Lentis, Social Media Influencers and Public Health

Introduction

Public health communication has historically relied on institutional authority like government agencies, medical professionals, hospitals, and traditional news organizations. These sources usually present information through expert statements, evidence-based recommendations, public service announcements, and formal media coverage. In this model, credibility is tied to professional expertise, scientific evidence, and institutional reputation.

In recent years, social media has changed how many people encounter and evaluate public information, including health information. This shift is visible in broader news habits: Pew Research Center reported that about one-in-five U.S. adults regularly get news from news influencers on social media, and the rate is higher among young adults ages 18 to 29 [1]. Pew Research Center also found that Facebook and YouTube remain major places where U.S. adults regularly get news, with many also using Instagram, TikTok, and X (formerly Twitter) for news [2]. These patterns matter because public health messages now compete in the same attention economy as influencer content, personal stories, and algorithmically recommended posts.

Why Do People Trust Influencers?

Influencers can become powerful sources of health information because of the “expertise paradox [3].” In theory, people should be most likely to trust health advice from individuals and institutions with verified medical or scientific expertise. In practice, however, social media users often assign credibility based on appearance, confidence, lifestyle, relatability, and perceived authenticity. A wellness creator, fitness influencer, or lifestyle vlogger may appear knowledgeable because they look healthy, speak with certainty, and present their advice through personal experience. Their authority is therefore not based primarily on professional credentials, but on the performance of expertise in a digital environment.

This form of trust is strengthened by parasocial relationships. Horton and Wohl (2016) introduced the concept of parasocial interaction to describe the feeling of intimacy audiences can develop with media figures despite the relationship being one-sided [4]. Social media intensifies this dynamic because viewers can encounter the same influencer repeatedly through videos, stories, livestreams, comments, and personal updates. Over time, the influencer can begin to feel familiar, almost like a trusted peer. This one-sided relationship can make audiences more receptive to advice because the creator appears approachable and emotionally available.

Social media platforms also reinforce influencer credibility through visible engagement metrics. Likes, shares, comments, follower counts, and algorithmic promotion can make a creator’s advice appear socially validated. A health claim that receives thousands of likes may seem credible because many other users appear to approve of it. Short-form video formats can further strengthen this effect by rewarding confidence, simplicity, and emotional appeal, while discouraging the nuance and uncertainty that often accompany responsible medical communication. Research on social media influencers and health outcomes supports this concern: Powell and Pring (2024) found that influencers can affect health behavior in both positive and negative ways, which shows why influencer health communication should be treated as a serious public health issue rather than a minor online trend [5].

Influencers and Brand Sponsorships

Health brands impact social media users by sponsoring influencers. Sponsorships are when influencers are paid to advertise the brand’s product or service, and they allow health brands to connect to influencers' viewers in a way that is perceived as more “authentic” than traditional company advertisements [6]. An example of a health brand sponsorship is the online therapy platform BetterHelp that has sponsored popular influencers with millions of viewers including Ariana Grande [7] and YouTubers The Try Guys [8] and Boogie2988 [9]. While the goal of sponsorships is to be beneficial to both parties, influencers may not agree with strict guidelines for sponsored content by brands [6] and sponsorships may bring negative publicity to the company. In the case of BetterHelp, increased publicity from sponsoring YouTube creators led to scrutiny of their dishonest practices and terms of service by creators and viewers [9].

Social Media and Health Misinformation

Social media algorithms show users content based on interaction on similar posts or shared interests between other followed users or friends [10]. These algorithms enable confirmation bias, the tendency for people to seek and process information that conforms to their existing beliefs [11], by continuously showing users similar content. As users with similar beliefs see similar content, this enables echo chambers, which are the dynamic where people only interact with and hear from people of similar beliefs [12]. Through confirmation bias and echo chambers, social media algorithms can lead to misinformation spreading and factual sources not reaching misinformed users.

Information, and misinformation, can be spread by anyone on social media. By nature of the platforms, anyone can post content on anything, and this content has the potential to be seen by any user. Some social media platforms have taken steps to combat misinformation; for example, X has the Community Notes feature that allows users to collaboratively correct misinformation or provide context for other users’ posts [13]. X Community Notes were found to provide credible information countering health misinformation about COVID-19 [14]. As of May 2026, Meta platforms (Instagram, Facebook, and Threads) are beta testing Community Notes [15]. YouTube provides Information Cues below videos on controversial topics such as COVID-19 or the Apollo 11 Mission that link to external sources like Wikipedia [16].

Social media platforms are not unbiased on what content they show to users. A 2021 study found that X amplifies right-wing content and sources at least as much and usually more than left-wing content in most countries [17]. While amplifying right-wing content does not necessarily mean more health misinformation will be spread, X has been historically used by influencers like President Trump to spread COVID-19 misinformation [18].

Impact of Health Information On Social Media

Social media has become an important source of health information, not just a place where people casually see health content. Pew Research Center found that 36% of U.S. adults get health information from social media at least sometimes, and that number rises to 52% among adults under 30 [19]. This matters because public health advice is no longer shaped only by doctors, government agencies, or medical institutions. It is also shaped by influencers, algorithms, comments, and viral posts. When the same health claim appears repeatedly in someone’s feed, it can start to feel familiar and trustworthy, even if it is incomplete or not supported by medical evidence.

One major concern is that social media can spread health misinformation quickly, especially during moments of uncertainty. The COVID-19 pandemic showed how easily false claims about vaccines, treatments, masks, and public health rules could circulate online. The World Health Organization describes this problem as an “infodemic,” where too much information, including false or misleading information, makes it harder for people to find reliable guidance [20]. This can create confusion, encourage risky choices, and weaken trust in health authorities. Misinformation does not have to convince everyone to cause harm; it only has to create enough doubt to make people hesitate or ignore reliable advice.

Social media can also make unsafe health products look legitimate. Reuters reported that more than 250 websites selling fake versions of popular weight-loss and diabetes drugs were taken down, along with 3,968 social media listings for fake drugs [21]. This shows that online health misinformation is not limited to bad advice. It can also connect people to products that may be unsafe or fraudulent. Posts about health products often rely on personal stories, before-and-after images, and influencer endorsements, which can make a product seem convincing before users ever see scientific evidence or warnings.

At the same time, social media can have positive effects when credible people use it well. Medical professionals and health educators can use short videos and posts to explain important issues in a way that is easier for the public to understand. For example, the Association of American Medical Colleges described how medical student Joel Bervell used social media to explain that pulse oximeters may be less accurate on darker skin tones. One viewer later remembered this information during a COVID-19 emergency and used it to advocate for proper care [22]. This example shows that social media can make health communication faster, more personal, and more accessible.

Overall, social media has changed public health communication by changing how people decide what to trust. It can help useful health information reach large audiences, but it can also reward content that is emotional, simple, or highly visible rather than accurate. The lesson from this case is that public health institutions cannot rely on expertise alone. They also need to understand how people build trust online and how platform design affects what information people see.

Health Information Regulations

In the United States, the Federal Trade Commission (FTC) is the primary agency responsible for regulating health-related advertising. In 2022, the FTC released its Health Products Compliance Guidance, which clarifies how existing law applies to modern advertising environments, including social media [23]. The guidance emphasizes that all health-related advertising must be truthful, not misleading, and supported by adequate substantiation before dissemination. For stronger health claims, this requires “competent and reliable scientific evidence,” which may include human clinical studies [24].

The FTC also regulates influencer marketing by requiring that any “material connection” between an influencer and a company, such as payment, free products, or affiliate links, must be clearly disclosed [25]. In this case, influencer posts are subject to the same standards of truthfulness and substantiation as other commercial advertisements.

However, these regulations fundamentally rely on the ability to classify content as advertising and to identify commercial relationships. In practice, influencer content often blurs the line between personal expression and promotion. The vast scale of creators on social media producing hard-to-classify content on social media also makes consistent enforcement difficult. As a result, much health-related content may fall outside effective regulatory oversight.

Future Considerations

The persistence of the infodemic highlights that addressing influencer-driven health communication requires more than correcting individual instances of misinformation. The World Health Organization states that “multisectoral actions to counteract infodemics and health misinformation are needed” [26]. Because the spread of health content is shaped by platform design, creator behavior, and audience interpretation, effective responses must target each of these components.

At the policy and platform level, algorithmic recommendation systems play a central role in amplifying certain types of content, often reinforcing confirmation bias and privileging engagement over accuracy. Potential interventions include improved, or automated detection and labeling of misinformation and sponsored content. This would make distinctions between advertising and personal expression more transparent and enable more effective enforcement by the FTC. Some jurists support this, arguing that sharing health misinformation is a violation of others’ right to life and liberty and should be criminalized [26], though such monitoring could also raise concerns about being excessive.

At the level of content creators, the expertise paradox discussed earlier suggests a need for stronger quality standards and clearer signals of credibility. Empirical evidence supports this concern: nearly 60% of health-related videos produced by nonmedical influencers contain non-factual or misleading information, compared to approximately 15% from medical professionals [27].

Finally, consumer interpretation remains a critical factor. Studies indicate that 58% of young adults regret health-related decisions influenced by misinformation from non-expert influencers [28], reinforcing the need for improved health and media literacy. Together, these considerations suggest that mitigating the public health impact of influencer content requires coordinated changes across platforms, creators, and audiences.

References

• ↑ Stocking, Wang, Lipka, Matsa, Widjaya, Tomasik, and Liedke. (2024, Nov. 18). America’s News Influencers. Pew Research Center. https://www.pewresearch.org/journalism/2024/11/18/americas-news-influencers/.
• ↑ Social Media and News Fact Sheet. (2025, Sep. 25). Pew Research Center. https://www.pewresearch.org/journalism/fact-sheet/social-media-and-news-fact-sheet/.
• ↑ Harbath, K. (2025, June 4). The Expertise Paradox. Anchor Change. https://anchorchange.substack.com/p/the-expertise-paradox.
• ↑ Horton, D. and Wohl, R. (2016, Nov. 8). Mass Communication and Para-Social Interaction. Psychiatry, 19(3), 215-229. https://www.tandfonline.com/doi/abs/10.1080/00332747.1956.11023049/.
• ↑ Powell, J. and Pring, T. (2024, Jan.). The impact of social media influencers on health outcomes: Systematic review. Social Science and Medicine, 340. https://www.sciencedirect.com/science/article/pii/S0277953623008298/.
• ↑ a b Levitt, A. (2024, June 21). Influencers Want Brands’ Sponsorship, But Not Their Rules. Stanford Graduate School of Business. http://www.gsb.stanford.edu/insights/influencers-want-brands-sponsorship-not-their-rules/.
• ↑ Grande, A. (2021, Oct. 10). World Mental Health Day BetterHelp Partnership] (social media post). Facebook. [http://www.facebook.com/arianagrande/posts/its-world-mental-health-day-and-im-beyond-thrilled-to-team-up-with-betterhelp-ag/416705039808708.
• ↑ The Trypod. (2022, Oct. 6). ok, let's talk about it. - The TryPod Ep. 181 (podcast episode). YouTube. http://www.youtube.com/watch?v=Ut68FBnWbAI.
• ↑ a b Alexander, J. (2018, Oct. 4). YouTube’s BetterHelp mental health controversy, explained. Polygon. http://www.polygon.com/2018/10/4/17932862/betterhelp-app-youtube-sponsorship-controversy-explained.
• ↑ Rodrigues, Newell, Babu, Chatterjee, Sandhu, and Gupta. (2024, June). The social media Infodemic of health-related misinformation and technical solutions. Health Policy and Technology, 13(2). https://www.sciencedirect.com/science/article/pii/S2211883724000091.
• ↑ Casad, B. (2026, Mar. 30). confirmation bias. Britannica. http://www.britannica.com/science/confirmation-bias.
• ↑ Kielty, C.,Gampa, A., and Nosek B. (n.d.). Echo Chambers, Audience and Community. University of Virginia School of Data Science. http://datascience.virginia.edu/projects/echo-chambers-audience-and-community.
• ↑ About Community Notes on X. (n.d.). X Help Center. http://help.x.com/en/using-x/community-notes.
• ↑ QI Communications Team. (2024, Apr. 24). Study Finds X’s (Formerly Twitter’s) Community Notes Provide Accurate, Credible Answers to Vaccine Misinformation. Qualcomm Institute. http://qi.ucsd.edu/study-finds-xs-formerly-twitters-community-notes-provide-accurate-credible-answers-to-vaccine-misinformation.
• ↑ How community notes work on Instagram and Threads. (n.d.). Instagram Help Center. http://help.instagram.com/1324409242092689.
• ↑ Mindshare FAST. (2018, Mar. 16). YouTube launches Information Cues. Mindshare in the Loop. http://www.mindshareintheloop.com/youtube-launches-information-cues.
• ↑ Huszár, Ktena, O’Brien, Belli, Schlaikjer, and Hardt. (2021, Dec. 21). Algorithmic amplification of politics on Twitter. Proceedings of the National Academy of Sciences, 119(1). https://www.pnas.org/doi/full/10.1073/pnas.2025334119.
• ↑ Ugarte, Cumberland, Flores, and Young. (2021, Feb. 1). Public Attitudes About COVID-19 in Response to President Trump's Social Media Posts. JAMA Network Open, 4(2). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775658.
• ↑ Pasquini, Stocking, Kikuchi, Pula, and Yam. (2026, Apr. 7). Users of social media and AI chatbots for health information are more likely to say they are convenient than accurate. Pew Research Center. http://www.pewresearch.org/science/2026/04/07/users-of-social-media-and-ai-chatbots-for-health-information-are-more-likely-to-say-they-are-convenient-than-accurate.
• ↑ Immunizing the public against misinformation. (2020, Aug. 25). World Health Organization. http://www.who.int/news-room/feature-stories/detail/immunizing-the-public-against-misinformation.
• ↑ Wingrove, P. (2024, Apr. 15). More than 250 websites selling fake weight-loss drugs reported by anti-counterfeit firm. Reuters. http://www.reuters.com/business/healthcare-pharmaceuticals/more-than-250-websites-selling-fake-weight-loss-drugs-reported-by-anti-2024-04-15.
• ↑ Bervell, J. (2023, May 11). TikTok’s Medical Mythbuster on using social media to fight health inequities. Association of American Medical Colleges. http://www.aamc.org/news/tiktok-s-medical-mythbuster-using-social-media-fight-health-inequities.
• ↑ FTC Announces New Business Guidance for Marketers and Sellers of Health Products. (2022, Dec. 20). Federal Trade Commission. http://www.ftc.gov/news-events/news/press-releases/2022/12/ftc-announces-new-business-guidance-marketers-sellers-health-products.
• ↑ Health Products Compliance Guidance. (2022, Dec.) Federal Trade Commission. http://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance.
• ↑ Disclosures 101 for Social Media Influencers. (2019, Nov.). Federal Trade Commission. http://www.ftc.gov/business-guidance/resources/disclosures-101-social-media-influencers.
• ↑ a b Borges do Nascimento, Pizarro, Almeida, Azzopardi-Muscat, Gonçalves, Björklund, and Novillo-Ortiz. (2022, June 30). Infodemics and health misinformation: a systematic review of reviews. Bulletin of the World Health Organization, 100(9), 544-561. https://pmc.ncbi.nlm.nih.gov/articles/PMC9421549/pdf/BLT.21.287654.pdf.
• ↑ Dimitroyannis, Fenton, Cho, Nordgren, Pinto, and Roxbury. (2024, May). A Social Media Quality Review of Popular Sinusitis Videos on TikTok. Otolaryngol Head Neck Surgery, 170(5), 1456-1466. https://aao-hnsfjournals.onlinelibrary.wiley.com/.
• ↑ Palmer, A., and Gorman, S. (2025, Sep.). Misinformation, trust, and health: The case for information environment as a major independent social determinant of health. Social Science and Medicine, 381. https://www.sciencedirect.com/science/article/pii/S0277953625006033.

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