Reassessing health crisis communication for a
generation dealing with crisis fatigue
by
Janine Palencia

Undergraduate Thesis Submitted in Partial Fulfillment of the
Requirements for the Bachelor of Communication
in the
School of Communication

© Janine Palencia 2024
CAPILANO UNIVERSITY
Spring 2024

Copyright in this work rests with the author. Please ensure that any reproduction
or re-use is done in accordance with the relevant national copyright legislation.

Approval
Name:

Janine Palencia

Degree:

Bachelor of Communication

Title:

Reassessing health crisis communication for a
generation dealing with crisis fatigue

Examining Committee:

Faculty Supervisor: Kym Stewart
School of Communication

ii

Ethics Statement
The author, whose name appears on the title page of this work, has obtained, for
the research described in this work, Human Research Ethics approval from Capilano
University Office of Research Ethics.
A copy of the approval letter is attached:

iii

Abstract
How does crisis fatigue affect a generation expressing declining trust towards public
institutions? What would happen if another major health crisis broke out? How can public
health cut through the noise in a media landscape saturated with misinformation? This
paper seeks to understand how the Generation Z (Gen Z) experience of growing up with
crisis media impacts interaction with health crisis and risk communications, and how to
adapt existing frameworks to consider this emergent phenomenon. Building off research
contextualized by the COVID-19 pandemic, the foundation of this study was developed
around concepts of information overload and message fatigue. Analysis was conducted
on existing health communication frameworks, social media campaigns from public
health authorities in British Columbia, online discourse around crisis fatigue, and survey
data on Gen Z’s mental health and media consumption habits. This study hopes to open
inquiry into current health crisis and risk communication frameworks, with the goal of
reassessing guidance to consider novel phenomenon experienced by younger
generations.
Keywords:

gen z; crisis fatigue; message fatigue; mental health; health risk

communication; crisis communication

iv

Dedication
I’d like to dedicate this paper to the following people:
To my friends & family, always cheering me on with whatever ambitious venture I have
going, and feeding me during breaks.
To my teams and management at Hollyburn Family Services – thank you for filling the
gaps while I’m off pursuing my studies, and taking such great care of our kids & families.
To the Communication Studies department at Capilano University, who continuously
push me to go beyond my limits and do my best.
To CAPUMA for giving me my first experience in grounded theory and inspiring the heart
of this research.
To Gen Z, thank you for caring so much about the world and everyone around you,
despite how much doom and gloom you grew up seeing. You continue to inspire this
Millennial.
And of course, to my partner Karl, who’s held me up when I’d been too exhausted from
everything I have going on, and continues to keep me grounded amidst my crazy ideas
and schedules.
I really couldn’t have done it without any of you. Thank you!

v

Table of Contents
Approval ............................................................................................................................... ii
Ethics Statement ................................................................................................................. iii
Abstract ............................................................................................................................... iv
Dedication ............................................................................................................................v
Table of Contents................................................................................................................ vi
List of Tables ..................................................................................................................... viii
List of Figures...................................................................................................................... ix
List of Acronyms ..................................................................................................................x
Glossary .............................................................................................................................. xi
Chapter 1.

Introduction ................................................................................................. 1

Chapter 2. Literature review ......................................................................................... 3
2.1. Gen Z and crisis fatigue: a mental health issue ...................................................... 3
2.2. Crisis fatigue as an outcome of message fatigue ................................................... 4
2.3. Maintaining trust in public institutions ...................................................................... 5
2.4. Further Research ..................................................................................................... 6
Chapter 3. Methods ....................................................................................................... 7
3.1. Netnography............................................................................................................. 7
3.2. Online survey ........................................................................................................... 8
3.3. Analysis of health organizations’ communication frameworks................................ 9
Chapter 4. Results ....................................................................................................... 10
4.1. WHO’s ERC framework & B.C.’s Pandemic Plan ................................................. 10
4.2. Defining crisis fatigue ............................................................................................. 11
4.3. Crisis fatigue on TikTok ......................................................................................... 13
4.4. Survey results: the Gen Z experience ................................................................... 16
4.5. Public health on TikTok ......................................................................................... 21
Chapter 5.

Discussion ................................................................................................. 25

Chapter 6.

Limitations ................................................................................................. 26

Chapter 7.

Conclusion................................................................................................. 27

References ....................................................................................................................... 29
Appendix A.

Survey .................................................................................................. 35

Appendix B.

Health authority areas in B.C. ........................................................... 36

Appendix C.

Web content analysis, April 2020 – March 2021 ............................. 42

Appendix D.

Web content analysis, April 2021 – March 2022 ............................. 43

vi

Appendix E.

Web content analysis, April 2022 – March 2023 ............................. 44

Appendix F.

Web content analysis, April 2023 – March 2024 ............................. 45

Appendix G.

WHO ERC Recommended Framework ............................................ 46

Appendix H.

B.C. Influenza Pandemic Response Framework ............................ 47

Appendix I.

Web content analysis - categories .................................................... 48

Appendix J.

Evolution of Google definition of “crisis fatigue”........................... 49

Appendix K.

Gen Z weekly concerns ..................................................................... 50

Appendix L.

World events during Gen Z’s lifetime ............................................... 51

Appendix M.

Social media habits vs. perceived mental health........................... 52

Appendix N.

Number of social media platforms used ......................................... 53

Appendix O.

Trust in institutions vs. perceived mental health ........................... 54

Appendix P.

Sentiment of COVID-19 messaging in B.C. ..................................... 55

Appendix Q.

How do you receive health-related news (currently)? ................... 56

Appendix R.
What sources did you find trust-worthy when looking for
information on COVID-19?................................................................................... 57
Appendix S.

Health characteristics, annual estimates. ....................................... 58

vii

List of Tables
Table 1 - Excerpt of the WHO’s ERC framework (WHO, 2017). ..................................... 10
Table 2 - Excerpt from the British Columbia Pandemic Response Plan (Government of
British Columbia, 2012) Communication and Education Framework. ..... 23
Table 3 - Excerpt from the WHO’s ERC guidelines (World Health Organization, 2017). 24

viii

List of Figures
Figure 1 – Summary of WHO ERC framework (World Health Organization [WHO], 2017).
................................................................................................................... 10
Figure 2 - Google Trends data on searches for "crisis fatigue" over a 10-year period. .. 12
Figure 3 - Number of posts with verbatim use of "crisis fatigue," between 2020-2024. .. 13
Figure 4 - Screenshot of Google Trends data over popularity of the term "unprecedented
times" over the past 5 years. .................................................................... 14
Figure 5 - Screenshot of Google Trends data over popularity of the term "major historical
events" over the past 5 years. .................................................................. 14
Figure 6 - Timeline chart of aggregated TikTok posts under analysis, making use of the
term "major historical events" in their content. ......................................... 15
Figure 7 - @josh_p_jackson (2021) ................................................................................. 16
Figure 8 - @kindra_erhart (2022) ..................................................................................... 16
Figure 9 - @tea_moneyy (2022)....................................................................................... 16
Figure 10 - @highcountryoutlaw (2022) ........................................................................... 16
Figure 11 - Survey data on participants' perceived mental health, categorized by
approximate years of birth. ....................................................................... 17
Figure 12 - Survey data comparing activities that respondents engage in during "good
days" and "bad days." ............................................................................... 18
Figure 13 - Word cloud highlighting common themes and terms coming from survey
participants' answers to the question "Finish the following sentence:
When I watch/read the news (television, social media, etc), I feel…” ..... 19
Figure 14 - Survey participants' sentiment on their experience with B.C.'s pandemic
communication efforts. .............................................................................. 20
Figure 15 - Comparison chart of frequency that survey participants seek out healthrelated news, currently vs. during the COVID-19 pandemic. ................... 21
Figure 16 - Vancouver Coastal Health's TikTok posting frequency between 2020-2024.
................................................................................................................... 22
Figure 17 - Fraser Health's TikTok posting frequency between 2020-2024.................... 22
Figure 18 - Norther Health's TikTok posting frequency between 2020-2024. ................. 23

ix

List of Acronyms
BCCDC

British Columbia Centre for Disease Control

BC SPEAK

British Columbia Survey on Population Experiences,
Action and Knowledge

ERC

Emergency Risk Communication

WHO

World Health Organization

x

Glossary
Crisis communications

Communications that respond to established crisis
events, often used in tandem with risk communications
during health crises

Crisis fatigue

A non-medical term used to describe burnout resulting
from prolonged exposure to crisis and crisis events.

Gen Z

Generation Z – population born between 1997-2012

Risk communications

Communications that respond to events with perceived
risk, often used in tandem with crisis communications
during health crises

xi

Chapter 1.
Introduction
Known as “digital natives,” Generation Z (Gen Z) are the first generation to grow up with
the internet interwoven into their daily lives (McKinsey & Company, 2023). In 2005, when
the oldest Gen Z began entering their teenage years, YouTube was first released
(Hosch, 2024) and over 1 billion people were accessing the internet worldwide
(Petrosyan, 2023). In 2007, the first iPhone was released (Apple, 2007) and 3G was
standard speed for mobile browsing (Galazzo, 2020). In comparison to preceding
generations, Gen Z have had the unique experience of having more access to real-time
and unfiltered information, to an almost-inescapable degree. And with technology
continuing to connect us in as many ways as possible, it has also opened the floodgates
for large volumes of information to spill through in all channels of communications.
As a novel virus, COVID-19 became one of the biggest health events in modern history.
Experienced by multiple generations in ways never experienced before, it exposed the
vulnerabilities and fragility of healthcare systems, and also became a very public test on
crisis communication at a global scale.
British Columbia, comprising multiple health regions (Appendix A), was seen as
successful in its response during the early days of the pandemic, due largely to public
leadership by Dr. Bonnie Henry (Porter, 2020). As the pandemic progressed, this
perspective began to be questioned, caused in part by challenges in communication
consistency (Wyton, 2022). Terminology changes drew public confusion (Jones, 2020),
and misinformation scattered all throughout online forums. By early 2022, dissent
became evident with public protests – approximately 500 trucks from British Columbia
joined a nation-wide demonstration, the Freedom Convoy, spearheaded by Canadian
truckers in opposition of vaccine mandates in the trucking industry (Chan, 2022). An
ongoing flow of information, initially public health’s number one weapon in rallying public
participation, turned against their efforts.
Meanwhile, the disruption in Gen Z lives brought by stay-at-home orders and lockdowns
saw a suspension in life milestones and segments of youth lost: bar mitzvas,

1

quinceañeras, graduations, driving lessons, summer jobs, among many more. It begs
the question: how did this once-in-a-lifetime experience shape Gen Z’s outlooks in life?
How did the non-stop flow of crisis information affect Gen Z’s mental health? And how
did the pandemic impact Gen Z’s interactions with information shared by public
institutions?
This study examines how the emerging phenomenon of crisis fatigue has impacted the
Gen Z population. This was done by looking at research conducted during the COVID-19
pandemic, exploring message fatigue caused by information overlad, as well as
conducting a mixed-method approach to confirm findings and theories at a local level.
Analysis was then conducted to understand the current landscape of public health crisis
and risk communications, to identify challenges and possible ways to move forward.

2

Chapter 2.

Literature review

2.1. Gen Z and crisis fatigue: a mental health issue
The Canadian Census classifies Gen Z as people born between 1997 and 2012, making
up 6.71 million of the overall population as of 2021 (Statistics Canada, 2022). As a
generation that grew up seeing a rapid development in communication technologies and
the coming-of-age of the internet, access to news and information became part of
everyday living. With information right at their fingertips, Gen Z no longer faced
restrictions to news in the same ways that previous generations had, relying on access
to news TV channels and structured publishing times. News, already available 24/7, saw
an exponential increase in volume at the advent of social media. As of 2023, 85% of
Canadians aged 15-34 reported getting news through social media or the internet
(Statistics Canada, 2024).
Wars, global economic instability, climate crises and health crises saturated screens of a
generation still heading towards adulthood. Inevitably, this had an impact on mental
health outcomes: Gen Z in the United States were more likely to report fair to poor
mental health in comparison to other generations (American Psychological Association
[APA], 2018, p. 4), and showed higher stress levels than other generations around
issues covered by national news (APA, 2018, p. 3). This was exacerbated by the
COVID-19 pandemic, where Gen Z adults in the U.S. were more likely to report worse
mental health in 2020 than 2019, compared to other generations (Vankar, 2023).
A large factor surrounding poor mental health outcomes for Gen Z, especially within the
sphere of social media during the COVID-19 pandemic, has been attributed to
information overload (Liu et. al, 2023). Following a S-O-R (stimulus-organism-response)
model, Liu et. al (2023) observed how environmental factors (social media information
overload around COVID-19) influenced individuals’ (322 Gen Z UK residents) responses
(social media discontinuance). The study’s findings pointed to increased likelihood of
social media discontinuance following negative mental health outcomes from social
media information overload. Information overload was found to lead to message fatigue.
This was also observed by Sun & Lee (2023) in American college students, who linked
these factors to behavioural outcomes in the form of message avoidance (p. 20349).

3

As communication technologies continue to evolve and extend ideas over time and
space (Innis & Watson, 2008), we are seeing for the first time the consequences of more
modern innovations. Constant exposure to crisis during an entire generation’s formative
years has led to an emerging phenomenon of emotional and mental exhaustion: crisis
fatigue (Kohli, 2023).

2.2. Crisis fatigue as an outcome of message fatigue
Audience research company GWI revealed in their 2023 Connecting the Dots report
that, in comparison to 2020 survey findings, there was an 11% increase in individuals
between 16-64 expressing that social media use causes them anxiety. The report,
drawing findings from over 950,000 surveys completed in 50 countries, also found a
90% decline in interest in news, politics, social issues and current events since 2020
(GWI, 2023).
This downward trend aligns with risk communication studies contextualized by the
COVID-19 pandemic. In a global study of digital crisis interaction among Gen Z and
Millennials, respondents from over 50% of all participating countries reported to being
overwhelmed by the amount of information they were exposed to about COVID-19
(Volkmer, 2021 p. 56). The study, identifying that crisis communication consists of
continuous interaction across multiple sources (Volkmer, 2021, p. 1), suggested that
information fatigue was a contributing factor to respondents expressing agreement
towards the statement, “I stopped paying attention to news and information on COVID19 in general,” (Volkmer, 2021, p. 58) and going on to state that “[b]ased on these
results, it is not surprising that respondents felt crisis fatigue and just stopped paying
attention” (Volkmer, 2021, p. 59).
In consideration to the magnitude of the COVID-19 pandemic, Sun & Lee (2023)
identified that “the primary purpose of repetitive messaging in risk communication is to
increase awareness about potential or imminent danger, thereby enhancing risk
perception and protecting public health and life” (p. 20358). Their study, which looked at
how information overload on social media during the pandemic led to message fatigue,
examined message avoidance in the context of psychological reactance theory and
cognitive load theory.

4

Seo et. al (2021) saw similar results among Italian adults, with one additional key finding:
message fatigue in health risk communications can negatively relate to trust in public
health information (p. 532). With public entities responsible for health risk
communication, this provides additional challenges in pushing key messages through
large volumes of misinformation that can be found across communication channels.
However, it does not seem to be an absolute conclusion, as Sun & Lu (2023) found that
communication from public health authorities on social media still held influence in health
behaviour outcomes over communication by other social media users. The study,
conducted online with 344 adults across America, found psychological reactance around
COVID-19 vaccine messaging was reduced when public health authorities rebutted
negative and misleading content online (Sun & Lu, 2023 p. 156).

2.3. Maintaining trust in public institutions
In comparison to 2022 and 2023, Canadians were reported to have decreased trust in
the Canadian healthcare system in 2024, (Maclellan & Eaton, 2024, p. 29) with British
Columbia showing the least amount of trust in the Canadian healthcare system
compared to Ontario, Quebec, Prairie provinces and the Atlantic provinces (Maclellan &
Eaton, 2024, p. 31). As of 2023, 53% of Canadians aged 15 and older were reported to
hold low levels of trust in media (Statistics Canada, 2024).
It was also found that Canadians with low levels of trust in media were more likely to
fact-check information (Statistics Canada, 2024). While good practice, the additional
effort required to fact-check information on a regular basis can add to cognitive load.
This circles back to the risk of information overload and message avoidance, which has
been observed in real time: between 2020 and 2022, there was a 14% increase of
consumers worldwide aged 16-64 who were reducing their time on social media in
relation to declining trust in news (GWI, 2023).
As health risk information primarily comes from public health agencies (Seo et. al, 2023,
p. 536), maintaining a solid level of trust remains key in successful behavioural
outcomes. Volkmer (2021) found that during the COVID-19 pandemic, a large group of
Gen Z and millennials worldwide expressed levels of distrust in their government, feeling
that their governments did not “present ‘the whole picture’ of crisis issues” (p. 59). A
Romanian study interviewing Gen Z participants looked at communications based on

5

relationship marketing principles and found that relationship management was a key
factor in the efficacy of building trust in messaging from public institutions (Stancioiu et
al, 2021). While the study remains limited in its focus on Romanian society, it
nevertheless provides insight on widely-practiced methods that could support
improvements in health crisis and risk communication practices.

2.4. Further Research
Further research within this area at larger scales present several layers of challenges
considering moving cultural factors as well as communication practices. Crisis fatigue
remains a relatively new phenomenon, though it is an off-shoot of an established
phenomenon. However, considering the regionality of health authorities and public
institutions, smaller-scale studies may be sufficient in accounting for these variables and
present solutions with immediate utility for respective communities. Non-online
communications would need to be considered to get a more nuanced understanding of
experiences of individuals with limited to no access to internet technologies, especially
as a significant amount of research in this area focus on social media and online
communications.

6

Chapter 3.

Methods

3.1. Netnography
Due to the niche nature of crisis fatigue relating to public health communications, few
studies were available with replicable research methods to confirm related
communication theories. As a result, methods for this research were chosen to build on
and complement related research, specifically message fatigue research contextualized
by the COVID-19 pandemic. In these, both qualitative and quantitative methods were
used. To better capture nuance within the subject of inquiry, qualitative and quantitative
methods were also used in this study, namely netnography and surveying.
Kozinets (2015) outlines netnographic research as “‘a specific set of related data
collection, analysis, ethical and representational research practices'” that are conducted
“within and upon the new tempero-spatial cultural coordinates mediated by
contemporary networked communications, such as the Internet and the variety of
devices and forms that humans use to access it” (p. 4). With 93% of Canadians between
the age of 15-24 reported to be most likely to communicate with friends via the internet
once per week, (Asselin et. al, 2021), online research became imperative to capture
enough data within the short study timeframe. A netnographic approach deemed the
most appropriate and accessible for this study, considering the large volume of content
and public forums available online.
A passive participant approach was used in the netnography, where observational data
was gathered on the general web and social media (specifically TikTok) to get an
understanding of the perception of crisis fatigue via internet culture. However, future
research may benefit from an active participant approach: as Costello (2017) asserts,
active participation, which incorporates researcher involvement in discussions held with
groups being researched, “provide[s] an ideal mechanism for cocreation, which can help
to sustain services that might otherwise be pruned back when resources are
constrained” (p. 9). In essence, participating in discussions in online communities has
the advantage of obtaining closer access to individuals, which may provide much deeper
understanding of connections between life experiences and communication behaviours.

7

Webpages indexed by Google from searching “crisis fatigue” were chosen for analysis,
filtered by specific timeframes (see Appendices C, D, E & F). Considering Google’s
search page redesign in 2021 to replace pages with continuous scroll (Mehta, 2022),
links were collected per inquiry up until Google’s search page prompted users to click for
“more results,” with the understanding that click-through rates drop off drastically after
the first search result (Tober, 2023). A total sample of 235 English-language pages were
collected. Pages were then filtered based on their verbatim use of the term “crisis
fatigue.” Webpages were then sorted based on categories of function for the website,
focusing specifically on health, education, business, news or “other,” encapsulating all
other types of content. This was done to find a universal definition of “crisis fatigue” in
online spaces, and to determine if there were any evolutions of the concept resulting
from world events or different industry contexts.
In May 2022, Canadians between the ages of 18-29 were the majority age group of
overall TikTok users in Canada, encapsulating a large proportion of the Canadian Gen Z
population. TikTok, the fourth most used social network in Canada as of December 2023
(Statista, 2022, p. 18) was a chosen platform for its prevalence in Canadian Gen Z social
media habits. A new account was made to ensure a “clean slate” for providing TikTok
behaviour data in order to reach content relating to the topic of study. Posts were sought
between February 19 - March 27, 2024, looking at specific keywords through TikTok’s
search page as well as through app functions allowing users to view TikToks using
specific audio. After filtering content for subject relevance, a sample of 68 Englishlanguage posts were collected for analysis. The main focus was to get an understanding
of how themes around crisis fatigue were being discussed within the TikTok community
and platform, as well as the language used around it.

3.2. Online survey
An online survey (Appendix B) was then conducted to close the loop on understanding
whether sentiments understood through netnography findings could be confirmed within
local populations. This was done with the aim of understanding sentiment around public
institutions, as well as provide a baseline for mental health measurement and compare
online communication habits between good mental health days and bad mental health
days. The survey also sought to understand whether the functions of “crisis fatigue”,
mainly the constant exposure to crisis event coverage through people’s lifetimes, were
8

actually experienced by the target population. The survey was hosted through the
researcher’s website on an installation of LimeSurvey. Dissemination was approached
by asking faculty from Capilano University to share the survey to students who fit the
participation criteria (individuals born between 1997-2005), and to share it with other
instructors who would be able to share the survey with their students. Recruitment was
also done online through posts on Reddit, TikTok and Instagram, to reach a broader
group of individuals who may exist outside of the local academic community. A total of
36 responses were collected through these efforts between March 12 to March 22, 2024.

3.3. Analysis of health organizations’ communication
frameworks
Lastly, ERC (emergency risk communications) frameworks and pandemic
communication guidance documents from the World Health Organization (WHO) and the
Government of British Columbia were gathered to get an understanding of current
guidance around managing communications during crisis events. These provided criteria
to reflect on when assessing communication strategies implemented by public health
institutions during crisis situations. Analysis was then done on posts on TikTok accounts
by public health authorities to get an understanding of communication approaches from
surrounding health regions. To address Canada’s public health structure being managed
at a provincial level, data from British Columbia health authorities were selected. Profiles
for Vancouver Coastal Health, Northern Health and Fraser Health were analyzed to
observe trends and communication strategies employed via TikTok.

9

Chapter 4.

Results

4.1. WHO’s ERC framework & B.C.’s Pandemic Plan
ERC frameworks have been developed in public health to provide guidelines on
managing public communication in events of health emergencies. The WHO (2017)
defines risk communications as “the real-time exchange of information, advice and
opinions between experts, community leaders, or officials and the people who are at
risk” (p. ix). The WHO’s framework categorizes ERC recommendations into the
following three processes (steps in each process can be seen in Appendix G):

Figure 1 – Summary of WHO ERC framework (World Health Organization [WHO], 2017).

The ERC practice is outlined as follows:

Table 1 - Excerpt of the WHO’s ERC framework (WHO, 2017).

10

During the COVID-19 pandemic, the Government of British Columbia developed a
Pandemic Provincial Coordination Plan (2020), providing a short rundown of roles and
responsibilities around external communications, referring to the BC COVID-19
Response Plan for public communications for further guidelines (p. 15). The Government
of British Columbia followed a Communication and Education Framework in response to
influenza pandemics (see Appendix H), which was based off the WHO’s six-phased
approach to a pandemic cycle (Government of British Columbia, 2012, p. 10). The
Government of British Columbia employed multiple communications tools, including
holding televised technical briefings, development of COVID-19 web portals for public
information, fact sheets, and social media (Government of British Columbia, 2020, p.
16).

4.2. Defining crisis fatigue
Though the term “crisis fatigue” existed prior to 2020, it began showing prevalence in
health-focused websites between 2020 and 2021, until other websites began exploring it
in mid 2021 (see Appendix I). Most posts around crisis fatigue were concerned with
defining it akin to a medical ailment, identifying signs/symptoms of it, as well as tips to
manage it. From April 2020 to March 2021, Google had not identified a recommended
meaning for the term; however, from April 2021 onwards, Google would provide
recommended definitions to “crisis fatigue” (see Appendix J). The term appeared to
retain the same meaning throughout the different contexts in which it was written about:
the burnout and fatigue resulting from prolonged exposure to crisis and crisis events.

11

Figure 2 - Google Trends data on searches for "crisis fatigue" over a 10-year period.

Between 2020 and 2021, multiple search listings mentioning “crisis fatigue” concerned
themselves with the global pandemic. Crisis fatigue results were also often listed
alongside websites that concerned themselves with other COVID-19-related and health
terms such as “compassion fatigue,” “burnout” and “chronic fatigue syndrome.” April
2020 to March 2021 saw a larger number of pages published on topics around “crisis
fatigue” in comparison to subsequent time frames (Figure 3). Heading into 2022 and
onwards, search results began to explore crisis fatigue around other events, such as
wars, famine and environmental issues. Between 2023-2024, artistic works titled “crisis
fatigue” begun to be surface online.

12

Figure 3 - Number of posts with verbatim use of "crisis fatigue," between 2020-2024.

4.3. Crisis fatigue on TikTok
One point of interest was the lack of cross-over of language found in webpages and
articles on TikTok posts. Despite the large collection of websites normalizing the term
“crisis fatigue” over the past few years, search results for “crisis fatigue” on TikTok
displayed posts around trauma and mental health crisis responses – different subject
matter than discourse on the phenomenon itself. Instead, language from COVID-19
communications, specifically the phrase “unprecedented times” became an artifact when
seeking sentiment around crisis fatigue, as well as variations of the phrase “major
historical events.” This became an important consideration in getting an understanding
of how Gen Z applied language when discussing personal experiences.
TikTok posts published between 2021 and 2024 were collected for content and trend
analysis. The majority of relevant posts found were posted in 2022, which align with
Google Trends data (Figures 4 and 5) on when the terms “unprecedented times” and
“major historical events” could have been adopted in the general public’s vernacular.

13

Figure 4 - Screenshot of Google Trends data over popularity of the term "unprecedented times" over the
past 5 years.

Figure 5 - Screenshot of Google Trends data over popularity of the term "major historical events" over the
past 5 years.

14

Similar to Figure 5, Figure 6 shows that TikTok posts using the term “major historical
events” appeared more likely around the same time as an announcement of a major
world event. Figure 6 displays a timeline of the posts that were analyzed, and when they
were posted. Specific events that were of interest included the Insurrection (January 6,
2021), the Russian/Ukraine war (February 24, 2022), the overturning of Roe v. Wade in
the United States (June 24, 2022), Queen Elizabeth II’s death (September 8, 2022), and
the Israel/Hamas war (October 7, 2023).

Figure 6 - Timeline chart of aggregated TikTok posts under analysis, making use of the term "major
historical events" in their content.

A commonly-used style for posts about crisis fatigue involves users filming themselves,
overlaying text, and using audio from existing TikTok posts or other online content. Texts
span between close captioning of audio used, to listing out world events over the past 20
years, to listing out concerns that users deal with (e.g. rising cost of living). Commonlyused audio included narration, as follows:
1. From a TikTok post by user @seanghedi (2021) – “I don’t know about you guys,
but I am sick and tired of [upbeat music plays] living through major historical
events.”
2. From a TikTok post by user @TheFitFlounder (2022) – “I am so fucking tired of
living through major historical events every other goddamn day! Fuck! Knock it
off!”
3. From a TikTok post by user @odette.net (2022) – “Living through historic events
is fucking shit. Very, very shit indeed.”
15

4. From a video by YouTube creator, Jenna Marbles – “Here’s the truth: the fatigue,
of like, just being alive is starting to set in.

Figure 7 @josh_p_jackson
(2021)

Figure 8 @kindra_erhart (2022)

Figure 9 @tea_moneyy (2022)

Figure 10 @highcountryoutlaw
(2022)

On January 7, 2021, user @swanksinatra.1 published a post outlining the timeline of
crisis events in relation to the Gen Z experience. The user starts off by stating that “Gen
Z starts in like 2000, 2001. Immediately, 9/11 and the war in the Middle East happen.”
He continues to list SARS, the 2008 economic crisis, the Syrian civil war, the Syrian
refugee crisis, and the COVID-19 pandemic, among global events in the Gen Z timeline.
He finishes by saying, “literally, Gen Z’s been putting up with the world’s bullshit since
the beginning.”

4.4. Survey results: the Gen Z experience
Participants in the study were separated based on year ranges, to get an understanding
of any possible variances due to life experiences: 1997-1999, 2000-2002 and 20032005. 18 participants were born between 1997-1999, 12 participants were born between
2000-2002 and 6 participants were born between 2003-2005. While there seemed to be

16

some correlation between age and experiences, each sample was too small to
determine the strength of these correlations.
To establish a baseline for analyzing mental health factors, participants were asked to
rate their perceived mental health between 1-10. Though there were some variances,
the majority of participants reported to be around the mid-range of 6. More participants
reported to have a mental health score on the lower range, however, than in the higher
range.

Age vs. Perceived Mental Health
1997-1999

2000-2002

2003-2005

5

Number of participants

4

3

2

1

0
1

2

3

4

5

6

7

8

9

10

Perceived Mental Health Score (1=Poor; 10=Great)

Figure 11 - Survey data on participants' perceived mental health, categorized by approximate years of birth.

When asked about issues and concerns that participants think about on a weekly basis,
responses averaged 6 or more life concerns (see Appendix K). When asked regarding
world events participants remembered living through, at least 50% of respondents
reported to remember living through at 8 (out of 13) or more of listed events (see
Appendix L).
Baseline mental health scores did not prove to be determinants on social media
consumption habits; most participants reported an increase in use of social media when

17

they are experiencing “bad days,” or poor mental health. Those who reported showing
the same consumption, or even a decrease in consumption on bad mental health days,
were those who self-scored 6 or lower (Appendix M). This may be attributed to a desire
to decrease further stimuli on mentally taxing days.
Participants were then asked what types of activities they liked to do on “good days”
(good mental health days) versus “bad days.” Overall, survey data illustrated that
individuals were less likely to engage in physically- and socially-demanding tasks (Figure
12). Data also illustrated an increase in use of social media. Additionally, 34 out of 36
respondents reported to be on more than one social media platform (Appendix N). This
would suggest further vulnerability to message fatigue due to amount of exposure to
content via social media, especially when individuals are reporting poor mental health.

Figure 12 - Survey data comparing activities that respondents engage in during "good days" and "bad days."

Survey participants were provided an open-ended way to respond to “Finish the
following sentence: When I watch/read the news (television, social media, etc), I feel…”
Participant 4 relayed their experience as “[o]verwhelmed. Tired. Saturated. Makes me
regret even trying to keep up with situations. It’s a never ending doom around us all.”

18

Participant 10 stated “I usually feel stressed and upset for the current state of my future
and of others. I feel slightly angry in regards to our government and how they are
ignorant of their constituents.”

Figure 13 - Word cloud highlighting common themes and terms coming from survey participants' answers to
the question "Finish the following sentence: When I watch/read the news (television, social media, etc), I
feel…”

There does seem to be a correlation in perceived mental health baselines and trust in
public institutions (Appendix O), which is in line with Statistics Canada (2024) reports,
stating that “[l]evels of trust in media were lowest among those who rated their mental
health (69%) or general health (66%) as fair or poor, compared with those who had rated
their mental health (50%) or general health (51%) as excellent or very good.”
It is important to note, however, that despite relatively mixed trust expressed in public
institutions, that a majority of survey participants still stated that they would turn to public
institutions (government websites, news) for health information.
When reflecting on their experience with COVID-19 communications, specifically those
who lived in BC during the pandemic, there did not seem to be any correlation regarding
frequency in seeking out health-related news and their opinion on the efficacy of the
efforts. Overall, sentiment seemed relatively positive.

19

Figure 14 - Survey participants' sentiment on their experience with B.C.'s pandemic communication efforts.

Sentiment regarding the amount of official messaging did not seem to have a significant
relationship based on information-seeking habits. Those who leaned to less frequent
checking habits (Rarely/Never & 1-2 times a week) expressed that there was enough
information while those with more frequent checking habits (Daily/More than once a day)
expressed that not enough information was available (Appendix P). Those who sought
news 3-4 times a week were split in the middle, between feeling like enough information
was available and not enough information being available (Appendix P).
Overall, there does seem to be a distinct difference in social media consumption habits
between now and during the COVID-19 pandemic (Figure 15). It is also worth noting that
86% of survey participants report to receiving health-related news on social media
currently (Appendix Q) despite most expressing the sentiment that public health
websites were most trust-worthy when seeking out health-related news during the
pandemic (Appendix R). This seems to suggest that one of the first touchpoints to
consider for Gen Z is social media, which can be used to feed into official government
websites.

20

Figure 15 - Comparison chart of frequency that survey participants seek out health-related news, currently
vs. during the COVID-19 pandemic.

4.5. Public health on TikTok
Considering the large population of Gen Z TikTok users, there is a lack of presence on
the platform when it comes to public health authorities. At the time of the study, only
three health authorities (Vancouver Coastal Health, Fraser Health and Northern Health)
appeared to be active on the platform, to varying degrees. Two accounts claim to
represent Interior Health and Vancouver Island Health Authority, though there are no
posts by nor connections to official sources to verify these channels. Providence Health
Care and First Nations Health Authority do not have TikTok accounts.
As of March 18, 2024, Vancouver Coastal Health had a total of 113 posts, and appeared
to be most active out of all health authorities. Fraser Health had 91 posts, with their
latest post published in March 2023. Northern Health had 16 posts, with their latest post
being published in October 2023.

21

Figure 16 - Vancouver Coastal Health's TikTok posting frequency between 2020-2024.

Figure 17 - Fraser Health's TikTok posting frequency between 2020-2024.

22

Figure 18 - Norther Health's TikTok posting frequency between 2020-2024.

Vancouver Coastal Health and Fraser Health were seemingly the only health authorities
active on TikTok during the pandemic, with first posts on both accounts published in
August 2020. With respect to BC’s framework responding to pandemic phases outlined
by the WHO, the creation of TikTok accounts occurred during Phase 6, seemingly under
the following guidelines:

Table 2 - Excerpt from the British Columbia Pandemic Response Plan (Government of British Columbia,
2012) Communication and Education Framework.

Due to the lack of pre-established presence on the platform, however, health authorities
not only needed to consider the delivery of messages to maximize views and
engagement, but also build their audience to maintain engagement. One way of building
audiences and reaching accounts would be to post frequently and maximize

23

discoverability – this strategy appeared to have been implemented by Fraser Health,
publishing multiple TikToks in 2020, on the same days in some cases. However, this
runs the risk of playing into message fatigue, especially for constituents following the
account. Another possible strategy in line with guidelines would be to engage with
constituents directly on TikTok through comments and direct messages; however, this
would require dedicated resources to upkeep, to ensure key messages are being
delivered appropriately and in a timely manner.
Despite other disease outbreaks locally reported between 2021-2024, such as
monkeypox and the avian flu, no posts were published between all three health authority
accounts addressing these events. As posts regarding COVID-19 guidelines and
vaccine announcements died down around 2022, subsequent posts between Vancouver
Coastal Health and Fraser Health began promoting different focuses, with Vancouver
Coastal Health promoting general health and Fraser Health focusing on employment
recruitment efforts.
With respect to the most updated WHO guidelines, future health crises may benefit from
identifying in advance social media channels that would help maximize the following
goals:

Table 3 - Excerpt from the WHO’s ERC guidelines (World Health Organization, 2017).

All health authorities’ TikTok accounts maintain open comment sections for most of their
posts, providing a platform for open feedback from their constituents. However, there is
seemingly a lack of engagement altogether across all three accounts, and low following
numbers relative to the overall population of the health regions they service.

24

Chapter 5.

Discussion

Study findings appear to suggest the importance of social media in the sphere of health
crisis and risk communications towards younger populations, at the very least within
British Columbia and other parts of Canada. 86% of respondents stated that social
media was one source they receive health-related news, in line with Statistics Canada’s
findings (2024). Influence of official channels still seem to bear weight despite mixed
trust levels towards public institutions – out of 32 respondents who answered the
question “If another health crisis were to happen today, where would you go for
information?” 21 (65%) of survey participants expressed that they would turn to public
health and/or government sources. Sun & Lu’s observations of a reduction in
psychological reactance when public health rebutted misleading content in their study
(2023, p. 162) further suggest that an online presence is also important in battling
misinformation.
In contrast to Liu et. al’s (2021) findings of social media discontinuance following
negative mental health outcomes from social media information overload, 83% of survey
participants self-reported to increase social media usage on “bad days,” in comparison
to “good days.” It is possible that social media consumption can differ based on regionspecific lifestyle factors – according to Statistics Canada, British Columbia ranked as
one of the most active provinces in Canada between 2021-2022 (Appendix S), which
may associate “good days” with higher engagement in physical and social. It is worth
further investigating the relationship of these behaviours, as there pose risks of
triggering an unhealthy habit loop: poor mental health leading to more social media use,
more social media use leading to further message overload, message overload causing
poor mental health outcomes through crisis fatigue, and poor mental health causing
increased social media use, etc.

25

Chapter 6.

Limitations

Other qualitative methods, such as focus groups and interviews, would provide much
deeper context and insight regarding perspectives and experiences from Gen Z, and
would be best pursued in future research with an extended timeframe. Longitudinal
research would help in understanding how technological advancements, as well as world
events, affect the fluid nature of health communications, as well as the need to reassess
frameworks and strategies to promote sustainable behaviour change during crisis
events. While multi-year data collection initiatives have been pursued around the
COVID-19 pandemic, like the BCCDC’s multi-year BC SPEAK Survey, it is worth noting
that it is limited based on one specific phenomenon, rather than looking into health
emergencies in its entirety.
Small incentives may be worth considering in further study within younger populations:
without incentives for participation, the survey only had an 8% completion rate, viewed
over 425 times, attempted 59 times over the course of 10 days, and resulting in only 36
completions. Data was also skewed towards older participants – a more even spread of
participants from all year categories would be beneficial in future studies.
As the subject matter of the study was presented upfront to survey participants, as well
as the process of self-selection acting as a participant filter, participation bias should be
considered when assessing answers. Participation from those without pre-determined
interest in the subject matter would be valuable in getting a better understanding of the
pervasiveness of crisis fatigue, and how it affects trust in public institutions.
Measures were taken to attempt to keep the survey local, however, due to its availability
online, it is difficult to determine just how many participants were in British Columbia at
the time of survey dissemination. As the survey was intended to be an initial gathering of
overall Gen Z experiences, demographic data was also not collected – demographic
information would provide more nuance to understand how socioeconomic status and
culture affect perspectives, media consumption, and levels of trust in public institutions.

26

Chapter 7.

Conclusion

Hermeneutical gaps, according to Fricker (2007) can be seen as “blanks where there
should be a name for an experience which it is in the interests of the subject to be able
to render communicatively intelligible” (p. 180). It is possible that though “crisis fatigue”
as a term is readily available, it does not serve to bridge the gap of understanding the
unique experiences of Gen Z, especially when compared against experiences of other
generations. Developing linguistic heuristics, according to Shulman et. al (2021),
provides a “processing fluency […] that people use to make judgments about whether
information is familiar, known, consistent with existing beliefs, and/or the type of material
one typically engages with” (p. 548). Several limiting factors come into play when
relaying messages through social media, necessitating the use of linguistic shortcuts –
short time limits, competition for audience attention/engagement, and social media’s
function in real-time conversations, among several others. With the proximity of COVID19 to the emergence of crisis fatigue in Gen Z discourse, it makes sense that the use of
pandemic-related language goes further in being widely understood than newly
popularized terms.
It is important to acknowledge that as a social media platform, TikTok currently holds a
contentious status in Canada considering ongoing concerns of foreign governance over
collected user data (Previl, 2024). At the time of research, the Canadian federal
government had already been months into a national security review on TikTok
(Karadeglija, 2024). The future of mass communication on social media platforms in
Canada is also currently undergoing many changes, most in part due to the passing of
the Online News Act in December 2023, with unintended consequences such as Meta
blocking Canadian access to news content on their multiple platforms. News releases
and articles are an important tool in health crisis and risk communications, which would
be more difficult to push to populations who are more likely to receive news through
social media (Leger & Canadian Press, 2023; Statistics Canada, 2024). Considering that
Meta platforms and TikTok are the most used platforms by Canadians (Dixon, 2024),
long-term strategies would need to be developed that can maneuver these limitations.
With that said, the landscape of social media remains fluid – other platforms may
overtake Meta and TikTok in the near future, that would be worth looking into by public
health.

27

In their guidance documentation, the WHO (2017) identifies multiple research gaps in
risk communication, including research around social media information overload and
lack of geographical diversity in studies (p.33). As new research emerges, especially
following the COVID-19 pandemic, revisions should be considered to account for
lessons learned, as well as changes in communications technologies. Social media,
designed to be interactive and instant, is a powerful platform in facilitating public
participation, timely message dissemination, monitoring constituent sentiment, and
providing a feedback loop – it would be worth considering these platforms further up in
the stages of risk and crisis frameworks, especially when attempting to establish
authority and combating misinformation.
The complex nature of building trust in public institutions must be further dissected,
especially at a time when misinformation runs rampant. The WHO states that the trustbuilding process, investigated under their systemic review, saw less coverage on the
recovery phase of emergency cycles as opposed to preparedness activities (2017, p.
11). This might be worth reconsidering due to the ongoing relationship between
institutions and their constituents – a strong recovery phase may feed into stronger
preparedness activities for future crisis events.
As recommended by Seo et. al (2021), leveraging a variety of media and executing
creative and innovative message design would aid in mitigating information overload,
with careful mapping of channels to avoid oversaturation (p. 536). Use of existing jargon
may supplement, if appropriate, to lessen additional processing effort required by
constituents, though this would require close attunement on efficacy and monitoring of
changes in sentiment. Last, but not least, continuous re-assessment of risk and crisis
communication frameworks to adapt with new processes and technologies is imperative
in ensuring that the needs and unique experiences of constituents are sufficiently met
through times of crisis.

28

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34

Appendix A.
Health authority areas in B.C.
A map outlining the health authority areas in British Columbia (Government of British
Columbia, 2022).

35

Appendix B.
Survey
Online survey disseminated online between March 12, 2024 – March 22, 2024.

36

37

38

39

40

41

Appendix C.
Web content analysis, April 2020 – March 2021
Chart of posts to analyze between April 1, 2020 to March 31, 2021. The selected
(checked) posts are those analyzed after filtering out non-relevant subject matter.

42

Appendix D.
Web content analysis, April 2021 – March 2022
Chart of posts to analyze between April 1, 2021 to March 31, 2022. The selected
(checked) posts are those analyzed after filtering out non-relevant subject matter.

43

Appendix E.
Web content analysis, April 2022 – March 2023
Chart of posts to analyze between April 1, 2022 to March 31, 2023. The selected
(checked) posts are those analyzed after filtering out non-relevant subject matter.

44

Appendix F.
Web content analysis, April 2023 – March 2024
Chart of posts to analyze between April 1, 2023 to March 15, 2024. The selected
(checked) posts are those analyzed after filtering out non-relevant subject matter.

45

Appendix G.
WHO ERC Recommended Framework
Structured recommendations from the World Health Organization’s Emergency Risk
Communication framework (2017, p. iii), providing evidence-based guidelines for health
organizations to use when communicating during health emergencies.

46

Appendix H.
B.C. Influenza Pandemic Response Framework
This table outlines the British Columbia’s Pandemic Response communication and
education framework (Government of British Columbia, 2012). The phases are based on
previous World Health Organization pandemic phase structure.

47

Appendix I.
Web content analysis - categories
Aggregated Google results on verbatim searches for the term “crisis fatigue,” colourcoded to categorize results based on publishing date, and categorized based on the
function of the website pages are hosted on.

48

Appendix J.
Evolution of Google definition of “crisis fatigue”
The evolution of Google’s definition of “crisis fatigue,” from 2021-2024.

49

Appendix K.
Gen Z weekly concerns
Charting survey answers to the question: “On an average week, which of the following
do you think about?”

50

Appendix L.
World events during Gen Z’s lifetime
Charting survey answers to: “In your lifetime, which world events do you remember living
through?” Analysis was then conducted to understand approximate ages of respondents
during these events.

Survey Data
World Events
Boston Marathon
Paris Attacks
Brexit
Sandy Hook
Swine Flu Pandemic
Hurricane Katrina
Global (2008) financial
crisis
Avian Flu Outbreak
BP Oil Spill
9/11
SARS outbreak
Occupy Wall Street
Arab Spring

Date(s) Responses

% of
respondents

Average ages at tail end
of events
1997- 2000- 20031999
2002
2005

April 15, 2013

30

83.33%

14-16

11-13

8-10

November 2015

29

80.56%

16-18

13-15

10-12

2016-2020

27

75.00%

21-23

18-20

15-17

December 14, 2012

25

69.44%

13-15

10-12

7-9

2009-2010
Aug 23, 2005 – Aug 31,
2005

22

61.11%

11-13

8-10

5-7

19

52.78%

8-6

3-5

0-2

2007-2008

18

50.00%

9-11

6-8

3-5

2020-2024
April 20, 2010 - September
19, 2010

18

50.00%

25-27

22-24

19-21

16

44.44%

13-11

8-10

5-7

September 11, 2001

9

25.00%

4-2

0-1

N/A

2002-2004
September 17 - November
15, 2011

9

25.00%

7-5

2-4

1-0

8

22.22%

12-14

9-11

6-8

2010-2012

3

8.33%

13-15

10-12

7-9

51

Appendix M.
Social media habits vs. perceived mental health
Charting out changes in social media habits of survey respondents based on perceived
good days and bad days, to be compared to baseline reported mental health state.
Response
ID

On average, how would you
rate your mental health? 1 =
poor, 10 = great

When you’re having a good
day, how much time do you
spend on social media?

When you’re having a bad
day, how much time do you
spend on social media?

Changes in
social media
use

1
2

6
3

5-8 hours
1-4 hours

9-12 hours
9-12 hours

Increase
Increase

3

6

5-8 hours

12+ hours

Increase

4

6

1-4 hours

5-8 hours

Increase

5
6

4
5

5-8 hours
1-4 hours

9-12 hours
5-8 hours

Increase
Increase

7

4

1-4 hours

9-12 hours

Increase

8

3

1-4 hours

5-8 hours

Increase

9
10

9
6

1-4 hours
1-4 hours

5-8 hours
5-8 hours

Increase
Increase

11

6

1-4 hours

5-8 hours

Increase

12

7

1-4 hours

5-8 hours

Increase

13
14

6
5

1-4 hours
9-12 hours

1-4 hours
1-4 hours

Same
Decrease

15

3

1-4 hours

0 hours

Decrease

16

4

1-4 hours

5-8 hours

Increase

17
18

3
5

1-4 hours
1-4 hours

5-8 hours
9-12 hours

Increase
Increase

19

5

1-4 hours

5-8 hours

Increase

20

6

5-8 hours

9-12 hours

Increase

21
22

7
6

1-4 hours
1-4 hours

5-8 hours
1-4 hours

Increase
Same

23

6

1-4 hours

5-8 hours

Increase

24

7

1-4 hours

9-12 hours

Increase

25
26

6
3

1-4 hours
1-4 hours

5-8 hours
5-8 hours

Increase
Increase

27

6

5-8 hours

9-12 hours

Increase

28

3

1-4 hours

9-12 hours

Increase

29
30

5
3

1-4 hours
5-8 hours

1-4 hours
12+ hours

Same
Increase

31

4

1-4 hours

1-4 hours

Same

32

7

1-4 hours

5-8 hours

Increase

33
34

3
3

1-4 hours
1-4 hours

5-8 hours
12+ hours

Increase
Increase

35

6

1-4 hours

5-8 hours

Increase

36

8

1-4 hours

5-8 hours

Increase

52

Appendix N.
Number of social media platforms used
Charting out social media platforms respondents report being on, compared to
approximate ages.

53

Appendix O.
Trust in institutions vs. perceived mental health
Charting out reported trust levels in institutions, between 1-10 (1 = poor; 10 = great),
alongside reported baseline mental health levels per respondent.

54

Appendix P.
Sentiment of COVID-19 messaging in B.C.
Sentiment over availability of COVID-19 messaging during the pandemic, for participants
who were living in British Columbia between 2020-2021. Answers were categorized
based on how often each participant sought out health-related news.

55

Appendix Q.
How do you receive health-related news (currently)?
Charting out where survey participants currently receive health-related news.

56

Appendix R.
What sources did you find trust-worthy when looking
for information on COVID-19?
Charting out where survey participants received health-related news during the COVID19 pandemic.

57

Appendix S.
Health characteristics, annual estimates.
Table of health characteristics from Statistics Canada (2023) data, filtered to show
percentage of population per province (excluding territories) engaging in regular physical
activity.

58