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Twitter Words May Predict A Region's Risk of Heart Disease

Twitter Words May Predict A Region’s Risk of Heart Disease

The belief that social media platforms would improve the assessment of a community’s health or well-being has been promised for years.

A new study suggests the prophecy may have been fulfilled as researchers at the University of Pennsylvania discover that Twitter can capture more information about heart disease risk than many traditional factors combined.

Previous studies have identified many factors that contribute to the risk of heart disease: traditional ones, like low income or smoking but also psychological ones, like stress.

Experts have long assumed that the psychological well-being of communities is important for physical health, but is hard to measure. Now, researchers believe Twitter can provide a window into a community’s collective mental state.

Investigators sifted through 148 million Tweets from 2009-2010, and compared language with county-by-county data from the CDC on heart disease death rates.

Researchers found that expressions of negative emotions such as anger, stress, and fatigue in a county’s tweets were associated with higher heart disease risk. On the other hand, positive emotions like excitement and optimism were associated with lower risk.

“In terms of psychological variables, the biggest thing we found that goes with higher heart disease is anger and hostility,” said Johannes Eichstaedt, lead author of the paper published in the journal Psychological Science.

Researchers believe analysis of tweets may be a useful tool in epidemiology and for measuring the effectiveness of public-health interventions, as the language used reflects the psychological states of communities.

With billions of users writing daily about their daily experiences, thoughts and feelings, the world of social media represents a new frontier for psychological research. Such data could be an invaluable public health tool if able to be tied to real-world outcomes.

With this in mind, the researchers have long been studying the degree to which the language people use online represents their inner thoughts and feelings.

As there is no way to directly measure peoples’ inner emotional lives, the team drew on traditions in psychological research that glean this information from the words people use when speaking or writing.

Earlier research from the group has shown that such linguistic analysis can work as well as traditional questionnaires in assessing an individual’s personality.

“Getting this data through surveys is expensive and time consuming, but, more important, you’re limited by the questions included on the survey,” Eichstaedt said.

“You’ll never get the psychological richness that comes with the infinite variables of what language people choose to use.”

Having seen correlations between language and emotional states, the researchers went on to see if they could show connections between those emotional states and physical outcomes rooted in them.

They had an ideal candidate in coronary heart disease, the leading cause of death worldwide.

“Psychological states have long been thought to have an effect on coronary heart disease,” said Margaret Kern, Ph.D., an assistant professor at the University of Melbourne, Australia.

“For example, hostility and depression have been linked with heart disease at the individual level through biological effects. But negative emotions can also trigger behavioral and social responses; you are also more likely to drink, eat poorly, and be isolated from other people which can indirectly lead to heart disease.”

As a common cause of early mortality, public health officials carefully count when heart disease is identified as the underlying cause on death certificates.

They also collect meticulous data about possible risk factors, such as rates of smoking, obesity, hypertension, and lack of exercise. This data is available on a county-by-county level in the United States, so the research team aimed to match this physical epidemiology with their digital Twitter version.

In the study, researchers reviewed a set of public tweets made between 2009 and 2010. Established emotional dictionaries, as well as automatically generated clusters of words reflecting behaviors and attitudes, were used to analyze a random sample of tweets from individuals who had made their locations available.

There were enough tweets and health data from about 1,300 counties, which contain 88 percent of the country’s population.

Investigators found that negative emotional language and topics, such as words like “hate” or expletives, remained strongly correlated with heart disease mortality, even after variables like income and education were taken into account.

Positive emotional language showed the opposite correlation, suggesting that optimism and positive experiences, words like “wonderful” or “friends,” may be protective against heart disease.

“The relationship between language and mortality is particularly surprising,” said H. Andrew Schwartz, Ph.D., a visiting assistant professor. He believes a choice of angry words is reflective of community stress since the people tweeting angry words and topics are in general not the ones dying of heart disease.

“But that means if many of your neighbors are angry, you are more likely to die of heart disease.”

This finding fits into existing sociological research that suggests that the combined characteristics of communities can be more predictive of physical health than the reports of any one individual.

“We believe that we are picking up more long-term characteristics of communities,” said Lyle Ungar, Ph.D., a Pennsylvania professor of computer and information science.

“The language may represent the ‘drying out of the wood’ rather than the ‘spark’ that immediately leads to mortality. We can’t predict the number of heart attacks a county will have in a given timeframe, but the language may reveal places to intervene.”

Other caveats to the method’s predictive power include the social factors that influence what kinds of messages people choose to share on Twitter.

“If everyone is a little more positive on Twitter than they are in real life, however, we would still see variation from location to location, which is what we’re most interested in,” Schwartz said.

This variation could be used to marshal evidence of the effectiveness of public-health interventions on the community level, rather than on an individual level. The team’s findings show that these tweets are aggregating information about people that can’t be readily accessed in other ways.

“Twitter seems to capture a lot of the same information that you get from health and demographic indicators,” said Gregory Park, Ph.D., a postdoctoral fellow in the Pennsylvania School of Arts and Science’s Department of Psychology.

“But it also adds something extra. So predictions from Twitter can actually be more accurate than using a set of traditional variables.”

Source: University of Pennsylvania

Twitter Words May Predict A Region’s Risk of Heart Disease

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Twitter Words May Predict A Region’s Risk of Heart Disease. Psych Central. Retrieved on October 28, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 22 Jan 2015)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.