YouTube plays a unique role in people’s daily lives, said Garth Graham, the company’s Global Head of Healthcare and Public Health.
“People come to us to learn how to fix their refrigerator and to learn about medicine,” he said in an interview. “There is a lot of responsibility and we take it seriously. Responsibility is at the heart of how YouTube operates and how we handle sensitive information, especially around health.”
Leading YouTube Health represents the culmination of his long-standing mission to provide people with the knowledge they need to make informed decisions, he said. His job is to ensure that when people ask questions about a lump in their stomach or a persistent dry cough, they get evidence-based answers from authoritative sources – not false claims or quackery from charlatans.
Graham, who is also a practicing cardiologist, spoke at STAT earlier this month The Milken Institute’s Future of Health Summit about YouTube’s efforts to fight health misinformation, support underserved communities and creators, and protect young people’s mental health. He also discussed the importance of engaging users with clear language, evidence-based content, and lessons learned from the Covid-19 pandemic about communicating the evolving nature of science. This interview has been edited for length and clarity.
How has your personal history led you to where you are today with YouTube Health?
I am a cardiologist and still practice cardiology. I was always fascinated by the idea that the majority of healthcare doesn’t take place in the doctor’s office. We spend a lot of time on that half hour or fifteen minutes when people go to their doctor. But the truth is that this is just the tip of the iceberg. The majority of health care takes place while people are going about their daily lives.
I was a researcher in the field of ‘social determinants of health’ and I spent much of my career working on these types of issues. This idea of information as a determinant of health – how information shapes how different communities decide what to do next and the journeys they take – that was the next natural evolution of my career. We do it on a large scale and in so many places around the world. So for me it meant taking this idea of managing health outside of the doctor’s office, understanding the determinants, understanding that information is a driving force behind that and that YouTube is one of the most important places in the world where people come for health information. . Our goal is to ensure that when you go to YouTube and search for health information, you get high-quality information.
What is Youtube Health doing to combat health misinformation?
We remove information that is dangerous and violates our Sensitive Health Information Policy. We collect and reward high-quality information. We’ve created things called “shelves” that show high-quality information early in the care journey, and we label them as coming from authoritative healthcare services, whether they’re licensed physicians or accredited hospitals. That’s why we try to collect high-quality health information and remove dangerous, low-quality health information.
How do you balance between taking down something that is disinformation and people being able to say, ‘This is freedom of speech.’.”
The line is crossed when it is dangerous. We are an open platform that encourages freedom of expression. And the limit around removal is when it comes to things that are harmful and dangerous, the consequences of which could lead to increased mortality and morbidity.
Are there any lessons you’ve learned from Covid when it comes to dealing with health misinformation?
One of these is understanding the importance of different voices. People want to hear from health experts, but they also want to hear from other people they hear from in other fields. We’ve used a lot of different voices to spread public health information, that’s one thing I think we’ve learned.
And another thing on a broader scale, not just on YouTube, but I think public health in general has learned that we need to educate people about science and the evolving role of science, and that there are things in science that can change as we gain more knowledge. information. Science is not necessarily just static, but a constantly evolving concept as we get more data.
One of the things I remember about Covid on YouTube was that every video that mentioned Covid had a box with more information. Is that used for other areas that are prime for disinformation?
Yes. We also do this for other areas that may be sensitive to incorrect information. An example of this is information about women’s health.
And vaccines?
Yes, exactly. Also information about vaccines. You’ll also see a similar thing appear at the bottom. The idea is to direct people to sources where they can get information outside of YouTube, such as the CDC or WHO, or other organizations that produce health information that is credible on the subject.
How else can YouTube Health build trust with its users in a time of mass disinformation?
We’ve seen tremendous growth and continued growth in the number of people coming to YouTube looking for health information. We saw that during Covid and it has continued post-Covid. Our strategy is to deliver authoritative information, high-quality health information and provide content that answers people’s questions.
A big part of that is reaching people where they are with answers that come from authoritative and quality sources. And we also have a plethora of information resources, from cancer to high blood pressure, to diet and exercise. It’s about capturing the range of questions people may have, but also thinking a lot about information, being involved and putting the information out there in the right way for them.
Who are some authoritative accounts for health information and what is the formula for success? Dr. Mike comes to mind.
Some of the most involved workers came from hospitals. There are hospitals like your Cleveland Clinics or your Mayo Clinics. Or government agencies such as the National Health Service. And then there are individual doctors. Dr. Mike for sure. He is one of those creators who has discovered how to make information not only fact-based, but also compelling. Dr. Reena Malik is another doctor like Dr. Mike. For us, it’s really about labeling them and getting them out early in the journey.
What works is thinking about the questions people have. Provide these answers in plain language, but in an evidence-based way. If you read the content of Dr. Reena Malik looks at, she talks about very sensitive information about men’s and women’s health. She addresses it in plain language, in clear terms, and then also cites the evidence to support it. A lot of information about healthcare needs to go there.
What is Youtube Health doing to further promote authoritative sources?
We label information when it comes from an accredited health organization or a licensed physician, with the goal of getting more people to engage with the information from accredited, evidence-based sources. We have that accredited source of information on the ‘shelves’. When you search for something, it will say “From Health Sources,” allowing the user to experience and use that information early in their health journey.
What is Youtube Health doing to protect the mental health of young people?
We know from the scientists we work with that if a young person sees a single piece of social comparison content, such as perhaps around the nose or some other physical feature, that one or two pieces of that content are not dangerous. But if they start consuming multiple versions of it, it’s dangerous. Once we got that down, we worked on our platform to spread that information so that a young person doesn’t fall victim to seeing that type of content repeatedly. … We address issues like eating disorders on the platform so that people who are high risk aren’t exposed to the kind of content that can cause them to imitate eating disorders.
Health equity is something you are passionate about. What is Youtube Health doing to drive change towards healthcare equity?
We have invested heavily in the voices of underrepresented health makers by supporting them on the platform. We have a specific program that we call The IQ that is about the quality of health information for minority groups. We’re going around the world supporting underrepresented creators in countries like Brazil, the US and the UK so we can get their voices on the platform. There is some information about video and prostate cancer diagnosis where minority communities do better when they get information from other underrepresented groups. For us, we’ve invested specifically in getting more of these creators on the platform and supporting those who are on the platform and being able to train them.