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Original academic article published by Neeraj G. Patel, Reshma Ramachandran, and Joseph S. Ross from JAMA Network Open 01 April, 2026.
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Introduction
Exposure to health misinformation, defined in a US Surgeon General Advisory as incorrect or misleading health information according to the best available evidence at the time, has increasingly spread through social media platforms, online forums, and smaller media outlets.1 Although several strategies focus on mitigating its reach, there has been recent interest in curbing misinformation at its source. Prior reports have suggested that misinformation websites are motivated by advertising revenue2 and that well-known brands frequently place advertisements on misinformation-spreading websites.3,4 Research has not focused on advertising by governments or health organizations, whose missions may be inconsistent with supporting misinformation-spreading websites. We characterized estimated payments made by government and health organizations to place advertisements on news websites identified for publishing health misinformation.
In this cross-sectional study, we used data from NewsGuard,5 a company that assesses the credibility and transparency of news websites using journalistic criteria, to identify news websites that repeatedly publish false or egregiously misleading content and were identified for publishing health misinformation as of August 2025 and topics on which those websites focus. We used data from MediaRadar, a company that produces commercial advertising intelligence, to estimate 2021 to 2024 advertising expenditures associated with each website identified by NewsGuard.6 MediaRadar’s MediaRadar360 database provides advertising expenditures for specific digital media categories. This study followed the STROBE reporting guideline. The Yale University institutional review board determined that neither consent nor ethics review was required because the study does not involve human participants. Additional details are provided in the eMethods in Supplement 1.
We calculated total annual advertising expenditures for all websites across all digital media categories, overall and stratified by 8 government and health organization advertiser categories (eTable in Supplement 1), identifying each category’s top 5 advertisers. Data analysis was conducted using R Studio, version 4.4.2.
There were 1229 news websites identified by NewsGuard for publishing health misinformation, and advertising expenditures were available from MediaRadar360 for 11; advertising expenditure data for internet display and mobile web were available for all 11 news websites (100%), online video for 2 (18%), mobile app for 1 (9%), and mobile web video for none. Content areas of significant focus included political news and commentary (n = 8), conspiracy theories or hoaxes (n = 5), health or medical information (n = 3), and general news (n = 2).
Overall, advertising expenditures from 2021 to 2024 for these 11 websites totaled $336 428 230, with $35 749 961 (10.6%) from government and health organizations. The median (IQR) advertising expenditure total per website among all advertisers and among government and health organizations was $13 448 278 ($10 656 148-$23 338 017) and $1 389 294 ($1 107 465-$2 162 362), respectively. Two websites, NewsMax and ZeroHedge, received 65.2% of all expenditures and 67.3% of expenditures by government and health-related organizations. The median (IQR) percentage of total advertising expenditure from government and health organizations per website was 9.7% (8.8%-11.2%), with 1 outlier (Healthy and Natural World) at 25.7%. Among government and health organization advertiser categories of interest, expenditures ranged from $571 843 on behalf of medical and health insurance companies to $19 242 621 on behalf of nonprescription remedy and wellness product advertisers (Table) and decreased from $16 688 593 in 2021 to $6 784 340 in 2024 (Figure).
Table. Estimated Advertising Expenditures From Government and Health Organizations to 11 News Websites Identified for Publishing Health Misinformation and the Top 5 Advertising Entities in Each Category, 2021-2024
Figure. Estimated Advertising Expenditures From Government and Health Organizations to 11 News Websites Identified for Publishing Health Misinformation, 2021-2024
Each dot represents the estimated annual total advertising expenditure from advertisers in the associated advertising category to place digital advertisements on 11 news websites that were identified by NewsGuard to have published health misinformation. Advertising expenditure estimates are from MediaRadar. HHS indicates US Department of Health and Human Services.
From 2021 to 2024, government and health organizations accounted for about one-tenth of the $336 million in estimated advertising payments made to 11 news websites identified for publishing health misinformation. Noteworthy advertisers included federal health agencies, such as the Centers for Disease Control and Prevention, and pharmaceutical companies, such as Pfizer, although their individual contributions represented a small share of all payments.
Although our study was limited to only 11 news websites identified for publishing health misinformation with available advertising expenditure data, and the proportion of website material made up of misinformation is not known, our findings illustrate the possibly inadvertent financial support many government and health organizations are providing by making advertising payments to these news websites. Advertisements from these organizations may enhance trust in misinformation or diminish trust in the government or health organization. Stronger restrictions may be needed to avoid placing advertisements on news websites that spread health misinformation.
Article Information
Accepted for Publication: January 29, 2026.
Published: April 1, 2026. doi:10.1001/jamanetworkopen.2026.5068
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2026 Patel NG et al. JAMA Network Open.
Corresponding Author: Joseph S. Ross, MD, MHS, Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510 (joseph.ross@yale.edu).
Author Contributions: Mr Patel had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Patel, Ross.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Patel.
Critical review of the manuscript for important intellectual content: Ramachandran, Ross.
Statistical analysis: Patel.
Administrative, technical, or material support: Ramachandran.
Supervision: Ross.
Conflict of Interest Disclosures: Dr Ramachandran reported receiving grants and research support for the Yale Collaboration for Regulatory Rigor, Integrity, and Transparency from Arnold Ventures; grants and research support for study focused on representation in oncology clinical trials from the US Food and Drug Administration (FDA); grants and research support for study focused on public stakeholder participation in Prescription Drug User Fee Act from the Greenwall Foundation; personal fees and honorarium for participation in the Reimagining America Fellows program from the Roosevelt Foundation; personal and consultancy fees from Debevoise & Plimpton, LLP; grants and research support for work related to the FDA conducted through the Health Research Group from Public Citizen outside the submitted work and serving on the Board of Directors in an unpaid, volunteer capacity for the nonprofit, nonpartisan organization Doctors for America. Dr Ross reported receiving grants from the FDA, Johnson and Johnson, National Institutes of Health, the Greenwall Foundation, and Arnold Ventures outside the submitted work. No other disclosures were reported.
Data Sharing Statement: See Supplement 2.
Additional Contributions: The authors thank NewsGuard for making their data available for this research study. A nominal fee of $1 was charged.
References
Office of the Surgeon General. 2021 Confronting health misinformation: the US surgeon general’s advisory on building a healthy information environment. Published July 2021. Accessed September 17, 2025. https://www.hhs.gov/sites/default/files/surgeon-general-misinformation-advisory.pdf
Herasimenka A, Au Y, George A, et al. The political economy of digital profiteering: communication resource mobilization by anti-vaccination actors. J Commun. 2022;73(2):126-137. doi:10.1093/joc/jqac043PubMedGoogle ScholarCrossref
Ahmad W, Sen A, Eesley C, Brynjolfsson E. Companies inadvertently fund online misinformation despite consumer backlash. Nature. 2024;630(8015):123-131. doi:10.1038/s41586-024-07404-1PubMedGoogle ScholarCrossref
Silverman C, Talbot R, Kao J, Klühspies A. How Google’s ad business funds disinformation around the world. ProPublica. Published October 29, 2022. Accessed September 17, 2025. https://www.propublica.org/article/google-alphabet-ads-fund-disinformation-covid-elections
NewsGuard. Media Intelligence Dashboard. Accessed September 15, 2025. https://www.newsguardtech.com/solutions/dashboard/
MediaRadar. Mediaradar360 Dashboard. Accessed September 15, 2025. https://www.mediaradar.com/
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Posted by: Nayara Güércio (Trilateral Research)