The New York Times – Opinion – Guest Essay –
Julia Belluz and
Ms. Belluz is a health reporter at Vox. Dr. Lavis is a professor at McMaster University in Ontario, Canada. Together, they worked on the Global Commission on Evidence to Address Societal Challenges.
Another week, another platform in trouble for allowing its talent to give voice to misinformation. This time, Joe Rogan suggested that the mRNA Covid-19 vaccines are a type of “gene therapy” and that young people are at a greater risk from the shots than the disease, among other false and dubious health claims featured on his popular, Spotify-hosted podcast. The calls to remove his podcast have only intensified after revelations that he’s also repeatedly used a racist slur on the show, leading Spotify’s chief to apologize to the company’s employees.
The best outcome of the scandal wouldn’t be that Mr. Rogan was kicked off Spotify, at least not for the health bunk. It would be seeing his misleading Covid content in context: It’s just a tiny drop in the ocean of online health nonsense.
Medical drivel has ballooned with the rise of streaming, e-commerce and social media platforms. Unlike the anti-vaccine pamphlets that skeptics handed out centuries ago, people spreading erroneous health advice today can near-instantly reach audiences of millions.
The problem is so much bigger than Joe Rogan or Spotify. And platforms, lawmakers and regulators aren’t keeping up.
To get a sense of the scale, take a stroll down the giant virtual health aisles at Amazon, which has more than 200 million subscribers and millions more customers who shop without subscriptions. There, retailers hawk sedative drops, dopamine boosters and metabolism boosters, all of which possess only dubious evidence for efficacy for their marketed uses. One supplement maker seems to imply it can help HPV “vanish,” while another purports to “help cleanse and repair the liver.”
If you’d rather read harmful health gobbledygook, Amazon has plenty of books to choose from. You can study a two-week plan to “kill H.I.V.,” a vaccine “reappraisal” from a doctor who promotes homeopathic medicine for childbirth, or “The Truth About Covid-19,” co-written by Joseph Mercola, an osteopathic physician whom researchers labeled the single-worst spreader of Covid misinformation.
Over at Netflix, Gwyneth Paltrow, a notorious peddler of dubious wellness claims, like the effectiveness of mediums, energy healing and “cold therapy,” shares her Goop Lab with the platform’s roughly 222 million subscribers. After Goop, you might watch a topsy-turvy nutrition documentary, like “What the Health,” which features such overstated claims as drinking milk can exacerbate cancer risks and eating an egg a day is as dangerous as smoking — one of the most dangerous human health habits. On Apple TV (and Amazon), you can bask in “The Magic Pill,” a documentary that touts a high-fat, low-carbohydrate ketogenic diet as a salve for autism and cancer.
Then we have the usual spaces for superspreading falsehoods: Twitter, Facebook and YouTube. In the middle range of the available estimates, roughly 10 percent of Covid-related tweets and posts have been found to contain misinformation. The diversity of the false Covid claims circulating on social media is staggering. Bleach, cocaine and water have all been promoted as remedies — as have ineffective and potentially harmful medicines, like hydroxychloroquine and ivermectin.
It’s clear that misinformation harms human health, stokes panic, wastes money and leads people to miss opportunities to pursue options that could have helped. But the new fire hose of bunk is also harming us in less obvious ways. It’s hitting our fractured societies — and, we believe, contributing to further polarization.
Quackery won’t disappear by deplatforming or censoring people. Dr. Mercola proved that: After his posts were curtailed by Twitter and Facebook, he simply migrated to the newsletter platform Substack, where he’s one of a number of anti-vaccine activists reportedly making over $1 million annually for stoking vaccine fears. If we really want to push back against health nonsense, we also need more than one-off celebrity condemnations and targeted content disappearing. Instead, we need to prevent false or misleading health claims from reaching millions of people in the first place.
Doing this won’t be easy. It will require a mix of strategies, tailored to different platforms and groups. E-commerce sites like Amazon could introduce content warnings or adjust their pricing and ranking algorithms for health products and books that have beenflagged for misinformation. Governments could also step in and mandate evidentiary standards for a broader range of health statements than the pharmaceutical and food claims they currently regulate.
Streaming platforms like Netflix and Spotify could introduce fact-checking for their nonfiction health content. They could provide additional context, including links to credible information sources, or adjust their algorithms to limit the spread of health misinformation. They could also play an educational role, developing programs that improve media and information literacy.
The best health bunk prevention of all may be education. Two randomized-control trials carried out in Uganda showed that schoolchildren and their parents can be taught to vet the reliability of health-treatment claims and make more informed decisions. If similar approaches became mainstream, we’d have little armies of lie detectors everywhere who could prevent dubious health figures from ever getting a big platform.
We also need approaches that would have an impact across the web, like raising the stakes for health professionals who, as two health care experts fighting disinformation wrote, are “weaponizing their white coats” to mislead the public. Right now, state medical regulatory bodies focus on individual patient encounters, not the role doctors might play as healers for the masses. The American Medical Association has commented occasionally on public-facing physicians, yet while doctor disinformation has only worsened in the pandemic, few physicians have been reprimanded by their state boards.
Whatever strategies companies and governments embrace, they must also protect other priorities, like well-functioning markets and freedom of expression. They should be applied consistently to all people, regardless of the tribe they’re part of — from liberal lifestyle gurus like Ms. Paltrow to libertarian-leaning talking heads like Mr. Rogan. And any approach tried should be defensible, rooted in evidence and tempered by a healthy dose of humility and empathy.
The good news is that it’s now easier than ever to make sure health claims are well informed. Alongside the torrent of health junk, there’s been a quiet revolution to surface the best-available research and make it accessible for all. As we described in a recent report by the Global Commission on Evidence to Address Societal Challenges on the importance of scientific evidence, “living” evidence syntheses have taken off during the pandemic. These are continuously updated documents that slot in new studies as they are published, based on their quality, so users have an evolving picture of what the entire research base, not just the newest paper, suggests about a particular issue.
The best living evidence reports also examine how findings vary by groups and contexts. Their analogue — living guidelines — extends the approach to evidence-based recommendations. But these tools remain sorely underused by the public and governments, even as Ms. Paltrow and Mr. Rogan command huge audiences.
It’s worth remembering that medical bunk isn’t a new phenomenon. There was a time when any apothecary could sell almost any drug with whatever claims its maker wanted to boast. It was only during the 20th century that the U.S. government introduced laws overseeing the effectiveness of pharmaceuticals and the accuracy of marketing campaigns.
Today, we don’t wait for musicians and other celebrities to protest dangerous drugs after people have died taking them. Drugmakers are supposed to prevent harm by proving their products are safe and effective. They have to provide regulators with evidence for claims they want to make about products before they reach the market.
The system isn’t perfect, but it’s certainly safer than it was a century ago. Freedom of expression remains intact and the market works, and it probably works even better. This gives us hope that a new strategy can emerge for combating today’s pseudoscience peddlers, just as one did for their predecessors.
Julia Belluz is a health reporter at Vox. John Lavis is a professor at McMaster University and director of the McMaster Health Forum. Together, they worked on the Global Commission on Evidence to Address Societal Challenges.