Health literacy in the too much information age

Want to know what to eat to lose weight, how to exercise to maintain bone density, or why your mental health takes a dive in the winter?

You can find your answers on the internet – probably too many answers. A simple search for “sleep and health” returns 3,540,000,000 results from various providers, with varying degrees of reliability.

Visits to the GP for basic health advice are increasingly uncommon. Two-thirds of Australians head online before they seek the opinion of a healthcare professional for common health conditions.

With a global repository of knowledge at our fingertips, we can access information more easily and share it more rapidly. It’s immensely useful when looking to quickly fill information gaps, but carries the risk of amplifying harmful messages and causing confusion.

The idea of a health information overload was popularised at the beginning of the COVID-19 era, when Dr Tedros Adhanom Ghebreyesus, the World Health Organization’s Director-General, declared, “we’re not just fighting an epidemic; we’re fighting an infodemic.”

Put simply, an infodemic is too much information. It causes uncertainty and risk-taking behaviours that can harm health, as people struggle to make sense of conflicting advice.

Infodemics undermine people’s ability to understand information about health and health care and apply that knowledge to make decisions. They also erode trust in genuine sources of health information.

While the term initially referred to the spread of information during disease outbreaks, its relevance to a variety of public health topics is clear.

The current digital environment, with its volumes of health information, lack of consistency in how information is presented, and conflicting advice, continues to undermine public health by confusing the public.

Alarmingly, but unsurprisingly, nine out of 10 Australians admit they don’t fully understand the health information they find on the internet.

“Navigating online health information and misinformation requires a high level of digital health literacy,” says Melody Taba, PhD candidate and youth health researcher at the Sydney Health Literacy Lab.

Taba adds that while young people are “digital natives”, they often face digital health literacy challenges, “due to their limited experience with the health system, and the lack of health information written specifically for their age group.”

Health literacy is not just about being able to spot misinformation online or understand medical terms. It also encompasses our capacity to access care, including the ability to navigate the system and seek support.

Dr Julie Ayre, a behavioural scientist and postdoctoral researcher, also based within the Sydney Health Literacy lab, says the way we think about health literacy has changed.

“It’s really important to recognise any individual’s capacity for health literacy is shaped by the health policies, systems and services they interact with.

“For example, think about the last time you or a loved one went to hospital. Not only can it be tricky to find the right department; often the information will have lots of medical jargon, and sometimes it’s hard to know exactly how to act on the advice from the doctor.

“On top of this, we often receive health information when we’re unwell, tired, stressed or distracted.

“It can be a very challenging situation for anyone, let alone for people who are already marginalised by health systems and services.”

There’s an urgent need to develop health literacy skills at the population level, both on and offline. Enabling health literacy means equipping all people with the skills to obtain the best health outcomes for themselves and their families.

This requires building health literacy capacities in the population and ensuring that the healthcare environment is responsive to the needs of the community.

Health communicators and health professionals have a role to play in achieving this, by ensuring the quality of information, and creating a link between information and healthcare consumers.

But Taba’s research has found that official health communication on the internet doesn’t always get it right.

For example, “whilst Australian health authorities used social media to share COVID-19 messages for young people during the pandemic, they rarely used social marketing techniques to appeal them, and even shared messages for young people on platforms that they do not even use.”

Taba emphasises the importance of evidence-based health information on social media, to “fill information voids and combat the health misinformation that proliferates on these largely unregulated platforms.”

The effects of getting it right can be substantial. Simple, accessible information, packaged in a broadly appealing way, supports people to take up healthy behaviours and leads to improved health outcomes.

“Easy-to-understand health information supports a range of different health behaviours, from correctly taking medication through to increased vaccination and screening uptake, and better self-management for people with chronic conditions,” says Dr Ayre.

“Of course, meeting health literacy information needs is just one factor that contributes to a person’s health.

“But it is fundamental to making informed health decisions and taking an active role in one’s own health care.”