Introduction to the Article: “Contemporary Visualities of Ill Health: On the Social (Media) Construction of Disease Regimes”
This article, titled “Contemporary visualities of ill health: On the social (media) construction of disease regimes,” is an original piece of scholarship. Authored by Stefania Vicari, Hannah Ditchfield, and Yuning Chuang from the Department of Sociological Studies at The University of Sheffield, UK, and funded by the Leverhulme Trust, it is set to be published in Sociology of Health & Illness in 2025. The research aims to fill a gap in sociological understanding by investigating the significant role digital platforms play in shaping the visual representation of illness in contemporary societies, a factor often overlooked.
The core inquiry of the article revolves around how mainstream social media platforms – specifically Instagram, Twitter (now X), and Facebook – frame distinct “visuality” (ways of seeing) regarding ill health, and how these visual forms relate to established practices of health and illness, known as “disease regimes”. The authors address Harrison’s 2002 call for sociological research to consider visual content not only as a resource but also as a topic in social life, recognizing its power to do “social work” by resonating with cultural codes and reproducing or challenging normative assumptions.
Methodology: The study adopted a mixed-methods approach combining cultural analytics, visual network analysis, and interpretive techniques. Over a 12-month period (May 2022 to April 2023), the researchers collected and analyzed 360 popular images (the top 10 most popular monthly images from public accounts/pages/groups on each platform) related to BReast CAncer (BRCA) hereditary cancer syndromes. Data was retrieved using keyword and hashtag queries (#BRCA, #BRCA1, #BRCA2). The analysis involved two phases:
- Phase 1: Developed a basic coding framework to categorize images based on content (e.g., display of people, text, data) and used image grids and color filtering to visualize platform-specific patterns and “visual vernaculars”.
- Phase 2: Developed a more comprehensive framework incorporating inductive, deductive, and text detection-based codes, including technological affordances like screenshots and sociocultural artifacts like selfies. Visual network analysis was then used to identify image clusters and emerging visual genres across the entire dataset.
Key Findings: The research highlights the emergence of platform-specific visual vernaculars:
- Facebook’s popular BRCA images, often broadcast through “pages” and “public groups,” closely resemble legacy media formats, frequently featuring human elements and popularizing BRCA through celebrity stories or as a symbol for genetic predispositions.
- Instagram content creators cultivate personal self-branding through repetition and aesthetic curation, presenting “live updates” or motivational advice related to cancer. While some images are “autopathographic” (first-person accounts of illness), they often show complex medical procedures entering mundane selfies without graphic expressions, indicating careful control over personal exposure and a focus on spectacularization or normalization of the healing body.
- Twitter (now X) predominantly features text and numerical data, with a significant portion (over a third) being screenshots from academic papers, posters, or scientific work. This indicates a strong homogeneity in content production, circulation, and audiencing, positioning BRCA primarily as a scientific issue for academic networking.
The study further identified two main visual genres across the social media ecosystem, as seen in Figure 7 of the source:
- Picturing the BRCA body: This genre, primarily from Facebook and Instagram, focuses on bodily representations. It encompasses glamorous femininity tropes, “outdoor selfies” that lack specific BRCA meaning, and “autopathographic representations” depicting hospital settings, medical devices, and often the white, reconstructed, or scarred female breast. Crucially, one image depicted a male individual with breast cancer scars, providing rare visibility to male breast cancer. “Silly selfies” also emerge, using humor to challenge conventional health and body norms.
- Verbalizing BRCA cancers and genes: Predominantly from Instagram and Twitter, this genre relies on text and data visuals. It includes memes and images crafted via graphic design apps for motivational messages, sometimes critically comparing risk-reducing surgeries to cosmetic procedures. A notable aspect is the widespread use of screenshots providing biomedical information (figures, tables, infographics, abstracts), signifying a growing circulation of scientific work on mainstream platforms.
Conclusion and Implications: The authors conclude that the BRCA visuality emerging from popular social media images primarily exacerbates existing racialized and gendered practices, largely centering on the white and female breast and aligning with normative assumptions of femininity in Western societies. They note that no images in their dataset offered alternative representations like non-white breasts or post-mastectomy flat closures, further denying visibility to less common consequences of BRCA mutations or negative outcomes of interventions.
While a “liminal space of imagination” exists, offering renewed but not necessarily disruptive ways to perceive the BRCA condition through curated autopathographic self-disclosure, these representations often embrace the “responsible, beautiful and likeable warrior” trope. This type of digital citizenship is shaped by platform “attention economies” and has limited potential to challenge exclusionary representations. The study finds that only a very small number of images offer explicit elements of disruption, such as the male breast cancer mastectomy photo or expressions of “silly citizenship”. These disruptive images, while normalizing ill health, challenge ableist assumptions of beauty, femininity, and the body. Ultimately, the article argues that the techno-commercial models of mainstream social media platforms significantly shape BRCA visualities in ways that rarely fully depart from dominant practices, downscaling optimistic views on social media’s potential for radical social change in the context of normative disease regimes.
References
Vicari, S., Ditchfield, H., & Chuang, Y. (2025). Contemporary visualities of ill health: On the social (media) construction of disease regimes. Sociology of Health & Illness. https://doi.org/10.1111/1467-9566.13846
