Information ecosystem disrupting health, Ex #3: misdirection and misleading in health information search results

(continuing the discussion of examples from a recent webinar)

There’s plenty of issues that impact how people find and use health information that has little to do with how a health authority directly communicates health information.

As public health practitioners, we have to understand the information ecosystem that is inhabited by communities we serve – and address health information inequities systemically.

One of the factors impacting people’s health information diet is driven by our trust in technology.

Tech platforms and services can misdirect and mislead people when they are searching for health information.

With every year, people are getting more and more comfortable with taking advice from computers. We’ve all followed our phone’s directions when driving our car, and all of a sudden realized we had taken a turn onto a dirt road on a cliff that wasn’t a safe way to our intended destination. If we are willing to listen to our phone and risk putting ourselves in traffic danger, we are therefore also willing to listen to our device when we are helping ourselves or someone else with their health issue.

Here’s three such examples:

• One massive problem that has impacted women seeking reproductive health and abortion services in states where they are the most vulnerable to restrictive laws – is a location service like Google Maps directing people who search for abortion clinics to so-called crisis pregnancy centers that actually advocate against abortion. The issue was so problematic that even US lawmakers called on Google to fix it. It took Google over two years from discovering the issue to actually starting to address it, but in the meantime, the legal and service environment for women seeking reproductive health and abortion services has changed even more dramatically, making such access to health information even more critical.
• Then there’s this example of virtual assistants that provide low quality advice on first aid emergency information. Considering that two-thirds of medical emergencies occur within the home and that an estimated 50 percent of internet searches are voice-activated through our devices, people will use voice assistants to search for health information as well.
• And lastly, we aren’t aware enough that the internet is not this aspiring marketplace of ideas where everyone has equal access to information – or that everyone receives information that is “out there”. A massive example of this is that users of Meta and Google platforms are accessing and “seeing” different reproductive health information depending on where in the world they live. How tech giants decide or implement their own advertising, content moderation, and algorithmic amplification practices can have disproportionate effects on health across the world and can create health information disparities across countries.

We have to become more mindful of the way the tech platforms shape the information ecosystem that we inhabit.

One significant way of addressing this is through policies that regulate how platforms are designed and governed. But we also must be aware that the internet is much less safe and more polluted for consumers in those countries where consumer protection laws are weaker and where users do not use the internet in the English language. The platforms invest in safe guards in those languages and those geographies where regulation exists – for example, European Union, Australia, Canada and the US.

For example, the European Union’s the Digital Markets Act requires the biggest tech companies to overhaul how some of their products work so smaller rivals can gain more access to their users. This was in the works for a decade and has addressed a gap in regulation of the tech sector that basically developed without any guardrails and regulations.

What this means is that the European users’ experience of the internet platforms will increasingly differ from people elsewhere in the world. In Europe, Instagram, TikTok and Snapchat users under the age of 18 no longer see ads based on their personal data, the result of a 2022 law called the Digital Services Act. Elsewhere in the world, young people still see such ads on those platforms.

Achieving health information equity globally is getting more complicated and challenging.

The strategy relying on running a global advocacy campaign in health and hoping to put a dent in promoting demand for health services, products or promote adherence to health guidance is becoming less useful.