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Social media has become an increasingly popular tool used by experts and laypeople alike to obtain, share, and create health information. Public health authorities have also begun to use web 2.0 platforms to share information and foster engagement with the public. Existing public health research about Twitter has explored its uses as a tool of health promotion, however communication on the Twitter platform has not yet been explored from a critical public health perspective. The purpose of this study is to analyze how talk about public health occurs online via Twitter. Using both content and discourse analysis of communication on Toronto Public Health's official Twitter feed, this study explores emergent themes of biomedicalization; how biomedical power is affirmed; and assesses whether Twitter can be a useful platform to facilitate a dialogue between citizen and state. The immediacy and transparency, characteristic of the Twitter platform, do support dialogues that question and responsibilize the health authority, however biomedical power is most often affirmed rather than challenged. This study argues that while Twitter may be an effective tool to facilitate engagement, it does little to reshape the existing power dynamic between citizen and state.