Why Health Equity Voices Are Going Quiet Online, and What Nurses Can Do About It

If your feed feels quieter lately, you are not imagining it. That is one of the first things Oni Blackstock, MD, MHS, founder and executive director of the health equity consulting and research firm Health Justice, tells hosts Marion Leary, PhD, MPH, RN, and Rebecca Love, RN, MSN, FIEL, on this episode of the Love n’ Leary Nursing Podcast.

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Dr. Blackstock, a primary care physician specializing in HIV care and a former assistant commissioner at the New York City Health Department, where she led the city’s response to the HIV epidemic, noticed something changing on LinkedIn over the past year. Posts about health equity and social justice that used to draw hundreds of engagements were suddenly reaching almost no one. When she posted about it, the responses came almost entirely from women, and many were women of color, reporting the same thing.

“It’s like humans against the algorithm.”

Marion and Rebecca have seen it too, both in their own reach and in colleagues who seem to be going quiet. For nurses, that matters. The voices being muted are often the ones pushing back on stereotypical narratives about who nurses are and what healthcare should be.

The conversation does not stop at the algorithm. Blackstock is open about why she left Twitter entirely: the platform had become genuinely frightening, and protecting her mental health had to come first.

“There is nothing that will justify me staying on here.”

Her approach now is intentional. She focuses on one or two platforms, pauses before posting, and curates what she shares instead of reacting in the moment. Rebecca describes a similar discipline, one carefully constructed post a day at most, personally fact-checked. Marion admits she often wonders whether anyone is listening at all, until a nurse messages to say a post meant something.

That tension, between using your voice and protecting your peace, will feel familiar to a lot of nurses. Blackstock’s answer draws on family history. Through a relative’s Facebook group, she discovered photographs of her great-grandparents, born in the 1870s during Reconstruction. Her mother, Dr. Dale Blackstock, grew up on public assistance in Brooklyn, became a physician against long odds, and spent her career serving Central Brooklyn before dying of leukemia at 47. Blackstock’s twin sister, Dr. Uché Blackstock, wrote about their mother and the role racism may have played in her illness in her book Legacy.

“I’m part of this lineage… I have this duty and sort of this purpose here on this earth to do the work that I’m doing.”

The people who came before her endured far worse and kept going.

She also gives nurses a shoutout that is hard to miss. Blackstock calls National Nurses United‘s organizing so impressive that she wishes physicians had an equivalent, and credits her nurse colleagues with getting her through training and clinical work.

Her current work brings the conversation full circle. Through Health Justice, she now studies how communities can shape whether and how AI is used in their care, including a Robert Wood Johnson Foundation funded project with community members in Harlem. Her question for health systems racing to adopt new tools is one nurses ask all the time: did anyone ask patients what they wanted?

“Do people ask for a chatbot, or do people ask for affordable, accessible mental health care?”

Her parting advice applies to every nurse, whether or not you ever write a post. Everyone has a sphere of influence: who gets invited to a meeting, how a hiring panel is built, which questions get asked about a budget. Citing organizer Mariame Kaba’s distinction between hope and optimism, she notes that hope comes with uncertainty.

“We actually don’t know if what we will be doing will make a difference, but we know that if we don’t do anything, then there’s no chance of making a change.”

You do not know if what you do will make a difference. You only know that doing nothing guarantees it won’t.

Listen to the full conversation with Dr. Oni Blackstock on the Love n’ Leary Nursing Podcast, or wherever you listen to podcasts.

🤔 Have you noticed your posts, or the advocates you follow, getting less reach lately? How do you balance speaking out with protecting your peace? Share your experience in the comments.