Mechanisms, impacts, and potential solutions for health misinformation in the post-truth era
By Jasmine Chow, Associate Editor
Photo source: Canadian Medical Association
In the age of social media, where clicks and engagement often matter more than real substance, it’s easier than ever for misinformation to spread online. Flashy and outlandish claims about science, health, and technology can be much more interesting than reality. For the average TikTok user, discerning medical fact from fiction is more difficult than it may seem.
In 2024, the World Economic Forum’s Global Risks Report identified misinformation and disinformation as the most severe short-term risk to our world. Two years later, it’s clear why. Though panic over the COVID-19 pandemic certainly exacerbated the issue, health misinformation like the anti-vaccination (anti-vaxx) movement has been growing online for decades. But how exactly does misinformation spread online, and how impactful is it really? More importantly, how can misinformation be combatted—systemically and individually?
Spreading a Pandemic of False Information
In 1998, former British doctor and researcher Andrew Wakefield published a paper in The Lancet claiming that the measles, mumps, and rubella (MMR) vaccine was connected to autism in young children. The paper drew criticism from his colleagues and was quickly retracted by The Lancet. Years later, Wakefield lost the ability to practice medicine in the UK due to “[bringing] the medical profession into disrepute.”
But the damage was already done. Wakefield’s false claims spread to other areas of Europe and to North America, causing drops in vaccination rates and an increase in measles outbreaks in countries across the globe. Wakefield’s paper is largely credited with the resurgence of the anti-vaxx movement over the past several decades, a movement that has only grown alongside the use of social media.
Researchers identify five key aspects of social media that are particularly conducive to the spread of misinformation:
- Anyone can instantly post anything, regardless of their qualifications. Social media moves rapidly, and misinformation often receives more engagement and reaches more users than truthful posts.
- Social media algorithms create “echo chambers.” These algorithms analyze what users interact with and what they ignore to continuously show users posts that they may enjoy. This leads to a self-fulfilling loop wherein a user that engages in health misinformation is repeatedly shown more health misinformation, to the point that they may not even be aware that other viewpoints exist.
- Robots or “bots” are known to imitate real users and post misinformation on social media, often about topics such as politics and health (and health is inherently political!).
- Content creators and social media platforms are financially incentivised to post misinformation, as misinformation again tends to receive more engagement.
- Human psychology and algorithms contribute to confirmation and repetition biases, where people are more likely to believe information that aligns with their beliefs and that they have heard many times.
Users online deliberately spreading health misinformation employ several tactics to further their agendas, such as skewing science, shifting hypotheses, and censoring or attacking critics.
But users may also be unintentionally spreading misinformation, such as TikTokers promoting the controversial practice of stem cell tourism to cure their child’s chronic conditions—a practice that is currently unregulated, ineffective, and linked with a myriad of complications including tumour formation. In cases such as these, users often have the good intentions of sharing something they believe to be a medical miracle. But despite their best intentions, the spread of health misinformation can often do more harm than good.
I Saw it on TikTok
In a cross-sectional study of social media posts about five popular medical tests—including full body MRIs and gut microbiome tests—most posts were misleading, using personal anecdotes over scientific evidence, and failed to mention potential harms such as overuse. Moreover, 68% of posters had financial interests in promoting these tests.
This growing pattern of health misinformation on short-form content platforms—such as TikTok and Instagram, where users often scroll through posts quickly without thinking about what they just saw—can impact public health outcomes and erode public trust in healthcare systems.
For example, an analysis of the 100 most-viewed TikToks related to ADHD showed that less than half of the claims made in those videos aligned with clinical guidelines for diagnosing ADHD. The study found that young adults were more likely to overestimate the prevalence and severity of ADHD symptoms if they consumed more ADHD-related content on TikTok. Moreover, young adults were more likely to consider unreliable videos as significantly more trustworthy than they actually are.
This demonstrates how misleading social media posts can alter public perception on various health issues and how easy it is for health misinformation to go unnoticed in young adults. This misinformation is often polarizing, with “wellness influencers” contradicting public health authorities, leading to mistrust of health organizations. People then turn to alternative sources online that spread misinformation and undermine qualified health experts, creating an endless cycle of misinformation leading to more misinformation and enabling its spread.
Health misinformation can also affect much more than public perception, having physical and quantifiable impacts on our health systems. The Council of Canadian Academies released an expert panel on the socioeconomic impacts of health misinformation, describing robust evidence that misinformation can cause individual and collective impacts to our healthcare system. These include illness and death from unsafe health interventions, illness and death from contagious and vaccine-preventable diseases, money wasted on ineffective products and services, increased healthcare and societal costs, and inaction or delayed public policy action.
Misinformation also exacerbates existing inequalities and social divides in the healthcare system, particularly in racialized communities. Negative health impacts during the COVID-19 pandemic, for instance, were found to disproportionately affect racialized and other underserved communities.
Scientific Legitimacy in the Post-truth Era
Given all of this, how can healthcare systems respond to the spread of misinformation online? And how can the average social media user learn to think critically about scientific claims online?
Unfortunately, the issue isn’t as simple as telling people to read scientific articles. Emotions and cognitive biases, as well as online echo chambers, make it difficult to reach people affected by misinformation. Instead, researchers have identified five research areas that must be studied to improve public policy and practice against health misinformation. These include enhancing surveillance for misinformation online, understanding psychological drivers, assessing the consequences of misinformation, focusing on vulnerable populations, and testing effective responses.
Many of these topics are being studied, but an increase in public health research is needed to develop effective frameworks against misinformation. For instance, how can qualified professionals best penetrate the misinformation bubbles that exist online? And what would effective legislation against misinformation on social media look like?
On a long-term scale, it’s also important to increase scientific and media literacy in the general population. Educating the public on how to assess a claim for its legitimacy, how to spot tactics used by agents of misinformation, and how to maintain a healthy level of skepticism towards sensational medical claims could all prevent misinformation in future generations.
For those reading who want to avoid falling into the trap of health misinformation: remain skeptical and alert. Consider the motivations of a post on social media. Read more from scientific experts and health authorities—and less so from wellness influencers or unqualified bloggers.
