Misinformation in public health

7 min readJan 23, 2021

As a generation, we are privileged be able to quickly and easily seek information. The internet and more recently social media have become a popular tool for people to learn about health and for healthcare professionals to share their research with a larger non-scientific audience. People are increasingly turning to the internet for answers regarding their health. It is not uncommon these days for someone to google their symptoms before contacting their GP. Whilst digital means of communication have been valuable in sharing public health information and guidance, they have also become a gateway for the rapid spread of misinformation.

Misinformation is simply the spread of false and or inaccurate information not based on scientific evidence. This is not something new; people have always sourced information outside of formal healthcare settings, but the rise in social media and the current pandemic has highlighted the dangers of misinformation, especially when they result in behavioural changes and minimise the effectiveness of important public health guidelines. Using COVID-19 as a framework, let us have a look at how misinformation is propagated, what we can do to identify what is misinformation and how we can start having dialogues with friends and family to help reduce its harmful effects.

Interaction and spread of misinformation:

Earlier this year we have seen the rise of what we termed as WhatsApp auntie’s who sent various health-related videos or messages on how to deal how to best deal with the pandemic. Theories on how garlic, ginger, lemon can help soothe the respiratory system and cure the virus. There was a rise in conspiracy theories on how the virus started, some said it was manufactured by the government to control population growth whilst others thought 5G was the cause. These types of information spread very fast, the two main ways being direct searches and content creating sites.

Searches:

A lot of people use the internet to search for health-related content. More than 50% of all google searches are health related, and it will be untrue to say that these are not useful. Research has shown that it can empower patients when making health related decision. It makes them feel part of the conversation and builds confidence. But how many times have you googled your symptoms only to find out you have cancer?

Some people also bypass a google search and go straight to sites they know. The problem here arises when they do not use reputable sources but instead rely on blogs that were the quality of research is questionable.

Content creating sites:

Nowadays, content creation generally refer to social media sites like Instagram and Twitter but also include places like Wikipedia where it is easy for information to be edited and newspaper sites that have discussion threads. Social media sites offer a rich ground for the spread of misinformation; sharing information is easier, often instant and permanent. Due to its direct nature, we sometimes miss the opportunity to weigh the reliability of the information we share. Social media can also generalise information making it hard to separate fact from opinion; influencers sharing their experience with a certain regiment (this one is often seen in terms of nutrition) can lead to thousands following the same without realising that they may not have the full information. Sometimes, the inaccurate information we share and adopt ourselves comes from a person we trust, which increases our likelihood of sharing.

Misinformation vs Disinformation

Not all information or misinformation is the same. Disinformation is coordinated, deliberate efforts to purposely spread false claims for a specific gain (money, power, reputation). It can be hard to decipher misinformation from disinformation because they are sometimes used interchangeably in the literature, but disinformation is a subtype of misinformation, usually attributed to big companies funding research to sway the data in their favour. For example, fizzy drink companies have funded research to create doubt on the health risk of sugar by focusing on other content like fat. Practices like these contribute to the mistrust in medical advice and aid in the spread of misinformation, which once its out there, you can almost never get it back. Look at the case of vaccines and autism; the original study has been retracted and refuted but it is still used as so called ‘evidence’ for people refusing to vaccinate their children.

Misinformation and your health

Having easy access to health-related information has its perks, but incorrect information can be a cost to individuals, communities and health systems. Research has shown that around 55% of health information online are problematic in terms of their quality. Most people use low quality sites when searching for information, turning to unaccredited websites for their health-related queries. Research has highlighted that people are causing actual harm to themselves and others in their care when interacting with misinformation. More and more people opt for alternative medicine to deal with chronic illnesses like cancer which has shown to double the risk of death when compared to conventional treatment. Misinformation can lead to adverse health effects and increase mental and physical ill-health. More indirectly, they promote a mistrust in science and affect people’s long-term judgement on health topics, giving them a false sense of scientific research. We have all heard of tricks to lose weight ‘fast and naturally’ or have younger looking skin with methods claimed, “your doctor won’t tell you”. Some of these types of treatment have led to life changing illnesses for some people. Misinformation also increases cost and burden of disease on the health system, disadvantaging a system that is already struggling.

Misinformation and COVID-19

The Coronavirus pandemic is the first pandemic in history where technology and social media has been widely used by scientist and healthcare professionals to inform people. The general public also use the internet more keep connected to friends and family, for work and school. The use of the internet has led to a proliferation of information, both correct and inaccurate. The WHO has used the term infodemic to describe the overabundance of information. The science is still developing in regard to COVID-19 so it creates a gap for conspiracy theories. The spread of misinformation, both unintentional and intentional ones from people pretending to be medical professionals to spreading false message, has led to poor observance of public health measures ultimately reducing their effectiveness.

Earlier this week, we saw Margaret Keenan become the first recipient of the COVID-19 vaccine in the UK. Prior to this point, there have been several infographics circulation on social media highlighting the public’s hesitancy to take up the vaccine. Many raised concerns over the historical pace at which this vaccine was created and used that as an opportunity to deem the vaccine as ‘unsafe’. These types of information circulation, without real scientific explanations to counteract on the same scale as they are spread, results in greater hesitancy amongst the public and leads to less uptake of the vaccine, essentially, we end up endangering our ability to control and ultimately stop the pandemic.

Research on misinformation and the COVID pandemic shows BAME individual were more susceptible to misinformation and more likely to refuse the vaccine. It is important that we realise that the mistrust faced by BAME populations is based on real adverse events and everyday experience of healthcare. Medicine has not always catered to BAME people, so their concerns whether medical advice is harmful to them is valid.

Identifying what’s fake from what’s real

It’s important that we know how to identify what is misinformation in order to make better health decisions. This can be hard because some of the fake information out there can be very convincing. The WHO puts the task on Members of States to develop plans to tackle misinformation but what can you do as an individual surfing the web?

First, do not share everything you’re sent. Try to critically analyse the information: does it make logical sense? Is there good research to back it up? Can you find different sources to fact check the information? If you’re unsure, chances are the information is not clear so best to not pass it on.

Be intentional about what you interact with on social media. There are many healthcare professionals and health organisations that have a social media presence. They also use a diverse platform from twitter to podcasts to YouTube channels. Interact with these alongside your other content so you can easily identify the style and language used to convey scientific information. It also means, you have a place to ask questions if you have any. I will post some of my favourite accounts and podcasts as a starting point.

ASK QUESTIONS! This is my most recommended method to identifying false information. Ask! You can ask your GP during an appointment if unsure about anything you heard, ask friends and family, question anything that stands out to you. Also be mindful of the information you are digesting, a small amount can be ok, but doing too much may be harmful. For example, traditional remedies may provide some benefits but they are usually not a cure. So, yes, enjoy your honey and ginger concoction if you’ve got a cold. It can provide some soothing benefits to you, but please be mindful that it will probably not cure it.

Better science communication as a tool to reduce misinformation

The coronavirus pandemic has highlighted that science communication needs to be accessible. We need to realise that people may spread information because we are looking for answers. There are many reasons for the propagation of misinformation, but an adequate attempt at communicating and teaching the process of science would have been useful in managing the pandemic. Simply letting people know that because the research is developing in real time, scientifically it is normal for the research to change as we learn. For example, when we first thought the virus only affected the elderly and those with pre-existing conditions, it was not made to the general public this was what the data showed at the time. So as the infection rate increased, and more people became infected, the change in narrative allowed an opportunity for people to question the scientist. Same premise with the vaccine. The process of vaccine research and clinical trials should have been openly communicated and the bureaucracy involved in the 10+ year process should be made clear, so it doesn’t affect the vaccine take up and undermine scientific work.

Combating misinformation is something we can all do. Here are some pages to follow

Instagram:

Public health. info — https://instagram.com/publichealth.info?igshid=1iamoatdi2uco

Equity in healthcare — https://instagram.com/publichealthvids?igshid=c3iz8ni9xxrz

Public Health in the Wild — https://instagram.com/publichealthinthewild?igshid=dkf3ioi5h4xn

The Public Health Hub — https://instagram.com/thepublichealthhub?igshid=sj5gs39c0fnf

Dr Amile Inusa — https://instagram.com/amileya?igshid=g4chud2j3bfx

Twitter:

The Health Foundation — https://twitter.com/healthfdn?s=21

Dr Sajjad Fazel — https://twitter.com/sajjadfazel?s=21

Dr Madhu Pai — https://twitter.com/paimadhu?s=21

Health Affairs — https://twitter.com/health_affairs?s=21