Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 13, 2020
Date Accepted: Jul 8, 2020
Date Submitted to PubMed: Jul 10, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Public Health in the Information Age: Recognising the Infosphere as a Social Determinant of Health
ABSTRACT
Background:
Since 2016, social media companies and news providers have come under pressure to tackle the spread of political mis- and dis-information (MDI) online. However, despite evidence that online health MDI (on the web, on social media, and within mobile apps) also has negative real-world effects, there has been a lack of comparable action by either online service providers or state-sponsored public health bodies. We argue that this is problematic.
Objective:
We seek to answer three questions: why has so little has been done to control the flow of, and exposure to, health MDI online? How might more robust action be justified? And what specific, newly-justified actions are needed to curb the flow of, and exposure to, online health MDI?
Methods:
We conduct a critical analysis of the literature and draw on extensive experience of engaging with policymakers.
Results:
We how that four ethical concerns—related to paternalism, autonomy, freedom of speech, and pluralism—are partly responsible for the lack of intervention. We then suggest that these concerns can be overcome by relying on four arguments: (i) education is necessary but insufficient to curb the circulation of health MDI; (ii) there is precedent for state control of internet content in other domains; (iii) network dynamics adversely affect the spread of accurate health information; and (iv) that justice is best served by protecting those susceptible to inaccurate health information. These arguments provide a strong case for classifying the quality of the infosphere as a social determinant of health, thus making its protection a public health responsibility. And they offer a strong justification for working to overcome the ethical concerns associated with state-led intervention in the infosphere to protect public health.
Conclusions:
We conclude that the above arguments provide a strong case for classifying the quality of the infosphere as a social determinant of health, thus making its protection a public health responsibility. And they offer a strong justification for working to overcome the ethical concerns associated with state-led intervention in the infosphere to protect public health. Clinical Trial: N/A
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Copyright
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