Abstract
BackgroundGender and race are known to impact attitudes toward mental health topics and help-seeking behavior. Men and minorities are more likely to cite stigma as a reason for not seeking help for mental health concerns, which is of particular relevance given the high rate of suicide in men and challenges of historic proportion currently facing minority communities. Instagram provides a platform to discuss mental health, though a lack of male and minority representation may further alienate these populations.ObjectiveWe aimed to investigate whether men and nonwhite individuals are underrepresented in Instagram photos tagged with #mentalhealth (compared to photos tagged with #health) to better understand how gender and race-based representations are manifested on this popular social media platform and discuss the implications.MethodsThree investigators of different genders and racial backgrounds met on nine different days via teleconference to analyze a total of 215 publicly available Instagram photos tagged with #mentalhealth and 215 with #health. These photos were generated using Instagram’s search function, and search results were sorted by most recently published at the time of data collection. For each photo, the three investigators recorded their observations about the gender (male versus female) and race (white versus nonwhite versus racially unclassifiable) of subjects featured in the photo, which they did not discuss with other investigators. Chi-squared analysis was performed on each investigator’s data set to compare the frequency of male versus female and white versus nonwhite subjects identified in each hashtag category. Kappa interrater agreement was calculated for each investigator pair, category (gender or race), and hashtag.ResultsAll three investigators observed significantly more female as compared to male subjects in photos tagged with #mentalhealth (X2=14.4, P<.001 for all investigators) while observing no significant difference between numbers of male and female subjects in photos tagged with #health (X2=1.533, P=.22; X2=1.241, P=.27; X2=0.096, P=.76). All three investigators identified significantly more white than nonwhite subjects in photos tagged with both #health and #mentalhealth (X2 values range from 11.912 to 98.927, P<.001 for all). Kappa interrater agreement revealed almost perfect agreement for gender (kappa=0.908-0.992) with the agreement for race ranging from 0.614 to 0.822, depending on hashtag and rater pair.ConclusionsWomen are featured more frequently than men in Instagram photos tagged with #mentalhealth. The topic of #health, meanwhile, is not gendered this way. Low visibility of mental health among men may both represent and exacerbate existing stigma and barriers to care. White subjects are featured significantly more frequently than nonwhite subjects in photos tagged with both #mentalhealth and #health. Directed interventions using the Instagram platform may be indicated to increase the visibility of underrepresented groups and break the cycle of stigma.
Highlights
With over 1 billion users [1], Instagram is one of the most widely used social media platforms in the world
The three investigators recorded their observations about the gender and race of subjects featured in the photo, which they did not discuss with other investigators
We aimed to investigate whether men and nonwhite individuals are underrepresented in Instagram photos tagged with #mentalhealth to understand better how gender and race-based representations present on this popular social media platform and to discuss the implications
Summary
With over 1 billion users [1], Instagram is one of the most widely used social media platforms in the world. It is, first and foremost, a visual platform, centered around sharing user-generated photos and videos accompanied by captions. Instagram users have the option to make their photos private or public. Public photos are visible to anyone—even those without an Instagram account. Without an Instagram account, site visitors can only scroll through approximately 30 photos before either logging in or refreshing the page and starting anew. Instagram provides a platform to discuss mental health, though a lack of male and minority representation may further alienate these populations
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