Ethics and Information Technology

, Volume 13, Issue 3, pp 227–240 | Cite as

Searching for health: the topography of the first page

  • Jill McTavish
  • Roma Harris
  • Nadine Wathen
Original Paper


Members of the lay public are turning increasingly to the internet to answer health-related questions. Some authors suggest that the widespread availability of online health information has dislodged medical knowledge from its traditional institutional base and enabled a growing role for alternative or previously unrecognized health perspectives and ‘lay health expertise’. Others have argued, however, that the organization of information retrieved from influential search engines, particularly Google, has merely intensified mainstream perspectives because of the growing consolidation of the internet with traditional, commercial media sources. In this paper we describe an analysis of ‘first page’ results retrieved through Google searches about several common health concerns, each of which has been the subject of controversy as a result of uncertain aetiology, diagnoses, outcomes and/or contested approaches to treatment. Our findings suggest that the online search tactics used by most lay health information seekers produce sources of information that, for the most part, reflect mainstream biomedical discourses, often linked to commercial interests, rather than a plurality of voices that offer a variety of perspectives and resources. We discuss the implications for health-interested internet searchers who fail to look beyond the ‘first page’.


Internet Consumer health information Search engine Health information-seeking Medicalization Social construction of health 


  1. APA. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. APA. (2002). Practice guideline for treatment of patients of bipolar disorder (revision). American Journal of Psychiatry, 159(S4), 1–150.Google Scholar
  3. Barker, K. K. (2008). Electronic support groups, patient-consumers, and medicalization: The case of contested illness. Journal of Health and Social Behavior, 49(1), 20–36.CrossRefGoogle Scholar
  4. Bogaards, M. C., & ter Kuile, M. M. (1994). Treatment of recurrent tension headache: A meta-analytic review. The Clinical Journal of Pain, 10(3), 174–190.CrossRefGoogle Scholar
  5. Bowker, G. C., & Star, S. L. (1999). Sorting things out. Classification and its consequences. Cambridge, MA: Massachusetts Institute of Technology.Google Scholar
  6. Bromfield, R. (1996). Second opinion: More and more children are diagnosed with attention deficit hyperactivity disorder. But is ADHD a real disease or just the latest fad? American Health, 15(5), 32–60.Google Scholar
  7. Carpenter-Song, E. (2009). Caught in the psychiatric net: Meanings and experiences of ADHD, pediatric bipolar disorder and mental health treatment among a diverse group of families in the United States. Culture, Medicine and Psychiatry, 33(1), 61–85.CrossRefGoogle Scholar
  8. Conrad, P. (1975). The discovery of hyperkinesis: Notes on the medicalization of deviant behavior. Social Problems, 23, 12–21.CrossRefGoogle Scholar
  9. Corbin, J., & Strauss, A. (1987). Accompaniments of chronic illness: Changes in body, self, biography and biographical time. Research in the Sociology of Health Care, 6, 249–281.Google Scholar
  10. Danforth, S., & Navarrio, V. (2001). Hypertalk: Sampling and social construction of ADHD in everyday language. Anthropology & Education Quarterly, 32(2), 167–190.CrossRefGoogle Scholar
  11. (2009). How to get your website first page on Google, Yahoo, Bing and other major search engines. Accessed 14 October 2009.
  12. Elgesem, D. (2008). Search engines and the public use of reason. Ethics and Information Technology, 20, 233–242.CrossRefGoogle Scholar
  13. Eysenbach, G., & Köhler, C. (2002). How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ 324(9 March), 573–577.Google Scholar
  14. Fox, S., & Jones, S. (2009). The social life of health information. Washington, D.C.: Pew Internet and American Life Project.Google Scholar
  15. Goadsby, P. J., Lipton, R. B., & Ferrari, M. D. (2002). Migraine—Current understanding and treatment. New England Journal of Medicine, 346, 257–270.CrossRefGoogle Scholar
  16. Goodwin, G. M. (2003). Evidence-based guidelines for treating bipolar disorder: Recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 17, 149–173.CrossRefGoogle Scholar
  17. Greendale, G. A., Lee, N. P., & Arriola, E. R. (1999). The menopause. Lancet, 353, 571–580.CrossRefGoogle Scholar
  18. Hardey, M. (1999). Doctor in the house: The internet as a source of lay health knowledge and the challenge to expertise. Sociology of Health & Illness, 21(6), 820–835.CrossRefGoogle Scholar
  19. Headache Classification Subcommittee of the International Headache Society. (2004). The international classification of headache disorders, 2nd edn. Cephalagia, 24(S1), 1–160.Google Scholar
  20. Hemminkia, E., Karttunena, T., Hovia, S.-L., & Karro, H. (2004). The drug industry and medical practice—The case of menopausal hormone therapy in Estonia. Social Science and Medicine, 58, 89–97.CrossRefGoogle Scholar
  21. Hoffman, D. E., & Torzian, A. J. (2001). The girl who cried pain: A bias against women in the treatment of pain. Journal of Law, Medicine and Ethics, 29, 13–27.CrossRefGoogle Scholar
  22. Horwitz, A., & Wakefield, J. (2009). The medicalization of sadness: How psychiatry transformed a natural emotion into a mental disorder. In A. Maturo & P. Conrad (Eds.), The medicalization of life, Salute e Società (VIII, 2, pp. 49–66).Google Scholar
  23. Huxley, N. S., Parikh, S. V., & Baldessarini, R. J. (2000). Effectiveness of psychosocial treatments in bipolar disorder. Harvard Review of Psychiatry, 8, 126–140.Google Scholar
  24. Hyde, A., Nee, J., Howlett, E., Drennan, J., & Butler, M. (2010). Menopause narratives: The interplay of women’s embodied experiences with biomedical discourses. Qualitative Health Research, 20(6), 805–815.CrossRefGoogle Scholar
  25. Introna, L. D. (2007). Maintaining the reversibility of foldings: Making the ethics (politics) of information technology visible. Ethics and Information Technology, 9(1), 11–25.CrossRefGoogle Scholar
  26. Introna, L. D., & Nissenbaum, H. (2000). Shaping the Web: Why the politics of search engines matters. The Information Society, 16(3), 169–186.CrossRefGoogle Scholar
  27. Jones, S. (2004). Psychotherapy of bipolar disorder: A review. Journal of Affective Disorders, 80, 101–114.CrossRefGoogle Scholar
  28. Kempner, J. (2006). Uncovering the man in medicine: Lessons learned from a case study of cluster headache. Gender & Society, 20(5), 632–656.CrossRefGoogle Scholar
  29. Keselman, A., Browne, A. C., & Kaufman, D. R. (2008). Consumer health information seeking as hypothesis testing. Journal of the American Medical Informatics Association, 15, 484–495.CrossRefGoogle Scholar
  30. Kopelson, K. (2009). Writing patients’ wrongs: The rhetoric and reality of information age medicine. JAC, 29(1–2), 353–404.Google Scholar
  31. Latour, B. (2005). Reassembling the social: An introduction to actor network theory. Oxford: Oxford University Press.Google Scholar
  32. Lefever, G. B., Dawson, K. V., & Morrow, A. D. (1999). The extent of drug therapy for attention deficit hyperactivity disorder among children in public schools. American Journal of Public Health, 89, 1359–1364.CrossRefGoogle Scholar
  33. Lonardi, C. (2007). The passing dilemma in socially invisible diseases: Narratives on chronic headache. Social Science and Medicine, 67, 1619–1629.Google Scholar
  34. Lyons, A. C., & Griffin, C. (2003). Managing menopause: A qualitative analysis of self-help literature for women at mid-life. Social Science and Medicine, 56, 1629–1642.CrossRefGoogle Scholar
  35. Maturo, A. (2010). Bipolar disorder and the medicalization of mood: An epidemics of diagnosis? Advances in Medical Sociology, 11, 2225–2242.CrossRefGoogle Scholar
  36. McTavish, J. R. (2004). Pain and profits: The history of headache and its remedies in America. New Jersey: Rutgers University Press.Google Scholar
  37. McTavish, J., & Harris, R. (2007). Relations of production: Representations of consumers and their health on mainstream and alternative health information sites. Canadian Journal of Information and Library Science, 31(3/4), 249–268.Google Scholar
  38. Meyer, G. A. (2002). The art of watching out: Vigilance in women who have migraine headaches. Qualitative Health Research, 12(9), 1220–1234.CrossRefGoogle Scholar
  39. Moulin, D. E. (2001). Systematic drug treatment for chronic musculoskeletal pain. Clinical Journal of Pain, 17(S4), S86–S93.CrossRefGoogle Scholar
  40. Nettleton, S., & Burrows, R. (2003). E-scaped medicine? Information, reflexivity and health. Critical Social Policy, 23(2), 165–185.CrossRefGoogle Scholar
  41. Olesen, J., Lekander, I., Andlin-Sobocki, P., & Jönsson, B. (2007). Funding of headache research in Europe. Cephalalgia, 27(9), 995–999.CrossRefGoogle Scholar
  42. Pan, B., Hembrooke, H., Joachims, T., Lorigo, L., Gay, G., & Granka, L. (2007). In Google we trust: Users’ decisions on rank, position, and relevance. Journal of Computer-Mediated Communication, 12(3), article 3.
  43. Post, R. M., & Leverich, G. S. (2006). The role of psychosocial stress in the onset and progression of bipolar disorder and its comorbidities: The need for earlier and alternative modes of therapeutic intervention. Development and Psychopathology, 18(4), 1181–1211.CrossRefGoogle Scholar
  44. Seale, C. (2005). New directions for critical internet health studies: representing cancer experience on the web. Sociology of Health & Illness, 27(4), 515–540.CrossRefGoogle Scholar
  45. Segal, J. Z. (2009). Internet health and the 21st-century patient. A rhetorical view. Written Communication, 26(4), 351–369.CrossRefGoogle Scholar
  46. Sim, J., & Adams, N. (2002). Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia. Clinical Journal of Pain, 18(5), 324–336.CrossRefGoogle Scholar
  47. Sim, J., & Madden, S. (2008). Illness experience in fibromyalgia syndrome: A metasynthesis of qualitative studies. Social Science and Medicine, 67(1), 57–67.CrossRefGoogle Scholar
  48. Sjaastad, O. (1992). Cluster headache syndrome. London: W.B. Saunders.Google Scholar
  49. Van Voris, B. (2001). Ritalin class actions: Fast start, big stumbles; but it’s still early, plaintiffs assert. National Law Journal, 23(50), pA1.Google Scholar
  50. Vandenbrouke, J. P. (2009). The HRT controversy: Observational studies and RCTs fall in line. The Lancet, 373(9671), 1233–1235.CrossRefGoogle Scholar
  51. Wessely, S., & Hotopf, M. (1999). Is fibromyalgia a distinct clinical entity? Historical and epidemiological evidence. Baillière’s Clinical Rheumatology, 13(3), 427–436.Google Scholar
  52. Williams, G. (1984). The genesis of chronic illness: Narrative reconstruction. Sociology of Health & Illness, 6, 175–200.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Faculty of Information & Media StudiesThe University of Western OntarioLondonCanada

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