Millions in public health advertising dollars are flowing to websites flagged for misinformation, raising urgent questions about how automated ad systems may be undermining trust in credible health information.
Study: Advertising Payments to News Websites That Publish Health Misinformation. Image credit: Shyntartanya/Shutterstock.com
A recent JAMA Network Open study estimated the volume and proportion of advertising spending by government agencies and health organizations on news websites identified as publishers of health misinformation between 2021 and 2024.
The Economics of Health Misinformation
Health misinformation, broadly defined as false or misleading content inconsistent with the best available evidence, has become a pervasive feature of the modern digital landscape, spreading across social media platforms, online forums, and smaller media outlets. Efforts to address this problem have historically emphasized demand-side interventions, such as media literacy programs and platform-level content moderation. More recently, focus has shifted to the financial structures that sustain these websites.
Advertising revenue is a primary economic driver of online misinformation. Previous analyses have documented that major commercial brands routinely place digital advertisements on websites with established records of publishing false or misleading content, often through automated programmatic ad-buying systems that lack site-level transparency. However, the extent to which government agencies and health-focused organizations, entities with explicit public health mandates, contribute to the advertising revenue of such websites has not been systematically examined.
Assessing Public Health Advertising Spending on Health Misinformation Websites
The current cross-sectional study integrated two commercial datasets to examine the flow of advertising revenue into health misinformation websites. Website credibility data were drawn from NewsGuard, a service that evaluates news websites against standardized journalistic criteria to flag those that repeatedly publish false or egregiously misleading content.
Websites flagged for health misinformation as of August 2025 formed the analytical sample, along with each site's topical focus areas. Advertising expenditure data were sourced from MediaRadar, a commercial advertising intelligence platform. Specifically, the MediaRadar360 database was used to extract digital advertising spend associated with each identified website for the period 2021 through 2024, disaggregated by digital media category.
Total annual advertising expenditures were aggregated across all identified websites and all digital media categories. Expenditures were then stratified by eight predefined government and health organization advertiser categories, and the top five advertisers within each category were identified.
Government and Health Organizations Spent More Than $35 Million on Health Misinformation Websites
NewsGuard flagged 1,229 news websites for spreading health misinformation. Of these, only 11 had advertising expenditure data from MediaRadar360. This small subset nonetheless exposed a notable pattern of advertising spending on platforms known to have published health misinformation.
Internet display and mobile web advertising data were available across all 11 websites, while online video data were accessible for just 2, and mobile application data for only 1. These findings may reflect limited visibility into certain areas of digital advertising rather than a confirmed systemic lack of transparency. The content on these sites was far from incidental: political news and commentary dominated, followed by conspiracy theories or hoaxes, health or medical information, and general news. Misinformation was not confined to health topics alone but often appeared alongside political, conspiracy-related, and general news content.
Between 2021 and 2024, a total of $336.4 million in advertising was spent across these 11 health misinformation websites. Notably, $35.7 million of that amount, roughly 1 in every 10 dollars spent, came directly from government and health organizations. This raised questions about how advertising placements occur within automated ad-buying systems.
Just two platforms, NewsMax and ZeroHedge, accounted for 65.2 % of all advertising expenditures and 67.3 % of funds from government and health organizations, suggesting the problem was not diffuse but anchored in a handful of high-traffic, politically oriented outlets. On a per-website basis, the median advertising expenditure from government and health organizations was $1.39 million. This represented about 9.7 % of each site’s total advertising revenue.
Healthy and Natural World stood out as a notable outlier, where government and health advertisers accounted for 25.7 % of its total ad spend. The breakdown by advertiser type was equally revealing, with spending ranging from $571,843 by medical and health insurance companies to $19.2 million by nonprescription remedy and wellness product advertisers, a category likely to target audiences interested in health-related content.
Encouragingly, advertising expenditures from government and health organizations fell from $16.7 million in 2021 to $6.8 million in 2024, suggesting that awareness of the issue may be increasing, though significant investment continued.
Conclusions
The current study reveals that government and health organizations may be inadvertently funding health misinformation through routine advertising. While this study is limited in scope, including the small number of websites analyzed and the lack of data on the proportion of misinformation within each site, the implications are significant: institutional advertisement on misinformation sites risks lending credibility to false content and eroding public trust. Policymakers should consider stronger advertising restrictions to prevent public health dollars from supporting the spread of misinformation.
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