Where do we get information about health and science?

In the News

My job is to be right, but it is even more to be read.^[3]

While there are many magazines and newspapers with a long tradition of reliable science reporting, some fundamental differences between how science and journalism are done can result in misleading stories. The most fundamental may be that for a science story to make it into the news it must be newsworthy: as a result, new findings or those that challenge the scientific consensus are more likely to be covered than those that reinforce the consensus or produce null results (for instance, results that don’t show a health impact of a particular substance) – even though these are just as important in science. This can also produce an impression that there is less of a consensus on some issues than there actually is, because findings that challenge the consensus on a politically charged issue, such a climate change, are automatically more newsworthy than those that support it. As well, the “inverted pyramid” structure of most news articles, which requires the most interesting details to be presented first, can de-emphasize important caveats or limitations of a study. Finally, the findings have to be presented in a way that readers will understand and find relevant. As one science journalist says:

Remember, newspapers are about trying to make a story; they are not presenting results from a science study. They are writing a story about a science study and trying to get you to read it and trying to get you interested in it.^[4]

Perhaps because of these factors, research has found that newspapers are actually more likely to cover medical research with weaker methodology and articles from less reliable journals.^[5]

Social Networks

As with other news, social networks have become an important way in which people first encounter health and science information: twenty-six percent of U.S. social media users actively follow science-related accounts. However, at the same time as it shows the usefulness of social networks for delivering this kind of information, the study also shows how social networks can spread misinformation: of the people that follow science accounts, just under two-fifths say they follow sources that “provide alternative perspectives to conventional science or medical research”. A slight majority say they distrust the science information they receive on social networks, compared to a quarter who say they mostly trust them; this may also be related to the finding that most commonly encountered content is about “strange or weird” findings and discoveries.^[6]

Two aspects of the architecture of social networks – the ability of users to create  personal networks, and the use of algorithms to push content that users are likely to respond to – can also make users more likely to be exposed to misinformation and, in particular, for misinformed views to be reinforced. With health issues such as vaccination, for instance, negative stories on Twitter have been found to spread more easily and have more impact than positive ones.^[7] This can have a powerful impact on behaviour: parents are likely to at least partly opt out of vaccination if more than a quarter of their network opposes it.^[8] Organized groups take advantage of this effect – and amplify it – by finding people who are seeking information and “recruiting” them into Facebook groups that reinforce misinformation and block out competing views, in much the same way that hate groups radicalize people online.^[9]

This thing about alternative facts and fake news, we’ve been living it in the autism community for 20 years. People gradually disappear into little bubbles – private email groups, Facebook groups. And then they seek confirmation.
– Mike Stanton, parent of an autistic child^[10]

This effect – dubbed the “majority illusion” by researchers – can lead participants in those closed networks to see only information that reinforces their views and to perceive scientific consensus as being marginalized.^[11]

As well, the practice of using “influencers” to endorse products on social media – which are frequently not identified as ads^[12] – has spread to health and medicine, with hospitals, pharmaceutical companies and market researchers paying patients to make testimonials on their behalf. Like other influencer campaigns, these dangerously blur the distinction between advertising and honest accounts of their patients’ experiences, and can be misleading to people who have recently been diagnosed with a condition, or who may suspect that they are suffering from one.^[13]

Search Engines

For many people seeking information about science and health, search engines – or their voice-operated kin such as Apple’s Siri – are their first and sometimes last stop. More than half of Canadians, for example, reported that they had done a health-related search in the last month,^[14] while a U.S. study found that two-thirds of health information seekers start with a search engine.^[15] The reasons for their popularity are obvious: convenience, familiarity, the quantity of information available, and the sense that their searches are private and confidential are all common reasons for using search engines to find health information.^[16]

The good news is that for most of these people, an online search is only the first step in a process that usually leads to consulting with a medical health professional,^[17] which has led doctors to also become sources of digital literacy education as patients sometimes arrive with information from unreliable sources. Dr. David Esho, a family physician at Toronto’s Western Hospital, told the Canadian Press:

Among my colleagues we would all definitely say that the Internet is becoming more important in terms of our patients seeking medical information and how it colours the interaction we have with our patients as well… They’ll Google something and they think they have this interesting or rare medical condition based on a constellation of symptoms… When they come in and they quote something that I’m not entirely sure is consistent with what we commonly accept in medical practice then I use that as an opportunity for us to both go on the website and look.^[18]

As with social networks, though, the fact that search engines do not generally discriminate between reliable and unreliable sources is a concern. In one study the top use of search engines was to research treatment options, with one in six participants specifically searching for alternative treatments.^[19] Young people are more likely to treat a search engine itself as a source of information^[20] or simply click on the first result: half of youth surveyed about their habits when searching for health information said that they do this, with the same number (wrongly) believing that Google is endorsing a source as reliable by placing it high in the search results.^[21] Google, the largest search engine by a significant margin, has said that they are working to improve how searches on health topics are delivered,^[22] but on the day this article was written a search for “should I vaccinate my children” the top results were four sources supporting vaccination, three opposed to it, and three presenting “both sides” of issue which has, from a scientific perspective, only one side. A rising number of people are being infected with potentially fatal diseases as a result of this misinformation.^[23]

The Web

Whether we get to it through search engines, social media or by bookmarking sources we know are reliable, most of the health information we get online ultimately comes from websites. Though there are excellent sources of health and science information available online, the ease of publishing on the Web means that information found there is often unreliable.^[24] This is problematic because, for many people, the Web is a trusted source of health information,^[25] and that information has an impact: for example, more than a quarter of teens have said they have changed their behaviour because of health information they found online.^[26]

The reliability of Web sources varies significantly. Video sites such as YouTube have many of the same problems as search engines and social networks, with both personal and algorithmic filters pushing viewers to watch increasingly extreme content: one study found that two-thirds of videos on the topic of vaccines were against vaccination, compared to just one in five that were in favour and one in six that were neutral. As well, the same research found that watching a single anti-vaccine video would lead to the site recommending others,^[27] potentially leading to the phenomenon known as “majority illusion,” where those who rely on videos or social networks for health and science information can come to believe in a false consensus that is opposite to the scientific consensus on a topic. Similarly, a review of online assessment tools found that only 34 percent gave a correct diagnosis and 56 percent gave appropriate advice on treatment.^[28] On the other hand, doctors who reviewed health discussions in the online forums Patient, Mumsnet and Reddit found that they were four times more likely to contain good-quality information than not: but the doctors’ main concern here was the general absence of an identified “best” recommendation.^[29]

In short, there is good quality information about health and science topics available online, but many of the sites, platforms and forums we use either do not discriminate between good and bad information or actively steer us towards content that is less reliable. As a result, it’s important that we be alert to the different kinds of misinformation on these topics – and the reasons why people promote them – and to have the skills to seek out good information and recognize it when we find it.