine the proportion of poorer and wealthier people who live within certain distance ranges of a hospital.

I use two datasets to analyze this question.

The first is a hospital location dataset from the Homeland Infrastructure Foundation-Level Data website, managed by the Department of Homeland Security (US Department of Homeland Security 2020). The dataset, last updated in May 2020, includes the geographic coordinates and characteristics of 7,596 hospitals throughout the country. It represents the population of all US hospitals because it includes all those on state record lists.

I narrow the results to the 5,705 hospitals in the “General Surgical and Medical” category that are currently open.

To integrate demographic information with the hospital data, I use data from the American Community Survey (ACS), conducted every year by the US Census Bureau.

This dataset comes from the National Historical Geographic Information System website run by the University of Minnesota (Manson et al. 2020). To maximize precision, I analyze block groups. The block group is the smallest unit of analysis available, usually containing between 600 and 3,000 people (US Census Bureau 2019). To examine block group population characteristics, I use the 2014-2018 five-year aggregated data, a compilation of each year’s survey data. The ACS constitutes a representative sample of the US population, which can be considered data from the full population because the sample size is very large. Because these are population data, all findings can be considered statistically significant without the need for statistical tests.

The US Census defines geographic areas as “urban” if they contain more than 2,500 people and “rural” otherwise (US Census Bureau 2020). I label each block group as “urban” or “rural” according to these criteria.

As a measure of socioeconomic status, I use the “Ratio of Income to Poverty in the Last 12 Months” variable from the ACS. This variable reports an individual’s household income as a proportion of the federal poverty level based on their household size. For example, during the time period of 2014 to 2018, a family of four at the poverty level earned an

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average of $24,420 per year (US Department of Health and Human Services 2020). I analyze three income categories: below 100% of the poverty level (“poor”), between 100 and 199% of the poverty level (“near-poor”), and above 200% of the poverty level (“not in poverty”).

To calculate the distance people live from the nearest hospital, I assume that each person lives in the center of their block group, defined by the center of mass of a polygon. I calculate the straight-line distance of each block group from the hospital nearest to it. I use straightline distance because it is easier to calculate than travel distance, and studies show that it usually does not differ much from travel distance (Boscoe, Henry, and Zdeb 2010; Phibbs and Luft 1995).

To find the mean distance that people in each income category live from the nearest hospital, I weight the block groups by the number of people in each income category living in them. I also divide block groups’ distances from the nearest hospital into five categories (less than 5 miles, 5-10 miles, 10-15 miles, 15-20 miles, and more than 20 miles) to find the proportions of people in each income category who live in each distance range.

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identical, except for the fact that 69% of the rural population is not in poverty (compared to 67% of the urban population). Table 1 presents descriptive statistics for the mean distance to the nearest hospital for all US residents.

The average distance is 5.6 miles, but varies widely, with a standard deviation of 7.6 miles.

Table 1: Distance to Nearest Hospital- Descriptive Statistics (total U.S.)

A majority (62%) of Americans live within 5 miles of the nearest hospital, and 84% live within 10 miles. However, some live much farther from a hospital. Figures 3 and 4 reveal that rural residents live much farther on average from the nearest hospital than urban residents. Those in rural areas live an average of 10.8 to 11.6 miles from the nearest hospital (depending on income level), compared to only 3.2 to 3.7 miles for urban residents.

RESULTS As Figure 1 shows, more Americans live in urban than rural areas, but rural residents still comprise a significant portion (27%) of the US population.

Figure 3: Distance to Nearest Hospital by Income Category: Rural Areas

Figure 1: Population by Urban or Rural Location

Urban and rural areas have approximately the same proportions of residents in poverty, near-poverty, and with higher incomes. Figure 2 depicts urban population by income category; rural population by income category is

Figure 4: Distance to Nearest Hospital by Income Category: Urban Areas

Figure 2: Urban Population by Income Category

Regarding income, rural residents with low incomes live slightly farther, on average, from the nearest hospital than those with incomes over twice the poverty level, but these differences are too small to be meaningful. Poor and near-poor people both live an average of 11.6 miles from the nearest hospital, compared to 10.8 miles for higher-income people.

On the other hand, urban residents with the hospital. At the same time, it is important lower incomes live slightly closer to the nearest to note that geographical proximity to a hoshospital; those in poverty and near poverty live pital does not guarantee accessibility, as some 3.17 and 3.38 miles away, respectively, comlow-income people may have transportation pared with 3.72 miles for those with incomes issues as well as other barriers to care. above twice the poverty level.

One key finding of this analysis is that The vast majority of urban residents live overall, rural residents experience much lonwithin 5 miles of the nearest hospital, and over ger distances to hospitals than urban residents.

95% live within 10 miles. Poor and near-poor While not all rural residents have low incomes, urban residents actually tend to live slightly a lack of proximity to hospitals in rural areas is closer to the nearest hospital than those with still a pressing public health problem. higher incomes: 83.3% and 81.1%, respectiveThis analysis has several limitations. First, ly, live within 5 miles, compared to 76.2% of assuming, as I did, that each person lives in the people with incomes twice the poverty level. center of their block group reduces the accuracy Figure of distance 6 shows that calculations. there are no Also, the clear differencdata I use es in distance are cross-secto hospitals in tional, so it rural areas for is impossible people in difto track the ferent income closures or categories. openings of While people hospitals over in poverty and time. In fun e a r - p ove r ture studies, ty are slightly examining more likely to longitudinal live more than data could 20 miles from help deterthe nearest hosmine whethFigure 6: Distance to Nearest Hospital by Income Category: Rural Areas pital (11.3% er hospitals and 11.0% veropen or close sus 8.4% for those not in poverty), they are also in response to the demographics of the comslightly more likely to live within 5 miles of the munities around them. In addition, qualitative nearest hospital. The other distance ranges also do studies could investigate the reasons why hospinot reveal clear patterns by income. tals, especially rural ones, open or close. Finally, On the whole, urban residents tend to live other factors, such as the quality and capacity much closer to the nearest hospital than rural of hospitals, affect access to emergency care in residents. Over 75% of urban residents in each rural areas and are an important future area of income category live within 5 miles of the closstudy. Overall, access to hospitals for rural peoest hospital, compared to only about 20% of ple and those of low socioeconomic status is an rural residents. important issue that deserves further attention in research and policy.

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Positioning in Holistic Medicine: An Assymmetrical Power Balance Celia Metzger

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This essay focuses on a wellness blog post titled “How to Stop Attacking Yourself: A Guide to Health Autoimmune Diseases,” featured on a holistic medicine website that offers health consultations and services. Using Davies and Harre’s (1990) definition of "positioning," particularly their concept of social category formations, I analyze how the blog’s author positions herself within the framework of socially relevant authority relationships with the reader. Relying on both positioning strategies used by typical Western doctors and those created by holistic doctors in contrast, the blog's author is able to claim authority as a medical expert. By relying on these established asymmetrical power dynamics, the author lends herself and her services credibility as a marketing strategy. After first examining scholarship in positioning theory and medical discourse, this paper delves into a discourse analysis of the blog itself, followed by a discussion of the author’s positioning strategy and how it relies on the disempowerment of the reader as a marketing scheme.

THEORETICAL BACKGROUND This essay relies on the theory of "positioning" as developed by Davies & Harre (1990) and further expanded on by Langenhove and Harre (1999). Positioning arose from Goffman’s (1974) work on framing and footing (1981). In this work, Goffman claimed that individuals “frame” their interactions with one another by applying the correct register, social etiquette, and other norms associated with the frame, thereby signaling to the addressee(s) the social context of the interaction.

For instance, a professor can frame their interactions with their class in a “teaching frame,” whereby they hold the conversational floor and speak uninterrupted with authority. Under this framework, social identity and interactions are negotiated by participants through discourse.

Davies and Harre (1990) took this idea and developed it further into positioning, a more dynamic envisioning of framing. They claimed that, rather than existing in a single, static frame, people position themselves throughout discourse, and that these positionings are negotiated and constantly changed.

Taking the same example of a classroom environment, a participant can position themselves as a student by quietly paying attention to the lecture, but in the next moment they could alter their positioning to one of a friend

in solidarity by whispering to their classmate about how the professor’s shoes are untied. In this way, positioning is dynamic and negotiated from moment to moment, rather than static in one framework throughout the entire interaction. Positioning adds yet another layer to framing by showing that, when someone positions themselves, they also position others around them (Davies and Harre 1990). Using the same classroom example, by positioning themselves as a friend to their classmate, the student also positions their classmate as a friend, thereby giving both of them a meaningful designation in the social interaction.

In order to position themselves, people often rely on “social category formations,” or commonly established social roles that are easily recognizable by other members of the same culture (Davies and Harre 1990).

For instance, by speaking legalese, one could position themselves as a lawyer, thereby drawing on culturally recognized social conventions. Some social category formations exist in pairs, like teacher and student, or parent and child. When a participant in discourse positions themselves as one of these identities, the addressee is likely to slot themselves in the complementary role (Johnstone 2018); for example, if someone positions themselves as a professor by lecturing, then their addressee is likely to take on the complementary role of student by listening quietly and attentively. Most pertinent for my analysis is the social category formation pairing of doctor and patient. A great deal of research has been conducted on the asymmetrical relationships between practitioners and their patients, in which doctors have more social capital than their addressees (MacArtney et.al. 2020).

While most of the discourse analysis research in this area has focused on the patient’s point of view in narratives, Barton (2004) claims that for Western medicine, “[u]sually, the treatment recommendation is framed within a claim to authority—either the authority of current medical research (e.g., based on studies) or the authority of good clinical practice (e.g., the standard of care, in that situation, in general, and here in the United States).” That is, doctors position themselves as authority figures in doctor-patient interactions in order to lend credibility to the medical advice they give out. For Western-trained doctors, this often means making appeals to science, referencing statistics, research, and engaging in other kinds of “medical speak.”

However, these positioning techniques only hold true for doctors trained in Western medicine. Those based in holistic medicine often rely on other arguments to position themselves as authority figures in the field. According to Gibson’s (2018) research on how online forum participants talk about homeopathic and Western medicine, positioning strategies for claiming credibility in holistic medicine are formed as a contrastive response to the hegemony of evidence-based Western medicine. Some practitioners based in alternative medical practices do try to assimilate to the style of Western-medicine-based positioning techniques, relying on science and research to claim authority (Gibson 2018). However, many others use alternative arguments to position themselves as spiritual guides, thereby asserting power in a markedly different way (Gibson 2018). For instance, certain alternative medicine practitioners make appeals to cosmic powers or vibrations, or claim authority from other scientifically unfounded fields, positioning themselves as the chosen holders of secret, mysterious information (Gibson 2018). Gibson also shows that participants position themselves (according to Davies and Harre’s 1990 conception of the term) as members of a medical community to consequently take up moral stance and make claims about what medicine should be (2018). Both the assimilative and contrastive positioning strategies of holistic doctors will be analyzed critically in the discourse of the wellness blog, to see how the author positions herself as a holistic practitioner.

METHODOLOGY Using this theoretical framework of positioning and techniques used by medical authorities, this analysis looks critically at the discourse of the wellness blog post. I examine how the blog's author positions herself both as a holistic doctor using assimilative strategies native to Western medicine and contrastive approaches originated by holistic practitioners. I also examine how this positioning creates an asymmetrical power relationship between the author and reader, which contributes to an argument for the author’s marketing services. The discourse derives from a blog post on a functional medicine business website, "Holistic Family Practice" (Steele 2020).

Analysis: The Author As a Holistic Doctor From the very start of the text, the author positions herself as a medical expert in ways that are often found in modern Western medicine.

In line 3, even before the main discourse begins, the author introduces herself as: [3] Dr. Erica Steele DNM ND CFMP BCND

First, the suffix of “Dr.” claims that the author has the appropriate qualifications to practice medicine. This is further emphasized by the

four acronyms that follow the author’s name.

Even if the reader does not know the meaning of these acronyms, they will know that they stand for important educational credentials the author has gained in order to be achieve a position of medical authority. Even though the actual licenses to which these acronyms refer are not related to typical Western medicine practices, they draw on the tradition of licensed physicians to assert their authority.

Fronting these qualifications at the beginning of the post, the author positions herself as a knowledgeable practitioner by appealing to Western cultural norms of educational certification.

The author continues to position herself as a Western authority by invoking medical jargon, particularly in lines 22-26: [25] difficult time distinguishing self from nonself. Imagine these negative emotions [26] weighing down the functions of these areas, leaving them more susceptible to [27] pathogenic invasions. The regret and lack of forgiveness of self that you may be [28] carrying to protect your heart could manifest into calcifications of the heart which then [29] generates inflammatory processes. Combine a poor diet with a feeling of unworthiness [30] and anger or frustration of self now you are on your way to generating a cardiac event.

The use of terminology like “pathogenic invasions” (line 27), “calcifications of the heart” (28), “inflammatory processes” (29), and “cardiac event” (30) positions the author as someone fluent in medical speak, who therefore must have received ample education and is now an expert in the field. By explaining the inner workings of the body, the author is also relying on the “informational” style of medical discourse, further positioning herself as a doctor fluent in the genre of medical speak (Wilce 2009). Because she speaks like a doctor, the author gives her audience the impression that she is one, and therefore should be afforded the same deference and respect ordinarily given to such a figure of authority.

In addition, the phrase “calcifications of the heart” is a hyperlink to another article about the subject—harkening back to the academic tradition of citations, which Western doctors also rely on as a positioning technique (Barton 2004). Through these tactics, the author simultaneously positions the reader as the opposite: unknowledgeable and unqualified. In saying “[i]magine these negative emotions” (line 25), the author gives a direct imperative command, taking authority over the reader.

Therefore, by both making appeals to Western medical credentials and by asserting their authority over the reader, the author positions herself as a Western doctor.

Indeed, she also positions herself as a credible physician by using these appeals to Western traditions and other authority-gaining discourse strategies. This is seen clearly in the

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final paragraph of the text:

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but with lifestyle advice:

[43] And finally who says you cannot transform your [44] health from a collection of symptoms to whole health? I propose that you can, and am [45] able to show you how. Doctor in Latin means teacher and that is my job to teach you [46] how to heal yourself by creating the environment to which healing can occur.

[8] Many people judge themselves, critics themselves and often beat themselves up.

[9] Remorse, grief, lessons from the past can often come up and haunt people in the [10] present moment. Being unwilling to let go of these ideas, concepts, emotions, from the [11] past creates a lack of unforgiveness in self which can translate to other people.

Invoking a rhetorical question of “who says” (line 43), the author simultaneously discredits other practitioners who may disagree with her advice while she also claims her own expertise.

This is further emphasized by the following declarative assertion that the author is “able to show you how” (45) to transform your health.

In following the rhetorical question with a declarative sentence, the author is able to assert her answer to the question as the correct one. In addition, by invoking Latin in line 45, the author makes an appeal to the position of privilege that Classical civilizations have in Western cultures. As ancient Rome and Greece were the birthplaces of Western medicine, the author positions herself as someone from a long line of medical excellence and rigor. She further continues her tactic of asserting authority over the reader, saying in line 45 “Doctor in Latin means teacher, and it is my job to teach you.” This tactic positions the reader as a student, as it is in a social category formation with teacher (which the author has positioned herself as). Since teachers have more authority in the student-teacher relationship, the author is positioned as a believable and respectable authority figure whom the reader should trust.

Just as the author does give herself credibility using assimilation techniques found in Western medicine, she also relies on the alternative legitimacy-claiming techniques found in holistic medicine. Even before she introduces herself as a doctor in the Western medical sense, she positions herself as a holistic doctor in line 2:

This discourse introduces the topic not as a medical issue, but as a spiritual, lifestyle issue. Although the article claims to be a guide for autoimmune health (line 4), the author initially focuses on emotional processes and concepts like “unforgiveness”(11). This diction positions the author as a doctor who also treats the mind and soul, as well as the body.

To enforce the spiritual nature of her practice, the author uses evocative language, claiming that negative emotions can “haunt” someone (9). This emphasizes the idea of the supernatural, further positioning the author as a spiritual guide. Furthermore, these sentences are all declarative, with no hedging strategies, giving the impression that the author is asserting all the information as factual. Such a discourse technique lends the author credibility, helping her to position herself as an expert in the spiritual field.

Throughout the blog post, the author also makes appeals to the reader: that they review autoimmune issues with a spiritual mindset.

In lines 25-27, she says, “Imagine these negative emotions weighing down the functions of these areas, leaving them more susceptible to pathogenic invasions.” By beginning the sentence with “imagine,” the author asks the reader to put themselves in a spiritual mindset. In addition, she transforms the abstract concept of emotion into a physical one, claiming that they “weigh down functions” of the body. This wording gives them corporeal form, allowing the author to liken them to any other physical pathogen.

This assertion of "spiritual subject mastery" compared to the reader’s unknowledgeable state is found in the first few lines of the final paragraph:

[2] Holistic Family Practice [3] Dr. Erica Steele DNM ND CFMP BCND [4] How to Stop Attacking Yourself: A Guide to Health Autoimmune Diseases

By positioning herself as a holistic practitioner before providing her credentials, the author makes it so that her identity is most relevant to the article. This is supported by other evidence found throughout the text, as the author relies even more heavily on alternative legitimizing strategies than on assimilative ones to position herself as a holistic doctor.

To do this, the author positions herself as a spiritual leader, as Gibson (2018) claims many holistic medicine followers do to gain authority. Directly after giving her credentials with the title of the article, she begins the main text not with any medical information,

[37] However, if you choose to learn spiritual lessons presented to you instead of resisting [38] them, judging them or others, while processing through the emotions not as a victim [39] yet as a powerful creator meant to turn darkness into life forgiving self and others now [40] you are on your way to not only preventing an autoimmune disease but perhaps [41] eliminating one. I’m not suggesting that it is that easy, or perhaps I am. Who says that

In line 37, the author asks the reader to stop resisting the spiritual lessons she presents to them. By offering the reader spiritual advice, the author presents herself as an authority in the matter, with the reader as the less-experi-

enced learner. This also positions the reader as an unruly patient who is noncompliant with the author’s medical advice. If the reader wants to achieve the health the author advertises, then they need to listen and accept the author as a medical and spiritual authority. Furthermore, in lines 38-39, the author tells the reader to live “not as a victim yet as a powerful creator,” implying that the reader can transcend their current state and remake their own reality if they follow these lessons.

She also makes allusions to “turning darkness into life,” using more abstract spiritual concepts reminiscent of Bible verses, further solidifying the spiritual nature of her advice. By positioning herself as a spiritual guide, with the reader as the one accepting her advice, the author solidifies her status as a credible holistic practitioner, despite the unfounded nature and implausibility of her claims.

advice from the authoritative doctor figure from a less critical viewpoint. In this way, the author relies on the disempowerment of her readers in order to market her health services, which are advertised on the same page.

Relying on both traditional Western and alternative positioning approaches, the author taps into the existing rhetorical metaphor comparing doctors to legendary heroes.

Because doctors have more power in these interactions, there is also a tendency to view doctors as heroic or mythical figures (Collie 2015). As Gillian Collie points out, “ heroic rhetoric, as applied to physicians, serves to inhibit communications between physicians and patients,” as patients can be intimidated into not asking important questions about their health (2015:iv). Particularly in using spiritual language and appealing to the reader to remake their reality (as in line 39, “a powerful creator meant to turn darkness into life”), the author draws on this metaphor to paint herself as a mythic figure able to conquer the realities of nature and health to transform as she wishes. By positioning herself as an imposing figure in this way, she once again discourages the reader from questioning her medical advice and markets herself as an undisputed expert in the field.

DISCUSSION Close analysis of the text shows that the author consistently positions herself as a doctor, using techniques grounded in both Western medical discourse and holistic medicine. By using these positioning techniques, she asserts herself not only as a doctor but also as an authority figure, as these same techniques are often used by practitioners to gain credibility in patient-doctor interactions. By positioning CONCLUSION herself with assimilative and contrastive stratThere are some limitations of my work. Not egies, the author claims expertise in both evmuch research has been done on the positionidence-based and holistic fields of medicine, ing strategies of holistic doctors, and so this thereby appealing to a wider audience. Those paper relies heavily on Gibson’s (2018) rewho are enticed by arguments of science may search on the discourse used by a general pubbe drawn in by the display of her credentials lic who use holistic medicine, but not doctors and her use of medical terminology, while in particular. In addition, this paper only uses those who find the spirituality of holistic medthe wellness blog discourse as a case study and icine appealing may be more intrigued by her cannot make larger claims about the discourse qualifications as of holistic practia spiritual leader. tioners as a whole.

Her dual positionMore research is By using these positioning techniques, ing strategy serves needed in this area, makes the author’s [the blog's author] asserts herself not particularly as wellknow-how seem ness and alternative extensive and en- only as a doctor but also as an authority medical practices compassing. are on the rise. figure, as these same techniques are Moreover, by Regardless, I have positioning herself often used by practitioners to gain credi- shown that the auas a doctor, the thor uses Gibson’s author creates a (2018) described bility in patient-doctor interactions. power imbalance positioning techbetween herself niques of assimilaand the reader. The relationship between doction to Western medicine and also appeals to tor and patient is a "paired framing," meaning spiritual expertise. While giving advice always that when the author positions herself as the involves some kind of power dynamic, it is doctor, it’s likely that readers automatically especially important to consider these imbalslot themselves into the complementary menances of social capital in patient-doctor intertality of patient (Johnstone 2018). Extensive actions. Because the party most affected by research has examined the consequences of such interactions is the patient—as it is their this asymmetrical power dynamic and has health that is being considered in such cases— found that patients often perceive a lack of efforts must be made to ensure patients can power in their interactions or note a sense of voice concerns and ask pertinent questions ambivalence from their doctors. This means about their health and the services provided. that the reader is likely to take on the submisRecently, many initiatives and a great deal of sive identity of the patient, therefore taking research have focused on the empowerment of

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the patient and how to find a balance between the practitioner’s authority and the patient’s choice and bodily autonomy during consultations (MacArtney et al. 2020). As a result, discourse like this should be analyzed critically for positioning techniques that could serve to disenfranchise the addressee, taking power from them and giving it to the addresser.

More research is needed in the future to help mitigate the disempowering effects that such discourse has on patients during patient-doctor interactions.

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REFERENCES Barton, Ellen. 2004. “Discourse Methods and Critical Practice in Professional Communication.” Journal of Business and Technical Communication 18(1):67-111.

Collie, Gillian Mary. 2015. “A Bakhtinian Approach to (Re)Visioning Heroic Rhetoric in Medical Discourse.” PhD dissertation, Indiana University of Pennsylvania.

Davies, Bronwyn and Rom Harré. 1990. “Positioning: The Discursive Production of Selves.” Journal for the Theory of Social Behaviour 20(1):43-63.

Gibson, William J. 2018. “Homeopathy, Western Medicine and the Discourse of Evidence: Negotiating Legitimacy in a Public Online Forum.” Current Sociology 66(7):1013-30.

Gamson, William A. and Erving Goffman.

1975. “Frame Analysis: An Essay on the Organization of Experience.” Contemporary Sociology 4(6):599-603.

Johnstone, Barbara. 2018. Discourse Analysis.

Hoboken, NJ: Wiley Blackwell.

Langenhove, Luk van and Rom Harré. 1999.

"Introducing Positioning Theory." Pp. 1431 in Positioning Theory, edited by R. Harré & L. van Langenhove. Oxford: Blackwell.

Macartney, John I., Rikke S. Andersen, Marlene Malmström, Birgit Rasmussen, and Sue Ziebland. 2020. “The Convivial and the Pastoral in Patient–Doctor Relationships: a Multi‐Country Study of Patient Stories of Care, Choice and Medical Authority in Cancer Diagnostic Processes.”

Sociology of Health & Illness 42(4):844-61.

Steele, Erica. 2020. “How to Stop Attacking Yourself: A Guide to Health Autoimmune Diseases.” Naturopathic & Functional Medicine Holistic Family Practice. Retrieved October 26, 2020 (https://www.holisticfamilypracticeva. com/how-to-stop-attacking-yourself-a-guideto-health-autoimmune-diseases/).

Wilce, James M. 2009. "Medical Discourse." Annual Review of Anthropology 38:199-215.

The Food Desert Saturated With Inequality: An Analysis of the Grove Community Helen Tariku In the southeastern section of James City County, in the center of the Historic Triangle of Colonial Virginia, lies Grove, Virginia, better known by locals as "the Grove."

Although just a mere seven miles away from Williamsburg, the Grove has suffered from displacement and poverty since its founding. This has affected the Grove’s residents by compromising their living circumstances, job opportunities, and food resources, the last of which is the focus of this essay. Through ethnographic observation and data collection, a group of students including myself temporarily emerged ourselves into the lives of these individuals, with special regard to food option and selection. In doing this, it became clear that in comparison to James City County as a whole, the Grove suffers from a lack of opportunities for and barriers to food security and sovereignty. In our analysis of this neighborhood, we have found that the lack of stores to purchase food and the absence of reliable methods of transportation to access food sources have contributed greatly to the Grove’s food insecurity.

BACKGROUND Several theories have been applied to the Grove situation in order to understand it better. Our team discovered that one of the main sociological concepts influencing the local food system is "institutional racism." Institutional racism is defined as racism that permeates our system, and those that are oppressed by such racism are put at an unfair disadvantage than compared to those who are not. Spencer D. Wood and Cheryl R. Ragar (2012) assist in our understanding of institutional racism; they illustrate how “land [serves] as a material basis of wealth [and] has been disproportionately inaccessible to African Americans while simultaneously serving as a key form of wealth for upward mobility for white Americans'' (16). Taking this into consideration, we see that in the Grove, land is distributed to nonWhite races is inadequate, while profitable land is reserved for primarily White-focused initiatives. This is illustrated through the Kingsmill neighborhood, which is adjacent to the Grove and is a very affluent area home to predominantly white residents. Although they essentially share the same land, the material wealth of the land has been disproportionately inaccessible to the non-white individuals of

the Grove. Additionally, considering the early history of the Grove—involving displacement of Black people and Black-owned businesses—we can draw a connection to the "Tillery project." Through the Tillery project, the land on which Tillery Farms sat was distributed to primarily white families; these families then tried to redstribute the land to include more Black farmers and families. However, federal funds for these projects were given to state commissioners so that they could distribute it at their discretion. Consequently, white commissioners gave better land to white owners and less harvestable land to Black owners.

This situation is an echo of the Grove's own history, when Black individuals, after WWII, were disenfranchised by programs supposed to help Black and African American citizens find homes and rehabilitation facilities, but ultimately catered to white Americans' needs.

This history set up the Grove on the path of poverty today.

History and Descriptive Statistics The Grove has changed drastically from its founding to how it is known today. Originally, the Grove flourished with businesses, interracial cooperation, and homes; now, the Grove lays barren. Previously known for its historic sites that signified Virginia's colonial past, such as the administrative center of Martin’s Hundred, the grounds of Carter’s Grove Plantation, and the Wolstenholme Towne, the Grove’s reputation has transformed into that of low-income residents, suspicious activity as a result of high crime, and disrepair: an illustration of what over a century’s worth of displacement and discrimination can cause to a community.

The Grove later served as a startup living space for many Black/African American individuals. These individuals would acquire a great deal of land and build their homes from the ground up. Unfortunately, as a result of WWII, Black communities were eventually displaced. Many of these individuals migrated to other locations including Colonial Williamsburg, Mulberry Island, Magruder, and the Reservation. The lack of a community and residence occupying the Grove, in addition to the many Black-owned organizations and businesses that closed, are the first signs of the formation of the Grove’s unsuccessful economy. In comparison to other parts of not

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only the state but also the nation, the Grove today remains a sparsely inhabited city. It has suffered much abuse and oppression, and the same idea applies to its current residences. The Grove’s population is a little over 4,500 people, roughly 6% of the size of the entirety of James City County. Poverty is spread heavily across the Grove and has affected a variety of races including Whites and African Americans. The number of individuals of each of these race groups that are food stamp eligible and/or on the Supplemental Nutrition Assistance Program (SNAP), is nearly double, in most cases in comparison to James City County. The percentage of White recipients of food stamps/SNAP in the Grove is a little over 20%, in contrast to James City County where Whites account for only 3.75%. For African Americans, the number increases to a little under 25% in the Grove, in comparison to 11.32% in James City County. And lastly, for the Latinx population that makes up the recipient pool, the Grove and James City County compare at 30% to 26.12% respectively. In addition, capitalism has led to food insecurity and the absence of opportunity for food sovereignty in the Grove. We see that the Grove falls into a cycle of insecurity set up by capitalism that continues to produce negative effects for its participants. There is a lack of businesses because the Grove does not seem profitable to outsiders, and as a consequence, many businesses want only to utilize the land for industrial zoning. The result is a lack of grocery stores, which inherently means decreased opportunity for jobs. Moreover, capitalism contributes to problems such as that identified in David Harvey’s "crisis of overaccumulation"; to 'fix' this issue, we have to implement spatial solutions which displace overaccumulation into another area. Indeed, short-term fixes lead to long-term economic instability, which cycles back to the reason why the Grove seems unprofitable.

Table 1: Racial makeup of the Grove versus James City County across the three largest racial groups

Table 2: Total number of recipients of Food Stamps/SNAP in the past 12 months for each race group

Newspaper Analysis The multitude of issues present within the Grove community are exemplified in numerous stories found in the many newspapers in circulation, including the Virginia Gazette and the Williamsburg Yorktown Daily. In uncovering and analyzing newspaper articles from 2009 to the present date, I found mentions of issues ranging from robbery to systemic racism to transportation problems.

Much of the information presented in various stories seemed to be a result of poverty and inequality issues. Some of the coding terms I utilized (in addition to those just stated) consider housing, which primarily dealt with finding affordable housing and homelessness; economic spending, which focused on government funding and taxes; food security, or the prominence of food deserts and decreased food access; as well as charity, which concentrated on food pantries, outreach centers, and donations. Matters that did not have as high of a priority or relevance included education, tradition, and destruction.

DATA COLLECTION In observing the Grove and gaining first-hand experience by driving through the area, the lack of resources as well as the stark difference between Williamsburg and the Grove proved to be very prominent. The roads became bumpier and appeared neglected due to lack of care for infrastructure, and there was a drastic change in scenery in which buildings were often abandoned, more spread out, houses became smaller in size, and, additionally, there was a lack of basic public service amenities such as sidewalks and crossroads. The lack of sidewalks and crossroads was something that we noticed right away, considering that we often saw individuals walking on the side of a busy road with cars at speeds upward of 50 mph, where they carried loads of groceries in a space no bigger than a bike lane. Additionally, on our drive to the Dollar General, there was only one bus stop, which was placed in a very inconvenient location—again in a space with no sidewalks or crosswalks. Considering this, we realized that individuals would have to cross four lanes of traffic while cars still drove at a fast speed to reach one stop. The amount of attention and resources that are put into focusing on this bus stop should be increased, considering over 50% of the Grove’s population does not have a reliable means of transportation for work. Oftentimes the bus is what they would use to travel. Not only is the carelessness of the safety of the individuals who would utilize the bus stop dangerous, it is also very concerning.

There was also a decrease in retail areas going to and around the Dollar General. The ones that were present were often dilapidated and served the purpose of being cheap convenience stores. In analyzing residential areas, the same showed for the case of the roads, in that there were many potholes, ditches, and

a lack of safety signals. The foliage and fauna that surrounded the houses on sidewalks and front yards seemed very unkempt and lacked necessary nutrients and treatment. The houses were relatively similar to one another, with each being on the smaller side and having damaged fences. Surprisingly, many houses had multiple cars but of old models. There were also a large number of mobile homes as well as a park of mobile homes located behind the Dollar General near the cul-de-sac of homes that we drove into.

As we continued to drive around and eventually enter the Dollar General, we noticed the lack of diversity present in the area.

A majority of the individuals that we encountered were of Black and/or African-American descent. Following this, we saw a few Hispanic individuals and very few White individuals. As we entered the store, much junk and garbage surrounded the outside of the store, including numerous littered cigarettes. The store was compact and filled with a variety of items from pool noodles, to coolers, to Fruit Loops and marshmallows as one delved deeper into the store. There was also inadequate lighting and a lack of workers or signs to assist in navigating through the store.

The Dollar General held many of the items listed on the Nutrition Environment Measures Survey (NEMS) for corner stores and at fairly decent prices, but did not hold many basic foods or food groups. The store did not sell fresh produce such as bananas, apples, corn, or carrots, nor did it sell any frozen fruit options, but it did have a few frozen vegetable options available (though at the moment they were out of stock). The Dollar General did, still, have many canned produce options including fruits such as pineapples and mandarin oranges, as well as vegetables including green beans and asparagus. In addition to lacking any fresh produce items, the store did not carry any baked good items, besides bread.

There was a wide variety of options of meat available that the store carried, but none of them would be considered a healthy choice.

This was the case for all ground meat products, hot dogs, and full meat products. A similar scenario was true for the carbonated soft drinks andhigh fructose corn syrup drinks, such as sodas and lemonades. The store only carried larger ounce options for these drinks.

We noticed that there was a lack of healthy breakfast options available at this store. The Dollar General held a wide variety of sugary cereals, and would have many options of the same brand of cereal rather than providing healthier cereal options. For example, Dollar General carried regular Lucky Charms, Lucky Charms Frosted Flakes, Lucky Charms Magical Unicorn, Lucky Charms with a leprechaun trap on the back, as well as off-brand Lucky Charms. Yet, they only carried about three non-sugar intensive options that would be considered healthy according to the NEMS.

The data collected from the Harris Teeter located near Kingsmill on Quarterpath Road (Williamsburg) varied greatly in comparison to the Dollar General. As we traveled to this location, safety warnings such as road conditions, signage, and public infrastructure had increased greatly. The racial makeup of consumers shifted to be predominately White, while the store workers were more racially diverse in comparison to the Dollar General and the Harris Teeter’s own consumers. Immediately upon entrance, the store was larger, products were evenly distributed, and the lighting was much brighter, contributing to a more welcoming shopping atmosphere. In

Table 3: Comparison of the two stores

contrast to the Dollar General, there was a multitude of fresh produce available near the entrance. The store also provided visual diagrams that served an educational purpose in helping customers learn what the product was and similar products that would fall into the same 'family.' There were many more workers on the floor who, on separate occasions, came up to members of our group, when we were individually ‘shopping,' and asked if we needed assistance. Besides assisting customers, the workers were continuously restocking items, ensuring that all shelves were filled; the only instance in which there was an empty shelf was in the dairy section, though many equivalent alternatives were available in place of the absent item.

Moreover, in comparison to the Dollar General, Harris Teeter offered a lot more coupon/value options for shoppers including taking certain dollar amounts off or getting more products for one price. The Harris Teeter had over ten cashier stations, some of which were self-checkout, which sped up the shopping process. Those that worked at the cashier were also more racially diverse in comparison to the Dollar General, which only had originally two African American cashiers (one left halfway through our visit). The ages of the customers also seemed to vary but mostly on the older side. Finally, one of the small items that we noted was that the Harris Teeter was giving out different samples of their food. They gave out fresh pineapple chunks, some type of

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cheese, and then an organic cheese dip along with their special crackers to complement the spotlight food. This strategy was similar to the sampling implemented at the farmers market to educate children on good groups, as Tracy Frey, the executive director of the market noted in an interview with her. This small act promotes education on food and the food system which is one of many steps that communities can take to fight against food insecurity. This idea along with the educational signage surrounding the fruits and vegetables shows the educational strides that Harris Teeter is taking to serve its community. There was also a worker nearby the cheese samples ready and able to assist and answer questions that customers may have about the sample or in general.

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CONCLUSIONS AND RECOMMENDATIONS Although the Grove has previously been subjected to gentrification, industrialization, and more, adding more homes to the neighborhood is a potential solution to the food insecurity that pervades the area. As can be seen through James City County (where there are more homes and neighborhoods), there was an apparent increase in food availability compared to the Grove. Currently, the Grove is seen as a work destination focused on its industrial aspects rather than the potential for a residential future. In considering this future, if more homes and neighborhoods are built, we can assume there will be an increase in interest from businesses like grocery stores, retail stores, specialty stores, and more.

Furthermore, if a just and reasonable combination of varied-income housing is built, we can expect for there to be businesses that accommodate diverse races, and that assist in providing a wider selection of food options to combat insecurity of certain food groups, as seen through what is currently occurring in the Grove. Thus, in addition to increasing the number of grocery store options available, implementing policies or rules to some degree that dictate stores hold basic necessary food items would be beneficial in alleviating the problem of food insecurity.

Although seemingly unfeasible, this can easily be done through recruiting stores that already meet such a basic requirement, including the Harris Teeter, while still keeping in mind the income discrepancies between groups within the community: in other words, making efforts to find stores that serve this food purpose while still being economically feasible to these individuals. Alternatively, state officials could work with higher-end stores to negotiate deals that would allow for the acceptance of financial assistance programs such as SNAP and food stamps. Besides, the installment of more cooperative businesses could possibly assist in the inequality gaps that are occurring in the community, which could lead to opportunities for food sovereignty and security.

The implementation of such strategies

would help organize the community’s goals and ideas as well as attach a personal tie to it. Given that, at present, much of the community’s work already impacts their daily lives within the Grove, a self-help and self-responsible model similar to a cooperative business—characterized by a well-structured work environment and an organized business— would benefit the individuals of the Grove.

This would also increase the number of job opportunities present in the community.

Lastly, to repair the system of inequality that is occurring within the Grove community, taking action toward taming capitalism could be beneficial. This strategy's primary target of dismantling and evolving the social structures that uphold our current system of inequality would allow for the neutralization of harms toward those impacted by it.

Alternatively, attempting to erode capitalism would strengthen the goals and values of the systems that apply to the Grove as opposed to capitalism. Through breaking the cycle of insecurity into which the Grove falls, there could arise many positive outcomes.

Currently, when capitalism/racism/patriarchy as a system of oppression sit at the top and control, they create incentives for dominant groups to reproduce the system. This leads to the formation of capitalist/racist/patriarchal states that implement policies that promote industrial agriculture systems and disproportionately benefit White men, causing an accumulation function that facilitates profit-making disproportionately for White men. This legitimates a social function that concedes in order to ensure political stability and reproduce discourses, as well as includes racialized gender identities to legitimate inequalities.

This leads to a multitude of issues such as the overrepresentation of racial minorities in undervalued food work communities. A division in this cycle could prevent and avoid these subsequent steps, which could provide reasonable and useful outcomes for the Grove.

REFERENCES Harvey, David. 2001. “Globalization and the ‘Spatial Fix.’” Geographische Revue 2:23-30.

U.S. Census Bureau. 2021. "SNAP Benefits Recipients in James City County, VA." Retrieved Jan. 1, 2021 (https://fred.stlouisfed. org/series/CBR51095VAA647NCEN).

Wood, Spencer D. and Cheryl R. Ragar. 2012.

“Grass Tops Democracy: Institutional Discrimination in the Civil Rights Violations of Black Farmers.” The Journal of Pan-African Studies 5(6):16-36.

Social Medusa: Effects of Social Networking Sites and Privacy Settings on Psychological Well-Being Matt Wright Social media is an umbrella term for intic connections serve different purposes and have ternet-based platforms used for mass comdifferent functions, and thus likely impact users munication, in which users can generate differently than friendship SNSs. Additionally, and share their own content (Alhabash & SNSs differ from websites like blogs, which ofMa, 2017). The dominant use of social meten act like an online diary for users, and mobile dia is social communication (Kraut et al. messengers, designed specifically for one-to-one 1998). Users often perceive communication or small-group communication (Chae 2018). via social media as immediate and intimate, For the purposes of this study, I focus on SNSs mimicking face-to-face social presence (Gudesigned for friendly rather than romantic connawardena 1995). Sharing photos, thoughts, nection or other social websites like blogs. opinions, and jokes are a popular function My research question focuses on the difof social media, and the most prominent ferences between public and private social motives for sharing on social media sites networking usage and the nuanced effects the include creating and maintaining relationtwo may have on users. I predicted that usships, presenting oneself in a certain way, ing social networking sites would negatively and expressing oneself creatively (Goh et impact users’ psychological well-being, espeal. 2008). Self-presentation on social media cially when using public accounts. However, often skews from reality, though, as people not much research exists that focuses on the have more time to cultivate the online image effects of privacy settings on online behavior, they want to portray (Chae 2018). Photos are SNSs, or well-being. Therefore, a majority of the most common means of sharing (Goh et this essay will examine broad effects of soal. 2008), likely because images rapidly concial media, with the inclusion of my minimal vey settings and feelings (Goh, Tan, and Park findings on privacy settings effects. I choose 2009) and facilitate social presence (Sundar, to focus attention toward social media’s most 2008); self-presentation via photos, although prominent audiences: adolescents and young portraying a person as somewhat different adults, ages ranging from 13 to 29 (Pew Refrom reality (Mayo Clinic 2019), is perceived search Center 2019). Young people spend as more realistic by other users because peo54% of their time online using social media ple trust visual portrayals more than text de(Thompson and Lougheed 2012), so examscriptions (Sundar 2008). ining the effects of social networking behavA social networking site (SNS) is a subiors may have significant implications for domain of social media, utilizing features adolescent and young adult mental health. like uniquely identifiable profiles, the ability I also choose to focus on this demographic to publicly display one’s connections, and the to examine the potential influences on adoability to interact with other users through lescents’ development and future adult lives. the creation and consumption of text posts, I examine social media effects through the status updates, and photos (Ellison and Boyd lenses of Facebook, Instagram, and Twitter, 2013). Hashtags exist on most SNSs and allow given the three platforms' vast popularity and users to search for posts associated with key easily examinable functions. Instagram is a words or phrases photo-based SNS, (Sheldon and BryTwitter is a textMy research reveals how social netant 2016). A differbased SNS, and ence exists between Facebook encourworking behaviors influence mental SNSs for romance ages use of both (e.g., Tinder, Match. well-being, especially for young people. photo and text com) and SNSs for sharing, making Readers may closely analyze their friendly connection it a hybrid pho(e.g., Facebook, Into- and text-based own social media behaviors and make stagram) (ValkenSNS; because these burg, Peter, and changes in order to maximize the bene- three cover the Schouten 2006). main categories of SNSs designed for social networking fits of using social networking sites. establishing romansites, research on

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these platforms may generalize to similar sites.

Snapchat and YouTube are two other popular social media sites, especially among young people, but I decided against studying them because of their unique functions compared to most other SNSs—Snapchat users mostly send photos to one another that quickly disappear and YouTube’s focus remains on video production.

My research reveals how social networking behaviors influence mental well-being, especially for young people. Readers may closely analyze their own social media behaviors and make changes in order to maximize the benefits of using social networking sites.

Additionally, readers may learn how to identify certain mental health red flags in themselves and others, based on online behavior, so they can intervene and support themselves or others if necessary.

SNSs are likely very popular because they satisfy the basic human need for interpersonal closeness (Sheldon, Abad, and Hinsch 2011) and self-presentation (Nadkarnia and Hoffman 2012). Social networking sites are useful for spreading information (Oh and Syn 2015), providing relaxed entertainment, nurturing pre-existing relationships and establishing new ones, voicing opinions, exploring identities, escaping problems, and procrastinating (Shukla 2019). Interestingly, people low in self-esteem and high in narcissism and loneliness are more likely to use SNSs (Shukla 2019).

Social networking sites may seem more attractive to teens and young adults because of their bonding capabilities and usefulness in connecting students to extracurricular activities and communities (Gray et al. 2013).

Among teens and young adults, the most common uses for SNSs include socialization and finding support through groups (Hurley 2019). Additionally, SNSs facilitate self-expression and supply motivational content (Berry et al. 2017).

based posts, individual photos and videos, or captioned photos. Text-based platforms lack the intimacy provided by photo-based ones, which can simulate face-to-face intimacy; however, text-based sites provide immediacy in responses and reactions (Pittman and Reich 2016).

The two main motivators across all three platforms, aside from social interaction and connection, are entertainment and convenience (Alhabash and Ma 2017). The primary motivators of using Instagram—apart from social communication—are to document experiences, gain knowledge about others, establish a cool or admirable presentation of the self, and creatively express oneself (Alhabash and Ma 2017; Sheldon and Bryant,2016). Twitter is used more for communicating about sports, news, and politics, as opposed to self-presentation (Ausserhofer and Maireder 2013; Chen 2011). Compared to the previous two platforms, Facebook use is more motivated by information sharing, but less motivated by entertainment (Alhabash and Ma 2017; Rae and Lonborg, 2015). Fear of disconnection also motivates Facebook use (Lup, Trub, and Rosenthal 2015). On Facebook, users become friends only if one user sends a friend request to another and the second user accepts; however, on Twitter and Instagram, it is possible to follow a user without that user reciprocating (Lup et al. 2015).

The three platforms also differ in subtler ways. Instagram likely contains more positively skewed content than Facebook or Twitter because of filters and editing apps that enable people to polish their photos before posting (De Vries et al. 2018). Narcissists are more likely to use Instagram as well (Sheldon and Bryant 2016). Twitter draws in more men than women, the only platform of the three to do so (Pew Research Center 2019). Facebook users likely feel more satisfied with their lives (Sheldon and Bryant 2016). Additionally, extroverted individuals low in conscientiousness are more likely to be drawn toward Facebook (Manago and Vaughn 2015).

THE THREE PLATFORMS Instagram, Twitter, and Facebook—the three platforms many social media studies examine—inherently differ in format. Instagram, an image-based platform, allows users to post captioned photos and videos.

However, users must upload a photo in order to post at all. Filters may be applied to photos to enhance image quality or tint the photo. Instagram is, as of recently, the fastest growing SNS (Sheldon and Bryant 2016).

Twitter similarly allows users to post photos and videos, but most user-generated content consists of “tweets” of 280 characters or less, thus making Twitter a text-based platform (Chen 2011). Facebook serves as a hybrid of the two, allowing users to create purely text-

PRIVACY CONCERNS Anatoliy Gruzd (2018) identifies two main concerns social media users express in regard to their privacy on SNSs. The first category of worry pertains to the social media platforms misusing personal information, collecting data, granting unauthorized use of information to a third party, or generating errors of accurate personal information; these are referred to as institutional threats to privacy. The second category, referred to as social threats, involve other users misusing one’s personal information or posting embarrassing content attacking someone. Users who feel concerned about social threats to their privacy over SNSs will not become less active on social media but will reduce the amount

SOCIAL NETWORKING SITES

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of accurate information they post about themselves (Gruzd 2018).

This essay will moderately discuss the differences between public and private SNS use.

Public social network usage encapsulates any form of social networking in which the user does not limit who can view their content (Sanders 2019). People typically present positive aspects of themselves on public accounts (Lin and Utz 2015). A potential benefit of public social media use is the ability to easily find and follow other users (De Beule 2014).

Private social media is defined as “any social space allowing users to choose exactly who they want to communicate with, without sharing info in a public forum” (Sanders 2019). Generally, users keep the number of followers on a private account purposefully low to ensure only friends can see the posted personal photos or stories and to prevent cyberbullying or blackmail (Safronova 2015).

Rob Sanders (2019) describes the private SNS environment as intimate and comfortable. Additionally, users of private accounts typically reach out and follow others to alert them of their private account’s presence, as opposed to public accounts, which are usually easily discoverable (Safronova 2015).

DEMOGRAPHICS OF SNS USERS Social media usage has increased rapidly since the early 2000s, with the number of American social media users growing from five percent in 2005 to 72% in 2019 (Pew Research Center 2019). However, the number of social media users has remained mostly stagnant since 2016 (Perrin and Anderson 2019), with posting frequency on all platforms having decreased across the past few years (Feehan, 2020). Women use social media consistently more than men, with 78% of U.S. women using at least one site compared to the 65% of U.S. men (Pew Research Center 2019).

Approximately 69% of all U.S. adults use Facebook (Pew Research Center 2019), with around 74% of U.S. adults logging onto Facebook at least once a day (Gramlich 2019). Thirty-seven percent of all Americans use Instagram (Pew Research Center 2019).

Across the world, approximately 63% of Instagram users log on to the platform daily.

Twenty-two percent of Americans use Twitter, and 42% of users log on daily.

As of 2019, approximately 90% of 18- to 29-year-old Americans use at least one SNS (Pew Research Center 2019), with 97% of teens aged 13 through 17 claiming to use at least one as well (Mayo Clinic 2019). Approximately 51% of U.S. 13- through 17-year-olds use Facebook, compared to the 72% of the same demographic using Instagram and 32% using Twitter (Chen 2020). Teens aged 13 through 17 shape the largest population on Instagram, while the same demographic compose the second largest age group on Twitter (Chen 2020).

Forty-five percent of American teens

aged 13 through 17 believe that social media does not have any significant positive or negative effects on people their age (Anderson and Jiang 2018). Of the 31% that believe social media use has a positive impact on teens, connectivity, access to information, self-expression, and entertainment are listed as the primary positive influences; the 24% that believe social media has a negative effect on teens report cyberbullying, time consumption, less meaningful interactions, peer pressure, and unrealistic views of others’ lives as the main drawbacks (Anderson and Jiang 2018). Older Internet users are more likely to view the Internet as negative for society in comparison to younger users (Vogels 2019).

About 45% of Americans have all of their social media accounts set to private, whereas 19% of Americans have no social media accounts set to private (Clement 2018). Thirty-six percent of participants in a global survey felt they have no choice in how apps use their data (Benes 2018), with 71% of U.S. residents concerned with how specifically their data may be collected (ExpressVPN 2019).

This study focuses on media effects on teens and young adults because of the developmental vulnerability teens face throughout adolescence, increasing their susceptibility to maladaptive behaviors (Kelly et al. 2019).

Additionally, teens are notoriously impulsive, leading them to potentially post inappropriate or uncomfortably intimate photos and stories (Mayo Clinic 2019). If harmful behaviors and media effects toward youth can be identified, perhaps young people may live psychologically sounder lives.

MEASURING WELL-BEING Norman M. Bradburn (1969) suggests measuring mental well-being using positive/negative affect scales, but more recent research describes this method as outdated. Morton Beiser (1974) thinks of mental well-being as equivalent to the question, “Considering everything in your life right now, would you say you’re happy?” Other psychologists think of psychological well-being as equating to happiness or subjective well-being (Chae 2018), so I may use the three terms interchangeably.

Regardless, subjective well-being is crucial to genuine psychological well-being (Seabrook et al. 2016).

According to Carol D. Ryff (1989), psychological well-being has six dimensions: self-acceptance, positive relations with others, autonomy (including an internal search for approval), environmental mastery (including taking advantage of opportunities), purpose in life, and personal growth. Typically, a person’s psychological well-being is measured through an itemized questionnaire surveying the above qualities, though some people equate psychological well-being with

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self-esteem, depression, anxiety, loneliness, social support, or satisfaction with life (Hunt et al. 1989). I will place extra emphasis on examining the social connection aspect of psychological well-being, given social networking sites’ primary purpose of connection and the fact that strong social ties – “positive relations with others” – lower the risk of mental illness and increase the likelihood of healthy behaviors (Shakya and Christakis 2017).

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EFFECTS OF SOCIAL NETWORKING Historically, there have been mixed findings on how social media affects users (Appel, Gerlach, and Crusius 2016; De Vries et al.

2018; Rae and Lonborg 2015; Seabrook et al. 2016). Part of the uncertainty stems from researchers’ inability to determine whether social media affects users’ mental health or if mental health affects social media behaviors (Coyne et al. 2020; Rae and Lonborg 2015). As an illustration of the latter concept, Heather Cleland Woods and Holly Scott (2016) find that lower self-esteem may be associated with increased SNS use because users low in self-esteem spend more time viewing others’ carefully constructed profiles.

Generally, socially anxious people like to use SNSs because it allows them to avoid face-toface encounters (Pierce 2009; Seabrook et al.

2016; Shaw et al. 2015), minimizes the fear of negative evaluation (Caplan 2006), and provides a sense of control to users (Pierce 2009).

Anxious users often provide more information about themselves on their profiles so to not talk directly with someone about themselves (Fernandez, Levinson, and Rodebaugh 2012; Seabrook et al. 2016). More identifying items in a user’s biography—a brief summary or description of one’s life, immediately seen upon clicking a user’s profile – is correlated with depression as well as social anxiety (Seabrook et al. 2016). It may be possible to discern someone’s mental health state based on their social media behavior; for example, depressed SNS users express negative affect more frequently, use more personal pronouns, interact less with others, are more active online at night, post less, and receive less likes, comments, and reposts or shares (Seabrook et al. 2016). Finally, depressed people may turn to digital communication to avoid face-to-face encounters, but this only perpetuates social isolation and worsens depressive symptoms (Kumar 2014). More depressed users use SNSs for longer, but researchers believe this extended use worsens their depression (Yoo and Jeong 2017).

A combination of the two concepts mentioned above—mental well-being influencing SNS use plus SNS use influencing mental well-being—could exist. Elizabeth M. Seabrook et al. (2016) suggest that self-esteem moderates both how a person uses and how he is affected by social media. One group of researchers, however, reveal that psychological well-being at baseline does not

consistently predict social media use (Hunt et al. 2018). Others report that neither affect nor worry predicts social media behaviors, so the researchers infer that SNS usage likely influences mental well-being and not vice versa (Kross et al. 2013). Overall, media effects research has been scattered in terms of results. Hurley (2019) attributes the mixed results to social media’s constant evolution.

Additionally, the researcher writes that most media effects studies are rather small, causing them to not have easily generalizable outcomes. Examining social media usage and behaviors is also difficult because asking users to self-report their behaviors may generate untrue data and observing online behaviors in an experimental setting may alter natural behaviors (Berry et al. 2018; Turner and Lefevre 2017). Others attribute the lack of concrete answers in the field toward the limited amount of experimental studies, with most existing research having a correlational nature (Hoge, Bickham, and Cantor 2017; Hunt et al., 2018; Shukla 2019). The information presented in this paper is mostly derived from recently published sources, in hopes to uncover current and solid answers.

GENERAL EFFECTS ON MOOD AND PSYCHOLOGICAL WELL-BEING Commonly cited positive social media behaviors include integrating with like-minded groups, discovering healthy lifestyles, maintaining and building relationships, seeking entertainment, producing creative content, and exposing oneself to differing opinions (Naruse 2017; Robinson et al. 2019; Shukla 2019). On the other hand, examples of detrimental behavior include social comparisons, social media addiction, and sharing inappropriate content like lewd photos (Robinson et al. 2019; Shukla 2019).

Increased SNS use is correlated with lower levels of loneliness and greater feelings of belonging, social capital, social support (Burke et al. 2009; Lup et al. 2015), life satisfaction, and self-esteem (Hawi and Rupert 2016; Seabrook et al. 2016). However, those who use only a moderate amount of social media have a much more positive social outlook than peers (Hawi and Rupert 2016).

Greater levels of social support act as a buffer to depressive symptoms, potentially because it encourages people to express themselves (Seabrook et al. 2016); this may be exemplified in how larger numbers of Facebook friends are negatively associated with loneliness (Rae and Lonborg 2015). Using an experience sampling method, in which researchers sent surveys to participants at regular intervals across a period of time, Ethan Kross et al. (2013) find that direct social network interactions likely lead people to feel better over time. Intensity of Facebook us—ein other words, investment in Facebook—has a positive association with life satisfaction (Ellison et al. 2007), and more time spent

on Facebook is positively associated with self-esteem (Gentile et al. 2012); however, increased frequency of checking Facebook is linked with worsened self-esteem (Mehdizadeh 2010). The type of content consumed may also influence well-being: Natalie Berry et al. (2018) report that viewing content like business advertisements is associated with worsened affect in comparison to consuming status updates from other users.

Others report that increased SNS use is negatively associated with positive affect, life satisfaction (Seabrook et al. 2016), perceived social support, self-esteem, and overall well-being (Hunt et al. 2018). Berry et al.

(2018) have also shown that social media use predicts reduced positive affect and increased negative affect in users, though usage does not predict self-esteem or paranoia. Content production (i.e., posting) and online interaction are correlated with depressive symptoms (Berry et al. 2018; Seabrook et al. 2016). Additionally, teens more likely feel anxiety after extended SNS usage (Pantic 2014; Vannucci, Flannery, and Ohannessian 2017). A potential cause of this may involve SNS use increasing exposure to negative social interactions like cyberbullying, which subsequently impacts psychological well-being and mood (Seabrook et al. 2016). Increased internet use in general is correlated with decreased social involvement, measured by communication within nearby or local social networks, and increased loneliness (Kraut et al. 1998). Additional effects of general internet use include greater depressive symptoms, possible social overload, and stress (Lup et al. 2015). Robert E. Kraut et al. (1998) assumes causation in their study, and they conclude that internet use adversely affects psychological well-being; the authors reason that internet use displaces social activity and encourages social withdrawal. In other words, users substitute strong in-person social ties with weak online bonds. Online relationships are generally feeble because such friends are less reliable for help, not encountered in a day-to-day environment, and are difficult to hold discussions with. Social media in general may contribute to mental illness because of the increased potential for miscommunication, unrealistic expectations, and social isolation (Seabrook et al. 2016). Merely spending time online, in and of itself, does not have consistent effects on overall well-being, however (Bessière et al.

2008).

IMAGE- AND TEXT-BASED PLATFORMS Image- and text-based social media platforms likely differ in their effects on users (Pittman & Reich 2016). Loneliness may decrease and happiness and life satisfaction may increase after using photo-based social media like Instagram; this is likely due to images’ power to imitate social presence or to convince someone they are communicating with actual

humans as opposed to computers or objects (Pittman and Reich 2016; Sundar 2008).

Text-based platforms like Twitter often center around disseminating news, information, opinions, or alleviating boredom, offering insight as to why text-based sites have no significant relationship with changes in psychological well-being (Pittman and Reich 2016).

One study shows that using Facebook evokes a flow state, characterized by improved mood and arousal (Mauri et al. 2011).

Facebook use has a correlation with a higher body mass index, which itself may influence self-esteem and psychological well-being (Shakya and Christakis 2017). Those who do not use Facebook for one week (i.e., they took a week-long break) show higher levels of both life satisfaction and positive mood compared to those who continue to use Facebook (Tromholt 2016). These effects are greater for heavy Facebook users, passive users (i.e. users who do not interact with posts by liking, commenting, or sharing them), and users who tend to envy others.

Instagram use is associated with lower levels of loneliness only for those with lower levels of social comparison orientation (Yang 2016). People more self-conscious about their physical characteristics post more photos on social media (Shim, Lee, and Park 2008), pointing toward those high in self-consciousness of overt characteristics being more likely to use photo-based platforms like Instagram.

A significant relationship exists between symptoms of orthorexia nervosa – an eating disorder involving obsessive healthy eating – and Instagram use, though no other SNS has this same effect (Turner and Lefevre 2017).

MOTIVES Motives for using SNSs, paired with subsequent usage, may influence psychological well-being (Bessière et al. 2008). Katherine Bessière et al. (2008) find that those who use the Internet for entertainment, acquiring knowledge, and escape demonstrate no difference in well-being, while those using the Internet to communicate with friends and family experience improved psychological well-being. The amount of time spent on Facebook is positively associated with psychological well-being among those that access Facebook for friendship purposes, but the two are negatively associated for those that use Facebook to make new friends (Rae and Lonborg 2015; Seabrook et al. 2016); this is consistent with research that reveals how incoming college students that use Facebook to create new connections report higher levels of loneliness than students that utilize in-person interaction (Rae and Lonborg 2015). Using Facebook for friendship purposes, paired with increased number of online friends, predicts higher levels of positive affect and life satisfaction (Rae and Lonborg 2015). Additionally, using social media to supplement existing friendships likely

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improves the quality and closeness of those friendships (Hoge et al. 2017). The number of genuine friendships and romantic connections formed through social networking sites does not affect adolescent self-esteem; however, the quality of such relationships over social media may predict a person’s level of social adjustment (Valkenburg et al. 2006).

Users who spend excessive amounts of time on their partners’ profiles experience feelings of jealousy (Lup et al. 2015) and those who accept friend or follow requests from an ex-partner experience more intense anxiety (Seabrook et al. 2016). The number of Facebook friends predicts lower levels of depression, though this may not generalize to Instagram and Twitter because of the latter two platforms’ ability for users to follow someone without the other user following them back (Rae and Lonborg 2015).

Should users post more frequent status updates, they may experience diminished mental well-being (Shakya and Christakis 2017). Ruminating on and venting one’s emotions, like through status updates, bring undesirable thoughts to the front of the mind, perpetuating a negative mood (Berry et al. 2018). However, intentionally sharing one’s emotions during stressful periods helps decrease depressive symptoms (Zhang 2017).

Posting about daily activities is associated with improvements in affect and self-esteem (Berry et al. 2018). Intentions to consistently and frequently blog on SNSs lead to higher depression and anxiety ratings (Seabrook et al., 2016). Using social media for the purpose of distracting oneself from their anxiety or stress can create a reinforcing cycle that teaches the user to avoid their emotions, subsequently worsening their symptoms and severity of anxiety (Erwin et al. 2004).

Social support from other users, either through likes, comments, messages, or shares, can influence self-esteem and selfworth (Sheldon and Bryant 2016), possibly outlining another motive for SNS use (Burrow and Rainone 2017). Further supporting this notion is the fact that receiving likes on a post activates the reward center in the brain (Hurley 2019), implying that receiving likes may be a form of reinforcement (Sherman et al. 2018). In this regard, a cyclical response-reinforcement chain may occur, causing people to post more in hopes of receiving positive attention in the form of likes (Burrow and Rainone 2017; Sherman et al.

2018). Even just viewing a highly liked photo activates regions in reward processing (Sherman et al. 2016), potentially urging users to imitate well-liked accounts (Burrow and Rainone 2017).

The more a user shares media posts, the more positive emotions are experienced by the sender and receiver (Goh et al. 2008).

Using websites to share memes facilitates discussions among groups, helping group members express their opinions and emotions, and

potentially helping them cope with burnout and stress (Drury 2019). Depressed people find memes joking about depression more funny than neutral memes, leading to improved mood (Akram et al. 2020), indicating a potential applicability for this effect to other mental illnesses. Sharing cute content, such as photos of small animals, can make senders and recipients feel good and may improve both parties’ psychological well-being (Bushman 2002).

SLEEP A commonly reported effect of social media use is poor sleep duration and quality (Coyne et al. 2020; Hurley 2019; Mayo Clinic 2019; Viner et al. 2019), with increased time spent on social media having an association with worse sleep health (Garmy, Nyberg, and Jakobsson 2012; LeBourgeois et al. 2017).

Better sleep patterns have an association with better psychological well-being (LeBourgeois et al. 2017; Woods and Scott 2016), so reducing SNS use – especially at night – may allow for sounder sleep and improved happiness. Social media use may result in inadequate sleep because the time a person spends on social media displaces the time a person would normally spend sleeping, engaging in physical activity (Cain and Gradisar 2010), or participating in face-to-face interaction (Coyne et al. 2020; LeBourgeois et al. 2017).

Screen use stimulates users’ minds and interferes with melatonin production (Cain and Gradisar 2010), subsequently affecting users’ circadian rhythms; this, in turn, delays bedtimes and contributes to poor sleep (Garmy et al. 2012; LeBourgeois et al. 2017).

Sara Thomée et al. (2010) suggest that a fear of missing out (“FOMO”) on social interaction, having fun, or keeping up-to-date with information and friends causes young people to lose sleep, as they are more likely to experience FOMO than older folk.

FOMO predicts more SNS usage (Hunt et al. 2018), potentially causing users to stay awake until later times, subsequently worsening sleep (LeBourgeois et al., 2017). SNSs create a unique social pressure for users to be consistently available in order to respond to messages and other relevant content rapidly (Thomée, Härenstam, and Hagberg 2011).

Researchers find that young people may feel guilt, stress, and anxiety when they have restricted access to social media, keeping them awake or causing them to avoid putting their phones down (Thomée et al. 2010). Other researchers report that phone notifications from social media alerts keep people awake at night (Woods and Scott 2016).

Eighty-six percent of adolescents sleep with a cell phone in their bedroom (Lenhart, Ling, Campbell, and Purcell, 2010) and 60% claim to use screen media within one hour of bedtime (LeBourgeois et al. 2017).

Woods and Scott (2016) find that increased emotional investment in SNSs – more com-

mon for younger users – is associated with poorer sleep quality, increased anxiety and depression, and lower self-esteem. The same researchers speculate whether or not poor sleepers use social media as a sleep aid or distraction, rather than social media causing inadequate sleep, though most of the research presented indicates a potential causal relationship between SNS use and poor sleep.

EMOTIONAL CONTAGION Evidence points toward emotional contagion via social media existing, meaning happy posts, for example, influence others to generate happy content (Coviello et al. 2014).

Emilio Ferrara and Zeyao Yang (2015) find that those who view more negative posts on Twitter post more negative content themselves. The same effect occurrs on Facebook (Kramer, Guillory, and Hancock 2014), suggesting emotional contagion exists across most platforms, given Facebook’s dual functions of photo and text sharing that relate to both photo- and text-based platforms. However, Facebook has notably been found to contain mostly positive posts and emotions (Lin and Utz 2015). Jiyoung Chae (2018) suggests that people could feel happier after viewing positive photos in comparison to positive texts, pointing to Instagram’s superiority in bringing users happiness. Relationship closeness between viewer and poster moderates the relationship between the content within a post and emotional contagion (Lin and Utz 2015). This implies Facebook’s superiority in bringing user’s happiness, though, given Facebook’s requirement for friends to mutually friend each other; Facebook friends typically know each other more off-line than Instagram or Twitter users, who may oneway follow random people they admire or accounts that interest them. Contrary to the above research on emotional contagion, MaiLy Nguyen Steers, Robert E. Wickham, and Linda K. Acitelli (2014) report that viewing positive posts may lead users to experience envy and depressive symptoms, though this may be dependent on one’s social comparison orientation.

SOCIAL COMPARISON People engage in social comparison whenever they are presented with information about others (Mussweiler, Corcoran, and Epstude 2005). Comparison information is much more available and salient via photos, posts, and profile descriptions (or “bios”), potentially causing users to more critically compare themselves after spending time online (Haferkamp & Krämer 2010). Frequency of social comparison has a negative correlation with happiness (Chae 2018) and satisfaction with life (Krasnova et al. 2013).

On photo-based platforms, like Instagram, users tend to engage in upward social comparison, meaning they focus on how much better the target of comparison

seems than themselves (Johnson and Knobloch-Westerwick 2016). Engaging in upward comparison often can result in negative thoughts about oneself (Appel et al. 2016), but it may improve mood when focusing on others’ career success (Johnson and Knobloch-Westerwick 2016). Additionally, comparing one’s opinions to another person’s opinions may improve mental well-being (Shukla 2019). Partaking in positive social comparison behaviors often leads to the lightening of depressive symptoms (Lup et al. 2015). Seeing profiles perceived as more popular, though, may cause users to evaluate themselves lower (Vogel et al. 2014).

Negative social comparisons are the root of envy (Appel et al. 2016). Women high in appearance comparison tendency report more dissatisfaction in their appearance after using a social networking site than after using a control website (Fardouly et al. 2015).

Should someone ruminate on their inferiority following a downward social comparison, she will likely feel increased stress (Feinstein et al. 2013).

Facebook use encourages negative social comparisons and envy, which may lead to a depressive mood (Appel et al. 2016). However, social comparison orientation plays a large role in whether or not someone engages in comparison on social media (Lee 2014). Instagram use has a positive correlation with frequency of social comparison, likely because vivid media (e.g. photos) appear less vague and thus cause people to not idealize the target of comparison (Chae 2018). In other words, images seem more real or genuine to life compared to text descriptions (Sundar 2008), encouraging users to compare themselves with seemingly real people that exist on the opposite side of the screen. Comparisons on photo-based SNSs like Instagram may bring about more negative emotions than on Facebook or Twitter because the self-presentations of the comparison targets seem more realistic or true, despite the numerous filters and edits that may be applied to pictures (Chae 2018). Twitter use, on the other hand, is negatively associated with the frequency of social comparisons, possibly because Twitter facilitates news and information more than self-presentation (Chae 2018).

SOCIAL CAPITAL AND OVERLOAD Social capital is gained through online interactions between social media users (Yoo and Jeong 2017). For those with higher social capital, more time spent using SNSs has an association with decreased loneliness and stronger social ties, which in turn improves satisfaction with life. However, for those with lower social capital, increased usage of SNSs is associated with more depressive symptoms (Yoo and Jeong, 2017).

The number of contacts a person has on social media positively predicts overall life happiness (Chae 2018). However, such an

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extensive network may contribute to social overload (Maier et al. 2012). Social networking sites may cause social overload due to continued stress and emotional fatigue from reading about others’ lives and their calls for help or attention, possibly because people frequently feel the need to acknowledge others’ posts through likes, shares, or reactions (Maier et al. 2012). In other words, users may feel like they are stretching themselves too thin in terms of the number of online friendships they feel obligated to maintain.

ACTIVE VS. PASSIVE USE Within the social networking realm, “active use” signifies involved online behavior like directed communication, which refers to interactions on the site between two users; example behaviors include direct messaging and tagging a user in a photo, which prompts viewers to click on the tagged user’s profile (Burke, Marlow, and Lento 2009; Shaw et al. 2015). Directed communication leads to the accumulation of social capital (Burke et al., 2009) and reduced loneliness (Shaw et al. 2015). Active social media use can improve users’ mood because of the likelihood of building social capital or connectedness ADOLESCENTS AND YOUNG ADULTS (Verduyn et al. 2017). When users post daily Across an eight-year longitudinal study spanstatus updates for a week, they report reduced ning adolescents’ growth into adulthood, reloneliness because of their stronger feelings searchers find that more time spent on social of connection experienced on a daily basis media is not associated with increased mental (Deters & Mehl, 2013). These feelings of inhealth issues (Coyne et al. 2020). However, creased connection are independent of direct one study suggests otherwise; Woods and social feedback from friends and followers.

Scott (2016) report that adolescents who Greater time spent spent more time interacting with online and using other SNS users SNSs experience Social capital is gained through online online is correlathigher levels of ed with boosted interactions between social media users depression and confidence in fuanxiety. . . . For those with higher social capital, ture in-person enStudents who counters (Erwin browse Facebook more time spent using SNSs has an while studying or et al. 2004). César G. Escobar-Viera schoolwork association with decreased loneliness doing et al. (2018), howperform signifiever, show that and stronger social ties, which in turn cantly worse acactive use has no ademically than improves satisfaction with life. Howev- students who do significant direct association with use Facebook er, for those with lower social capital, not mental well-being. while studying Passive SNS (Junco & Cotincreased usage of SNSs is associated use refers to the ten 2012). Poor with more depressive symptoms. consumption of academic perforcontent (e.g. viewmance, in turn, ing photos or stamay hurt a stutus updates) without liking, commenting, dent’s ego and self-esteem. Social media plator posting anything (Shaw et al. 2015). The forms may help college students – specifically commonly used internet term “lurking” refirst-generation and minority students – adfers to passive use (Shukla, 2019). Passive use just better to university life; minority groups occurs more frequently than active use on likely adjust better because SNSs facilitate SNSs (Escobar-Viera et al. 2018), although their search for groups and belongingness it may cause users to feel less happy through (Gray et al. 2013). Participation within comincreased social comparison and envy (Vermunities, even online, is linked to improved duyn et al., 2017). Aditya Shukla (2019) finds subjective well-being (Shukla 2019). Intera connection linking FOMO and social comacting with online groups may cause memparison to passive use and negative self-perbers to imitate the behaviors of one another

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ceptions, explaining that passive use may encourage us to compare ourselves to others’ carefully crafted images. Increased passive use has a positive correlation with loneliness (Shaw et al. 2015), depression (Shukla 2019; Escobar-Viera et al. 2018), anxiety, and, should a person passively view another profile for an extended period of time, passive use may make users more socially anxious during future in-person encounters (Rauch et al. 2014). “Lurkers” also likely have low self-esteem (Shukla, 2019). Passive use by women has a stronger correlation with worsened mental well-being than it does for men (Shukla, 2019), potentially because women face more harassment online and thus experience increased harm to their body images and self-esteem (Kelly et al. 2019).

Contrary to the effects outlined above, one study demonstrates that lower levels of envy at baseline result in passive use reducing depressive symptoms, indicating that envious feelings at the start of lurking on SNSs may cause users to feel more negative emotions (Seabrook et al. 2016).

(Kaakinen, et al. 2018), potentially solidifying group identities. One study shows that the number of perceived “actual” friends on Facebook does not predict social adjustment, but the number of Facebook friends that attend the same university as the user does predict adjustment (Gray et al. 2013). The extent to which students can access emotional and meaningful support through SNSs also predicts students’ ability to socially adjust to college as well as their satisfaction with their social lives (Gray et al. 2013).

PUBLIC SOCIAL NETWORKING EFFECTS When users own public social media accounts, they commonly present themselves as more attractive or ideal than they appear off-line (Chae, 2018), usually to avoid judgment from peers or employers (Duffy, 2017).

SNS users have a more negative body image of themselves after viewing beautiful profiles than users who saw less attractive profile pictures (Haferkamp & Krämer, 2010). Viewing beautiful profile photos may trigger adverse emotions (Lup et al., 2015). Commonly, users may follow celebrities on their public accounts; viewing celebrities’ accounts, which often contain pictures of them appearing happy and pretty, may cause viewers to attribute the happiness to personal characteristics instead of circumstance and thus viewers may judge themselves more harshly (Lup et al., 2015). A negative relationship exists between life satisfaction and using Instagram to appear cool (Sheldon & Bryant, 2016), which could be associated with public accounts, given the tendency for public users to present themselves in a better light than off-line life.

Public account users are more likely to follow strangers than private account users (Safronova, 2015). As the number of strangers followed increases, so do depressive symptoms (Seabrook et al., 2016). Among people high in social comparison orientation – meaning they are more likely to compare themselves to others – viewing strangers’ positive Instagram posts decreases positive affect; however, those low in social comparison orientation experience increased positive affect (De Vries et al., 2018). Lup et al. (2015) find that the number of strangers a user follows moderates the correlation between Instagram use and social comparison. Their findings imply that increased Instagram use generally has negative consequences for users who follow more strangers but positive consequences for those who follow fewer strangers. This is consistent with findings that Facebook users with more online friends that are strangers place increased emphasis on internal characteristics when viewing others’ profiles, leading to more frequent harmful social comparisons (Chou & Edge, 2012).

Defining social support as the number of friends and family within a one-hour drive,

Bessière et al. (2008) report that using the internet to meet new people predicts increases in depression among those with higher levels of social support but not for those with low social support. The researchers explain this effect may exist because using SNSs takes time away from maintaining preexisting friendships (Bessière et al., 2008). Meeting new people is more closely aligned with the functions of public social media, given the tendency for private accounts to only interact with pre-existing friends. Valkenburg et al. (2006) find that receiving positive feedback boosts adolescent self-esteem whereas negative feedback declines self-esteem when using public social media. Gruzd (2018) reports users self-disclose personal information about themselves on both public and private accounts, rather than sharing such information only with friends on private accounts; the researcher claims that people likely feel a sense of privacy despite their information being publicly available.

PRIVATE SOCIAL NETWORKING EFFECTS On Instagram, many young people own private accounts which they refer to as their “Finsta” – a portmanteau of “fake Instagram” (Duffy, 2017). Twitter users may possess a private account, but oftentimes choose to remain public, as two large appeals of Twitter include the ability to widely “retweet” (repost) another user’s tweet and the ability to comment under posts (De Beule, 2014). For Facebook, users can change the settings so that only certain people can see certain posts.

Private social media offers the unique ability for users to experiment with identity without much judgment from their followers (Safronova, 2015). Private accounts also offer users a space in which they may feel less pressured to present themselves in an unauthentic but attractive fashion (Safronova, 2015).

However, private use may still seem performative if users feel a pressure to act funny for their friends (Duffy, 2017). Users are more likely to post pictures involving alcohol, unattractive selfies, text message screen captures, memes, and embarrassing stories on private pages as well (Safronova, 2015).

Private accounts are often used to avoid judgement from peers or employers (Duffy, 2017). Despite private accounts being more useful for those who want to feel less connected (Sanders, 2019), private social media can also help establish quality one-on-one conversations (De Beule, 2014), which are associated with reduced loneliness and depression (Burke et al., 2009). An additional perk of using a private account is more immediate responses from friends (Safronova, 2015).

As mentioned in the “Social Comparison” section of this review, Haferkamp and Krämer (2010) report that social media encourages users to compare themselves to oth-

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ers, but Chae (2018) finds that when a user compares herself to a friend, the potential negative effects – envy (Appel et al., 2016), decreased happiness (Chae, 2018), and decreased satisfaction with life (Krasnova et al., 2013) – are less likely to linger over several months. Commonly, users with private accounts follow only their close friends (Safronova, 2015), indicating private accounts’ usefulness in avoiding long-lasting harmful social comparison behavior.

Throughout SNSs, venting and expressing genuine feelings – which occur more often on private, secure accounts than public ones – predict low positive affect and self-esteem, and high negative affect and paranoia (Berry et al., 2018). Berry et al. (2018) posits that users do not receive the support and reinforcing responses they hope for when posting about their feelings, partially causing the effects listed above. The idea by Berry et al. (2018) aligns with the findings that social attraction toward SNS users decrease after viewing posts from the user that are highly personal and contain negative self-disclosure (Orben & Dunbar, 2017). Forest & Wood (2012) similarly affirms the idea posited by Berry et al. (2018), demonstrating that negative online disclosures by individuals with low self-esteem receive undesirable responses because of the negativity expressed.

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DISCUSSION I would like to outline potential alterations in one’s social media usage, based on the research described above, in hopes that these suggested changes may improve one’s shortterm and long-term psychological well-being. To start, research on social media’s effects on sleep point toward notifications disrupting sleep; a simple yet occasionally overlooked solution is to turn all smartphone notifications off before bedtime (Woods and Scott 2016). Additionally, setting the phone down one hour before bedtime may result in healthier sleep.

Based on the research by Christian Maier et al. (2012) that details the potential for social overload due to reading emotionally heavy posts or feeling a pressure to interact with every post one scrolls by, perhaps SNS developers and programmers could implement an efficient way to filter what sort of content a user sees. This way, users can avoid viewing upsetting or emotionally draining content and can focus on interacting with their close friends, even if they only want to use public social media. Users themselves can minimize the possibility of social overload by carefully selecting who they follow and/ or cleansing the list of unfamiliar users they follow in order to reduce the number of posts he must scroll through (Maier et al. 2012).

The extensive research on social comparison behavior online describes comparison

behavior as inevitable. However, reminding oneself of her security in her appearance and/ or happiness may help counter any negative feelings experienced because of comparison.

If a user knows he has a high comparison orientation, he would do well to avoid social media altogether (Chae 2018). In other words, if a user frequently feels uncertain about himself and worried how others perceive him, he will likely struggle with social comparison online. If users struggle with comparison behavior, perhaps they should turn to Twitter to satisfy their want for social media, based on Instagram’s (Chae 2018) and Facebook’s (Appel et al. 2016) strong associations with comparison behavior. Or, if users wish to remain on more visual-based platforms, they could carefully choose to follow the accounts of less attractive users to avoid comparing themselves with exceptionally attractive people. Viewing one’s own SNS profile is associated with increased self-esteem (Gonzales and Hancock 2011), so perhaps forcing oneself to examine and admire one’s own account will counteract negative feelings from social comparison.

Orben and Dunbar (2017) highlight how negative self-disclosures online (e.g., venting about negative feelings) often lead viewers of such disclosure to lower their opinions of the poster and feel more negatively about them. Instead of fishing for sympathy online, people should talk to their friends directly.

Direct communication may hold friends more accountable by making them feel more responsible for another person’s happiness (Shaw et al. 2015).

Limiting social media use to 30 minutes a day can improve well-being by reducing depression, anxiety, loneliness, and FOMO, which should become apparent after a couple weeks of limitation (Shukla 2019). Restricting social media usage even more to 10 minutes per day per platform may have similar effects, though this technique will likely be more useful for those with higher baseline levels of depression (Hunt et al. 2018). The study that demonstrates this had participants experimentally limit their time spent on SNSs, possibly implying that merely being more aware of one’s social media usage may have an impact on feelings of depression and anxiety. Within the same study, student participants attribute their personal improvement in happiness to the decrease in comparison behavior (Hunt et al. 2018).

Mobile phone usage itself may increase depressive symptoms, so if someone plans to use social media, perhaps accessing his account through a computer may have less detrimental effects (Bickham, Hswen, and Rich 2015). Amy J. Morgan and Anthony F. Jorm (2008) advise SNS users to seek humor, peer connection, and a wide social network in order to reduce social media’s effects on functioning and well-being. Katie Hurley (2019) encourages parents to talk with their

children about appropriate online behaviors to steer adolescents and children in the right direction early in their development. Intervening early has significant long-term benefits (Kelly et al. 2019).

The studies outlined above are neither concrete nor exhaustive in their study of social media effects; some studies are rather short in duration and others contain small sample sizes, but they provide interesting insight at the very least. Future researchers may do well to expand the number of participants they use and the diversity of their samples (e.g., non-Westerners) to find more generalizable results. Increased longitudinal studies focusing on adolescent development will likely provide more concrete answers as to how social media affects teens and may reveal lingering or permanent effects. I also encourage future researchers to focus specifically on one social networking site to further examine the nuanced effects of each platform. Finally, I strongly hope that future research will provide specific answers to a question I minimally fleshed out: How do private and public social media usage differ in their effects on psychological well-being?

better than they do off-line. Choosing to use a private account over a public account will likely reduce the negative effects of general social media usage because of the closer friendships tied to private accounts. To maximize the benefits of social networking sites, focus on maintaining relationships and spreading happy news. Alternatively, deleting social media altogether may provide relief from the negative consequences of using social media, though the primary benefit of social networking sites – feelings of social connection – may suffer as a result.

REFERENCES Owing to the essay's extensive citations, a reference list can be viewed and downloaded online at the following permalink: https:// drive.google.com/file/d/1lJb8zy7ht_zePIHWK1xl-yUav1BsaA22/view?usp=sharing

CONCLUSION Social networking sites pervade everyday life for many adolescents and young adults.

Social media seems to have very little effect on psychological well-being across adolescent development, but smaller and more temporary consequences may arise. Increased social media use in general will likely alleviate loneliness but users may suffer a decrease in life satisfaction and overall well-being.

Passively scrolling through one’s feed likely has negative consequences for psychological well-being; engaging with other users, either through liking, commenting, sharing, or messaging, may alleviate such negative effects. Although causation cannot be confirmed, evidence suggests that using social media for the purpose of supplementing existing friendships will have psychological benefits, whereas using social media to make new friends may harm well-being. Posting too much and using social media near bedtime may have detrimental effects on mental health as well. Receiving likes and attention on social media may create a reward-reinforcement cycle, perpetuating users’ desire to accumulate likes and comments and potentially creating a reliance on social networking to feel satisfied. Increased SNS use, especially the use of photo-based sites like Instagram, increases frequency of social comparison which often results in negative feelings for the comparer. Those who primarily use public social media accounts may experience worsened self-esteem because of the uptick in social comparisons made against strangers, who come across as happier and all-around

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Op-Ed: Let’s Contextualize, Not Villainize, Vaccine Hesitancy Carlos Noel The COVID-19 vaccine has created hesitancy among marginalized populations. Instead of criticizing said individuals, we should work toward understanding and addressing why.

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“Grow the f*ck up and get the vaccine!” one healthcare professional exclaimed on the Jimmy Kimmel show. The two-minute video showed several US doctors sharply criticizing individuals that are hesitant about receiving the COVID-19 immunization (Nowthisnews 2021). While the physicians hoped to encourage herd immunity, this effort ultimately falls flat, lazily undermining the complexities of vaccine opposition.

The spread of misinformation has been a driving force in the current adverse reaction to vaccine science. While the growing momentum of anti-vax disinformation is a cause for concern, critics must be intentional in their response.

We must situate medical mistrust within the framework of American history. The stigmatization of hesitant individuals is an ineffective means of generating faith in empirical knowledge. Rather, this discourse marks an alienation of individuals within a misinformed movement that is linked to political, economic, and racial issues.

It is especially common among liberal circles, such as the group of physicians presented in the Jimmy Kimmel segment, to malign anti-vaxxers. These blanket condemnations lack context, however.

Mistrust within marginalized communities is a rational response in light of the sociocultural history of medicine in America.

Medical mistrust refers to a lack of faith in the motives of organizations and individuals within the healthcare context (LaVeist 2009). A 2007 study by Katrina Armstrong et al. highlights how medical mistrust disproportionately affects Black and Hispanic communities. Across surveys done in Boston, Las Vegas, and Philadelphia, Black and Hispanic people of low socioeconomic status (SES) demonstrated a 1-3% higher mean level of physician distrust compared to their white counterparts. This staggering disparity is no coincidence.

The intersection of mistrust and race connects to legacies of unethical medical experimentation. The 1932 Tuskegee Syphilis Study, for example, knowingly withheld treatment from 600 African American participants without their consent (CDC, 2020). Madrigal v Quilligan was a federal lawsuit during the late-1960s to mid-1970’s

that cites thousands of forced sterilizations of Puerto Rican, Native American, and African American women (Stern 2005). From these examples alone, medical mistrust is a product of the generational trauma tied to years of dehumanizing research.

This assertion is in no way meant to excuse the anti-vax movement. There is a unique dynamic within vaccine opposition that distinguishes those refusing vaccinations due to medical racism and those refusing vaccinations in order to disseminate propaganda. The London-based Center for Countering Digital Hate has shown how white anti-vaxxers often recognize medical mistrust in marginalized communities, utilizing it to amplify medical misinformation (Hotez 2021).

Hesitancy and anti-vax have distinct definitions. ‘Vaccine hesitancy’ is a product of sociocultural context from race to SES, while ‘anti-vax’ is an effort based on empirical inaccuracies exacerbated by extremist politics.

Simply condemning vaccine opposition altogether will not have the intended effect because the methods of combating these complex and separate phenomena are entangled.

Contextualizing vaccine hesitancy also involves addressing hesitancy. Indeed, highlighting the nuances of vaccine opposition is necessary for enhancing trust, ultimately saving lives. To criticize vaccine hesitancy on a micro level without underlining the historical backdrop that shapes said hesitancy is not only irresponsible, but also completely disregards the experiences of marginalized peoples. So, what must be done?

First, national authorities must make tangible efforts to address the structural drivers of vaccine disparities. On a federal level, plans that address the institutional issues creating barriers for Black and Brown communities must be implemented. This wide-scope approach involves significant changes across such factors as access, education, and health insurance. Equity underlies all these approaches: enacting policies that meet the needs of marginalized individuals.

On a local level, communities must work to create educational interventions that are tailored to marginalized groups. This means incorporating accessible knowledge—not

empirical jargon—to effectively communicate information related to vaccine efficacy.

Moreover, communities must create space for Black and Brown professionals to lead these initiatives. A study conducted at Stanford University demonstrates how Black families have improved health outcomes and trust when working with Black doctors (The Associated Press 2020).

And on a micro level, physicians must practice patience and empathy—not aggression or blame. The dismissible behavior displayed in the Jimmy Kimmel segment is only a microcosm of the concern of patientphysician interactions that defines modern healthcare. Doctors must put aside their pride, sit down with hesitant patients, and soothe their reasonable concerns with maturity.

Instead of demanding that individuals who have fallen victim to the faults of a disastrous and antagonistic system “grow the f*ck up,” action should be directed at said system and the dark histories that perpetuate valid fears. It is not only complacent, but violent to ridicule the symptoms of systemic racism without confronting their roots.

Politicians, community leaders, and even healthcare professionals must grow the f*ck up and take an active approach in the overdue healing of disenfranchised America.

REFERENCES Armstrong, Katrina, Karima L. Ravenell, Suzanne McMurphy, and Mary Putt. 2007.

“Racial/Ethnic Differences in Physician Distrust in the United States.” American Journal of Public Health 97(7): 12831289.

CDC. 2020. “U.S. Public Health Service Syphilis Study at Tuskegee.” Retrieved June 1, 2020 (www.cdc.gov/tuskegee/timeline. htm).

Hotez, Peter. 2021. “COVID Vaccines: Time to Confront Anti-Vax Aggression.” Nature News, April 27 (www.nature.com/articles/ d41586-021-01084-x).

LaVeist, Thomas A, Lydia A Isaac, and Karen Patricia Williams. 2009. “Mistrust of Health Care Organizations Is Associated with Underutilization of Health Services.”

Health Services Research 44(6): 20932105. nowthisnews. 2021. “‘Grow the f*ck up and get the vaccine’—These health care workers shared their honest thoughts about anti-vaxxers in this hilarious PSA on ‘Jimmy Kimmel Live!’” Twitter, May 6 (https:// twitter.com/nowthisnews/status/1390245 705432793089?s=21).

Stern, Alexandra Minna. 2005. “Sterilized in the Name of Public Health: Race, Immigration, and Reproductive Control in Modern California.” American Journal of Public Health 95(7): 1128-1138.

The Associated Press. 2020. “During Pandemic, Black Families Put Trust in Black Doc-

tors.” NBCNews.com, September 8 (www. nbcnews.com/news/nbcblk/during-pandemic-black-families-put-trust-black doctors-n1239505).

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