Information ecosystem disrupts health, Ex #1: social and influencer marketing is hijacking health conversations

Public health problems are uniquely affected by the information environment.

I recently gave a talk at the CAPHIA - Council of Academic Public Health Institutions Australasia masterclass where I discussed the information ecosystem in health. The information environment can impact people's attitudes and behaviors that, challenge a health organization's effort to promote health guidance, health services, and products or disseminate health information.

Health systems aren't yet equipped to mitigate the challenges the information environment poses to its mission to provide evidence-based health care and promote public health. I spoke about this, trust building and demand promotion in health at the webinar, which will also be available as a recording on the CAPHIA Vimeo channel.

The challenge of the information environment on health

One of the things that I showed in my talk was examples of the wide diversity of challenges that the information environment poses to the public health mission.

Most often, people associate the problem with so-called bad information that is circulating on the Internet. But mis and disinformation are a very small part of our interactions, information, and exchanges on the internet. Before the pandemic, the share of misinformation in people's information diet was less than 0.15%, and later estimates have put this share between 5 and 25%. I believe it is still on the lower end of all of the conversations on the internet, although it depends on the topic and community.

The bigger problem is the other kinds of interactions, connections, exchanges that people have over the digital media and channels. Claire Wardle calls this the "drip, drip, drip" of low-level doubts, half-trusts, questioning that if left unaddressed can have a massive accumulative effect on people's beliefs and attitudes over time.

Corporations and individuals can profit from exploiting these. The online social media ecosystem has been designed to sell ads to users for things and services.

When this collides with public health, we get serious problems.

Example #1: Industry marketing and influencer activity can sway health attitudes and behaviors

Like the ones in Example #1 that I have put forward. Industry marketing and influencer promotions skew the conversations across communities and can counter the efforts of health authorities in promoting health.

• A grassroots movement against weight bias and diet culture and that was promoting body positivity has been usurped by food industry’s anti-diet marketing and the influencers they sponsored to support their campaign. This has been done in ways that users cannot spot easily, because the influencers use the same language, memes, hashtags, than the body positive movement. They can reach out and appear trustful to the audience because they use familiar language even though their end objectives are very different. The trust that online users put into an identity is being exploited to change their attitudes to food, with consequences on their health.
• Big industries know that the issue with future generations is managing the perceptions and trust of young consumers on a variety health and related topics. Wired had recently reported on the beef industry's efforts, partnering with teachers, to influence the attitudes of young people in relation to beef and the industry's heath and environmental costs. Having been long underfunded, the educational system can be swayed by offering free teaching materials and teaching grants to science teachers. I wonder how this will down the road impact even the basics like confidence in science and understanding of evidence.
• And then there's this report by the New York Times, discussing a new study that found that nearly two-thirds of the 100 most popular “fitfluencers” — a term that can describe any influencer who posts content related to fitness — lacked sound advice or posted messages that could negatively affect people’s mental and physical health by, say, promoting exercise as a tool to become skinnier.

Whether it is large industries taking advantage of the influencer marketing to move consumer attitudes and behavior on health topics, or influencers themselves building their brand around the interests of their audience - this is the type of a challenge that health authorities are not equipped to handle yet systematically.

Consumer protection laws in relation to health may help. For example, influencers in India that speak on health topics must now be registered with the government and show their health credentials in their profiles.

However, we could also use guidance on how health authorities can interact with influencers in health awareness campaigns. One of the biggest risks of working with influencers on health campaigns is that the health authority opens itself to being vulnerable to future deviations of the partner influencer on health topics. While the influencer only gains credibility partnering with a Ministry of Health, they have no obligation to speak in alignment with the Ministry of Health in future if their brand promotion benefits.