It is a common assumption that national wealth automatically translates into stronger digital skills. However, a new global survey has completely upended this notion, revealing that digital health literacy is actually highest in low- and middle-income countries and lowest in high-income nations.
Led by researchers at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), the cross-national study surveyed 31,000 adults across 30 countries to examine how people judge the quality of online health information.
“Digital skill is not a function of national wealth,” explained Assistant Professor Rachael Piltch-Loeb, the study’s lead author. “Some of the highest digital health literacy in our data was in countries where social media has become a primary route to health information.”
Who do we trust?
The study, conducted in support of the Nature Medicine Commission on Quality Health Information for All, found that medical providers remain the most universally endorsed source of trusted health information globally (40.7 per cent), closely followed by verification across multiple sources (31.2 per cent). Government sources lagged behind at 21.6 per cent, while only 6.5 per cent of respondents relied on family or friends.
However, there were stark regional anomalies. In Russia, trust in medical providers plummeted to a notably low 14.6 per cent.
When it comes to the format of the information, preferences varied sharply across demographics. While combined text-and-image formats dominated globally, video-only formats were highly preferred (by 26.2 to 41.7 per cent of respondents) in Egypt, India, and Pakistan.
Age also heavily dictated the channel of delivery. Social media was the leading source of health information for 36.1 per cent of respondents aged 18 to 29, compared to just 10.6 per cent of those aged 60 and older, who instead relied heavily on physical clinic brochures and patient leaflets.
The AI divide
The survey also uncovered a massive global divide regarding the acceptance of artificial intelligence. Globally, 58.3 per cent of respondents said they would be likely to accept AI-generated health information, with younger, post-secondary-educated adults the most receptive.
However, the geographic split was substantial:
- High Acceptance (Above 75 per cent): China, India, Pakistan, and Indonesia.
- Low Acceptance (Below 50 per cent): Canada, Poland, Switzerland, Italy, France, the UK, Australia, Belgium, Russia, Sweden, and Japan.
Across the board, respondents universally valued health information that is easy to access, easy to understand, and clearly identifies its source.
Piltch-Loeb warned that public health communicators can no longer assume audiences are interchangeable. Strategies designed for high-income, institution-led environments simply may not work in lower-income settings where social media and AI-generated content are already actively shaping the public’s understanding of health.
