Health Management in the Age of the Internet

This study examines the way people use online resources within their personal healthcare practices to better understand how individuals manage their health issues in the age of the Internet. It specifically addresses the extent to which the Internet is used as an information database and associated patterns of use, whether the Internet represents a source of support or enables a supportive encounter and the implications of using the Internet as part of the health management across relationships with medical professionals and oneself. Using a sequential mixed methods design, the data was gathered within a larger multidisciplinary research project conducted in East York, Ontario. An initial quantitative analysis of 350 surveys describes Internet usage. The qualitative analysis of the 86 follow-up interviews of people recounting their personal health management processes demonstrated the importance of social networks, subjective health status and Internet user-style. The facile ability to engage with health information is transforming definitions and experiences of health and relationships with medical professionals. Examining medical encounters mindful of the aspects of trust, power, knowledge and privilege reveals an evolution to the doctor-patient relationship brought about by both information and personal empowerment. Using the Internet reinforces primary relationships and points to the development of new relationships that are sought at moments of meaningful life events or circumstances. New types of connections are being built across the Internet based on shared experiences, health concerns and health identities. Applying Actor Network Theory furthers an understanding of how search engines and online resources can emerge as actors in health information seeking and health management processes. Internet use is now a part of everyday life and is no longer limited to affluent early adopters as the gaps between those with access diminish in urban Canada. While its use is becoming intrinsically linked to health management it is not a panacea for improving health outcomes. As the populations’ collective health knowledge increases, so does the presumption that health management is a personal imperative. This notion that the achievement of good health is an individual responsibility or the theory of Healthism, frames the interpretation of the large percentage of the sample indicating they are striving to become healthier. Social workers need to acknowledge the place of the Internet within its practice and to balance the emphasis on individualized health management with the perspective that health outcomes reflect community mores. It is important for social workers to treat the Internet as a medium of relationships and for social workers to become knowledgeable about what these connections can provide in terms of support and information and what the limitations and risks of these relationships can be.Ph