社交媒体中的健康谣言对老年人健康决策的影响与干预机制

The Impact of Health Rumors in Social Media on Health Decision-Making of Older Adults and Intervention Mechanisms

摘要: 随着人口老龄化与媒介数字化双重进程的加速，社交媒体已成为老年群体获取健康信息的重要场域，但同时也成为健康谣言滋生与扩散的温床。农村及城市老年人在健康信息甄别、数字素养等方面处于相对弱势地位，易被圈层内流传的虚假养生内容误导，进而干扰其健康决策。本文立足于积极应对人口老龄化的国家战略背景，运用社会信任理论与社会支持理论的基本思想，将老年人视为社会网络的节点，将亲情、邻里、社区等熟人关系视为连接节点的边，系统探讨社交媒体健康谣言对老年人健康决策的影响机制。研究发现，健康谣言借助圈层化封闭传播与熟人信任背书，不仅扭曲了老年人的健康认知，干扰其就医选择，更导致其社会支持网络的功能退化与信任结构的“内卷化”。并从政府统筹、平台监管、社会供给、家庭代际支持与个人赋能五个维度提出了系统性的协同干预策略，最终目标是通过这些努力，有效阻断健康谣言的社会传播链，提升老年人在数字时代的健康决策能力，守护其身心健康与合法权益。

Abstract: With the acceleration of population aging and media digitalization, social media have become a crucial arena for the elderly to access health information, yet they have also fostered the proliferation of health rumors. Elderly people in both rural and urban areas are relatively disadvantaged in terms of health information discernment and digital literacy, making them vulnerable to misleading false health content circulating within their closed social circles, which in turn interferes with their health decision-making. Grounded in the national strategic context of actively responding to population aging, this study draws on social trust theory and social support theory, conceptualizing the elderly as nodes in a social network and their kinship, neighborhood, and community relationships as edges connecting these nodes, to systematically explore the mechanisms through which social media health rumors influence the health decision-making of the elderly. The findings reveal that, facilitated by closed-circle dissemination and trust endorsement within acquaintance networks, health rumors not only distort the elderly’s health perceptions and interfere with their medical choices but also lead to functional degradation of their social support networks and the “involution” of trust structures. Furthermore, a systematic multi-stakeholder collaborative intervention strategy is proposed from five dimensions: government coordination, platform regulation, social supply, family intergenerational support, and individual empowerment. The ultimate goal is to effectively disrupt the social transmission chain of health rumors, enhance the health decision-making capacity of the elderly in the digital age, and safeguard their physical, mental, and financial well-being.