A large-scale international study involving over 31,000 adults across 30 countries overturns existing assumptions about digital health literacy. The study reveals that digital health literacy is actually highest in low- and middle-income countries, whilst it lags behind in wealthier nations.
The study, led by the CUNY Graduate School of Public Health and Health Policy in collaboration with, among others, the Barcelona Institute for Global Health, shows that national prosperity does not automatically lead to better digital skills. According to lead researcher Rachael Piltch-Loeb, factors such as the use of social media play a key role.
“In some countries where social media is the main source of health information, we see the highest levels of digital literacy,” says Piltch-Loeb. This shifts the picture of how citizens worldwide engage with digital health information. The findings have been published in Nature Health.
Trust in sources varies greatly
The research also shows that the way in which people assess reliable health information varies greatly from country to country. Medical professionals remain the most trusted source worldwide: 40.7 per cent of respondents cite healthcare providers as their main source of information. In addition, 31.2 per cent say they verify information through multiple sources.
It is striking that government sources are mentioned less frequently (21.6 per cent), whilst family and friends play only a limited role (6.5 per cent). In some countries, such as Russia, trust in healthcare providers is significantly lower than average.
According to the researchers, these differences highlight that uniform communication strategies are ineffective. What works in one country may have less impact in a different context.
AI acceptance and social media
Acceptance of AI-generated health information varies widely across the globe. On average, 58.3 per cent of respondents say they trust such information, but the differences are significant. In countries such as China, India and Indonesia, acceptance exceeds 75 per cent, whilst in many Western countries it remains below 50 per cent.
Younger and more highly educated respondents generally appear to be more positive about AI in healthcare. At the same time, social media is playing an increasingly significant role as an information channel, particularly among young people: 36.1 per cent of 18- to 29-year-olds use social platforms as their primary source, compared with just 10.6 per cent of those aged 60 and over.
Preferences for information formats also vary. Globally, people prefer combined formats of text and images, but in countries such as Egypt and Pakistan, video content is relatively popular.
Policy and communication
The findings have significant implications for policymakers and healthcare organisations. Respondents indicate that they particularly value information that is easily accessible and understandable, and where the source is clearly stated. Strikingly, official endorsement by governments is considered less important.
According to the researchers, this means that traditional, institutional communication strategies cannot simply be applied in a digital environment where social media and AI play a major role. Effective health communication requires customisation, transparency and variety in presentation formats.
The research, conducted in August and September 2025 in countries including the United States, India, Brazil and the Netherlands, underscores that digital health literacy is not a fixed given, but is highly dependent on context and media usage.
For the future of digital healthcare and public health, this means that technology alone is not enough. Understanding users, their preferences and their information-seeking behaviour is just as crucial.
AI health literacy
Last year we published a story from professor Kristine Sørensen where she talked about the fact that AI is rapidly transforming healthcare, shifting from traditional tools to autonomous, generative systems. This evolution makes AI health literacy increasingly essential. Without it, patients and professionals risk becoming dependent on systems they do not understand, undermining informed consent, trust, and autonomy.
AI health literacy builds on general health literacy by enabling individuals to understand how AI works, evaluate its outputs, and recognize ethical and social implications. It empowers users to question algorithmic decisions, protect their data, and engage in shared decision-making.
The concept goes beyond digital health literacy, which focuses on using digital tools, by emphasizing critical thinking about automated systems and their influence on care. Strong AI health literacy helps mitigate risks such as bias, misinformation, and over-reliance on automation, while maximizing benefits like personalized care. Ultimately, it is key to ensuring AI supports safe, transparent, and human-centered healthcare.
