JMIR Infodemiology

Generative AI has transformed the health information ecosystem by enabling scalable, sophisticated health misinformation production at near-zero marginal cost. Current literature addresses AI’s role in health misinformation predominantly through a binary threat detection framework, systematically overlooking the structural, multilayered mechanisms through which AI simultaneously embeds false claims across intersecting human trust systems. This paper introduces the Multilayered Epistemic Disruption Framework (MEDF), which conceptualizes how AI-driven health misinformation structurally undermines public trust through four interdependent layers of cognitive and institutional disruption: discursive (clinical language shielding: fluent medical terminology and fabricated citations deployed as credibility signals), biometric (embodied authority transfer: deepfake appropriation of real clinicians' faces and voices), temporal (the synthetic chorus effect: near-simultaneous fabrication of apparently independent corroborating sources), and systemic (structural epistemic erosion: cumulative macro-level collapse of trust in medical institutions). Adopting a socioecological and structural epistemic approach, this viewpoint synthesizes empirical findings from communication psychology, medical sociology, and digital infodemiology, and the MEDF is explicitly positioned relative to established health communication frameworks, including the i-frame and s-frame distinction (individual-level vs system-level intervention targets) and socioecological infodemic models, with each construct's novelty defined in relation to adjacent concepts in prior literature. The MEDF proposes that AI-driven health misinformation is distinctively dangerous due to its capacity to exploit variable individual receptivity to medical authority claims and to simultaneously lower epistemic thresholds across multiple trust layers. Population-level data indicate that individuals who frequently encounter health misinformation on social media are 1.66 times more likely to report systemic distrust of health care institutions (odds ratio 1.66, 95% CI 1.11-2.48). Perceptual studies document that listeners correctly identify AI-generated voice clones only about 60% of the time and perceive a cloned voice as identical to its real counterpart in approximately 80% of trials. Existing defenses—including Content Provenance and Authenticity standards, automated deepfake detection (showing area under the curve drops of up to 50% under real-world conditions), and prebunking interventions—are shown to address only subsets of the proposed cascade, leaving temporal and systemic layers substantially unmitigated. Four testable hypotheses are advanced for empirical validation. Addressing AI-driven health misinformation requires moving beyond individual-level i-frame interventions toward structural, s-frame policy responses calibrated to each layer of the MEDF cascade. Policymakers and platforms must implement source identity verification, clinician biometric protection protocols, cross-platform ecosystem governance, and proactive trust infrastructure, with particular urgency in lower- and middle-income country contexts where regulatory capacity and platform oversight are most limited.

Multiple sclerosis (MS) is a chronic neurological disease that starts in young adulthood and can significantly affect quality of life (QoL) due to various symptoms, and the risk of disability. MS directly affects people living with the disease and indirectly affects their relatives and family caregivers.

Algorithm-driven social media platforms such as TikTok are increasingly creating stratified layers in the cosmetic medical market, thereby influencing patient decisions and safety. In Taiwan, TikTok has 2 parallel markets: one is a formal tier promoting “cosmetic surgery tourism” to the public and the other is an underground tier targeting Southeast Asian migrant workers, providing informal, high-risk services.

Sexuality discourse in Ghana has become more divided, especially around gender and lesbian, gay, bisexual, transgender, and queer rights, leading to new antigay laws criminalizing lesbian, gay, bisexual, transgender, and queer activities, and other forms of sexual practices. One of the most controversial pieces of legislation, previously titled “The Promotion of Proper Human Sexual Rights and Family Values Bill,” proposed in 2021, sought to criminalize the use of sex toys, sparking opposition from leading political figures. The then minister of communication, Ursula Owusu-Ekuful, a staunch women’s rights advocate, publicly opposed the clause criminalizing sex toys, stating that such initiatives infringed on women’s sexual autonomy. Her stance sparked heated debates on several social media platforms, reflecting the broader tensions surrounding conversations about sexuality in Ghana. To better understand the public’s reactions to the minister’s counterproposal, we analyzed comments from various social media platforms.

Influenza seasons may be associated with increased anxiety-related expressions on social media. Social media can reflect population-level emotional expression patterns in real time.

Repetition is a central feature of digital news consumption, where engagement-driven algorithms often expose users to similar health-related content. Prior research suggests that repeated exposure can influence perceived truth and evaluation, but most studies use brief or decontextualized stimuli and have rarely distinguished between explicit and implicit attitudes. Little is known about how repeated exposure to full-length, polarized health news shapes explicit and implicit attitudes, particularly toward familiar products such as dietary supplements.

Oral nicotine pouches, such as Zyn, have rapidly grown in popularity in the United States, with sales increasing from 83.2 million cans in 2020 to 385 million cans in 2023. This growth has occurred alongside concerns about youth use. At the same time, Zyn’s visibility on social media has also expanded, where youth-targeted content may shape perceptions and influence product uptake.

The variation of language concerning tobacco products and tobacco use is known to impact the understanding of related risks and influence behaviors including use uptake and product cessation. Transnational tobacco companies can use such complexities to change the acceptability of tobacco use and influence public understanding of related risks. These changes, in turn, impact tobacco use behaviors. Looking at variations in the language used by different groups can therefore offer helpful insights into tobacco use cultures and make imbalances of information between groups plain. This paper examines the language of tobacco use, specifically smoking, across a sample of health organizations (the National Health Service, the World Health Organization, the National Institute for Health and Care Excellence, and the Centers for Disease Control and Prevention), the tobacco industry (British American Tobacco and Philip Morris International), and in “general English.”

This study, using natural language processing and manual thematic analysis of Reddit posts, revealed a rapid rise in discussions about tianeptine, with posts frequently reporting dependence, withdrawal, and coingestion with other unregulated substances, highlighting tianeptine as an emerging public health concern.

With the rapid development of pharmaceutical e-commerce, online drug sales have led to additional safety risks, while providing convenient services to the public. These risks pose challenges to public health security and regulatory systems.

Mpox was declared a public health emergency of international concern in 2022. Instagram is widely used by age groups and communities disproportionately affected by mpox; yet platform-specific evidence on mpox information characteristics and engagement remains limited.

Tetanus is a severe but vaccine-preventable neurological disease that remains a public health concern, especially in resource-limited settings. As social media becomes an important source of health information, concerns persist regarding the quality and reliability of tetanus-related content online.