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How the Power of Shared Identity Can Help Defuse Health Misinformation

Summary

  • In an interview with IHI, Dannagal Young discusses what drives misinformation, how media and identity shape our beliefs, and how health care professionals can unlock better communication with patients. Young will be a keynote speaker at the IHI Forum.

Dannagal G. Young, PhD, is a Professor of Communication and Political Science at the University of Delaware and Director of the University's Center for Political Communication. She studies the content, audience, and effects of nontraditional political information and how people make sense of their political worlds. She has published over 70 academic articles and book chapters on the content, psychology, and effects of political information, satire, and misinformation. Her latest book, Wrong: How Media, Politics, and Identity Drive our Appetite for Misinformation, explores the demand side of misinformation — that is, why we are attracted to falsehoods. 

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Dannagal Young

A lot of your work focuses on how we process information and misinformation. How does misinformation find its way into our politics and our health?

There's a huge amount of research on the content side of mis- and disinformation and how it travels. But, given how our media environment works, there wouldn’t be as much false information out there if there weren't a demand for it. So I sought to understand what needs misinformation satisfies for people — what it is they “get” from falsehoods, and why they want it.

I also wanted to write about it in a way that acknowledges that we all have these needs, so I decided to approach it with humility to say, “Even as a social scientist, I am vulnerable to these same dynamics. I am attracted to information that is false. We all are attracted to information that is false. And here are some of the reasons why.”

I talk about what I call the “three Cs”: our needs for comprehension, control, and community. These are fundamental needs that shape not just our behaviors every day, but also how we make sense of our worlds.

When we're making sense of our world, there aren’t just consequences for politics. There are consequences for health as well. If we encounter information that makes us feel like we comprehend what's going on, or it makes us feel like we have control over a situation, or it makes us feel really connected with our community, it doesn't matter so much to us whether it's empirically true or false, because it's satisfying some more fundamental needs that are guiding us. That is at the heart of what drives our appetite for misinformation.

How do our identities affect our relationship with information?

Our political media world rewards and incentivizes thinking about ourselves as members of giant political teams, the left and the right. These identities get activated over and over again through the things that we watch and through social media. Then, our needs for comprehension, control, and community all operate in service of our “team.”

We want to comprehend the world the way that our political team does. We want to control the world in ways that are good for our political team. And we want to enact community in the same way that our political team does.

Our political and media world cultivates these identities in ways that keep this engine running and that keep our demand for “identity-driven falsehoods” high.

Health care professionals are having conversations with their patients. In addition, they may have friends or family reach out to them with questions about health information. Are there different strategies we use to communicate with someone when we already have a personal relationship, for better or worse?

I have some dear friends who are doctors, and I always ask them for medical advice first. My sense is that the way my doctor friends speak with me is the way that health care providers should speak with everyone.

They’ll say things like, “If it were my loved one, I would say that they should get this treatment,” or, “Based on my experience, I’ve never seen that happen before.” It’s not about statistical probabilities. It's very human. They speak with emotion and compassion and even communicate uncertainty in their approach.

In my recent work I’ve been exploring some of the consequences of rising populist movements around the globe. Populist leaders often allege corruption in politics, media, science, or health, and their rhetoric promises to empower “the people.” Populist language tends to celebrate a common-sense understanding of the world — a layperson’s understanding. This emphasizes a belief in the tangible and intuitive over data, evidence, or abstract theory. It’s rooted in, “Here’s what I experienced, here’s what I saw, here’s what I feel, so this is what I believe.” And this layperson’s understanding can often cause people to push back against science and health facts, in favor of alternative remedies and belief in health misinformation.

As much as folks in the health and science communities can be frustrated by this trend, there are ways to meet people where they are — adopting a layperson’s approach to understanding the world as we communicate our work. In fact, if we're being honest, this is more in keeping with how we live our lives every day. No, it’s not how we do science, because there's a procedure and a method to that, but we all value intuition. We all value direct experience. We all draw upon “common sense.”

We can think about ways of communicating scientific findings that embrace intuition, emotion, and our lived experience, while remaining consistent with the empirical findings.

We know that using fear to try to motivate health behaviors can really backfire.

Yes. You do need information [about the threat] to cause people to be motivated in the first place. But it must be coupled with efficacy information, that is, concrete steps that this individual can take to avoid the threat, as well as some indication that it will make their likelihood of being harmed go down. I think that that's what a lot of folks forget.

When you spoke with the ABIM, you talked about understanding communities. You said that even when people share false information about how to meet their needs, “The needs themselves are never wrong.” Do you have suggestions for how people in the health care field can better listen to those needs?

One, sometimes just a realization that those needs are themselves reasonable changes the lens through which health care providers think about these constituencies, rather than as people who are thinking the wrong way. That can create a healthier dynamic for a more meaningful and productive conversation.

Two, it allows you to say, “What is the need that’s underlying this misperception?” For example, belief that COVID is not real? That is such a hopeful misperception. It makes you feel like everything’s okay. Like “I have control, it’s not real.” Sometimes threats are so big and so horrifying that we create a false narrative to just put our mind at ease.

Once you recognize that, the next step is to communicate about the threat in ways that still protect this individual’s agency. Recognize that we want to feel like we have power here. There are real mechanisms of power and control. For example, thinking back to COVID, one of those ways is wearing a mask. One of those ways is getting vaccinated.

It’s very challenging when you’re talking about folks who hold a misperception because they are embedded in a community that also holds that misperception. Trying to tackle that misperception head on sometimes [leads to] backlash.

Instead, what about tapping into a shared social identity that is outside of the social world that has them believing the falsehood — outside of politics, for example. Perhaps a social identity tied to physical place and one’s community? For example, “We’re both parents. We’re from this geographic community.” Even saying, “We both root for the same sports team.”

How do we engage with members of communities who have been harmed by health care institutions and continue to be harmed by health care institutions? What can support better communication there?

These approaches can’t only be communication approaches. They have to be behavioral approaches on the part of the health care community. This can't be approached as a public relations campaign.

Trust has to be earned. The medical community must acknowledge wrongdoing. There are reasons for a lack of trust. We can say, “Here is what we're doing within the community to right those past wrongs.”

Sometimes the medical community makes mistakes. [We can’t] pretend that everyone has ample reason to trust in the medical community. It’s important to communicate openly.

I talk a lot about intellectual humility — the openness to being wrong — and personal vulnerability. Saying and embracing, “here's where I'm at based on what I know so far, but I could be wrong.” People in institutions of power are not used to vulnerability or humility. If the goal is to engender trust and to deserve that trust, then humility and vulnerability are necessary.

In addition to humility and vulnerability, how can we further guard ourselves against misinformation?

Upstream, I look at the habits that we fall into that tend to reactivate political identities in subtle ways that will drive us to want falsehoods. How can we disrupt those?

A lot of that has to do with changing the way we engage online. Being a little more honest about the ways that maybe we don’t fit with our political team. Sometimes because the social pressures to perform in keeping with our team are so strong, we stay quiet about certain topics upon which we may not perfectly align. But if we’re honest, we will empower and enable other people who don’t fit the caricature [to speak up]. That will create new shared identity in ways that we may think is impossible.

You talk so much about the power of shared identity. How can we grow communities that have a positive effect on shared values?

It’s clear that when folks invest in their geographic communities and activate that identity as members of neighborhoods and their town, it reduces a lot of what we’ve been talking about. It quiets political identities a little bit, because we have things that we care about in common.

I’m always an optimist. There are hobbies and aspects of our culture that bring people together every day. I also have been inspired by the fact that some of the most popular shows over the last five years have been shows that are popular across different politics. Humans have a desire to have things in common, and I believe that we will find them.

Editor’s note: This interview was edited for length and clarity.

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