'Life-or-death' issue: How one tool is identifying false health claims on social media

In this Jan. 21, 2021 file photo, a medical staff member prepares the Pfizer COVID-19 vaccine at Tudor Ranch in Mecca, Calif. (AP Photo/Jae C. Hong, File)

On social media, health-related misinformation pops up as relentlessly as furry heads in a game of whack-a-mole. In recent years, posts have claimed that ginger can be “10,000 (times) more effective” at killing cancer than chemotherapy, that fluoridated water provides “no benefits, only risks,” and that the measles vaccine is “more dangerous than becoming infected with measles.”

A national survey released in January by Abacus Data and the Canadian Medical Association (CMA) found that false health claims can have a direct impact on patient care. Encountering health misinformation led 35 per cent of respondents to delay seeking appropriate medical care and 29 per cent to avoid effective treatments.

But the sheer volume of social media posts published on a daily basis means health experts hoping to set the record straight face a near impossible challenge – how do you know which claims will sputter out, which ones will gain momentum, and the best way to counteract false messaging?

These are some of the questions researchers at the University of Waterloo in Ontario hope to answer with a tool used to identify health misinformation on social media.

Named U-MAS, short for UbiLab Misinformation Analysis System, the University of Waterloo research tool is able to track health misinformation patterns before they become potential catastrophes. While the project launched in 2022, development is ongoing. The tool has been used to explore false claims about the war between Russia and Ukraine, and its current focus is on vaccine hesitancy and misinformation related to fluoride, heatwaves and diet.

A 2022 study conducted by the World Health Organization identified misinformation in about 60 per cent of social media posts related to pandemics (29 per cent specifically on COVID-19) and more than 50 per cent on vaccines. Social media posts came from platforms such as X (formerly known as Twitter) and Instagram.

In addition to monitoring which posts gain traction, U-MAS researchers can identify sometimes overlooked factors that may fuel misinformation. Their work on vaccine hesitancy, for instance, found that while many of the concerns during the COVID-19 pandemic revolved around the safety of vaccinating young children, adults were also concerned about the safety of seniors, a worry that may have caused some to discourage their parents from getting vaccinated.

For now, only Waterloo researchers and their colleagues at other institutions can access the tool. But the development team — Zakir Hussain, development lead Dr. Jasleen Kaur and principal investigator Prof. Plinio P Morita — is aiming to make it accessible to a broader audience.

Misinformation a 'very bad public health outcome': expert

As part of one study published in 2022, the tool examined 500 Instagram posts that contained the term “fluoride-free,” a keyword often used by social media users who oppose fluoridation.

Common concerns emerged among users — many messages suggested fluoride use was inconsistent with a healthy lifestyle, while others took issue with governments mandating its addition to water supplies. But noticeable differences appeared when the tool examined the likes, comments and retweets these messages received.

While posts about lifestyle concerns were liked and shared, messages characterized as political, which represented about 16 per cent of the data set, spread more widely. Posts that saw high amounts of engagement often suggested governments were deliberately overlooking dangerous side-effects.

The analysis also showed that anti-fluoride messaging became more prevalent with the onset of the COVID-19 pandemic, a period when government conspiracy theories thrived.

Community water fluoridation has been endorsed by major public health bodies including the World Health Organization, the Canadian Dental Association and the Public Health Agency of Canada, according to a 2022 report published by the Office of the Chief Dental Officer of Canada. Studies cited by the U.S. Centers for Disease Control and Prevention also show fluoridated drinking water is associated with a 25 per cent reduction in tooth decay among children and adults.

Still, since 2017, more than a dozen communities in Canada have discontinued water fluoridation programs. The reasons vary, but include concerns about “putative health effects” of fluoride, the report noted. Research conducted throughout the years has shown that in Canada, much of the documented risk associated with community water fluoridation involves dental fluorosis, caused by exposure to too much fluoride during tooth development. The most common form of dental fluorosis is considered mild, according to the 2022 report.

Misinformation about the risks of public health initiatives poses a threat not only to individuals, but to the broader population, says Irfhana Zakir Hussain, a PhD student in the University of Waterloo’s School of Public Health Sciences, who served as core designer and developer for the misinformation project.

If left unchecked, false claims can spread quickly and widely, with negative consequences, says Zakir. “If (they are) shared and become an infodemic, that becomes a very bad public health outcome,” she says.

A case in point involves a water department official in Richmond, Vermont, who in 2022, admitted to quietly lowering the levels of fluoride being added to local water supplies. He expressed concerns about the quality of fluoride being sourced from China and also stated that he didn’t believe the level of fluoridation recommended by the state was warranted.

“To err on the side of caution is not a bad position to be in,” he told the city’s Water and Sewer Commission.

This led community residents to express concerns around their children’s dental health and overall government transparency.

How can false health claims be addressed?

Armed with his knowledge, health experts could develop a campaign directly targeting misinformation, Zakir Hussain says.

“Ideally, you’d be using the system for a variety of use cases and monitor them over time to see what needs to be spoken about and what does not,” she says.

Dr. Joss Reimer, CMA’s current president and the medical lead for Manitoba’s COVID-19 Vaccine Implementation Taskforce, says new support to combat misinformation is critical to Canadians’ well-being.

“During the pandemic, I saw first-hand how misinformation becomes literally a life-or-death issue,” she says.

The Council of Canadian Academies, a not-for-profit that examines evidence on various scientific topics, published a report suggesting the belief that COVID-19 was a “hoax” or an exaggerated threat contributed to more than 2,800 deaths in 2021. COVID-19 misinformation also led millions of Canadians to delay getting vaccinated, the report noted.

“In Manitoba, there were people struggling to breathe, but still denying COVID was real. We had pregnant patients who believed the lies about the vaccine, got sick and gave birth prematurely, leading to lifelong health problems for those infants,” Reimer says.

Those without COVID-19 vaccinations faced increased risk of severe symptoms, hospitalization and death – and the dangers didn’t disappear once they got over their initial infections, a 2023 study found. Published in the Nature Medicine journal, the U.S. study discovered these patients were at higher risk of developing a host of health complications, including blood clots and heart problems, for up to two years after recovering. Pregnant women who weren’t vaccinated risked worse COVID-19 symptoms and a higher possibility of losing their baby, according to a separate study published in the Nature journal in 2022.

Timothy Caulfield, an outspoken expert on health misinformation and a Canada Research Chair on health law and policy, says the U-MAS system is part of a growing international movement taking aim at health misinformation. In the past, he says, some experts may have ignored false claims, assuming that science-based information would prevail, “but now there’s growing recognition that action is required.”

Practitioners can play a key role in encouraging this action, says Reimer, referencing some of the results of the national survey by Abacus Data and the CMA released earlier this year.

“We found that physicians are the most trusted source of health information for Canadians, closely followed by nurses and pharmacists,” says Reimer. “That privilege gives us the opportunity to address false health claims head-on.”

In addition to direct conversations with health providers, Caulfield says curbing the spread of health misinformation requires tactics such as regulatory interventions by different levels of government, an educational curriculum that emphasizes critical thinking skills among students, and “pre-bunking” messaging that anticipates concerns about a particular health issue and addresses them before they become rampant.

Resources like U-MAS can inform all of these strategies, he says, by identifying the false messaging most likely to gain traction.

Along with making the tool accessible to more users, the development team hopes to expand their analysis, which draws on posts from X and Instagram, to include material from YouTube, Facebook and other platforms.

“Tools like this that take a big-data approach are desperately needed,” says Caulfield. “They’re helping build resilience against misinformation.”

This piece is part of a partnership between the Canadian Medical Association (CMA) and CTV News. For more information on the CMA, visit www.cma.ca.