Misinformation (unintentional inaccuracies) and disinformation (intentional lies) are significant public health issues that have been exacerbated by changes in information consumption and during the COVID-19 pandemic. These are primarily affecting health literacy (the capacity to access, understand, and apply health information to make informed choices).
Conventionally, their impact has been perceived as health literacy shaping individuals’ ability to make informed decisions like vaccination uptake. However, this viewpoint is too narrow. Disinformation also operates at broader systemic levels, influencing political ideologies and shaping public trust in institutions and evidence-based policies on issues like vaccination, climate change, and obesity.
A key failing of existing approaches to public health is a focus on downstream factors addressing misinformation while ignoring upstream factors that create and spread disinformation. Disinformation is not simply a deficit of facts; it involves power structures, framing, and narratives that shape how information is interpreted.
People consume information rooted within stories that induce emotion and meaning, often exhibiting fundamental power asymmetries. Therefore, addressing disinformation requires examining who produces it, how it is disseminated, and whose interests it serves.
Intent, which is difficult to demonstrate, is usually included in definitions of disinformation. Other perspectives emphasize misleading information for economic or political purposes, highlighting the role of business in influencing narratives to advance their interests and shape regulations. Industries like processed food, fossil fuels, alcohol, and tobacco have used coordinated strategies to alter or delay policy action, scientific evidence, and public perception.
Disinformation can be subtle, including mixing truths and deceptive information, excluding information, or selective framing. Companies may admit some hazards but not others and shift blame by naming multiple causes, which creates uncertainty and reduced public mobilization.
Disinformation can deceive while appearing to inform by omitting important details. This can be seen in educational and public communications paid for by corporate interests, which may not include all risks or present information in a manner consistent with those interests. Disinformation is never created in isolation; it involves front groups, networks of corporations, and institutions that can be used for these narratives.
Digital platforms have intensified disinformation through directed advertising tools that reach specific vulnerable audiences. Because these platforms profit from such content, they have limited incentive to curb it, and enforcement of policies remains inconsistent, often shifting responsibility onto users rather than platform systems.
Most strategies to address disinformation have been based on factchecking and debunking, which can increase knowledge but not necessarily beliefs and attitudes. What works better are trusted sources, framing, and prebunking. More recently, upstream measures like industry and digital platform regulation, countermarketing, and reducing conflicts of interest are increasingly recognized as critical. In short, disinformation is a systemic public health problem with commercial and political drivers that demands solutions at the source.
Reference: Maani N, Kim K, van Schalkwyk MCI, Petticrew M, Zenone M. The politics and profit of disinformation in public health. Annu Rev Public Health. 2026;47:267-282. doi:10.1146/annurev-publhealth-071723-124408
