Twitter-Derived Social Neighborhood Characteristics and Individual-Level Cardiometabolic Outcomes: Cross-Sectional Study in a Nationally Representative Sample

BACKGROUND: Social media platforms such as Twitter can serve as a potential data source for public health research to characterize the social neighborhood environment. Few studies have linked Twitter-derived characteristics to individual-level health outcomes. OBJECTIVE: This study aims to assess the association between Twitter-derived social neighborhood characteristics, including happiness, food, and physical activity mentions, with individual cardiometabolic outcomes using a nationally representative sample. METHODS: We collected a random 1% of the geotagged tweets from April 2015 to March 2016 using Twitter’s Streaming Application Interface (API). Twitter-derived zip code characteristics on happiness, food, and physical activity were merged to individual outcomes from restricted-use National Health and Nutrition Examination Survey (NHANES) with residential zip codes. Separate regression analyses were performed for each of the neighborhood characteristics using NHANES 2011-2016 and 2007-2016. RESULTS: Individuals living in the zip codes with the two highest tertiles of happy tweets reported BMI of 0.65 (95% CI –1.10 to –0.20) and 0.85 kg/m(2) (95% CI –1.48 to –0.21) lower than those living in zip codes with the lowest frequency of happy tweets. Happy tweets were also associated with a 6%-8% lower prevalence of hypertension. A higher prevalence of healthy food tweets was linked with an 11% (95% CI 2% to 21%) lower prevalence of obesity. Those living in areas with the highest and medium tertiles of physical activity tweets were associated with a lower prevalence of hypertension by 10% (95% CI 4% to 15%) and 8% (95% CI 2% to 14%), respectively. CONCLUSIONS: Twitter-derived social neighborhood characteristics were associated with individual-level obesity and hypertension in a nationally representative sample of US adults. Twitter data could be used for capturing neighborhood sociocultural influences on chronic conditions and may be used as a platform for chronic outcomes prevention.