Silence Is Not a Strategy | Dr. Ami Palmer

Silence is one misinformation strategy — it's just the wrong one. And when organizations do speak up, they often make the same mistake: assuming that better information changes minds. Dr. Ami Palmer, clinical ethicist and health misinformation researcher at MD Anderson Cancer Centre, has a more useful framework, and it starts with showing up in the information environments where your audience actually forms its beliefs.

The conversation covers why frequency matters as much as accuracy, why organizations need to be present in the spaces where misinformation is already circulating, and why targeting the extremists is a waste of resources. The people worth reaching are the ones in the middle, still open to evidence, who just need a clear, respectful, data-backed counter to the talking points they are already hearing. Palmer also explains why changing someone's mind is rarely about giving them better information.  And what organizations need to understand about how beliefs are actually formed.

Transcript

SPEAKER_02 0:03

Welcome to Mythinform Science, a podcast about misinformation, disinformation, and the science of what to do about it. Conversations with experts in the study of misinformation. So, Justin, it's easy to think about health misinformation as a problem of very recently, of the Internet age, certainly the social media age, even since COVID, but it's really been around for much longer than that, hasn't it?

SPEAKER_01 0:41

Yeah, I mean, two examples that come to mind when I think about this is the smoking, smoking tobacco and seat belts. So when I you know when I think about smoking, there's so much misinformation around smoking and and especially in the the 1950s and the 60s, I think largely driven by ultimately the tobacco industry. And we can look back at some of the ads that they put out now, maybe laugh a little bit about the use of doctors and making claims about promoting safer cigarettes like there is such a thing, sowing a lot of doubt, at least, even when the evidence was increasingly crystal clear, just how harmful smoking is. And that misinformation really costs lives, truly costs lives. And I mean the other one that I mentioned is seatbelts, which you know, when you think about it now, it feels like such a normal, non-issue, almost non-thinking part of driving now. But uh as recently as the 60s through to the probably the 80s, there was a lot of misinformation around seatbelts. They weren't mainstream cars at the time, really. And you know, there's misinformation about them not being safe, and even when at that point the evidence was super clear, just how life-saving seatbelts are. And I think that's another example to me of misinformation really delayed implementing seatbelts in cars even when the evidence was in. And that's another one that cost lives. But no, these are still relatively recent examples. Can you think of any other examples?

SPEAKER_02 1:58

Yeah, well, uh it's interesting to go back to even the start of vaccination. So Edward Jenner's smallpox vaccine, which is really the first, first true vaccination. He had designed or he had the insight that people who had had cowpox, which is a related but less severe disease, were less likely to get smallpox, which was a truly miserable and deadly disease. And so his idea was to develop a vaccine based on cowpox. But when that start started being rolling out rolled out, and when it was starting to become clear that it was effective for limiting the incidence and severity of a smallpox, the fact that it was based on cowpox, that it was based on cows, a vaccine that had at some point been present in in cows, set people on edge. The idea of injecting something from cows into the bloodstream. So there even then there was the beginnings of that was really a reflection of uncertainty or fear, but it was certainly also the kind of beginnings of misinformation around vaccine, even back then.

SPEAKER_01 3:12

Yeah. And I mean, I guess what's changed nowadays is the social media age more connected and and it's maybe just the amount of misinformation now that we're talking about and the opportunity for some people to potentially become less and less connected to science-supported information, maybe more and more relying on sources that they liked, which may or may not be science supported and ultimately maybe lower quality to have to make decisions about their health.

SPEAKER_02 3:37

Yeah, I mean, the internet was supposed to connect everybody, right? It was supposed to connect people more. And but the other side of that was that prior to the internet, we had we had things like broadcast news, or before that we had newspapers, and before that or around the same time, radio. And these were all things that at least provided some common ground that you might not necessarily agree with everything that was on the radio or on television, but at least you were probably exposed to it at some point. So everybody at least had some familiarity with the basic information. But now we've got the situation where I've I will never willingly watch Breitbart News or Fox News unless I'm actively trying to see what you know is uh lots of people are being exposed to. Lots of people will never watch CBC or look at the New York Times for exactly the same reason. So you're getting this increasing gap between based on the information you choose to be exposed to.

SPEAKER_01 4:49

Exactly. Yeah, and it makes you think about what are the long-term consequences of that isolation of information, not just obviously politically, but in terms of what we're most closely interested in health and health risks. We're already seeing examples geographically of people becoming more susceptible to communicable diseases because of vaccine hesitancy in certain sort of physical places. But we just talked about that interconnected online world that this goes potentially well beyond the brick and mortar geography based um where people's are con people are connecting. What are other long-term health challenges are going to emerge here?

SPEAKER_02 5:25

Yeah. It's the information ecosystem in which people live and choose to live and lets you makes you think about well, is the information ecosystem itself potentially a health risk? Something that as public health actors, we have to think about on a population level. Is that a health risk? So this is to lead into our guest, this is the sort of thing that our guest has thought a lot about. Dr. Amy Palmer is an assistant professor and a clinical ethicist at the Center for Clinical Ethics in Cancer Care at the University of Texas, MD Anderson Cancer Center. His work focuses on health misinformation in a cancer setting and the ethics of medical AI. He's also the lead author on a 2025 paper in social science and medicine that I really liked. It was called Misinformation, Trust, and Health: The Case for Information Environment as a Major Independent Social Determinant of Health. It's a really fascinating paper. I was really glad to uh be able to connect with uh Dr. Palmer and have a chat with him. So, our conversation with Dr. Amy Palmer coming up.

unknown 6:52

Dr.

SPEAKER_02 6:52

Amy Palmer, welcome. Thank you. It's a pleasure to be here. Yeah, I'm really interested to get into some of the ideas in this paper. Maybe we could just set things up a little bit. Can you just give us a little bit of an introduction on social determinants of health? How would you describe what they are, what their importance is in terms of understanding the health of populations?

SPEAKER_00 7:16

So the WHO, the World Health Organization, defines social determinant of health as the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. So we can think about health decision making at various levels. So you know, very simple level would be at the individual level. But individual decisions always take place within a certain context. And that context is shaped by a variety of factors over which the individual often has very little control. Some of these factors include socioeconomic status, educational status, their built environment, their proximity to healthcare resources. Yeah, and uh all these things will shape the kinds of decisions that are available to the person.

SPEAKER_01 8:28

And I mean it it leads us right into neatly your really fascinating paper in social science and medicine. That makes the case, I think, a really strong case for a need to focus on information environments and characterizing information environments as potentially a social determinant of health. How would you describe what is an information environment? It's not just, you know, I guess believing different myths. It's not, I guess, about health literacy necessarily. It's more about where you get your information from more broadly.

SPEAKER_00 8:59

Yeah, I think like in a very broad sense, information environment is the aggregate of the individuals and institutions that we go to for information. Not actually not even necessarily go to, but sometimes we're just passive recipients. Sometimes it's just it's just kind of like the water we swim in. Yeah, so that's how I characterize information environment.

SPEAKER_01 9:26

Is it an environment or multiple environments?

SPEAKER_00 9:30

Yeah. So just like there are multiple economic environments and social environments, there are different uh information environments and they have different qualities. And I think this is something I've been this is actually something I've been reflecting on recently, is they can the norms of those in for information environments or the kind of reason for their existence can be different. I think, you know, especially people coming from an academic background, we just automatically assume that people form kind of informational social communities with one goal in mind, and that is the truth. But I think a nuanced investigation of what these some communities are trying to do, it's not that they don't care truth about truth at all, is that that's not the most important thing that they're trying to accomplish?

SPEAKER_02 10:24

I mean, so the this idea of an information environment or multiple information environments, you can read the National Enquirer and still be a healthy person. You're you can watch Fox News and still get your vaccinations. So is there data out there to really point to a direct relationship between information environments and health? Well, what do we know about that relationship? Is it extremely indirect? Are there examples of where it may be a little bit more direct that relationship?

SPEAKER_00 11:01

Yeah, this is a great question. So I think there are really two kind of intuitive arguments. One is that our beliefs are strongly influenced by the information that we most commonly encounter. So that's step one. Environment influences my beliefs, and my beliefs influences my behaviors, right? And then so we're gonna have a difference in beliefs, which leads to a difference in behaviors, and different behaviors in the context of health lead to different health outcomes. So I think that's like the really intuitive case. And so, as anybody who works in you know, a science or any kind of academic discipline knows that what is theoretically plausible isn't always the case. And so we need to do the hard work of seeing, well, is it true that we can draw this causal chain from environment to different health outcomes? Right. And that's really what the paper is about. Let's pressure test this hypothesis and see whether it withstands scrutiny.

SPEAKER_02 12:12

So do you see the the mechanism by which information environments have their effects on health? Is it primarily a frequency effect? Is it prime or is it are there other sort of social components like-minded people gathering together, those kinds of things that also contribute to the relationship between health and information environments?

SPEAKER_00 12:38

Yeah, this is an excellent question. Let's go back to COVID. I mean, there was a barrage of misinformation surrounding lots of questions with COVID. But you know, some people saw that and I was like, that's dumb. Or that's not from a credible source, or that doesn't cohere with my worldview, right? And other people saw it and say, Oh, yeah, definitely, right? So so it's you're exactly right, it's not just frequency, although frequency is important, it's also trust, right? Who do we think are trustworthy sources of information? Because only in rare cases are we never exposed to an opposing viewpoint on an issue. It does occur. There are some people that are locked into what we call echo chambers, but most people do encounter information supporting both sides of an issue, and so we need to account for the fact why is it that some people defer to one source but not to the other, and vice versa. And really a big part of this has to do with what's called the prestige bias. So we tend to defer to sources or institutions and individuals that within our social group we deem as prestigious. And we can understand prestige quite broadly, right? It can be degrees, academic degrees, it can be wealth, it can be having a particular physical appearance, it can have be like having a certain number of followers on our TikTok account, right? Right? So prestige is really determined by what let's call what we call local standards, like within that social group, that is what determines prestige. There's no like universal identifier for prestige. And so certain groups value certain things more than others. And so we're gonna look for those markers of prestige that are kind of part of our social group, and we're gonna defer to those sources.

SPEAKER_01 15:00

That's super interesting. And it almost pivots us to how information environments are created in the first place and you and defined social determinants of health and define information environments as a kind of interplay between individuals and institutions, and someone or some organization is positioned to foster information environments in this sort of way. So I want uh building off of what you described in terms of frequency and prestige bias, talk a bit more about how do people go about creating environments that support beliefs?

SPEAKER_00 15:27

Yeah, this is an excellent question. So, like all interesting questions, these are multifactorial, right? There's not just like the one cause, right? There's multiple contributing factors. So, yeah, this is something actually I was thinking about over the weekend, knowing I was going to be talking to you guys. So, like, how do people end up in the information environment that they end up in? And I think some people are just like born into particular information environments. They grow up in a household with a certain social identity, and that's just what they grow up into. And that can be excellent, like a good thing, because you just like luck into an epistemically reliable information environment, but also be a bad thing. You just happen to grow up in an epistemically unreliable environment on particular issues, but then like it gets interesting to think about because sometimes people actually actively choose their information environments, right? So I have a particular social identity, and this comes with certain values and a worldview, and it's just I want to find sources that support my worldview and values, right? And this is why what I talked about earlier, which is I think like for academics, it's very easy, it's very natural for us to say, oh, the purpose of epistemic communities is the pursuit of truth, right? But I don't think that's actually what's going on in many social identity-based information environments, right? What they're looking for is confirmation that their social identity and worldview is the correct one. And so evidence that confirms that, thumbs up, evidence that disconfirms it either never enters or is discarded. So that's that's like a people actively choosing their environments and shaping their environments. But as has been well discussed in the literature, there's also, you know, other systems in the background that are directing us towards particular information environments. This is algorithms. They see we liked this one thing, and so now it it recommends us or puts us into contact with other sources that are similar to that, and that can have a snowballing effect, and we can just we can find ourselves in an information environment very different from the one that we started out in. So a big part of in information environments is what are the norms, what are the epistemic norms in that information environment? Do you in that information environment, if there is an uncomfortable piece of information that might disconfirm some of the prevalent beliefs in that ecosystem, do people say, hey, we need to change our view? Look, this piece of information just came out? Or are people like, no, you can't trust them? That was written by the adversarial social group, so you you can't trust it.

SPEAKER_02 18:31

So do you see is there a direct relationship between effects of equity and likelihood of being in certain social certain information environments? Are they parallel constructs that may or may not be related to each other? What's the relationship between the information environments that people are in and health equity-related issues? I know it's not a very well-framed question, but you know what I mean.

SPEAKER_00 19:04

Yeah, I think like so in in the early literature on the relationship between information environment and health equity, the concern was some uh social groups uh and demographics don't have very good access to the internet. Right? Right. But that concern is long is largely gone now. But also, we also know that access to the internet in itself does not guarantee that you end up with reliable sources. Yeah, it's a wild west out there. And so health equity, yes, is partly about access to information, but really it's about what sources are readily prevalent in your information environment and that have some prestige in your group. Because if your group either never hears from reliable sources because they're pushed out of that environment, or yeah, so one could just be omission, they're just not there, right? The other one is that this is like the what's called an echo chamber, is that the narrative of the of that information environment is that you cannot trust this outgroup. Anything that they say is false. And so even if people in that ecosystem encounter the correct information, they dismiss it. And so they're gonna have different health outcomes. We saw this in the COVID pandemic. People that were in heavily right-leaning media ecosystems had worse health outcomes related to COVID, regardless of age, social economic status, and geographic location, and and prevalence of COVID in their community.

SPEAKER_01 20:59

Yeah, I mean, this is just such a fascinating conversation. When I first when you're first describing the information environment and its definition, it felt like it was leading itself down the path of people are weather veins and are just exposed to different information in the environment they happen to be in and then influencing their beliefs and their behavior. But the way you're describing things is much more nuanced than that. People have agency within those information environments, maybe they bounce between information environments. And that the sort of that very human social identity and wanting to belong feeling within that. It's just it's a really, I think, useful way for to hear you describe the people living and believing within information environments is not just this sort of external causal influence. Is that right and how I'm thinking about it?

SPEAKER_00 21:47

Yeah, like any social phenomena is extremely complex. Right? I think like the important thing really to keep in mind is that the old model of how we acquire our beliefs is. Is that as individuals, we are rational individuals, we encounter evidence, and then we appraise that evidence and we see how it fits with our existing belief set. And it's all kind of individual and internal. But you know, what's been called the the social epistemological turn started around 2010, is that there's this huge understanding now that most of our beliefs are acquired socially through social processes, right? And they are what Christina Bicchieri calls conditional social attitudes, right? So we adopt or reject them in large part based on what our how our social group responds to those beliefs, not because of some rigorous Cartesian analysis that we've done. And I should just add, this is not calling anyone stupid. This is actually necessary in the modern world. Nobody has a PhD in every domain, right? So anytime we encounter information from a complex domain and we need to make a decision, I can't go, I don't have my own lab, I can't like decide whether the COVID vaccine has these side effects or not, or relative what are the side effects of COVID. I don't have a lab, like I can't do that. I have to defer to others. So this isn't like, oh, you're weak, you didn't do your own research or whatever. No. In our modern society, on issues where trial and error is either not possible or in very costly, we must defer. It's a condition of being a social creature and the complex environment in which we live. The real issue is how do we, as non-experts in a particular domain, decide to whom we're going to defer?

SPEAKER_02 23:51

Yeah. Yeah, very nice. One issue that you brought up at the towards the end of the paper, and I think we've touched on a number of these issues, but you bring up the notion that we need a taxonomy of information environments, the idea that we can categorize information environments in terms of their important characteristics in some way. And I could imagine that you could slice up information environments in terms of maybe how insular they are, how how open they are to other opinions. We talked about prestige and it struck it, it really struck me as interesting that maybe different kinds of prestige lend themselves to different kinds of information environments. So lend themselves to different kinds of leaders and that kind of thing. What are some of the other ways you might usefully slice up these kind of different kinds of environments?

SPEAKER_00 24:57

Yeah, I think like very broadly we can think about epistemic environments in terms of two main kinds of criteria. One is epistemic criteria. So that would include are these things like the nature of the epistemic objects, right? So are these like are they highly emotional or are they like measured like academic papers, right? So what kind of objects are typically in that environment?

SPEAKER_02 25:29

We can think about So like really really just so like really emotional anecdotes versus hard, hard data science sort of stuff.

SPEAKER_00 25:38

And also the medium, so some environments, images are the primary object that gets passed from video videos and images, right? And those we know from a lot of research, short circuits are critical thinking faculties, right, versus an environment that's text-based. Right there, that in when we have to read something, it engages our critical faculty. So just the nature of the object itself is gonna influence how likely we are to endorse something because they're gonna certain types of objects short circuit our thinking and others don't. And then there's the epistemic norms of the community. So we can think about the epistemic norms of a scientific community, are very different from the epistemic norms of see if I can do this without throwing out someone under the bus. Let's just say there can be different epistemic norms from those of a scientific community. How they appraise evidence, these sorts of things. And then we talked about before, like the purpose of that epistemic community and environment. What is it constructed to do? Some it like I said, like I don't think so. I think all epistemic environments care about truth. It's just sometimes they care about other things more. Yeah.

SPEAKER_02 26:56

Yeah, in the purpose and norms of the community, you could imagine that they're certainly online. There are communities that are are moderated, they are they're led in a way that can very explicitly enforce certain norms, right?

SPEAKER_00 27:13

Yeah, and the other category is like the structure of the environment, which is kind of what you're getting at a little bit, right? So some epistemic environments are constructed for virality, right? So think social media, right? It's constructed for information to spread very quickly, right? But we know that in those environments, falsehoods can spread very quickly, right? Contrast that with the environment of an academic journals, right? It takes forever to get something out there, but we're probably getting better quality. I'm not saying it's perfect, but relative to a social media platform, the likelihood of approaching truth is greater.

SPEAKER_02 27:55

Yeah, I always get a kick out of thinking about debate as it happens within academic journals, where it can happen over the course of multiple issues and probably years as the carefully crafted arguments are submitted in different papers and that sort of thing, compared to your average YouTube video where the comments are just people uh arguments are flying fast and furious.

SPEAKER_00 28:19

Yeah, and there are gatekeepers versus social media. There's no gatekeepers. Social media, you can look at the dominance of certain individuals, like how different nodes are connected to each other. So people who study social network analysis look at the mathematical structure of environments, and this tells this can tell us a lot.

SPEAKER_01 28:43

Yeah, right. Amazing. I mean, you've made a really compelling case for information environments with us today. And I guess I wanted to pivot us a little bit to solutions about what we can do about it. We clearly haven't been that good at breaking down certain information silos in society at the moment with our scientific wisdom. Um how do we limit some of the damage that some of these information environments might pose more broadly? We talked a little bit about is it about reshaping the pestemic norms, looking at trust bridges. Are there tools, are there approaches that you're working on that um that might help us towards more solutions here?

SPEAKER_00 29:20

Yeah. So yeah, the so I think again, going back to levels of analysis, right? We can look at the individual, we can look at the institutional, we can look at the systemic, right? So a lot of people have talked about teaching critical thinking integrated throughout primary education all the way through high school. I think it's a nice idea. I think it could maybe it'll help. There's a bootstrap problem because not all teachers have those skills as well. Critical thinking is a separate skill. And if you've never studied it as a skill, I don't know how you're gonna teach it. So that but you know, in the medical context, we know that one of the most trusted sources of information sources of information for most people is their doctor or their nurse, right? However, you know, I did a study a couple years ago asking physicians about their communication strategies and the kind of responses that patients have to it. Basically, there's no training for physicians to have these conversations. Well, I should say, shouldn't say none. There's there's some coming online for having conversations about vaccines, but this is not the only medical misinformation out there. So there's misinformation about cancer care, there's misinformation about basically any chronic illness, there's misinformation about it. And it's a profit-driven industry, right? So we have to treat communication skills as central to medical training. We need CME credits for it, we need to build it into the curriculum. Because when I talk to our clinicians every day here at ND Anderson Cancer Center, this is a constant frustration for them. And it gives them significant moral distress because it's not uncommon for patients to come in, refuse treatment because they saw some herbal supplement online, and then they come back a year later, and now that it the cancer's progressed too far where we can't do anything. Maybe we can do provide palliative care, but we can't reverse it. We would if we had caught it early, if they had adhered to the treatment plan early that we were offering, possible cure, certainly significant life extension. Right? So this is a bit this is a big issue. The other one I'll say is we need to think about the frequency bias, right? There is a massive profit incentive for people selling medical, non-evidence-based interventions. Um, and very often they're not regulated by the FDA, unlike pharmaceutical interventions. And so people face a deluge of misinform health misinformation, people selling everything, but there's no message going the other way, right? The worst thing that institutions can do is to say nothing. Because if we just think at the level of groups and systems, what determines statistically whether people believe one thing or another is the relative frequency of exposure to that idea. That's a big piece of it. And so if there's no messaging going the other way, people don't encounter it. And the other piece of this is that like for me to it's kind of like if we have to post on our social media, uh our institutional photo social media accounts, think about NASA. Like the earth is round, the earth is round. It seems so dumb, right? Like, why should I have to post that the earth is round? And the same thing the medical attacks are like vaccines are safe and effective. Vaccines are it's like why why are you telling me to do this? And it sounds like silly, but you need to give concrete refutations of the talking points that are circulating, right? Because if people don't encounter those refutations, then they've only heard information on one side and frequency bias will push them towards that. And actually, they don't even need to endorse it. All they need is to doubt the safety and efficacy of vaccines or some anti-cancer treatment. They don't need to think, you know, that the whatever herbal supplement is going to cure them. They just need all they need is for doubt. And the harm's been done.

SPEAKER_02 33:47

So yeah, I mean, yeah, I absolutely agree. I th I mean, does this not put us into a frequency war where we're just we're just pulling pushing out as much low interest, low quality stuff as the misinformation side is, hoping that desperately that something will stick. But I guess the idea is we want to get eyeballs, we want to get people exposed to scientific data and scientific truths meaningfully, not just producing yet another Twitter that says the earth is round, those kinds of things. So it's quality of the messages as well as the frequency, too.

SPEAKER_00 34:28

Yeah, and also so NASA, their climate division, they have a social media account on Facebook. I don't know if it's on other platforms, they do a wonderful job. So they'll post something about climate change, and then inevitably climate change denialists or skeptics, whatever you want to call them, will make some comment in the comment section. But then the NASA people will respond to it in a way that you know is respectful, clear, and concise, and backed by data. This is critical in in the literature on replying to misinformation. You gotta have data, you gotta have a respectful tone. And the other important thing I think that people often forget is that we're not trying to reach the extremists. You will never reach the extremist on any issue. What you're trying to prevent is the people in the middle from falling to the wrong side. Right? The people who are still open-minded and maybe they've heard, oh, this and that, and this and that. But then here's like a clear, concise, data-backed, respectful response to a talking point that they probably heard, and they're like, oh, that guy was that guy's wrong, actually. I can see it. Right? That's who we're after. We're not after the extremists.

SPEAKER_02 35:56

Yeah, really, really interesting stuff. Yeah, I mean, we talk about this stuff all day. The the information environment paper that we've been focusing on, I it's a small part of your research. Are there other pieces out there that you think we should know about that that uh you'd like to emphasize before we wrap this up?

SPEAKER_00 36:16

So I have a publication coming out, I I can't remember when it's coming out. It's in uh medicine and philosophy on this question, the broader philosophical question. What do we do in a democracy where you know the norm in a democracy is that the laws must be endorsed in some way by the people who are subject to them, right? And so if people don't endorse the public health policies or public health laws, even though they're grounded in very strong science, what do we do within democratic theory? Right. So that's the question I tackle there. That's in Medinf medicine philosophy. It should come up out in a couple months. If people are interested, they can they if people are really interested, they can reach out to me, send me an email, I'll send you a draft. One of my I think my two of my pilot studies are published on um the cancer misinformation guide and also my survey of clinicians on their perceptions of engaging with patients who endorse medical misinformation about their cancer care. Yeah, those are the I guess the main ones.

SPEAKER_02 37:22

Fantastic. Listen, this has been really interesting. I mean, I really appreciate your time. I do think that this notion of information environments is it's not going away. It's clearly something that's gonna be something that continues to be part of our lives. It's something that I think we really have to explore scientifically. And this paper and your works really provided us with a really great starting point for that work. So thanks very much, and thanks for being here.

SPEAKER_01 37:54

Yeah, thank you.

SPEAKER_02 37:55

It was a pleasure. Thank you both. So I really uh really enjoyed that conversation. Yeah, really interesting perspective, really thoughtful guy, obviously. One like information environments, I really was taken with the idea of trying to pull apart the different categories of them or the different descriptors of them. The taxonomy piece. Yeah, the talks you're right. And the he had some really good points about it that the objects matter, that it's you know, it matters whether it's a TikTok video or long-form narratives that has that has some impact on the information that gets circulated. It really yeah, it really got me thinking about what would be a useful taxonomy of information environments. I think that's really something to follow up.

SPEAKER_01 38:47

Yeah, I was struck by that as well. And it's really reinforced why the putting this idea out there of information environments as a social determinant of health. It just feels useful because it provides a kind of categories of things that we can work on. So rather than it just being, you know, we need to tackle misinformation generally, which feels super nebulous, that having this concept of there are information environments that people navigate that are part of, and that they have different ways of being described and what characterizes them just it feels like gives us something to focus on more directly.

SPEAKER_02 39:18

Yeah, and and the social determinative health piece really situates it within a sort of public health space where it's where we're talking about populations, we're not talking about individuals. It suggests that the levers to have something to say about information environments are large organizational, governmental type levers, perhaps, and not maybe not as much the sort of individual-level interventions that I spend my time thinking about.

SPEAKER_01 39:48

But I did like how he navigated between those ideas that on the one hand there's these system level issues that we can tackle with the information environments, but recognizing that people are making decisions in those environments and are deciding potentially to go between or have multiple information environments. And so I feel like it's not I came away from this feeling like yes, there's definitely these bigger picture ways of thinking about it from a social determinants of health, but it doesn't take the individual totally out of it either. That people have agency that can be part of the solution as well, not just reacting to the system.

SPEAKER_02 40:22

Yeah, and I remember there there was a paper that I came across at one point where there was downplaying the idea of echo chambers, the idea that there's certainly a a sense that echo chambers happen and that people's opinions get increasingly polarized within echo chambers. But this paper was saying, well, actually most people they don't just they're not just exposed to one medium, they're not just on Twitter, they're not just on one social media, they actually go from one to the next. Yeah. And so that's at least a potentially moderating influence that there are multiple information environments that people get exposed to.

SPEAKER_01 40:58

Yeah. That's great. And I mean, one thing I wanted to run past you that I really liked your point and the discussion around there was a lot of discussion talk around the kind of frequency bias, and like people are just exposed to lots. And you were making the point that no, we can't get ourselves into an arms race of just flooding the system and everybody's just putting more and more information out there to counter everything. And I wonder if you did you have any more thoughts around what's the alternative then?

SPEAKER_02 41:21

Yeah. Yeah. I mean, it it's uh there's lots of potential levers from a cognitive perspective, right? I mean, it's all about making certain kinds of information more attractive, more salient, more attention-grabbing than others. And so there's there's a whole industry, they call it the attention economy, right? That that certain actors are getting very good at gra getting people's attention for whatever influence. And I think we just for whatever reason, and often for profit motive or whatever, but it sounds like that as public health actors, we probably need to understand and implement some of those attention-grabbing, salient, develop, salience developing mechanisms that other actors are particularly good at. At least that's one thing that I think about.

SPEAKER_01 42:15

Yeah. So not necessarily more is better, but it's the quality of what's going on.

SPEAKER_02 42:19

You know, there's lots of lots of starting to be more research into narratives and the potential of story to guide people's overall beliefs and actions, not just at an individual at a specific level, but at a broader level. And I think that's the kind of thing that some political actors are really good at. They're develop they develop the overall story so that the individual details don't matter so much. You might not remember them, you might not care about specific details, but the overall story is really what's guiding behaviors and that sort of thing. I think we really need to start thinking about narratives and storytelling a little bit more.

SPEAKER_01 42:59

Yeah, yeah. Make the evidence a bit more human.

SPEAKER_02 43:01

Yeah. Yeah. I like I also like the his talk about prestige, the idea that there are different kinds of different forms of prestige that different information environments value. Yeah. And that is not always the truth. But that's that really is clear. And it just reminded me, I I watched that Louis Thoreau Netflix thing about the Manosphere recently as a doc one of his documentaries. And it was very clear that the sort of prestige that attracted people into that world is not necessarily one about quality of information or truth as something else, it's success. Financial success, success with women, the projection of it, regardless of whether the of the truth of it, all of those kinds of things. So yeah, it was. Uh this notion that we need to understand what's linking people within certain environment environments, and that it's not necessarily what you think it is uh is interesting to think about.

SPEAKER_01 44:12

Yeah, and I guess that's the ultimately the that social identity and belongingness and those higher values of just being a person in a social environment and trying to find your people, trying to find how you fit in, that the that that kind of prestige bias is providing some of that food for especially folks that are looking for that in their life. Um and yeah, moving beyond just thinking that the science-based prestige is is the way to go is is something that we should really be thinking about more carefully.

SPEAKER_02 44:42

Anyway, yeah, the chat with Amy Palmer are really interesting, lots of food for thought around information environments and how it affects the health of populations.

SPEAKER_01 44:57

This podcast is produced in collaboration with Podcraft Productions.

SPEAKER_02 45:01

For links to the research discussed in this episode, go to the show notes.

SPEAKER_01 45:05

If you enjoyed this episode, we'd love your support. Subscribe wherever you get your podcast, leave a review and a five-star rating. It helps others find our show. I'm Justin Presseau.

SPEAKER_02 45:14

And I'm Jamie Perho. Thanks for listening.