Personal Responsibility, Personal Shame: A Discourse Tracing of Individualism about Healthcare Costs

America's individualistic culture is reflected in deeply held beliefs about how people should manage their health and their (lack of) money. In this essay, we trace the ideological discourse of individualism at macro and micro levels, explicating how macro-level discourses surrounding finances and health fulfill key functions of individualism: explanatory and evaluative as well as identity and prescriptive. For each function, we illustrate at the micro level how social adherence to discourses of individualism affects people, relationships, and communities. In particular, we argue, failure to live up to individualistic ideals fosters internalized shame and guilt and worsens mental, physical, and financial health. Grounded in critical rhetorical theory and drawing upon critical interpersonal and family communication and health communication approaches, we illustrate how individualistic discourse is circulated and taken up by people, constituting their identities and relationships. We also showcase the benefits of investigating exigent social issues from multidisciplinary vantage points.

Using crowdsourced medicine to manage uncertainty on Reddit: The case of COVID-19 long-haulers.

OBJECTIVE: Causes of and treatments for long-COVID syndrome remain unknown. Drawing on uncertainty management theory (UMT), this study elucidates the communicative nature of crowdsourced medicine as a means by which COVID "long-haulers" respond to their poorly understood illness. METHODS: 31,892 posts on the long-haulers subreddit (r/covidlonghaulers) were analyzed, starting with its creation date, July 24th, 2020, until January 7, 2021. The Meaning Extraction Method was used to identify clusters of words that mathematically group together across the text observations. RESULTS: Analyses yielded 16 distinct factors of words, which we thematized based on their composition, the data, and UMT. The 16 themes encompassed symptoms (e.g., pain, respiratory, sensory), diagnostic concerns (testing, diagnosis), broad health concerns (immunity, physical activity, diet), chronicity, support, identity, and anxiety. CONCLUSION: Findings provide a succinct, yet robust set of themes reflecting the information-seeking (i.e., "This is happening to me") and support-seeking functions of long-haulers' talk (i.e., "Is this happening to you?"). Findings have implications for collective uncertainty management, online crowdsourcing, and patient advocacy. PRACTICE IMPLICATIONS: We recommend that health care providers employ sensitivity when addressing the anxiety that long-haulers are experiencing while also validating that their physical symptoms are real. Online communities help long-haulers manage their uncertainty.