Misinformation, trust, and health: The case for information environment as a major independent social determinant of health

We argue for the inclusion of information environment as a major independent element in social determinants of health (SDoH) models. During the early COVID-19 pandemic, healthcare policymakers began to recognize the threat medical misinformation presents to public health, however, major health agencies have yet to formally adopt information environments into their models, which indicates that further argument and advocacy are required to bring about needed institutional changes. We present empirical evidence demonstrating how information environments significantly influence health-related beliefs, behaviors, and outcomes. Drawing on cultural evolution, social epistemology, and social network analysis, we integrate multidisciplinary theoretical frameworks which explain and predict how information environments function analogously to established SDoH factors. This parallel implies that healthcare institutions should apply similar resources and concern to information environments as they do to other SDoH. Recognizing information environment as an SDoH is critical for addressing health inequities in the digital age. We conclude with policy recommendations for public health institutions. By incorporating information environment into SDoH models, health policy can more effectively combat misinformation, promote health equity, and improve population health outcomes in our increasingly complex information landscape.