Medical Misinformation Disproportionately Impacts Vulnerable Populations: Johns Hopkins Study Reveals Correlation Between Social Determinants, Mistrust, and COVID-19 Misinformation
The COVID-19 pandemic underscored the pervasive and potentially devastating impact of medical misinformation, particularly among marginalized communities. A recent study conducted by the Johns Hopkins Center for Health Equity (CHE) has shed light on the complex interplay between social determinants of health, sources of information, medical mistrust, and the susceptibility to misinformation. The research, published in the Journal of General Internal Medicine, reveals a concerning correlation between lower educational levels, limited health literacy, heightened medical mistrust, and a greater likelihood of believing COVID-19 misinformation and conspiracy theories. This vulnerability highlights the urgent need for targeted public health interventions to combat misinformation and promote trust in reliable sources of medical information.
The CHE study, led by pre-doctoral trainee Emily Carletto and mentored by CHE Director Dr. Lisa Cooper, surveyed 561 adults in Maryland and Pennsylvania between August 2020 and March 2021. Participants were part of the CHE’s Rich Life Project, a cohort of individuals with hypertension and at least one other related health condition. The survey assessed participants’ beliefs regarding ten COVID-19 related statements, eight focusing on health myths and two on conspiracy theories. By analyzing responses and correlating them with various social determinants, the researchers aimed to understand the factors influencing the acceptance of misinformation.
The findings paint a stark picture of the vulnerability of certain populations to misinformation. Individuals with less than a bachelor’s degree were significantly more likely to believe in both health myths (49% more likely) and conspiracy theories (22% more likely). This disparity underscores the importance of accessible and easily understandable health information for all educational levels. Similarly, limited health literacy, measured by confidence in filling out medical forms, was significantly associated with a greater likelihood of believing health myths (24% more likely) and conspiracy theories (21% more likely). This emphasizes the need for clear and concise communication in healthcare settings and public health messaging.
Medical mistrust emerged as a particularly strong predictor of belief in misinformation. Participants with higher levels of medical mistrust were substantially more likely to believe in health myths (34% more likely) and conspiracy theories (a staggering 72% more likely). This finding highlights the crucial role of trust in healthcare providers and institutions in combating misinformation. Building trust within communities, particularly those historically marginalized and underserved by the healthcare system, is essential to fostering acceptance of evidence-based information.
The study also examined the influence of information sources on beliefs. Participants who did not rely on government and medical professionals for COVID-19 information were 28% more likely to believe in health myths, underscoring the importance of promoting access to credible and reliable health information sources. Notably, reliance on social media or other informal channels was not specifically assessed in this study, but previous research has highlighted the role of social media in the spread of misinformation.
The researchers discovered a significant link between vaccine hesitancy and belief in both health and conspiracy myths. Individuals unwilling to get vaccinated were markedly more likely to subscribe to misinformation, further emphasizing the need for targeted interventions to address vaccine concerns and promote vaccine confidence. Importantly, while race and ethnicity were initially considered as potential factors, they were not found to be independently associated with misinformation beliefs after accounting for other factors like education, health literacy, and medical mistrust. This suggests that addressing the underlying social determinants and promoting trust in healthcare are key strategies in mitigating the disparities in misinformation susceptibility.
Based on their findings, the researchers advocate for targeted public health interventions aimed at groups with lower educational attainment, limited health literacy, and higher levels of medical mistrust. These interventions should focus on promoting reliance on scientific sources and fostering trust in healthcare professionals and institutions. Strategies may include community-based education programs, culturally tailored health communication campaigns, and initiatives to enhance health literacy and improve access to reliable health information. Addressing medical mistrust requires a multifaceted approach, including acknowledging historical injustices, promoting transparency and accountability in healthcare, and fostering culturally competent communication between healthcare providers and patients.
Finally, the study underscores the crucial role of public health agencies, healthcare providers, and community organizations in combating medical misinformation and building trust. By working collaboratively and addressing the underlying social determinants of health, these stakeholders can empower individuals to make informed health decisions based on evidence-based information, ultimately improving health outcomes for all. The findings of the Johns Hopkins CHE study serve as a call to action for a concerted effort to combat misinformation and ensure health equity, particularly during public health crises.
