INTRODUCTION:
The rapid growth of social media has transformed how health information is produced, circulated, and consumed. Social media platforms have become a dominant source of health information, shaping public understanding, attitudes, and responses to health issues. Whilst these platforms offer opportunities for timely public health communication, they also facilitate the widespread circulation of health misinformation. Algorithm-driven visibility, emotionally engaging content, and peer-to-peer sharing, amplify misleading health narratives and increase exposure to unverified information.¹-³ This has contributed to declining trust in public health institutions and adverse health behaviours.²,⁴ This review explores how health misinformation spreads through social media and examines its implications for public health communication.

METHODS:
A narrative review was conducted using peer-reviewed literature and institutional reports examining health misinformation, social media dynamics, public trust, and public health communication strategies. Key sources were selected to reflect empirical evidence, conceptual frameworks, and policy perspectives.¹-⁶ Findings were synthesised thematically, with emphasis on mechanisms of misinformation spread, impacts on health beliefs and behaviours, and evidence-informed communication responses.

RESULTS:
The literature identifies that social media platforms amplify health misinformation through the following major drivers: engagement-driven algorithms, visual content, and prominent non-expert sources.¹-³ Exposure to misinformation is consistently associated with reduced trust in public health authorities, increased vaccine hesitancy, and delayed health-seeking behaviour.²,⁵ Traditional corrective approaches, such as fact-checking alone, show limited effectiveness. More effective strategies include proactive public health messaging, prebunking techniques, culturally responsive communication, platform-level accountability, and strengthening digital and health literacy.¹,⁴-⁶

CONCLUSIONS:
Health misinformation circulating on social media represents a significant challenge for public health communication. Addressing this challenge requires a shift from reactive correction toward preventive, trust-centred communication strategies that account for both technological and social drivers of misinformation. Integrative public health communication approaches are essential to support informed decision-making, rebuild trust, and protect population health in the digital era.¹,⁵,⁶