1
Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
he U.S. urgeon eneral’s Advisory on
uilding a ealthy Information Environment
Confronting
Health
Misinformation
2021
I am urging all Americans to help slow the
spread of health misinformation during
the COVID-19 pandemic and beyond.
Health misinformation is a serious threat
to public health. It can cause confusion,
sow mistrust, harm people’s health, and
undermine public health efforts. Limiting
the spread of health misinformation is
a moral and civic imperative that will
require a whole-of-society effort.
Vivek H. Murthy, M.D., M.B.A.
Vice Admiral, U.S. Public Health Service
Surgeon General of the United States
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
Table of Contents
BACKGROUND
WE CAN TAKE ACTION
What Individuals, Families, and Communities Can Do
8
What Educators and Educational Institutions Can Do
9
What Health Professionals and Health Organizations Can Do
10
What Journalists and Media Organizations Can Do
11
What Technology Platforms Can Do
12
What Researchers and Research Institutions Can Do
13
What Funders and Foundations Can Do
14
What Governments Can Do
15
WHERE WE GO FROM HERE
REFERENCES
4
6
16
17
A Surgeon General’s Advisory is a public statement that calls the American people’s attention
to a public health issue and provides recommendations for how that issue should be addressed.
Advisories are reserved for significant public health challenges that need the American people’s
immediate awareness. For additional background, visit SurgeonGeneral.gov.
ABOUT THE ADVISORY
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
During the COVID-19 pandemic, people have been exposed to a great deal of information: news, public
health guidance, fact sheets, infographics, research, opinions, rumors, myths, falsehoods, and more. e
World Health Organization and the United Nations have characterized this unprecedented spread of
information as an “infodemic.”
1
While information has helped people stay safe throughout the pandemic, it has at times led to confusion.
For example, scientific knowledge about COVID-19 has evolved rapidly over the past year, sometimes
leading to changes in public health recommendations. Updating assessments and recommendations based
on new evidence is an essential part of the scientific process, and further changes are to be expected as we
continue learning more about COVID-19.
2
But without sufficient communication that provides clarity
and context, many people have had trouble figuring out what to believe, which sources to trust, and how
to keep up with changing knowledge and guidance.
3, 4, 5
Amid all this information, many people have also been exposed to health misinformation: information
that is false, inaccurate, or misleading according to the best available evidence at the time.
6, 7, 8
*
Misinformation has caused confusion and led people to decline COVID-19 vaccines, reject public health
measures such as masking and physical distancing, and use unproven treatments.
5, 9, 10
For example,
a recent study showed that even brief exposure to COVID-19 vaccine misinformation made people
less likely to want a COVID-19 vaccine.
11
Misinformation has also led to harassment of and violence
against public health workers, health professionals, airline staff, and other frontline workers tasked with
communicating evolving public health measures.
12, 13
Misinformation can sometimes be spread intentionally to serve a malicious purpose, such as to trick people
into believing something for financial gain or political advantage. is is usually called “disinformation.”
14, 15
But many people who share misinformation aren’t trying to misinform. Instead, they may be raising a
concern, making sense of conflicting information, or seeking answers to honest questions.
16
Health misinformation is not a recent phenomenon. In the late 1990s, a poorly designed study, later
retracted, falsely claimed that the measles, mumps, rubella (MMR) vaccine causes autism. Even after
the retraction, the claim gained some traction and contributed to lower immunization rates over the next
twenty years. Just since 2017, we have seen measles outbreaks in Washington State, Minnesota, New York
City, and other areas. Health misinformation is also a global problem. In South Africa, for example,
“AIDS denialism”—a false belief denying that HIV causes AIDS—was adopted at the highest levels of
the national government, reducing access to effective treatment and contributing to more than 330,000
deaths between 2000 and 2005.
22
Health misinformation has also reduced the willingness of people to
seek effective treatment for cancer, heart disease, and other conditions.
1, 23, 24, 25
19, 20, 21
18
17
BACKGROUND
is advisory focuses on health information specifically, not other kinds of misinformation. Defining misinformation is a challenging task,
and any definition has limitations. See References for further discussion of the definition used in this Advisory, including the benchmark
of ‘best available evidence at the time.’
*
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
In recent years, the rapidly changing information environment has made it easier for misinformation to
spread at unprecedented speed and scale, especially on social media and online retail sites, as well as via
search engines. Misinformation tends to spread quickly on these platforms for several reasons.
26, 27
First, misinformation is often framed in a sensational and emotional manner that can connect viscerally,
distort memory, align with cognitive biases, and heighten psychological responses such as anxiety.
People can feel a sense of urgency to react to and share emotionally charged misinformation with others,
enabling it to spread quickly and go “viral.”
24, 31
28, 29, 30
In recent years, the rapidly changing information
environment has made it easier for misinformation
to spread at unprecedented speed and scale.
Second, product features built into technology platforms have contributed to the spread of
misinformation. For example, social media platforms incentivize people to share content to get likes,
comments, and other positive signals of engagement. ese features help connect and inform people
but reward engagement rather than accuracy, allowing emotionally charged misinformation to spread
more easily than emotionally neutral content. One study found that false news stories were 70 percent
more likely to be shared on social media than true stories.
31
33
32
ird, algorithms that determine what users see online often prioritize content based on its popularity
or similarity to previously seen content. As a result, a user exposed to misinformation once could see
more and more of it over time, further reinforcing one’s misunderstanding. Some websites also combine
different kinds of information, such as news, ads, and posts from users, into a single feed, which can leave
consumers confused about the underlying source of any given piece of content.
35
34
e growing number of places people go to for information—such as smaller outlets and online forums—
has also made misinformation harder to find and correct. And, although media outlets can help inform
and educate consumers, they can sometimes inadvertently amplify false or misleading narratives.
37, 38
36
Misinformation also thrives in the absence of easily accessible, credible information. When people look for
information online and see limited or contradictory search results, they may be left confused or misinformed.
39, 40
More broadly, misinformation tends to flourish in environments of significant societal division,
animosity, and distrust. For example, distrust of the health care system due to experiences with racism
and other inequities may make it easier for misinformation to spread in some communities. Growing
polarization, including in the political sphere, may also contribute to the spread of misinformation.
42, 43
41
Additional research is needed to better understand how people are exposed to and affected by
misinformation and how this may vary across subpopulations based on factors such as race, ethnicity,
socioeconomic status, education, age, sexual orientation, gender identity, cultural and religious practices,
hobbies and interests, and personal networks.
44
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
During the COVID-19 pandemic, there have been significant efforts to address health misinformation.
Here are just a few examples:
Trusted community members, such as health professionals, faith leaders, and
educators, have spoken directly to their communities to address COVID-19-related
questions (e.g., in town halls, community meetings, via social and traditional media)
Researchers have identified leading sources of COVID-19 misinformation, including
misinformation “super-spreaders”
45
Media organizations have devoted more resources to identify and debunk
misinformation about COVID-19
46, 47
Some technology platforms have improved efforts to monitor and address
misinformation by reducing the distribution of false or misleading posts and
directing users to health information from credible sources
48, 49, 50
Governments have increased their efforts to disseminate clear public health
information in partnership with trusted messengers
51
But there is much more to be done, and each of us has a role to play. Before posting or sharing an item
on social media, for example, we can take a moment to verify whether the information is accurate and
whether the original source is trustworthy. If we're not sure, we can choose not to share. When talking
to friends and family who have misperceptions, we can ask questions to understand their concerns, listen
with empathy, and offer guidance on finding sources of accurate information.
52, 53, 54, 55, 56
It will take more than individual efforts, however, to address health misinformation. e threat of
misinformation raises important questions we must answer together: How do we curb the spread of
Because it pollutes our information environment, misinformation is harmful to individual and public
health. Together, we have the power to build a healthier information environment. Just as we have all
benefited from efforts to improve air and water quality, we can all benefit from taking steps to improve the
quality of health information we consume. Limiting the prevalence and impact of misinformation will help
all of us make more informed decisions about our health and the health of our loved ones and communities.
WE CAN TAKE ACTION
Together, we have the power to build a
healthier information environment.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
harmful misinformation while safeguarding user privacy and free expression? What kinds of measures
should technology platforms, media entities, and other groups adopt to address misinformation? What
role is appropriate for the government to play? How can local communities ensure that information
being exchanged—online and offline—is reliable and trustworthy? How can we help family and friends
who may have been exposed to harmful misinformation?
Addressing health misinformation will require a whole-of-society effort. We can start by focusing on the
following areas of action:
Equip Americans with the tools to identify misinformation, make informed
choices about what information they share, and address health misinformation in
their communities, in partnership with trusted local leaders
Expand research that deepens our understanding of health misinformation,
including how it spreads and evolves; how and why it impacts people; who is most
susceptible; and which strategies are most effective in addressing it
Implement product design and policy changes on technology platforms to slow
the spread of misinformation
Invest in longer-term efforts to build resilience against health misinformation,
such as media, science, digital, data, and health literacy programs and training for
health practitioners, journalists, librarians, and others
Convene federal, state, local, territorial, tribal, private, nonprofit, and research
partners to explore the impact of health misinformation, identify best practices
to prevent and address it, issue recommendations, and find common ground on
difficult questions, including appropriate legal and regulatory measures that address
health misinformation while protecting user privacy and freedom of expression
Addressing health misinformation will require
a whole-of-society effort.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
Learn how to identify and avoid sharing
health misinformation. When many of us share
misinformation, we don’t do it intentionally: We
are trying to inform others and don’t realize the
information is false. Social media feeds, blogs,
forums, and group chats allow people to follow
a range of people, news outlets, and official
sources. But not every post on social media can
be considered reliable. And misinformation can
flourish in group texts or email threads among
friends and family. Verify accuracy of information
by checking with trustworthy and credible
sources. If you’re not sure, don’t share.
Engage with your friends and family on the
problem of health misinformation. If someone
you care about has a misperception, you might be
able to make inroads with them by first seeking
to understand instead of passing judgment. Try
new ways of engaging: Listen with empathy,
establish common ground, ask questions,
provide alternative explanations and sources of
information, stay calm, and don’t expect success
from one conversation.
What Individuals, Families,
and Communities Can Do
When many of us share
misinformation, we don’t do it
intentionally: We are trying to
inform others and don’t realize
the information is false...
If you’re not sure, don’t share.
Address health misinformation in your
community. Work with schools, community
groups such as churches and parent-teacher
associations, and trusted leaders such as educators
and health care professionals to develop local
strategies against misinformation. For example,
invite local health professionals to schools or to
faith congregations to talk about COVID-19
vaccine facts.
WE CAN TAKE ACTION
WE CAN TAKE ACTION
What Educators and
Educational Institutions Can Do
Strengthen and scale the use of evidence-based
educational programs that build resilience
to misinformation. Media, science, digital,
data, and health literacy programs should be
implemented across all educational settings,
including elementary, secondary, post-secondary
and community settings. In addition to teaching
people how to be more discerning about the
credibility of news and other content, educators
should cover a broader set of topics, such as
information overload, internet infrastructure
(e.g., IP addresses, metadata), the challenges of
content moderation, the impact of algorithms
on digital outputs, algorithmic bias, artificial
intelligence (AI)-generated misinformation (e.g.,
deepfakes), visual verification skills, and how
to talk to friends and family who are sharing
misinformation.
Educate students and the public on
common tactics used by those who spread
misinformation online. Recent research
suggests that teaching people how to spot
these tactics can reduce people's willingness
to share misinformation.
57
Examples of
misinformation tactics used by those who deny
scientific consensus on health issues include
presenting unqualified people as experts;
misleading consumers with logical fallacies;
setting impossible expectations for scientific
research; cherry-picking data or anecdotes; and
introducing conspiracy theories.
58
Establish quality metrics to assess progress in
information literacy. While there is substantial
media and information literacy work being
carried out across the United States, there is
a need for more consistent and empirically
evaluated educational materials and practices.
Media, science, digital, data,
and health literacy programs
should be implemented across
all educational settings.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
What Health Professionals and
Health Organizations Can Do
Proactively engage with patients and the
public on health misinformation. Doctors,
nurses, and other clinicians are highly trusted
and can be effective in addressing health
misinformation. If you are a clinician, take the
time to understand each patient’s knowledge,
beliefs, and values. Listen with empathy,
and when possible, correct misinformation
in personalized ways. When addressing
health concerns, consider using less technical
language that is accessible to all patients. Find
opportunities to promote patient health literacy
on a regular basis.
59
Use technology and media platforms to share
accurate health information with the public.
For example, professional associations can equip
their members to serve as subject matter experts
for journalists and effectively communicate peer-
reviewed research and expert opinions online.
Partner with community groups and other
local organizations to prevent and address
health misinformation. For example, hospital
systems can work with community members
to develop localized public health messages.
Associations and other health organizations
should offer trainings for clinicians on how to
address misinformation in ways that account for
patients’ diverse needs, concerns, backgrounds,
and experiences.
WE CAN TAKE ACTION
Associations and other health
organizations should offer
trainings for clinicians on how
to address misinformation in
ways that account for patients’
diverse needs, concerns,
backgrounds, and experiences.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
What Journalists and
Media Organizations Can Do
Train journalists, editors, and others to
recognize, correct, and avoid amplifying
misinformation. Media organizations should
develop in-house training programs and partner
with journalism schools, nonprofits, technology
platforms, and others to democratize access to
high-quality training for all media outlets.
Proactively address the public’s questions.
When something is new—such as a vaccine—
people will understandably have questions. By
anticipating and proactively answering those
questions, media organizations and journalists can
help get ahead of misinformation and increase the
public’s health and information literacy.
Provide the public with context to avoid
skewing their perceptions about ongoing
debates on health topics. For example, when
discussing conflicting views on an issue, give
readers a sense of where the scientific community
stands and how strong the available evidence is
for different views. Consider questions like: How
much disagreement is there among experts? Is a
given explanation plausible even if it is unlikely?
If evidence is not equally strong on all sides of an
issue, avoid presenting it as such.
Carefully review information in preprints.
Preprints are research papers published online
before peer review. ey can provide scientists
and the public with useful information, especially
in rapidly evolving situations such as a pandemic.
However, because preprints have not been
independently reviewed, reporters should be
careful about describing findings from preprints
as conclusive. If reporting on such findings,
include strong caveats where appropriate, seek
out expert opinions, and provide readers with
context.
Use a broader range of credible sources—
particularly local sources. Research shows
us that people have varying levels of trust in
different types of people and institutions.
In
addition to relying on federal and state public
health authorities as sources, build relationships
with local health professionals and local trusted,
credible health organizations.
4
Consider headlines and images that inform
rather than shock or provoke. Headlines are
often what audiences will see and remember.
If a headline is designed to fact-check a rumor,
where possible, lead with the truth instead of
simply repeating details of the rumor. Images
are often shared on social media alongside
headlines and can be easily manipulated and used
out of context. Picture desk and social media
editors should consider how provocative and
medically inaccurate imagery can be a vehicle for
misinformation.
60
WE CAN TAKE ACTION
Give readers a sense of where
the scientific community
stands and how strong the
available evidence is for
different views.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
What Technology
Platforms Can Do
Assess the benefits and harms of products
and platforms and take responsibility for
addressing the harms. In particular, make
meaningful long-term investments to address
misinformation, including product changes.
Redesign recommendation algorithms to avoid
amplifying misinformation, build in frictions”—
such as suggestions and warnings—to reduce the
sharing of misinformation, and make it easier for
users to report misinformation.
Give researchers access to useful data to
properly analyze the spread and impact of
misinformation. Researchers need data on
what people see and hear, not just what they
engage with, and what content is moderated
(e.g., labeled, removed, downranked), including
data on automated accounts that spread
misinformation. To protect user privacy, data can
be anonymized and provided with user consent.
Strengthen the monitoring of misinformation.
Platforms should increase staffing of multilingual
content moderation teams and improve the
effectiveness of machine learning algorithms
in languages other than English since non-
English-language misinformation continues
to proliferate.
Platforms should also address
misinformation in live streams, which are more
difficult to moderate due to their temporary
nature and use of audio and video.
61
Prioritize early detection of misinformation
"super-spreaders" and repeat offenders. Impose
clear consequences for accounts that repeatedly
violate platform policies.
Evaluate the effectiveness of internal policies
and practices in addressing misinformation
and be transparent with findings. Publish
standardized measures of how often users are
exposed to misinformation and through what
channels, what kinds of misinformation are most
prevalent, and what share of misinformation is
addressed in a timely manner. Communicate why
certain content is flagged, removed, downranked,
or left alone. Work to understand potential
unintended consequences of content moderation,
such as migration of users to less-moderated
platforms.
Proactively address information deficits. An
information deficit occurs when there is high
public interest in a topic but limited quality
information available. Provide information
from trusted and credible sources to prevent
misconceptions from taking hold.
40
Amplify communications from trusted
messengers and subject matter experts.
For example, work with health and medical
professionals to reach target audiences. Direct
users to a broader range of credible sources,
including community organizations. It can be
particularly helpful to connect people to local
trusted leaders who provide accurate information.
Prioritize protecting health professionals,
journalists, and others from online
harassment, including harassment resulting from
people believing in misinformation.
WE CAN TAKE ACTION
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
What Researchers and
research institutions Can Do
Strengthen the monitoring of health questions,
concerns, and misinformation. Focus on a
broader range of content and platforms, as
well as on information flow across platforms.
For example, examine image- and video-based
content and content in multiple languages. To
address existing research limitations, expand data
collection methods (e.g., recruit social media
users to voluntarily share data).
Assess the impact of health misinformation.
ere is an urgent need to comprehensively
quantify the harms of health misinformation.
For example, how and under what conditions
does misinformation affect beliefs, behaviors,
and health outcomes? What is the role of
emotion, cognition, and identity in causing
misinformation to “stick”? What is the cost to
society if misinformation is left unchecked?
Prioritize understanding how people are
exposed to and affected by misinformation,
and how this may vary for different
subpopulations. Tailor interventions to the
needs of specific populations. Invite community
members to participate in research design.
Evaluate the effectiveness of strategies
and policies to prevent and address health
misinformation. For example, can flagging
certain content as misinformation have
unintended consequences? Is it possible to build
resilience to misinformation through inoculation
methods such as “prebunking”? (Debunking
involves correcting misinformation once
someone has been exposed to it. Prebunking,
or preemptively debunking, involves warning
people about misinformation they might come
across so they will be less likely to believe it when
exposed.)
57
WE CAN TAKE ACTION
ere is an urgent need to
comprehensively quantify
the harms of health
misinformation.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
Move with urgency toward coordinated, at-
scale investment to tackle misinformation.
Assess funding portfolios to ensure meaningful,
multi-year commitments to promising research
and programs.
Invest in quantifying the harms of
misinformation and identifying evidence-
based interventions. Focus on areas facing
private and public funding gaps. Examples
could include independent and local journalism,
accountability mechanisms for platforms, and
community-based health literacy programs.
Provide training and resources for grantees
working in communities disproportionately
affected by misinformation (e.g., areas with
lower vaccine confidence).
What Funders and
Foundations Can Do
WE CAN TAKE ACTION
Incentivize coordination across grantees to
maximize reach, avoid duplication, and bring
together a diversity of expertise. For example,
encourage coordination around monitoring
health misinformation across multiple languages.
Assess funding portfolios to
ensure meaningful, multi-year
commitments to promising
research and programs.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
What Governments Can Do
Convene federal, state, local, territorial, tribal,
private, nonprofit, and research partners to
explore the impact of health misinformation,
identify best practices to prevent and address
it, issue recommendations, and find common
ground on difficult questions, including
appropriate legal and regulatory measures that
address health misinformation while protecting
user privacy and freedom of expression.
Increase investment in research on
misinformation. For example, more research
is needed to better define misinformation,
document and process its harms, and identify
best practices for preventing and addressing
misinformation across mediums and diverse
communities.
Continue to modernize public health
communications. Work to understand
Americans’ health questions, concerns, and
perceptions, especially for hard-to-reach
populations. Deploy new messaging and
community engagement strategies, including
partnerships with trusted messengers. Proactively
and rapidly release accurate, easy-to-understand
health information in online and in-person
settings. Invest in fact-checking and rumor
control mechanisms where appropriate.
62
Increase resources and technical assistance to
state and local public health agencies to help
them better address questions, concerns, and
misinformation. For example, support the creation
of teams within public health agencies that can
identify local misinformation patterns and train
public health misinformation and infodemic
researchers. Work with local and state health
leaders and associations to address ongoing needs.
Expand efforts to build long-term resilience
to misinformation. For example, promote
educational programs that help people
distinguish evidence-based information from
opinion and personal stories.
WE CAN TAKE ACTION
Deploy new messaging and
community engagement
strategies, including
partnerships with trusted
messengers. Proactively and
rapidly release accurate,
easy-to-understand health
information in online and
in-person settings.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
During the COVID-19 pandemic, health misinformation has sowed confusion, reduced trust in public
health measures, and hindered efforts to get Americans vaccinated. And misinformation hasn’t just
harmed our physical health—it has also divided our families, friends, and communities.
While health misinformation has always been a problem, today it spreads at unprecedented speed and
scale. We are all still learning how to navigate this new information environment. But we know enough
to be sure that misinformation is an urgent threat, and that we can and must confront it together.
e only way to address health misinformation is to recognize that all of us, in every sector of society,
have a responsibility to act. Every single person can do their part to confront misinformation. But it’s not
just an individual responsibility. We need institutions to recognize that this issue is their moral and civic
responsibility, too, and that they are accountable.
We have the power to shape our information environment, but we must use that power together. Only
then can we work toward a healthier information environment—one that empowers us to build a
healthier, kinder, and more connected world.
Where We Go From Here
We are all still learning how to navigate
this new information environment.
But we know enough to be sure that
misinformation is an urgent threat, and
that we can and must confront it together.
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
References
WHO, UN, UNICEF, UNDP, UNESCO, UNAIDS, ITU, UN Global Pulse, & IFRC. (2020,
September 23). Managing the COVID-19 infodemic: Promoting healthy behaviours and mitigating
the harm from misinformation and disinformation. World Health Organization. https://www.who.
int/news/item/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-behaviours-and-
mitigating-the-harm-from-misinformation-and-disinformation
Branswell, H. (2021, April 21). We know a lot about Covid-19. Experts have many more questions.
STAT News. https://www.statnews.com/2021/04/20/we-know-a-lot-about-covid-19-experts-have-
many-more-questions/
Smith, R., Cubbon, S., & Wardle, C. (2020, November 12). Under the surface: Covid-19 vaccine
narratives, misinformation & data deficits on social media. First Draft. https://firstdraftnews.org/
vaccinenarratives-full-report-november-2020
Baum, M., Ognyanova, K., Chwe, H., Quintana, A., Perlis, R. H., Lazer, D., Druckman, J., Santillana,
M., Lin, J., Della Volpe, J., Simonson, M.D., & Green, J. (2021). e COVID states project #14:
Misinformation and vaccine acceptance. OSF Preprints. http://doi.org/10.31219/osf.io/w974j
Roozenbeek, J., Schneider, C., Dryhurst, S., Kerr, J., Freeman, A.L.J., Recchia, G., van der Bles,
A.M., & van der Linden, S. (2020). Susceptibility to misinformation about COVID-19 around the
1
2
3
4
5
* Note: Defining “misinformation” is a challenging task, and any definition has limitations. One
key issue is whether there can be an objective benchmark for whether something qualifies as
misinformation. Some researchers argue that for something to be considered misinformation,
it has to go against “scientific consensus” (e.g., Chou, Gaysynsky, & Cappella (2020)). Others
consider misinformation to be information that is contrary to the “best available evidence” (e.g.,
Johns Hopkins Center for Health Security (2021)). Both approaches recognize that what counts
as misinformation can change over time with new evidence and scientific consensus. is Advisory
prefers the “best available evidence” benchmark since claims can be highly misleading and harmful
even if the science on an issue isn’t yet settled. At the same time, it is important to be careful
and avoid conflating controversial or unorthodox claims with misinformation. Transparency,
humility, and a commitment to open scientific inquiry are critical. A second key issue is whether
misinformation should include not only false information but also misleading information. is
Advisory includes misleading claims in the definition. Consider an anecdote about someone
experiencing a rare side effect after a routine surgery. e specific anecdote may be true but hide the
fact that the side effect is very rare and treatable. By misinforming people about the benefits and risks
of the surgery, the anecdote can be highly misleading and harmful to public health. Going forward,
there is a need for further alignment on a shared definition of misinformation. However, we can
meaningfully improve the health information environment even without a consensus definition of
misinformation. For further discussion on definitions, see Vraga & Bode (2020).
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Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment
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