YouTube plays a unique role in people’s everyday lives, says Garth Graham, the company’s global head of healthcare and public health.
“People come to us to learn how to fix their fridge and to learn about medicines,” he said in an interview. “There’s a lot of responsibility, and we take that seriously. Responsibility is at the core of how YouTube works and how we treat sensitive information, particularly around health.”
Leading YouTube Health represents the culmination of his career-long mission to empower people with the knowledge they need to make informed decisions, he said. It’s his job to ensure that when people ask questions about a lump in their abdomen or a lingering dry cough, they’re met with evidence-based answers from authoritative sources — not bogus claims or quackery peddled by charlatans.
Graham, who is also a practicing cardiologist, spoke with STAT earlier this month at the Milken Institute’s Future of Health Summit about YouTube’s efforts to combat health misinformation, support underserved communities and creators, and protect youth mental health. He also discussed the importance of engaging users with plain-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 now with Youtube Health?
I’m a cardiologist and I still practice cardiology. I was always fascinated with this idea that the majority of health care does not occur in a doctor’s office. We spend a lot of time focusing on that half an hour or 15 minutes that people see their doctor. But the truth of the matter is, that’s just the tip of the iceberg. The majority of health care occurs as people are living their day to day lives.
I was a “social determinants of health” researcher and I spent a lot of my career working on these kinds of issues. This idea of information as a determinant of health — how information drives how different communities decide what to do next and the journeys they undertake — that was the next natural evolution of my career. We do it at scale and in so many places across the world. So for me, it was taking this idea of dealing with health outside of the doctor’s office, understanding the determinants, understanding that information is a driver of that and that YouTube is one of the primary places around the world that people come to for health information. Our goal is to ensure that when you go to YouTube and you look for health information, you get high quality information.
What is Youtube Health doing to combat health misinformation?
We remove information that is dangerous and that violates our policies around sensitive health information. We raise and reward high-quality information. We’ve created these things called “shelves” that show high-quality information early on in the health journey, and we label it as coming from authoritative health services, whether it’s licensed doctors or accredited hospitals. So we try to raise high-quality health information and remove dangerous and low-quality health information.
How do you balance taking down something that is misinformation versus people who might say, ‘This is free speech.”
The line is crossed when it’s dangerous. We are an open platform that encourages free speech. And the line around removal is when it comes to things that are harmful and dangerous, where the consequences of that could lead to increased mortality and morbidity.
Are there lessons you learned from Covid when it comes to dealing with health misinformation?
One is understanding the importance of different voices. People want to hear from health experts, but they also want to hear from other people who they hear from in other topic areas. We’ve utilized a lot of different voices to raise public health information, that’s one thing I think we’ve learned.
And the other thing on a broader scale, not just at YouTube, but I think public health in general learned that we need to educate people on science and the evolving role of science and that there are things in science that may change as we get more information. Science isn’t necessarily all static, but a constantly evolving concept as we get more data.
One of the things I remember from Covid on Youtube was that any video that mentioned Covid had a little box offering more information. Is that being utilized for other areas that are prime for misinformation?
Yep. We do that for other areas that may be prone to misinformation. An example would be information about women’s health.
And vaccines?
Yes, exactly. Information about vaccines, too. You’ll see a similar kind of thing pop up down at the bottom as well. The idea is to redirect people to sources where they can get information outside of YouTube, like the CDC or WHO, or other organizations that produce health information that is credible on this topic.
How else is YouTube Health building trust with its users during a time of mass misinformation?
We have seen huge growth and continued growth of people coming to YouTube looking for health information. We saw that during Covid and it has continued past Covid. Our strategy is to deliver authoritative information, quality health information, and to have the content that answers people’s questions.
A lot of that is reaching people where they are with answers that come from authoritative sources and good quality sources. And also having a plethora of sources for information from cancer to hypertension to diet and exercise. It’s about capturing the gamut of questions that people might have, but also thinking through a lot about information, being engaging, and raising the information appropriately for them.
Who are some authoritative accounts for health information and what’s the formula for success? Dr. Mike comes to mind.
Some of the most engaged forces have been from hospitals. There are hospitals like your Cleveland Clinics or your Mayo Clinics. Or government entities like the National Health Service. And then there are individual doctors. Dr. Mike for sure. He’s one of those creators who has figured out how to make information not just evidence-based but also engaging. Dr. Reena Malik is another clinician like Dr. Mike. For us, it’s really about labeling them and having them show up early in the journey.
What works is thinking through the questions that people have. Delivering those answers in plain language, though in an evidence-based manner. If you watch Dr. Reena Malik’s content, she talks about very sensitive information about men and women’s health. She addresses it in common language, plain terms, and then she cites the evidence that backs it up as well. That’s where a lot of health care information needs to go.
What does Youtube Health do to further promote authoritative sources?
We label information when it comes from an accredited health organization or from a licensed doctor with a goal of having more people engage with the information that comes from accredited evidence-based sources. We have that accredited source of information show up in the “shelves.” When you search for something, it says “From health sources,” and it allows the user to experience and engage with that information early on in their health journey.
What is Youtube Health doing to protect youth mental health?
We know from the scientists we work with that sometimes if a young person sees a singular piece of content about social comparisons, like maybe around the nose or another physical feature, that one or two pieces of that content is not dangerous. But then when they start to consume multiple versions of it, it’s dangerous. Once we learned the science of that, we worked on our platform to disperse that information so that a young person isn’t subject to seeing that kind of content in a repetitive manner. … We are tackling issues like eating disorders on the platform so that people who are at high-risk for them aren’t exposed to the kind of content that may make them imitate eating disorders.
Health equity is something that you’re passionate about. What is Youtube Health doing to drive change towards health equity?
We’ve invested a lot in the voices of underrepresented health creators by supporting them on the platform. We have a specific program that we call The-IQ that’s around health information quality for minority populations. We go around the world and we support underrepresented creators in places like Brazil, the U.S., the U.K., so that we can get their voice on the platform. There’s some information around video and prostate cancer diagnosis where minority communities do better when they get information from other underrepresented groups. For us, we’re invested specifically in getting more of those creators on the platform and supporting the ones who are on the platform and being able to train them.
