5.2: Public Health and the Fight Against Misinformation
One of the essential public health services is to inform, educate, and empower communities and individuals about their own health. But what should be done if other sources are putting out conflicting and potentially harmful information? Being barraged with confusing and conflicting information can cause people to lose trust in public health agencies, and they may resist complying with public health guidance or policies. To add to the noise, some individuals use conspiracies and purposeful disinformation for their own gain - to sell books and supplements, or to increase their followers on social media and podcasts for ad revenue. Public health now has a new epidemic to address: the “infodemic” of misinformation.
It is important to define the types of incorrect information shared by whether or not there is a clear intention to mislead the public. The term “misinformation” is an umbrella term that includes errors in the interpretation of data, research, or messaging, or perhaps information that was considered accurate and true at one point in time, but which has since been discovered to be false. Misinformation may be believed and shared naively. Disinformation on the other hand is a type of misinformation which is shared intentionally and with an ulterior motive - which could be for social, political or financial gain. However, it is difficult and sometimes dangerous to assume the intentions of whomever is sharing. Unless the intentions of the sharer are obvious and nefarious, we should use the term misinformation to give them the benefit of the doubt (Swire-Thompson & Lazer, 2020).
Historically, erroneous health messaging ranged from the classic “snake-oil salesman”of the 19th century, to the invention of Coca-Cola as a tonic for a variety of health complaints (the original version had cocaine in it), to doctors promoting the health “benefits” of smoking in cigarette advertisements. In 1998, a well known “infodemic” ensued after two scientific publications in the Lancet proposed a link between the measles, mumps, and rubella (MMR) vaccine and Autism Spectrum Disorder (ASD). The papers were subsequently critiqued and found to be faulty, the Lancet retracted them (albeit nearly a decade later), and the author - Dr. Andrew Wakefield - was stripped of his medical license - although he continued his anti-vaccine messaging on any platforms that would host him. A plethora of different studies were subsequently done that refuted the link between vaccines and ASD. Yet, this misinformation began to spread across the globe and was endorsed by celebrities, causing parents to delay or decide not to vaccinate their children at all. And eventually, this had an impact on population health outcomes. Even though measles had been declared eliminated in the U.S. in the year 2000, vaccine hesitancy led to several measles outbreaks over the next two decades (DeStefano & Shimabukuro, 2019).
More recently, misinformation and conspiracy theories about the SARS-CoV-2 virus, the COVID-19 vaccine and other public health measures such as lockdowns and masking were virulently spread; primarily online via social media, but occasionally also picked up in mainstream media like TV news channels and news publications as well. The original conspiracy theories were most often associated with extreme political ideology (at both ends of the spectrum). Yet as they were picked up by celebrities, podcasters, and content creators, they became more mainstream in the public consciousness. Many of these theories were overtly or covertly racist, and beyond expressing a general distrust of science and public health, they inferred that public health measures were the result of corrupt political agents (Walter et al., 2023). With the rapidity of internet and social media communication misinformation has the opportunity to change population behaviors, eventually also muddying political identity and health belief norms (Seymour et al., 2015).
The COVID-19 pandemic was a short term study in how misinformation and politicization of health beliefs can have a significant effect on population behaviors. The novelty of the virus and shifting guidance from government health agencies did not bolster public confidence in official messaging, which created a prime environment for conspiracy theories to grow. Combined with generalized anxiety about the virus itself, it’s no wonder that there was a significant loss of trust in public health agencies and more broadly, in science as well. Combined, misinformation and lack of trust in public health agencies had a direct effect on individual behaviors. Violent confrontations occurred around masking requirements (Hutchinson, 2020), and later vaccine requirements at workplaces became equally controversial (Bardosh et al., 2022).