No doubt, the Internet can make you sick
Back in 1988, the UK government’s junior health minister, Edwina Currie, was forced to resign after issuing a warning that “most of” the country’s egg production was “affected with salmonella.” Her comments, which were lambasted by the industry as wildy inaccurate, led to a 60 per cent decline in UK egg sales and the slaughter of 4 million hens. Later, a report revealed that there had been a problem with the bacteria, although not quite as severe as Ms Currie had stated. And we are still not sure if eggs are healthy.
An article published last week in the Journal of the American Medical Association reignited a long-running debate about the link between eating eggs and an elevated risk of heart disease. A similar conversation rumbles on about coffee. Newspapers recently cited a UK research study that debunks earlier opinions about coffee consumption being associated with a heightened risk of heart disease and stroke. With so much conflicting health information now available to anyone at the click of a mouse, it can be hard to know who to listen to and what to believe – especially, when some of the material is factually inaccurate. The Credibility Coalition, an independent online misinformation watchdog, recently examined popular health-related news stories, specifically those with the highest levels of social media engagement.
Their findings suggest that, among the top 10 mostshared health stories of 2018, the majority contained misleading or false information. Information – and misinformation – overload can prompt at least two problematic responses. The first is for people to shrug and dismiss all health advice as nonsense, on the basis that anything they read is likely to be superseded and contradicted in a week or two. This attitude is likely to lead to delayed diagnoses and lost opportunities to make valuable lifestyle changes. I also suspect that it is, at least in some cases, a result of people burying their heads in the sand at the prospect of danger. The second response is to take all health advice with borderline obsessive seriousness.
This is particularly common among people who have high levels of pre-existing health anxiety. At least for some of us, the more we know, the more we fear. At its most extreme, this can develop into illness anxiety disorder. Illness anxiety disorder, or hypochondria as it used to be known, is a recognised condition included in the American Psychiatric Association’s latest diagnostic manual. Those who live with it are excessively preoccupied with the possibility of having an undiagnosed medical condition. Typically, they devote a great deal of time and energy to worrying about and researching ailments they believe they might have.
Unfortunately, the glut of frequently conflicting information now available on the internet has made this problem significantly worse. Reading online reports of the latest health research can heighten existing health anxieties. Some of us might imagine that we have all kinds of symptoms and, after a few more searches, become convinced that we need urgent medical attention. This preoccupation can end in costly and unnecessary investigatory procedures, some of which might even be risky in themselves. This problem of internet-triggered health anxiety has become so bad that some researchers are now referring to it as “cyberchondria”.
It is increasingly common for patients to arrive at the doctor’s surgery armed with websites and pages of “evidence” from the Internet. While it is good for patients to be informed, such behaviour can put a strain on the traditional doctor-patient relationship. If the doctor disagrees with the patient’s web-based self-diagnosis, this can lead to distrust followed by “doctor shopping”, as healthcare professionals refer to attempts by patients to find a more agreeable doctor. Sometimes, health information can even play a part in causing health problems. In medicine, this is known as “iatrogenesis”, which comes from the Greek for “brought forth by the healer”.
Iatrogenic illnesses can include those brought on by the use of certain medicines, medical error or infection. However, a good example would also be a poorly thought out obesity prevention campaign contributing to the rise of eating disorders. In her book, The Cyber Effect, the cyberpsychologist, Professor Mary Aiken, notes that, in the US, iatrogenic death has increased fourfold between 1999 and 2011, rising roughly in line with the growth of the internet. While such correlations are never evidence of cause and effect, Aiken suggests that perhaps cyberchondria is a far more serious problem than we presently imagine.
If we are to protect ourselves from the downsides of our digital age, we need to place greater emphasis on critical thinking and information literacy. Such a strategy will have to start in our education systems and will require reinforcement throughout people’s adult lives. Bearing this is mind, it is tempting to consider that perhaps there really is such a thing as too much information.