Unequal Burdens of Health Misinformation: Disparities in Exposure, Susceptibility, and Outcomes

Health misinformation is a pervasive and inequitable public health challenge with consequences that extend beyond knowledge deficits to influence behavior, healthcare engagement, and psychosocial well-being. This narrative review and critical synthesis examines current evidence on health misinformation disparities, drawing on empirical, theoretical, and policy-relevant literature to characterize differential patterns of exposure, susceptibility, and outcomes across population groups. Exposure and susceptibility are not evenly distributed, as they disproportionately affect populations with intersecting vulnerabilities related to race, ethnicity, socioeconomic status, language, digital access, and health literacy. Evidence demonstrates that susceptibility is shaped by historical and structural factors including medical mistrust, limited health and digital literacy, and algorithmically reinforced social media ecosystems. Meanwhile, age, cognitive style, and sociocultural context further modulate risk. Health misinformation has tangible downstream effects, contributing to vaccine hesitancy, delayed or avoided care, and adverse psychosocial outcomes, including increased anxiety, depressive symptoms, and erosion of trust in healthcare institutions. Cross-national data indicate that disparities are amplified in regions with weaker digital health infrastructure and limited access to timely, multilingual information. Interventions such as debunking, prebunking, media literacy programs, and community-engaged initiatives show the strongest evidence for correcting specific false beliefs whereas evidence for durable translation to behavioral change and sustained health outcomes is more limited and requires further evaluation in equity-diverse populations. Addressing health misinformation through an equity-focused lens is critical for mitigating disparities, restoring institutional trust, and promoting equitable health outcomes across populations.