In 2001, the Pew Internet & American Life Project collaborated with the Medical Library Association[13.numoffset=”13″ Medical Library Association: A User\u2019s Guide to Finding and Evaluating Health Information on the Web<\/em>. Available at: http:\/\/www.mlanet.org\/resources\/userguide.html<\/a>] to devise a series of questions about how internet users conduct health information inquiries. At that time, using a somewhat different methodology to identify health seekers and ask in-depth questions of health seekers, we found that only one-quarter were vigilant about following the research protocol recommended by medical librarians, that is, to always check the source and date of the information found online.[14. \u201cVital Decisions\u201d (Pew Internet & American Life Project, 2002). Available at: https:\/\/alpha.pewresearch.org\/pewresearch-org\/internet\/Reports\/2002\/Vital-Decisions-A-Pew-Internet-Health-Report.aspx<\/a>] Another quarter of health seekers checked the source and date of health information online \u201cmost of the time.\u201d About half of health seekers reported they \u201conly sometimes, hardly ever, or never\u201d check the source and date of health information online.<\/p>\n\n We now find that the percentage of \u201cvigilant\u201d health seekers who always check the source and date of health information found online has dropped to about 15%. An additional 10% of health seekers fall into the \u201cconcerned\u201d category by reporting that they check these two essential information quality indicators most of the time. Approximately three-quarters of health seekers say they check the source and date only sometimes, hardly ever, or never and therefore fall into the \u201cunconcerned\u201d category. That last group translates to about 85 million Americans who are gathering health advice online without consistently examining two key information quality indicators, as identified by the Medical Library Association. <\/p>\n\n Health seekers might be forgiven if they give up what at times is a search for a needle in a haystack. A recent study commissioned by the U.S. Department of Health and Human Services (HHS) finds that a tiny percentage of health sites display the source and date of the information on their pages.[15.numoffset=”15″ CDC Wonder Data 2010. Healthy People 2010 Health Communication Focus Area 11, Objective 11-4.]<\/p>\n\n The study is part of Healthy People 2010, an initiative led by HHS to improve the health of all Americans. One goal within Healthy People 2010 is to increase the proportion of health-related websites that disclose information that can be used to assess the quality of the site. HHS\u2019s Office of Disease Prevention and Health Promotion, working with industry experts, identified six types of information that should be publicly disclosed to health seekers: the identity of the site\u2019s sponsors, the site\u2019s purpose, the source of the information provided, privacy policies to protect users\u2019 personal information, how users can provide feedback, and how the content is updated. Of the 102 websites reviewed for the report, none met all six of the disclosure criteria and only six complied with more than three criteria. Just 4% of \u201cfrequently visited\u201d health websites disclosed the source of the information on their pages and 2% disclosed how the content is updated. Less-popular health sites fared even worse: 0.3% of these sites listed their content\u2019s source and only 0.1% disclosed how the content is updated.<\/p>\n\n It is interesting to note that American adults are likely to pay attention to informative labels when they are more readily available. A September 2006 Wall Street Journal\/Harris Interactive online survey found that 17% of American adults \u201calways\u201d read food labels that provide nutritional information in order to make informed food choices for themselves or for their family. An additional 34% of adults say they \u201cvery often\u201d read labels. Forty-four percent of adults say they read food labels \u201csometimes\u201d or \u201chardly ever.\u201d Five percent of adults say they \u201cnever\u201d read food labels.[16.numoffset=”16″ \u201cMost Americans Read Labels When Choosing Food, Poll Finds\u201d (Wall Street Journal Online\/Harris Interactive Health-Care Poll, September 26, 2006). Available at: http:\/\/online.wsj.com<\/a>]<\/p>\n\n One aspect of the landscape that has changed since 2001 is the broadening base of the internet population. In 2001, 46% of high school graduates had access to the internet. In 2006, 60% of high school graduates have access. By contrast, college graduates only modestly increased their numbers online during the same time period (going from 89% to 91%).<\/p>\n\n While less-educated Americans are increasing their numbers online, they are less likely than college-educated internet users to look online for health information and less likely to check the two information quality indicators included in our survey. Seventy percent of internet users with a high school diploma have looked online for information about at least one of seventeen health topics, compared with 89% of internet users with a college degree. Fully 80% of health seekers with a high school diploma fall into the \u201cunconcerned\u201d category, compared with 64% of health seekers with a college degree. On the other end of the spectrum of vigilance, 9% of health seekers with a high school diploma say they \u201calways\u201d check the source and date of health information they find online, compared with 20% of health seekers with a college degree.<\/p>\n\n This gap between Americans with more and less education dovetails with the data laid out in the September 2006 report by the National Center for Education Statistics, \u201cThe Health Literacy of America\u2019s Adults.\u201d It found that Americans with less education often lack the skills required to read and understand written health information encountered in daily life.[17.numoffset=”17″ \u201cThe Health Literacy of America\u2019s Adults: Results from the 2003 National Assessment of Adult Literacy\u201d (National Center for Education Statistics, September 6, 2006) Available at: http:\/\/nces.ed.gov\/pubsearch\/pubsinfo.asp?pubid=2006483<\/a>] Fully 49% of Americans who had not attended or completed high school have \u201cbelow basic\u201d health literacy. Fifteen percent of high school graduates have \u201cbelow basic\u201d health literacy and just 3% of college graduates have such low levels of health literacy. On the other end of the scale, 4% of high school graduates are \u201cproficient\u201d (able to handle more complex health information), compared with 27% of college graduates and 33% of Americans who have done graduate work. In addition, the report found that 80% of people with below basic health literacy do not use the internet for health information, nor do about one-half of people with basic health literacy.\u00a0<\/p>\n\n Another factor in the eroding attention to information quality indicators is the sense of confidence and efficacy prevalent among most internet users. Recall that only one in five health seekers say they felt \u201cfrustrated by a lack of information or an inability to find what they were looking for online\u201d during their last search for health information online. And only 3% of health seekers say they or someone they know has been seriously harmed by following the advice or information they found online.<\/p>\n\n This echoes what the Digital Future Report found in 2004: Fewer than 20% of health seekers said they wanted more health information, but did not know where to find it online or did not have time to get it. The same study found that about only one in five health seekers said they were concerned about the quality of the health information they encountered online.[18.numoffset=”18″ \u201cSurveying the Digital Future: Year Four\u201d (The Center for the Digital Future: www.digitalcenter.org<\/a>).]<\/p>\n\nFew health sites display the source and date, along with other information quality indicators.<\/h3>\n\n
Consumers check food labels more often than they check the source and date of health information online.<\/h3>\n\n
Demographic shifts are one factor in the erosion of concern about information quality.<\/h3>\n\n
Health seekers\u2019 success may bolster their sense of confidence about what they find online.<\/h3>\n\n