Government agencies, health advocacy groups, and health-related businesses spent nearly $37 million over four years to advertise on news websites accused of promoting misinformation, a new study shows.
Although authors of the report question the wisdom of financially supporting websites whose content undermines public health, marketing experts say it’s important to reach vaccine-hesitant consumers, wherever they’re found.
In the new study, published this week in JAMA Network Open, researchers scrutinized advertising revenue from 11 news sites flagged for spreading health misinformation, including false claims about the safety of COVID-19 vaccines.
About 10% of the more than $336 million that the sites made from advertising from 2021 to 2024 came from health groups, including government agencies such as the Centers for Disease Control and Prevention (CDC); drug makers such Pfizer and Eli Lilly; and nonprofits such as the American Heart Association (AHA) and Alzheimer’s Association.
News websites with a history of spreading health misinformation, including NewsMax and ZeroHedge, “are directly at odds with the missions of these organizations,” said Neeraj Patel, a fourth-year medical student at the Yale School of Medicine and first author of the new paper.
Raking in billions a year
The misinformation industry earns $2.6 billion a year in estimated advertising revenue, according to a 2021 report from NewsGuard, which deploys trained journalists to track online misinformation, and Comscore, which measures audience, traffic, and advertising for tens of thousands of websites. For every $2.16 in digital ad revenue sent to legitimate newspapers, US advertisers send $1 to misinformation websites, according to the report.
In another report, NewsGuard found that more than 4,000 top brands advertised on websites publishing COVID-19 misinformation. Because many of these ads are placed through automated ad-buying platforms based on algorithms, such as Google’s DV360, companies and organizations may not realize where their ads show up.
In their joint report, NewsGuard and Comscore write that, “the data underscore the scale at which online misinformation and disinformation is unintentionally bought and paid for by major advertisers, who place their ads on thousands of websites using programmatic advertising, a byzantine, computerized process—leaving brands with little idea where their ads are appearing and what messages they are financing.”
Health groups say ads were unintentional
The AHA bought nearly $67,000 in ads on misinformation sites, according to the report. The AHA uses automated advertising systems “to reach specific audiences with evidence‑based health information,” said Laura Gorr, the group’s national director of marketing communications.
“Any advertising placement on sites that publish misleading or inaccurate content is unintentional,” Gorr said. “When issues are identified, we review them promptly and take steps to strengthen controls and oversight going forward.”
Both the AHA and the Alzheimer’s Association, which spent more than $89,000 on ads on misinformation sites, said they’re committed to providing evidence-based health information to consumers.
The Alzheimer’s Association uses “keyword‑exclusion filters designed to prevent ad placement on websites that promote misinformation or harmful content,” said Mike Lynch, the group’s director of media engagement.
“Despite these safeguards, the dynamic nature of digital advertising means ads may occasionally appear alongside content that does not align with our values or standards,” Lynch said. “When we learn this occurs, we work promptly with our media partners to review placements and take corrective action as appropriate.
The Department of Health and Human Services (HHS) spent more than $623,000 on ads on misinformation websites, according to the study. Andrew Nixon, an HHS spokesman, said the ads were purchased by the Biden administration. “The fact that taxpayer dollars were directed to outlets flagged for spreading health misinformation is a serious failure of oversight and accountability,” Nixon said. “That’s exactly the kind of breakdown in judgment that helped erode public trust in our healthcare system.”
Preaching beyond the choir
Some public health and marketing experts say it’s important to educate people who don’t consume mainstream news.. Yotam Ophir, PhD, an expert on misinformation, criticized the new paper for failing to distinguish between commercial advertising and public service announcements, which aim to be informative.
“You need to reach people who do not agree with you,” said Ophir, PhD, a communications professor at the University at Buffalo, State University of New York who leads the school’s Media Effects, Misinformation, and Extremism lab. “Nobody wakes up in the morning and goes to the FDA website. So they have to reach out to people where they are.”
Demetre Daskalakis, MD, MPH, told CIDRAP News that some of the most successful public health interventions happen in unorthodox venues. “Public health has to be willing to go to uncomfortable places,” said Daskalakis, who led the CDC’s National Center for Immunization and Respiratory Diseases until August.
In the past, Daskalakis set up shop in New York City sex clubs to provide HIV testing, condoms, and prescriptions for medications that can prevent HIV. He also has appeared on Newsmax to talk about vaccines.
“On Newsmax, you may have some people who are on the fence and may give them some information that leads them to get a vaccine,” said Daskalakis, now the chief medical officer at Callen-Lorde Community Health Center in New York. “The point of outreach is to reach folks in a movable middle. Preaching to the choir is not helpful.”
