Special Issue: What do misinformation practices feel like? Embodiment,health and digital spaces

Abstract

This editorial explores how misinformation is expressed across a range of health practices and contexts.

The focus of this special issue is on the intersection of health misinformation and digital spaces. The contributions to the issue engage with how misinformation is felt, embodied and navigated across a range of health practices. Initially, we conceived this special issue as a response to the health misinformation that seemed to grow exponentially during the Covid-19 pandemic. Happily, the articles we are publishing in this special issue are more expansive, tracing the complexities of misinformation across a variety of health and wellness spaces and considering the influence of social media on how we live in and with our bodies.

It is easy to mistake health misinformation as, in essence, an ‘information’ problem. During the early days of the pandemic, the proliferation of misinformation about the virus was famously declared an ‘infodemic’ by the World Health Organization (World Health Organization, 2020). Public health campaigns often focus on getting the ‘right’ information disseminated, and correcting the ‘wrong’ information. While these strategies are important, this thinking can obscure the blurry boundaries between what is right and wrong information, especially when the available evidence is changing. Furthermore, the framing of health misinformation as primarily an information problem can continue a preoccupation with individual-level behaviours as both prevention and cure for any number of chronic diseases and illness, perpetuating a neoliberal assumption of personal responsibility for one's wellbeing (Ayo, 2012). Such a framing forecloses discussion about the broader inaccessibility and inequity of health systems, which creates the conditions in which misinformation can flourish.

What we explore in this issue are the messy affectivities of health, wellness and misinformation that may mean that people behave in ways that may appear illogical or contradictory on the surface. Thinking about how misinformation feels, how it is embodied and lived in daily life. The long tail of the Covid-19 pandemic has left a complicated information environment in its wake. As the pandemic moves into its endemic phase, it is still essential to understand how various forms of health and wellness misinformation are taken up, distributed and debunked through digital and social media.

Importantly, this special issue seeks to problematise the binaries that often creep into how we think about, talk about and respond to health information and misinformation. It is comforting to think of information in binary terms of good and bad or true and false. However, there remains little interrogation of misinformation outside these binaries. We were interested in assembling timely research that thought critically about how misinformation is ‘felt’ beyond approaches that treat it as an ‘information disorder’.

This special issue opens with Southerton and Clark's compelling examination of the intertwined and dialectical relationship between misinformation and debunking on TikTok, ‘OBGYNs of TikTok and the role of misinformation in diffractive knowledge production’. Their account raises important questions about how we can consider misinformation as a generative force within knowledge-making practices on TikTok. Focusing on sexual health misinformation via the accounts of popular OBGYNs on TikTok they argue that examining debunking content is the ideal site to complicate the binary between ‘credible’ information and misinformation (Southerton & Clark, 2022). Importantly they highlight how, ‘misinformation is implicated in the performance and construction of so-called ‘credible knowledge’’ (Southerton & Clark, 2022). As with other articles in this special issue, they situate misinformation in networks of knowledge production and circulation, reminding us that the binary between misinformation and credible knowledge is a function of Foucauldian ‘regimes of truth’ which legitimise expert over lay forms of knowledge (Southerton & Clark, 2022). In situating gynaecological edutainment on TikTok within regimes of truth, Southerton and Clark explore the ‘interplay, overlap and tensions that emerge between ‘expert’ voices and misinformation’ through the lens diffraction (Barad, 2007).

In tracing how TikTok creators use the affordances of the platforms (duets, stitches, green screen and response and reply) to debunk misinformation, Southerton and Clark (2022) thoughtfully demonstrate that dichotomies between the ‘factual’ and ‘misinformation’ limit our perspective on the productive and generative properties of misinformation. They highlight how TikTok's affordances allow creators to create new forms of knowledge in and through engagement with misinformation. Their creative use of Barad (2007) is an important reminder that, while we often think of misinformation as coming from ‘the outside in’, we can never sit outside knowledge-making processes and that ‘healthcare providers respond to so-called “misinformation” in creative, embodied, and affective ways that yield new forms of information and knowledge’. Debunking is a creative, responsive, iterative and overlapping engagement with misinformation. The broader, compelling question that Southerton and Clark (2022) pose is about the necessity of misinformation to the work of knowledge production.

Albury and Hendry's article ‘Information, influence, ritual, participation: Defining digital sexual health’, also considers the messiness of regimes of knowledge production and circulation. In their engagement with sexual health education, Albury and Hendry (2022) take a pedagogically informed approach to learning about the ‘right’ type of sexual health information. Their thoughtful analysis highlights how epidemiological metaphors (like ‘viral’ and ‘contagion’) are often used in traditional quantitative or information-based approaches to describe media practices. As Albury and Hendry note, while the field of communications has broadly moved on from the ‘hypodermic needle’ model of communication, we can still see its influence in the fields of public health communication strategies. As Albury and Hendry explain,

practitioners still seem to assume that a ‘good’ sexual health message or campaign is one that provides an authoritative signal that is a prophylactic (or antidote) to the ‘noise’ of vernacular digital sexual cultures.

How we find and engage with ‘good’ health information is a thread that runs throughout this special issue. From Albury and Hendry's work, we can begin to question the assumptions that underpin what is frequently regarded as ‘good’ health information, which is largely dependent on shaky and imprecise boundaries. To do so, they build on Hagood's (2020) reading of Spinoza's ethics to reject the framing of media content as a moral battle between legitimate information and misinformation. Albury and Hendry illuminate the messiness inherent in attempting to define boundaries between official and lay sexual health discussions online; in their work they, ‘push back against the notion that media use should primarily be understood as a process of “information seeking” and “information transmission”’ and suggest a more expansive framework for understanding digital sexual learning practices and cultures.

Albury and Hendry call attention to ways that sexual health practices are biomedical, relational and embodied. They highlight how, like other health practices in this issue (e.g. Topham & Smith, 2023), they are mediated through practices of advice-giving. In their careful contextualisation of ‘lay expertise’, they trace sexual health advice-giving practices back to magazines and other advice columns, long before the internet and social media. Sexual health advice columns gave early feminist ‘sexperts’ an avenue both to share and to legitimise first-person expertise, a practice now normalised on social media.

Following from this, Thompson's (2022) ‘Public health pedagogy and digital misinformation: Health professional influencers and the politics of expertise’ also considers the ways reliable public health information can be made accessible and relatable by investigating the intersection of public health pedagogy and social media influencers. Through an in-depth examination of the social media presence of Dr Michael Mrozinski, Thompson argues that health professional influencers can serve important educative functions as public health pedagogues. Like Southerton and Clark, Thompson examines how the platforms provided by social media sites like TikTok and Instagram can serve as iterative sites of knowledge production and circulation. Thompson argues that health professional influencers can serve as bridging sites between the anti-expertise sentiment that often circulates on social media and good health advice. Thompson highlights how Mrozinski achieves this through a range of strategies. Specifically, Thompson suggests that misinformation can be more effectively addressed when the debunking effort is positioned as a collective action, as a dialogue between audience and creator, rather than a top-down directive.

The importance of the collective also emerges in Hendry's exploration of the temporality of email marketing in wellness culture. In ‘“Hey lovely! Don’t miss this opportunity!” Digital temporalities of wellness culture, email marketing, and the promise of abundance’. Hendry argues that email communication is an often overlooked aspect of online communication cultures. Email is a significant site of study, distinct from social media platforms in that it enables ‘narrative communication and a sense of intimacy or support’ (Hendry, 2022). Hendry's deeply researched article highlights how email marketing also allows wellness entrepreneurs to avoid being de-platformed or otherwise censored on social media. Hendry's analysis considers how emails ‘produce temporal relationships between bodies and wellness practices and knowledge’. Further, Hendry notes that spiritually informed wellness practices draw on concepts of divine timing, that subscribers would know when the right time to take up a new wellness practice or product would be. Wellness, as communicated in the emails analysed in Hendry's research, is both temporally limited (something to be done right now) and always available. As with Topham and Smith's (2023) analysis of What I Eat In a Day videos, there is an emphasis on knowing in your body whether something is right for you, which suggests that the body is implicated in the circulation of misinformation. The health and abundance promised by wellness entrepreneurs is a sensory form of knowing; it is only by connecting and feeling in/with the mind/body that you can assess whether a wellness practice is ‘right’ for you. Hendry's work also reinforces one of the key themes in this issue: that wellness and misinformation practices are potent because they draw on personal, embodied expertise.

Wellness marketing emails are also a technological ‘back-up’ for social media engagement. Hendry argues that this functions on two levels, first, as a buttress against being banned or de-platformed from social media and, second, as a way to redirect subscribers to social media posts and entrepreneurs’ work. Emails also function as a form of networking, allowing entrepreneurs to share the work of others, such as podcasts, which, as Hendry explains, ‘mutually reinforce[s] the legitimacy and intimacy of their wellness contributions’.

The implications of the felt and sensory aspects of misinformation are again drawn into focus in Topham and Smith's (2023) article, ‘One day of eating: Tracing misinformation in “What I Eat In A Day” videos’. Focusing on the popular YouTube ‘What I Eat In A Day’ (WIEIAD) format, Topham and Smith (2023) explore these videos that give a snapshot of an influencer's food intake for 24 hours. Qualitatively analysing 84 videos across 59 YouTube accounts, Topham and Smith trace the entanglement of expertise, personal experience and pseudoscience in this vlog-style content that is common among wellness influencers. Topham and Smith seek to complicate reductive understandings of misinformation as simply ‘not true’, and dig into the embodied and affective aspects of misinformation that render it appealing. Drawing on the compelling case study of WIEIAD videos, they consider how wellness discourses and misinformation circulate and are negotiated through bodily feelings. Their analysis takes inspiration from Hendry et al.'s (2022) concept of ‘influencer pedagogy’, which refers to the kind of lay expertise of the influencer built on intimacy with their audience. Topham and Smith compellingly draw out the ways that creators in the WIEIAD videos assemble their pedagogy through practices that align their beliefs with more ‘legitimate’ knowledge. For example, they invoke deferred expertise by encouraging viewers to consult a nutritionist for personalised advice or making claims that, on their face, ‘sound’ scientific.

Topham and Smith's account offers a rich exploration of how misinformation can be compelling, precisely because it circulates and proliferates in ways that make it difficult to easily categorically determine that it is false. Creators of the WIEIAD videos are careful to couch their claims as based on their personal experiences, and not medical expertise, but the videos nonetheless operate and circulate as part of discourses about health and food consumption. The underlying message, whether explicit or not, is read, ‘if you eat like this, you’ll look like me’. Topham and Smith offer a generative way forward that ‘refocuses our attention on the sensory as a means of thinking about and responding to the ‘problem’ of misinformation’.

Russell's (2022) exploration of anti-politics in the anti-vaccination movement, ‘Pox populi: Anti-vaxx, anti-politics’, also seeks to complicate binary assumptions about protest and political engagement. Russell traces how the anti-vaccination communication, which, pre-pandemic, was more typically associated with the ‘left’ of the political spectrum is now understood to be part of the ‘cosmic right’, akin to the QAnon shaman. However, as Russell argues, anti-vaxxers and associated post-pandemic wellness cultures are not easy to map onto the left/right political binary. Nonetheless the, ‘desire to read the anti-vaxx movement as political requires a nostalgic attachment to the era of mass politics, in which social movements could be reasonably expected to gain greater institutional coherence, and ultimately to influence democratic state governance’ (Russell, 2022). To move on from this unproductive binary Russell suggests that anti-vaccination maps onto ideological extremism, not simply left vs right.

In mapping the complex political terrain of anti-vaccination sentiment in the pandemic and post-pandemic landscape, Russell suggests that the framework of anti-politics is a useful way to begin to understand the seeming contradictions inherent in the anti-vaccination space. Humphrys (2019) defines anti-politics as a ‘short-lived bursts of protest, electoral volatility and political crises … [which] tends to dissipate if not given direction’. Anti-politics can also be understood as an ‘attack on representational democracy and conventional political institutions by political actors’ (Russell, 2022). Anti-politics is a useful frame to understand the affective tenor of anti-vaccination activities because it detaches what Russell identifies as the political aesthetics of protest from politics or the political. This helps us to understand anti-vaccination protests as ‘sticky’ sites. Russell argues that they are enlivening and may be attractive as a seeming reprieve from the perceived ‘stagnation of contemporary representational politics’ (Russell, 2022). While anti-politics may speak to the hollowing out of political action and the possibility for change in representative politics, it is also, in many ways, a hopeful reading of the anti-vaccination movement. In understanding anti-vaccination protests during the pandemic as affective experiences, it seems as if they are less a symptom of a resurgent far right and more a symptom of ‘the end result of virtually mediated affect bubbling over and pouring onto the streets and into city squares’.

Conclusion

This special issue seeks to resist the popular framing of health information and misinformation circulating in digital spaces as simply the output of unscrupulous influencers. We argue that a focus on the embodied, affective and relational aspects of information and misinformation goes some way to explaining how some health information seems, at times, incoherent. Misinformation is not believed or implemented in a linear or consistent manner. Attending to the relational and felt dimensions provides a framework to explain the uneven spread and take up of misinformation. Further complicating matters is the often unacknowledged fluidity of knowledge. Information is not static in its correctness and, as Latour (2010) reminds us, facts are not plainly objective but are fabricated through the same social processes as other forms of belief.

Importantly, the articles in this issue refocus our attention away from the idea that misinformation is a problem of other people that exists ‘out there’, that misinformation is a threat to the order of things, penetrating our social world from the outside in, seeded by ill-intentioned actors determined to undermine our social order. As the articles in this issue demonstrate, misinformation is an emergent property of our social system; it is the stories we tell ourselves about how the world works, stories that feel right, feel authentic, give us hope or justify our actions.