What does online harassment look like?
Online harassment can take many forms. It might resemble in-person bullying via personal insults and threats. It also might take unique forms on social media. For example, harassers can use bots to automate hateful messages and amplify their impact. The anonymous and decentralized nature of social media can also make it hard to assign responsibility for harassment. Online harassment itself can be traumatic, such as when it involves identity-based hate speech or threats of violence. Online harassment might also seep into offline spaces. For example, harassers can use social media to coordinate in-person stalking.
What tactics are part of online harassment?
Here are some examples of prominent tactics in online harassment. Learning about these tactics and the terminology around them can help you better understand and describe your experiences:
Astroturfing: coordinated online behaviors meant to mislead audiences about the scale or intensity of public opinion. Example: a small number of people could use fake profiles to make social media backlash appear as if it is coming from a large crowd.
Concern trolling: the use of positive language to frame an antagonistic message. Example: someone might say they support the goals of your public health research, while raising objections in the form of far-fetched hypotheticals.
Cyberbullying: the use of web technologies to humiliate someone or shame them in front of others. Example: someone might make public posts to personally insult a health professional.
Cyberstalking: the use of web technologies to repeatedly invade someone’s privacy, especially across platforms and communication services. Example: someone might send threatening messages to a public health official across all of their professional and personal social media accounts, as well as their professional and personal email accounts.
Deepfake: a computer-generated image or audio/video clip that provides a false “record” of something that never actually happened. Example: someone might feed footage of real press briefings into software to create a clip purportedly showing a health policy announcement that never happened.
Dogpiling: when a large number of coordinated accounts respond negatively to a social media user. Example: a large group might post insulting comments on a promotional video for a vaccine that a celebrity spotlighted for them.
Dog-whistle: the use of in-group codes and double meanings to mask a harmful message. Example: someone might evoke harmful stereotypes while demeaning a health official through careful wording so as to not breach a platform’s terms of service or face content moderation.
Doxing: when someone publicly shares another person’s private information. Example: someone might publicly share a scientist’s home address and cell phone number online.
Hashtag hijacking: the coordinated use of an existing social media hashtag to drown out the intended messaging. Example: a coordinated group might use a vaccination campaign’s hashtag to amplify vaccine disinformation and personal attacks against medical professionals.
Impersonation: posting content with the aim of deceiving others into thinking it came from someone else. Example: someone might make a social media account to post offensive messages under a doctor’s name and photo, with the goal of harming their professional reputation.
Targeting: abusive behaviors that cross a boundary between one’s professional and personal life. Example: someone might harass a health professional’s child as a means of intimidation.
Swatting: falsely reporting someone to law enforcement so as to get a SWAT team to confront them.
Why is online harassment a concern for the field of public health?
There were at least 1,499 incidents of harassment at local health departments between March 2020 and January 2021. In a 2021 nationally representative survey, 1 in 6 local public health workers felt bullied, threatened, or harassed due to their professional role. This is a serious problem, and we can’t expect it to improve any time soon. Surveys show the portion of people in the US who believe it’s okay to threaten or harass public health officials increased during the pandemic.
Avoiding harassment isn’t as simple as deleting social media accounts. Public health depends on community engagement to work. Event organizers, employers, and publishers regularly share info about public health professionals as part of their jobs. And government funding often requires public availability of public health professionals’ contact information.
What institutions are at risk of online harassment?
With political division around public health and the use of social media to coordinate harassment, any institution is at risk. That being said, we know that institutions working toward health equity face heightened risks. Threats of violence can be especially harmful for researchers and practitioners working with Black, trans, and marginalized communities more broadly who have long navigated bigotry and political violence.
Maryland’s Frederick County Health Department held an online meeting to discuss the findings of their research into Black maternal health inequities in April 2023. Less than 30 minutes in, racist trolls disrupted the meeting with death threats and graphic imagery.
Boston Children’s Hospital became the target of an online disinformation campaign around gender affirming care. This culminated in a flood of harassment, including bomb threats and threats of violence against providers in August 2022. The Children’s Hospital of Pittsburgh and Children’s National Hospital in Washington, D.C. faced similar harassment campaigns that summer as well.
Who is at risk for online harassment?
We know that anyone in public health might experience online harassment. However, our public health work takes place in a broader context of racism, transphobia, and other forms of discrimination. Thus we can’t assume everyone faces the same kind of risks.
With a lack of data in public health, data from related fields provide important insight. A survey of journalists found that people who identified as LGBTQ+, women, and/or people of color faced higher rates of online harassment than others. A survey of climate scientists found women were more likely to face online threats of violence and attacks on their personal appearance than men. A survey of physicians found women were more likely than men to experience sexual harassment on social media. Such patterns are particularly important for the public health workforce, which is about ¾ women and nearly ½ Black, Indigenous, and people of color.
What fields within public health are at risk of online harassment?
Some areas of public health have long been targets of harassment and disinformation campaigns, e.g. abortion care and stem cell research. Over the past few years, we’ve seen increased politicization and disinformation around antiracist health research and trans healthcare. However, as the examples below illustrate, anyone in any area of public health is at risk.
Tiffany Dover is a nurse who was working in Chattanooga, TN, when she became a focal point for anti-vaccine propaganda. She fainted upon receiving a COVID-19 vaccine in December 2020. It didn’t matter that her fainting was due to a known medical issue, nor that she quickly recovered and went back to work after mere minutes. Conspiracy theorists were convinced that she died. They showed up to her house to demand answers. They called her employer repeatedly. They picked apart her every move on social media for years.
Dr. Peter Hotez is Dean for the National School of Tropical Medicine at Baylor. He became the target of an online pile-on after criticizing a prominent podcast interview with anti-vaccine advocate Robert F. Kennedy Jr. After refusing a debate challenge from the podcast, prominent figures like Elon Musk and Tucker Carlson baselessly attacked his credibility for their audiences. This culminated in harassment at his home in June 2023.
Dr. Angela Rasmussen is a virologist with the Vaccine and Infectious Disease Organization at the University of Saskatchewan. She has described the slow response of Twitter’s safety team in the face of very public doxing, physical threats, and sexual harassment. She has noted the toll that prolonged periods of harassment can take on scientists, and the way this tactic can drive health experts off social media platforms.
Dr. Akiko Kawasaki is a professor of immunobiology, dermatology, and epidemiology at Yale. She has spoken about the double-edged nature of her growing platform on Twitter. While it has been an effective platform for science communication, it has also been a site of trolling and abusive interactions questioning her expertise. She’s also spoken out against bullying, discrimination, and harassment within academia, especially for women of color. She’s noted how these different forms of harassment take time away from actually doing her job.
Why is organizational action required?
The problem of online harassment of public health professionals and students is too big to address at just one level. Public health institutions, social media companies, and professional organizations all benefit from the work of public health professionals and students. These institutions also control access to a lot of public health professionals’ and students’ personal data. Thus they have critical duties to protect us.
Public health and medical institutions can be more proactive in understanding, preventing, and responding to online harassment. For example, the Universities of The Netherlands have adopted policies including supportive measures for scientists experiencing harassment and a data collection platform focused on these incidents. Our institutions also need to listen to the needs of their workforce and rise to meet them.
Social media companies can better prevent harassment on their platforms by listening to creators from marginalized backgrounds. For example, Black streamers and streamers of color petitioned Twitch to make changes in light of rampant automated harassment on the platform.
Lawmakers and government officials can do more to protect the public health workforce. For example, the National Association of County and City Health Officials advocated with the US Attorney General for an increased response to threats of violence against health officials. No single policy will suffice, but they can still support the workforce in meaningful ways. For example, Colorado lawmakers made it illegal to dox public health workers.
The Digital Safety Kit was created by Sam Mendez for the Harvard T.H. Chan School of Public Health’s Center for Health Communication. It is designed to help you prevent and reduce the harm of online harassment in public health.
