The 2013 US Government Shutdown (#Shutdown) and Health: An Emerging Role for Social Media

摘要

In October 2013, multiple United States (US) federal health departments and agencies posted on Twitter, “We’re sorry, but we will not be tweeting or responding to @replies during the shutdown. We’ll be back as soon as possible!” These “last tweets” and the millions of responses they generated revealed social media’s role as a forum for sharing and discussing information rapidly. Social media are now among the few dominant communication channels used today. We used social media to characterize the public discourse and sentiment about the shutdown. The 2013 shutdown represented an opportunity to explore the role social media might play in events that could affect health. Behind the Super Bowl, the government shutdown was the second most talked about topic on Facebook in 2013. 1 The October 2013 government shutdown affected and furloughed millions of people in the Unites States, was the second longest shutdown since 1980, had a projected $2 billion to $6 billion lost in output, and stopped or reduced services provided by several departments and agencies that protect and promote health. 2 Nothing similar was observed during the 1995 to 1996 shutdown when the Internet was emerging as a social medium. The Centers for Disease Control and Prevention (CDC) surveillance support for infectious disease outbreaks (e.g., tuberculosis, hepatitis), annual flu monitoring programs, and vaccine campaigns was reduced. 2 Approval of medical products, devices, and drugs by the Food and Drug Administration was delayed. 2 The Vaccine Injury Compensation Claims process directed by the Health Resources and Services Administration was disrupted. Hundreds of new patient enrollments for certain National Institutes of Health (NIH)-sponsored clinical trials were slowed, along with support services for planned, new, and existing trials as three quarters of NIH and two thirds of CDC employees were furloughed. 2 The Children’s Hospitals Graduate Medical Education Payment Program, which supports the training of future pediatric health care workforce, stopped. 2,3 Head Start Program grantees, which provide services for more than 6300 children, had to close centers for nine days before being reopened with funding from private foundations or states. 2 Because of the broad base of health’s social determinants, including nutrition, education, and employment, the impact of the government shutdown on health was much larger than what would be estimated if only those effects on traditional health care were considered.