New York, NY | April 28, 2026: A cross-national survey of 31,000 adults in 30 countries finds that digital health literacy is highest in low- and middle-income countries and lowest in high-income countries, challenging assumptions that national wealth translates into stronger digital skills. The study, the first to examine how adults judge quality health information across this many countries, also documents wide variation in acceptance of AI-generated health content and in which sources people rely on for credible information.
The study was led by researchers at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH) with collaborators at the Barcelona Institute for Global Health (ISGlobal), the University of Alabama, and Baraka Impact Finance / Drugs for Neglected Diseases initiative (DNDi) in Geneva. The work was conducted in support of the Nature Medicine Commission on Quality Health Information for All research agenda.
Across countries, medical providers were the most frequently endorsed source of trusted health information (40.7%), closely followed by verification through multiple sources (31.2%). Government sources were named by 21.6% of respondents, and only 6.5% pointed to family or friends. Trust in providers was notably lower in Russia (14.6%) than elsewhere.
Acceptance of AI-generated health information varied widely. Globally, 58.3% of respondents said they would be likely to accept it, but the range was substantial: above 75% in China, India, Pakistan, and Indonesia, and below 50% in Canada, Poland, Switzerland, Italy, France, the UK, Australia, Belgium, Russia, Sweden, and Japan. Younger adults and those with post-secondary education were more receptive than older respondents.
“Digital skill is not a function of national wealth,” says Assistant Professor Rachael Piltch-Loeb , the study’s lead author. “Some of the highest digital health literacy in our data was in countries where social media has become a primary route to health information. The patterns we see also suggest that the same message will not work everywhere, and that public health communicators need to plan for clarity, transparent sourcing, and format diversity rather than assume audiences are interchangeable.”
Format and channel preferences differed sharply across age and country groups. Combined text-and-image formats were the dominant preference globally (range 41.4% to 84.7%), but video-only formats were preferred by 26.2% to 41.7% of respondents in Egypt, India, and Pakistan. Social media was the leading channel for 36.1% of respondents ages 18 to 29, compared with 10.6% of those 60 and older. Older respondents relied more on healthcare-based channels such as clinic brochures and patient information leaflets.
Across all countries, respondents valued health information that is easy to access, easy to understand, and clearly identifies its source. Government approval and endorsement by a known medical provider were rated less important on average. The authors note that strategies designed for high-income, institution-led communication environments may not transfer to settings where social media and AI-mediated content are already shaping how people encounter health information.
The survey was conducted online between August 29 and September 8, 2025, and included adults ages 18 and older from Australia, Belgium, Brazil, Canada, China, Ecuador, Egypt, France, Germany, Guatemala, India, Indonesia, Italy, Japan, Kenya, Mexico, Nigeria, Pakistan, Peru, the Philippines, Poland, Russia, South Africa, South Korea, Spain, Sweden, Switzerland, Turkey, the United Kingdom, and the United States. Stratified quota sampling was used within each country, and country samples were weighted to national population benchmarks for age, gender, education, and region.
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About CUNY SPH
The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to promoting and sustaining healthier populations in New York City and around the world through excellence in education, research, and service in public health and by advocating for sound policy and practice to advance social justice and improve health outcomes for all.
Nature Health
Survey
A Global Survey on Trust and Literacy in Health Information
28-Apr-2026