Geotagged US Tweets as Predictors of County-Level Health Outcomes, 2015-2016.

HEALTH surveys; TWITTER (Web resource); HEALTH behavior; HEALTH status indicators; ALCOHOL drinking; COMPUTER network resources; MORTALITY of people with alcoholism; FOOD; HAPPINESS; LONGITUDINAL method; MORTALITY; OBESITY; PUBLIC health; SOCIAL context; SOCIAL media; SEDENTARY lifestyles; PHYSICAL activity; DESCRIPTIVE statistics

Objectives. To leverage geotagged Twitter data to create national indicators of the social environment, with small-area indicators of prevalent sentiment and social modeling of health behaviors, and to test associations with county-level health outcomes, while controlling for demographic characteristics. Methods. We used Twitter's streaming application programming interface to continuously collect a random 1% subset of publicly available geo-located tweets in the contiguous United States. We collected approximately 80 million geotagged tweets from 603 363 unique Twitter users in a 12-month period (April 2015-March 2016). Results. Across 3135 US counties, Twitter indicators of happiness, food, and physical activity were associated with lower premature mortality, obesity, and physical inactivity. Alcohol-use tweets predicted higher alcohol-use-related mortality. Conclusions. Socialmedia represents a newtype of real-time data thatmay enable public healthofficials toexaminemovement ofnorms, sentiment, andbehaviors thatmayportend emerging issues or outbreaks--thus providing a way to intervene to prevent adverse health events and measure the impact of health interventions. [ABSTRACT FROM AUTHOR]

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