Does Your Health Identity Belong On Your Facebook Wall?

As part of its master plan to take over the world, Facebook launched a new plug-in earlier this month: article comments. Websites can replace existing commenting software with Facebook's new service.

With this change, your Facebook picture will show up in the article's comments and on your wall. If a Facebook friend comments on your comment, her picture will show up in the article's comment thread as well, even if she never read the article.

TechCrunch has already made the switch to Facebook comments. Editors there note that the overall volume of comments has gone down but the quality is higher. People can't hide behind "anonymous" any more to insult the topic or the writer of an article.

The look and feel of the comment plug-in makes you feel like you are on Facebook.




 This is the comment stream from one of TechCrunch's posts about Facebook comments.

For publishers and service providers, this has a big upside. Anything that reduces the barriers to participation and gets more people to comment is good. This new service reduces spam as well, which benefits both publishers and readers. This change is similar to Facebook Connect, which launched a couple years ago.

Personal me vs. work me vs. health me

In the manydiscussions about this new plug-in, people brought up the impact on identity. Steve Cheney says that this change moves us one step closer to having only one online identity: Facebook's. He thinks this is a problem because, in real life, people participate in many distinct communities -- personal, work, intellectual, cultural, spiritual -- that don't have anything in common. Chaney argues that if you try to mesh all these separate groups together, you're forced to have one identity, which is not always desirable or authentic.

Robert Scoble says that Chaney's argument is the dumbest thing he's ever heard because identity = accountability and authority.

One reader suggested that Facebook offer the option of several identities:

"Perhaps Facebook should have persona modes -- 'business me,' 'family me,' 'friends me,' etc., with different colors, fonts, look, feel so that you know which persona you're in ...."

If that list included a health identity, what would it look like?

How would it be different from a professional identity?

Could you have a higher level of privacy and prevent tracking of your online health persona?

Part of Facebook's goal with each new expansion is to find out even more about people so they can sell even more information to marketers and target ads even more specifically. Having a pair of shoes follow me around the web is one thing; having a health-centric product follow me raises the privacy stakes.

How public is your health identity?

It's a bit of a cliché to say, "Online health is different!" but it might be true in this instance. Some health issues are very personal and not always for general consumption. People who seek out online communities to find support for miscarriage, depression, or sexually transmitted infections may not want their Facebook friends to be part of that social circle.

If a health site adopted Facebook comments, commenters wouldn't have the choice of keeping their online activities separate. Many health sites have a better understanding of privacy issues than general web sites, so chances are they would offer other commenting options. The benefits of the Facebook plug-in are persuasive, though, particularly for small sites that may not have a large tech staff or that need all the traffic they can get.

Some people with serious health conditions do not want to be defined by their illnesses. For example, health writer Amy Tenderich uses the phrase "people with diabetes" instead of "diabetics."

Other people living with chronic conditions feel a sense of pride in being an expert on a particular topic and in helping other people with the condition. For them, their health condition is a central to the idea of identity.

Health publishers and service providers will have to strike a careful balance to attract and retain both groups, and to respect the privacy of everyone who wants to discuss health issues online.

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