Over the course of the COVID-19 pandemic, it has become clearer than ever that misinformation and disinformation is a public health issue. Communication of public health information is an essential part of keeping individuals and communities safe and healthy. Unfortunately, evidence shows that access to accurate, trustworthy health information to guide critical decision-making is inequitable and has contributed to the disproportionate impact of COVID-19 on racialized, low-income, and other marginalized populations.
Increasingly, there have been calls to recognize the information environment or “infosphere,” which refers to mediated and interpersonal communication channels, formal and informal communication networks, and information and communication technologies that enable individuals to engage with health information, as a social determinant of health. Other determinants, including employment, education, poverty, housing conditions, and race and ethnicity, also contribute to differential access and one’s capacity to process, understand, and act on public health messaging.
The disparities in COVID-19 vaccine uptake across racial and low-income groups are a key example of how poor information environments can lead to vaccine hesitancy and mistrust in public health communication. For many vulnerable groups, especially Black and racialized communities, exclusionary and traumatic experiences with health care systems, government agencies, and law enforcement lead to institutional distrust.
Institutional distrust refers to an individual or group’s lack of confidence in public institutions and systems in representing and delivering on their needs and priorities. Early in the pandemic, public health guidelines across Canada focused heavily on social distancing, masking, and staying at home to avoid COVID-19 transmission. However, those living with poorer social determinants – such as overcrowded housing conditions and precarious work – were unable to abide by these regulations and found themselves at considerably higher risk of serious illness.
Consideration of the social determinants of health and the consultation with marginalized groups to form policy responses to public health issues is necessary to build community trust and decrease the spread of mis/disinformation among vulnerable populations.
A growing ‘parental rights’ movement
Early in the pandemic, a widespread narrative was that children were generally immune from severe COVID-19 infections. Research has proven that to be inaccurate, showing that children and youth are in fact susceptible to the virus and that those with co-morbidities are especially vulnerable to severe outcomes, including long COVID. This is deeply concerning, as vaccine uptake for children remains worryingly low.
While anti-vaccine sentiment is not new – especially parental hesitancy around childhood vaccination – the spread of mis/disinformation from the far-right has contributed to the politicization of vaccines and threatens to heighten COVID-19 risk among children and youth.
Mis/disinformation is not only limited to vaccines and COVID-19 public health measures. In the recent municipal elections advocacy groups raised concerns about a slate of far-right, anti-2SLGBTQIA+ and anti-equity candidates running for school trustee positions across Canada, all of whom were openly and proudly spreading transphobic rhetoric during the municipal election campaign period.
Although largely unsuccessful, with only a handful of these candidates elected to school boards across the province, it brought renewed attention to a widespread and fairly organized group of people who believe that parents should be able to dictate what their children learn in schools.
In 2021, there was a highly publicized debate over the merits of teaching critical race theory in public schools in the United States. Soon after, arguments against teaching critical race theory began in Canada as well, with school boards being questioned about their anti-racism curriculum and policies.
For many, critical race theory has now come to mean any sort of teachings on racial injustice, with some parents not wanting their children to explore race and racialization and learn lessons about how our laws and institutional and public policies enable racial inequities and discrimination. This also extends to other curriculum that centres social justice and equity, including LGBTQIA2S+ inclusive health and sex education.
The role of schools in addressing mis/disinformation
Since the COVID-19 pandemic has led to students spending increasing amounts of time online, they are left more vulnerable to misinformation. A 2021 study found that children often start believing in conspiratorial ideas by the age of 14, and many teens find it difficult to critically assess information they find online. Social media also leaves young users highly vulnerable, with research showing that disinformation campaigns often target young people.
Education is an important social determinant of health, playing a critical role in shaping one’s opportunities, employment, and income. Schools are not only a place for learning, but are important for children’s emotional and social development and are an integral part of children’s information environment. They provide a safe place to learn and ask questions, build resilience, and form communities
Regardless of the potential for political interference and concerns from parental rights groups, the public school system and educators possess the necessary tools to teach young students how to critically analyse information, encourage thoughtful reflection, and participate in mindful discussions about sensitive topics.
While some schools do offer media literacy courses, they are not mandatory as part of public school curriculum and are not consistent across classrooms and school boards in Canada. A CBC article recently highlighted a teacher-librarian from Winnipeg who teaches a high school class on “Information Literacy in the Age of Fake News,” which provides students with lessons on biases, the importance of checking multiple sources, and other skills needed to identify mis/disinformation.
Countries like Finland and Estonia – both of which ranked highly on Open Society Institute’s Media Literacy Index in 2021 – have integrated media literacy in the curriculum for kindergarten to high school. This initiative aims to counter mis/disinformation by teaching students from a young age how to assess a range of information on its relevance and reliability.
In Ontario, the quality of public education is being threatened by chronic underfunding, cutbacks, privatization, and a growing anti-LGBTQIAS2S+ movement, making it difficult for schools to implement important programs to improve information and media literacy and arm students against mis/disinformation. This will no doubt have the largest impact on the most vulnerable students, who have been most disadvantaged by the education and health impacts of the pandemic.
It is clear that now is a critical time to invest in education – an often overlooked social determinant of health. As discussed in the Lancet, a strong publicly-funded education system is essential for improving health outcomes and reducing social and economic inequalities. We must ensure that schools have the adequate funding they need to enable educators to empower students to form strong relationships, build trust, have healthy information environments, and be protected from mis/disinformation in all of its forms.