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BY 4.0 license Open Access Published by De Gruyter Mouton September 19, 2022

Can older people stop sharing? An ethnographic study on fake news and active aging in Brazil

Marilia Duque

Marilia Duque is an Associate Researcher in the Anthropology of Smartphones and Smart Ageing project at University College London (UCL) and a researcher at Institute LiteraCity. She holds a PhD in Communication. Her research focuses on digital literacy and its impacts on ageing and health in Brazil.

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and Luiz Peres-Neto

Luiz Peres-Neto is a Serra Húnter Lecturer at the Department of Journalism and Communication Science and an Associate Researcher at the Institute of Communication (InCom) at the Autonomous University of Barcelona, Spain. His research interests focus on media and politics, political communication, ethics, and human rights perspectives in communication and new technologies.

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Abstract

Purpose

An association between age and misinformation is frequently found in literature, which contributes to a moral panic about older people’s participation in the dissemination of fake news. This qualitative study adds context to this discussion by investigating why older people are motivated to engage with online information and why sharing matters in old age.

Design/methodology/approach

A 16-month ethnographic study was conducted with a group of older adults in São Paulo, Brazil. Participant observation was complemented by in-depth interviews in order to approach participant strategies to evaluate online content and health information.

Findings

Participants were connected in multiple WhatsApp groups in which they shared content associated with active aging. Sharing helped them to craft their identity as third-agers at the same time that their work as curators was motivated by the local work-oriented ethics. An indirect system of influences impacted the participants’ decisions to trust and share content. Content was evaluated based on long-term interpersonal trust, while health information was validated by expertise in the healthcare area. “Doctor friends” provided medical guidance by warming the health information that the participants found online.

Practical implication

Regardless of their level of education, older adults need expert friends to warm health information. This dependency impacts active aging and challenges the idea that the internet could empower health decision-making.

Social implications

This study provides information for policymakers and industries to understand how older adults can access health information and obtain medical guidance.

Originality/value

This paper shows how sharing behavior can be influenced by local cultural contexts and contributes to mitigating the causal association between age and fake news.

1 Introduction

In early 2019, Guess et al. (2019) published a study on fake news and social sharing on Facebook during the 2016 US. presidential campaign. The authors found this practice to be mostly rare, thus supporting the discussion on how alarmist discourses about online misinformation can be disconnected from empirical findings and how media coverage can increase a “moral panic” surrounding fake news (Altay et al. 2021). However, the study contributed to spreading the “moral panic” about older people’s participation in the dissemination of fake news. Although the authors mentioned that the observational data used in their model “cannot provide causal evidence on the determinants of fake news sharing” (p. 5), they found that Americans over 65 years old shared almost seven times more articles from fake news sites than the youngest age group. Media outlets worldwide used this finding to provide scientific evidence that older people “share fake news stories on Facebook more than any age group,” according to the CNN headline (Jan. 10, 2019) taken here as an example.

The correlation between aging and fake news has become a constant finding in many studies (Allcott and Gentzkow 2017; Brashier and Schacter 2020; Grinberg et al. 2019). However, the digital skills needed to deal with misinformation are not determined by age alone. More attention should be paid to cultural contexts and socioeconomic backgrounds, highlighting the motivations and circumstances in which older people interact or engage with misinformation. Otherwise, the narrow causality between age and fake news may contribute to ageism, resulting in individual prejudice and a “broader, pervasive aversion to and embarrassment about the condition of the old age in general” (Lamb 2019, p. 7).

This ethnographic study challenges the aforementioned causality and provides a contextual approach to understanding why older adults in Brazil are motivated to share information and how they might stop engaging with misinformation. Regardless of age, the social inequalities in the country influence online sharing behavior, which supports the idea that education is the most consistent predictor for ICT use (van Deursen and van Dijk 2011). Among Brazilians with lower levels of education, 22% do not check the content veracity before sharing it as compared to 7% with higher levels of education. Education also influences the ability to identify fake news and evaluate content on social media. For example, 32 and 7% of Brazilians with lower and higher levels of education, respectively, claimed that they never identified fake news. The proportion was 43 and 11% for those who considered the influence of the person from whom they received the news as the most relevant aspect when deciding to trust online information (DataSenado 2019).

This work considers, however, a best-case scenario. Fieldwork took place between February 2018 and June 2019 in a middle-class neighborhood in São Paulo. Participant observation was complemented by in-depth interviews, but only the ones conducted with participants who had a bachelor’s degree were selected for this discussion. Beyond education, our focus is on the cultural context and how local values may influence this group to engage with online information. We found that: (1) there is a relation between active aging and motivation to share; (2) sharing content related to this topic helps participants to craft their identity as “third agers;” (3) sharing news in WhatsApp groups can become a “job,” compensating for retirement and fitting the local ethics of the work-oriented São Paulo; (4) the decision to trust and reshare a piece of information is highly influenced by personal relationships; (5) friends’ expertise on the topic shared is less influential than interpersonal trust; (6) for health-related information, however, friends’ expertise in the healthcare area is the most influential factor for trust; (7) when participants have a health issue or need medical advice, they prefer to check information with “doctor friends” on WhatsApp instead of asking “Dr. Google.”

Based on these findings, we propose the following structure for analysis. We start by providing some theoretical background on misinformation and disinformation and approach the relation between active aging and content dissemination in old age. We then introduce the methodology, followed by results and discussion. We propose that an indirect system of influence can turn “chaos into order” and “warm” the information that participants find online. We discuss how this system is shaped by the local context and how it works, regarding the two-step flow theory (Katz and Lazarsfeld 2017) and the role played by warm experts (Bakardjieva 2005).

2 Background: theoretical starting points

2.1 Information disorder: mis/dis/mal-information

The advent of Web 2.0 and the spread of social media and smartphones has shaped a culture of connectivity whose effect is the excess of information available online. Scholars have approached this excess as an “information disorder” phenomenon (Bechmann 2020; Wardle 2018). Wardle and Derakhshan (2017) propose that information disorder can be categorized as follows: (1) misinformation makes reference to all false – in short, wrong – information created and shared, but without the intention to cause harm; (2) disinformation refers to those pieces of false information deliberately created and spread to harm “a person, social group, organization or country” (p. 4); (3) mal-information describes those pieces that are also “used to inflict harm,” but are based on reality or trustworthy content.

Fake news is commonly targeted as disinformation, representing false content intentionally produced to mislead readers (Allcott and Gentzkow 2017). However, there is no epistemological consensus in using the term “fake news” to explain information disorder as a social phenomenon. While Wardle (2018, p. 951) stresses the need to refine the terminology of “this polluted information ecosystem,” Kuo and Marwick (2021, p. 2) argue that “reframing ‘disinformation’ from a problem of information pollution to a form of knowledge requires addressing questions of power from ‘nonnormative’ and ‘marginal’ positions.” However the terminology used, a sociocultural approach can provide the context needed to understand online sharing behavior, thus supporting the contribution made by this paper.

We begin by situating the information disorder in Brazil during the 2018 presidential election, which occurred in the same year as the ethnographical research conducted in São Paulo. Disinformation is a political issue, as it concerns democracy (Freelon and Wells 2020), and both Brexit and Trump’s election in 2016 are examples of its effects (Morini 2020). The current president Bolsonaro’s campaign made large use of disinformation tactics, with WhatsApp playing a central role in the dissemination of fake news (Almeida 2019; Chagas 2022; Chaves and Braga 2019). Known as the “cabinet of hate,” Bolsonaro’s campaign managed an organized structure, with bots and fake profiles being used to spread fake news (Santos et al. 2021), thereby contributing to the polarization of society during the election process. A similar tactic was used by the Bolsonaro administration in 2020 to deny the Coronavirus pandemic and then to attack the credibility of Covid-19 vaccines (Nugent 2021).

2.2 Active aging and the positive image of aging

The representation of aging has been changing over the past few decades. Old age as a burden and a stage of frailty, decline, senility, and dependence has been replaced by the emergence of what has been termed the third age. So-called third-agers are expected to take care of their health and postpone dependence in order to enjoy the freedom offered by consumer culture. As Featherstone and Hepworth (2005, p. 360) have observed, “exemplary profiles of the ‘heroes of aging’” emerge from this shift, in media and advertising campaigns, showing that older people can exercise their personal choice to “fight decline, along with the ‘quick fix’ solutions which are there to be purchased.” More than a lifestyle, however, remaining healthy and independent is reinforced as a moral imperative, which is not restricted to older people.

Taking care of oneself has become a form of citizenship in neoliberal economies, in which individuals are expected to remain healthy, independent, and productive (Lamb 2019). Rose (2001) develops the concept of a “healthy nation” to address how the neoliberal state treats individuals and families as partners who should accept the responsibility of managing their health and well-being. Health has become a measure of success, while illness may be seen as a failure (Neff and Nafus 2016). Even so, a greater expectation is placed on the aging population as older people demand more from healthcare and pension systems. The new representation of aging has the educational purpose of providing examples of what older people should be doing while placing a set of responsibilities and virtues on them. This expectation and the role played by images are addressed in Active Aging: A Policy Framework (World Health Organization 2002). On the one hand, older people are expected to adopt healthy habits to extend their autonomy and participation in society. On the other hand, the media and older people themselves are targeted as actors responsible for disseminating a positive image of aging, with the latter being responsible for becoming a model of active aging for younger generations.

Lamb (2019) argues that the moral responsibility to “stay fit, healthy, active, and independent as we age” (p. 7) is unfair as this ideal hides socioeconomic inequalities that may result in very different experiences of aging which have nothing to do with individual choices. In that sense, the images which support healthy aging as a meritocracy could be seen as a kind of mal-information, which is based on reality but can be used to harm people. It is true that healthy habits can improve the quality of life in old age. However, aging is a field of inequalities, and successful aging discourses can harm people as they can internalize the feeling that they have failed to achieve its outcomes (Rodrigues and Soares 2006). Even so, these images can become so omnipresent that this ideal can appear as the only proper way to age (Rocha and Miné 2018). The normativity surrounding representations of age was also observed in Brazil (Debert 1997; Leibing 2005), where active aging has been adopted as public policy (Dias and Pais-Ribeiro 2018).

3 Methodology and contextualization

This study is based on broader ethnographic research conducted by the author Marilia Duque between February 2018 and May 2019 in an upper-middle-class district in the city of São Paulo (Duque 2022). This choice facilitated the investigation of the active aging agenda influence on the participants’ behavior on and offline. The fieldwork took place in the neighborhood chosen for the roll-out of a pilot project that aimed to turn São Paulo into an age-friendly city. Based on WHO’s guidelines, age-friendly cities adapt their structures and services to enable active aging (World Health Organization 2007). The project was developed in partnership with a Medical School, which also maintains an Aging Studies Sector in the area, where residents older than 60 can access an outpatient service and enroll in activities and courses focused on preventative care. The Medical School turned the area into a health hub with many facilities from public and private sectors. Along with hospital programs, there are museums, parks, institutes and churches that offer a vast portfolio of activities aligned with the active aging framework. Older people from different districts in São Paulo also visit the area to participate in these activities.

Marilia Duque was accepted in some of these activities and the groups were informed of the purpose of her presence. Usually, the person in charge of the activity creates a WhatsApp group to support members and the researcher was also added to those groups where she could access and observe conversational and sharing behavior. The choice for WhatsApp can be explained by the centrality of this messaging app in Brazil: 98% of smartphone users in the country have WhatsApp (Mobile Time Opinion Box 2021). WhatsApp was the app participants were most interested in adopting. The desire to connect with family and friends is a driver for tech adoption by older people (Gonzalez and Katz 2016), as messaging apps now mediate the communication between nuclear, extended, and transnational families (Plaza and Plaza 2019; Nedelcu, 2017; Taipale and Farinosi 2018). During fieldwork, WhatsApp workshops were the most popular course aimed at the “third age,” and the offering did not meet the demand. For 16 months, the first author volunteered as an instructor in WhatsApp workshops offered by a Catholic church in the neighborhood. She created and managed three WhatsApp groups to support her students.

As in other WhatsApp groups, these spaces were quickly appropriated by members to circulate information other than the ones restricted to the group’s original topic. Even when the activity comes to an end, it is not uncommon that the interactions in WhatsApp groups goes on. Along the fieldwork, 10 WhatsApp groups were observed. The smaller one had 12 members, the larger one almost 200. In addition to the three already mentioned, 7 other WhatsApp groups were observed. These were created and managed by older adults who also volunteered in activities aimed at the “third age” in the area. Older adults are likely to attend more than one activity during the week. Thus, they could become members of multiple WhatsApp groups, resulting in a powerful network for information and care as discussed later in this paper.

The participant observation was complemented by in-depth interviews and an informed consent form was applied (Ethical approval via Certificate of Presentation for Ethical Consideration [CAAE] # 90142318.2.0000.5511). For this analysis, we considered respondents who attended at least one activity related to the active aging agenda and who hold a bachelor’s degree. Participants’ quotes were excerpted from the 19 interviews selected for this analysis (12 women and 7 men, aged 51 to 76). Although these activities were designed for people aged 60 and over, some accepted attendees younger than that. Among respondents, 12 were retired, 4 were retired but still had some paid activity, 3 were not retired and worked as freelancers or entrepreneurs, and 2 were neither retired nor working. Those not retired claim that they lived in “limbo,” as they were not eligible for retirement nor for employment as companies considered them “too old.” The activities that they joined during the week compensated for their idle time, restoring a sense of productivity and usefulness. The desire to fill the time was observed even among retirees, including those who still had some paid activity. The earliest age of retirement in the group was 49.

4 Findings and discussion

4.1 Selecting content: friendship and censorship

As the ethnographic research was developed around the active aging agenda, we assumed that participants would be somehow aware of the importance of adopting health habits focused on prevention. At the same time, politics would be a relevant topic, as a large part of the fieldwork occurred during the 2018 election, when WhatsApp was massively used to spread misinformation (Almeida 2019; Chagas 2022; Chaves and Braga 2019). Thus, it was expected that content on politics and active aging would be among the ones shared in WhatsApp groups. However, whenever someone shared content related to politics, other members were more likely to intervene and remind the person that the topic was forbidden in the group. The censorship was applied to avoid polarization that could have resulted in arguments and even conclude with an offended person leaving the group.

In a survey on behavior in WhatsApp groups (Garcia and Vivacqua 2021), affinity in the thematic group was the main factor that led Brazilians to join a discussion group. As noted in the methodology section, this was the case for participants who joined WhatsApp groups created to support a related activity, such as workshops. However, participants use these spaces to stay connected while exchanging messages not exclusively related to the activity’s topic. Over time, these groups arguably evolve to become more like groups of friends, despite affinity being what brings them together at first. The aforementioned survey found that feeling offended was a reason for 65% of respondents to leave a group of friends, while the fear of losing contact with participants was the reason for 54% to stay. Both reasons support the censorship regarding politics observed in WhatsApp groups. By excluding this sensitive subject, participants could decrease the chances of a possible offense or conflict, as leaving the group would bring broader consequences to all of them.

Online groups provide a sense of space and belonging, as participants share practices, interests, resources, support, and collective identities (Baym 2010). This is also the case for WhatsApp groups. Maintaining a support network is particularly relevant for the perception of quality of life in old age (Paúl 2005), and WhatsApp is the place where participants build that network, with friends becoming a crucial resource for autonomy and care. Thus, apart from politics, participants were more likely to share content related to active aging, which means not only focused on health habits and prevention but also on information that allows them to keep participating in society. News about to what benefits they may be entitled, warnings about scams, interesting facts about aging, and information about new opportunities for activities, such as courses, lectures, and free events, were also among the content that they valued and shared the most.

4.2 Motivation: sharing as a form of participation

The demand to stay productive and participate in society is a milestone for the active aging framework. These expectations gain a local meaning in the cultural context of the work-oriented São Paulo. Being the destination of multiple waves of migrants from abroad and from other regions of Brazil, São Paulo’s identity was built upon the glorification of work. Work is seen as a virtue and is also what bonds people together, providing a sense of citizenship (Moura 1994; Queiroz 1992). Among participants, the desire to be and to be seen as a busy person remains even after retirement and is crucial for understanding the role played by WhatsApp. Their participation in WhatsApp groups complements their face-to-face activities and helps them to fill the gaps between them until they can reproduce their past working routines and say, “I don’t have time.” Joining the conversation on multiple WhatsApp groups can provide proof that they are busy. However, selecting and sharing useful information with peers was the work that really denoted participation.

Sharing content is work anyone can do. As previously noted, even groups created by instructors to support learning activities are quickly appropriated by members and turned into a collaborative and non-hierarchical space. Content associated with active aging can result in two kinds of achievements. Through it, participants communicate their intention to age in a good shape just as the aforementioned “exemplary profiles of the ‘heroes of ageing’” that circulate as models in media and advertising campaigns (Featherstone and Hepworth 2005). In other words, participants give visibility to their “will to health” (Higgs et al. 2009), meaning the demonstration of their commitment to make healthy choices and age well. By doing this, they are crafting their collective identity as “third agers” (Higgs et al. 2009) and as citizens (Rose 2001). On the other hand, content addressing health-tips and opportunities for active aging are highly valued by peers. By sharing this content, curators can turn WhatsApp groups into a valued source for information and participation, which are key factors for age-friendly communities (Stafford 2018). In addition, curators gain social capital in terms of reputation and gratitude (Duque 2021).

The volunteer work of curators can place participants within the participatory culture (Shirky 2010). Curators are motivated by the desire for connection and belonging at the same time that they demonstrate autonomy or competence to a visible network. It is true that their content curation cannot compare to the work done by content curators as discussed in participative journalism. Participants do not select and organize multiple content and sources into newsworthy information (Stanoevska-Slabeva et al. 2012). However, as noted by Guerrini (2013, p. 7), the etymology of the word “curator” carries the idea of “someone who takes care” and, as the author suggests, a “curator is someone who takes an inordinate mass of material, and turns chaos into order.” Turning “chaos into order” is what participants do when they select content on the internet and in other WhatsApp groups that fits their interests or the active aging agenda. Thus, “curator” will be the term used from now on to name this kind of work.

When the group attributes value to content, members will comment on it and thank the curator for sharing it. Other members will then share the content with other WhatsApp groups. By doing this, they take their chance to achieve the status and reputation of curators. The network structured by WhatsApp groups can be challenging for curators. As many people participate in more than one activity and are in multiple (sometimes overlapping) WhatsApp groups, the information keeps moving from one group to another. Consequently, participants are overwhelmed by the “information overload” (Boczkowski 2021). In addition to this, acting fast matters as news can quickly become obsolete, making a curator’s work even harder. Besides the rush to get the latest scoop and gain the social capital associated with a valued piece of information, participants had to manage overlapping audiences and interminable message exchanges between groups (Duque 2021). This means that things can become stressful and go wrong for curators, who might end up engaging with fake news, which should here be understood as misinformation, as the participants do not intend to cause harm to their peers (Wardle and Derakhshan 2017). On the contrary, they end up engaging with misinformation to socialize and signal group membership (Altay et al. 2021). As previously argued, sharing can endorse their collective identity as third-agers and their status as citizens of São Paulo, since curating is seen as a kind of participation, by providing proof that they remain busy working for the collective.

4.3 Evaluating information: the personal influence in WhatsApp groups

According to DataSenado (2019), 30% of Brazilians aged 60 or above claimed that they had never come across fake news on their social networks. Among those aged 16 to 29, only 11% claimed the same. Older people appear to be less likely than others to identify fake news on social media (Brashier and Schacter 2020). Thus, they might end being target as the age group that shares fake news the most, as observed in the U.S. election by Guess et al. (2019). As argued so far, findings like these can be decontextualized and generalized by media outlets, contributing to a causal association between age and fake news.

This causality impacts the classificatory system of age. As Bourdieu (1993) argues, age defines permissions and privileges that are under dispute in the opposition between the young and the old. The “third age” emerges between them. Third-agers are not defined by chronological age but by autonomy, while the old, identified with frailty and dependence, is reallocated to the fourth age (Laslett 1991). On the other hand, technology use and digital skills may become a new classificatory criterion for age, as they are more likely to be associated with youth (Miller et al. 2021), In that sense, if fake news is positevely related to age, sharing fake news can be a sign that someone has become old. Being classified as old (and loosing third-ager status) is what participants try to avoid the most.

Stopping sharing would then be a self-preservation strategy. However, sharing information is a means to express commitment to active aging, achieve social capital, and bond together as productive citizens of São Paulo. Thus, continuing to share is a risk that some participants are motivated to take. In these cases, participants came up with other strategies to minimize risk. For example, a 56-year-old man waited before sharing anything that he receives. “Usually the news will come from different people and on different social networks. So, I wait to see if anyone is going to contest it. When it turns out to be fake news, someone always comments on it, saying that it is fake news.” During the ethnographic research, participants were still getting familiar with fact-checkers. But when fact-checkers were used to reply to the message with fake content, this reply was then followed by a collective public reprimand, for which the curator apologizes.

Curators can justify their mistake by saying that they forgot or did not have time to check the information. However, they frequently add a message saying that whoever shared it with them was a trustworthy friend, showing that a friend’s reputation can be more important than the source of the data itself. That is a second strategy that they use. Participants are more likely to evaluate a piece of information based on how they trust the person from whom they received it. Like them, almost a quarter of Brazilians consider who shared it to be the most important factor for trusting content (DataSenado 2019). For participants, this means that they might reshare news based not only on its appeal but also on the person from whom they receive it. As a 57-year-old man explains, “Gosh, no, of course I always check the information. I never share anything without knowing who shared it first.” A message that circulated on WhatsApp groups during the ethnographic research alerted for the risks of this strategy: “Stop fake news! Don’t share ANYTHING without checking. Even if the person who published it was your mother, your father, your best friend, your boyfriend, your girlfriend, your boss, your pastor, your priest, your children. ALWAYS BE SUSPICIOUS.”

Although addressing the mass media, the two-step flow theory (Katz and Lazarsfeld 2017) has been revisited to explain influential behavior on social media and the emergence of information disorder in the digital landscape (O’Regan 2021). The theory defines two key elements to explain the personal influence on mass media consumption and influence: group norms and opinion leaders. The acceptance, maintenance, or change of any opinion is inflicted by social norms forged under small group interactions. Within groups, individuals recognized as opinion leaders have “a major share in determining whether or not a piece of information will be circulated and whether or not it will be favorably received” (Katz and Lazarsfeld 2017, p. 130). In other words, the theory identifies an indirect system of influence in which opinion leaders influence the flow and evaluation of information from mass media by commenting, endorsing, or recommending it to group members.

With similarities and particularities, the two-step flow theory supports the personal influence over curators’ decision to trust and reshare a piece of information in the WhatsApp groups observed during the ethnographic research. WhatsApp is the source of information most used by 79% of Brazilians (DataSenado 2019), and that is also the case for this group of older adults. However, someone (the first curator) must do this prior work of selecting and bringing a piece of information to WhatsApp. This work considers content adherence to the group norms and interests of third-agers. The adherence will define if the content will be evaluated as useful by the group, which results in social capital for the curator. A second task is to decide whether or not this piece of information should be reshared from one WhatsApp group to another. Once again, the decision-making process will consider adherence to the potential group norms and the opportunity to gain the reputation and gratitude attributed to a valued piece of information. As such, the personal relation with the previous curator will be the key element for an evaluation of whether the content is trustworthy or not.

The nature of the influence of the previous curator over successive curators differs from the one observed in the indirect system of influence as proposed by Katz and Lazarsfeld (2017). The particularity for participants is that influence is not based on the recognition of a particular expertise, which would give the previous curator the status of an opinion leader. On the contrary, previous curators can influence successive curators to reshare information about any subject (provided that it is adherent to group norms) because their qualification for curation is based on their character as a friend and not necessarily on their knowledge in a specific domain. The exception is for health-related content, when expertise in the healthcare area remains a strong factor influencing how participants evaluate information that they find online.

4.4 Engaging with health information: when expertise matters

Endorsing active aging, health tips focused on prevention are valued and shared by participants. However, while for everyday subjects the trust attributed to a friend-curator seems to be influential enough, expertise (or the simulation of it) reappears, influencing how curators evaluate health-related content in WhatsApp groups. In these cases, expertise is attributed to content authorship. Participants usually share health tips attributed to a medical authority, scholars, or scientific studies. A message that circulated in WhatsApp groups during the ethnographic research illustrates the relationship between tips on prevention, active aging, and how medical authorities are evoked to give content some credibility. The text reads:

After 60, we experience many kinds of diseases. However, what worries me most is Alzheimer’s. It’s not just because I wouldn’t be able to take care of myself. It is also because it would cause a lot of inconvenience for my family members … A doctor friend of mine taught another friend a tongue exercise which is effective in preventing Alzheimer’s. This exercise is also useful for reducing and improving weight, hypertension, blood clots in the brain, asthma, nearsightedness, ringing in the ears (the list continues).

The message simulates a testimonial for a tip (tongue exercise) that would be effective in preventing Alzheimer. As supported by active aging, prevention would postpone dependence (which “would cause a lot of inconvenience for my family members” and result in loss of autonomy, as “I wouldn’t be able to take care of myself”). In addition to this, the tip is attributed to a medical authority: “a doctor friend of mine.” In this case, the “doctor friend” blurs the influences attributed to expertise and to personal relation, as curators who reshared the message could believe that somehow the authority was a friend of the friend who had first shared the testimonial. Based on observation only, it is impossible to say whether these tips somehow influenced members’ health habits. But they are effective in other terms. Health-related content focused on prevention and active aging bond the third-agers together. By sharing it, participants can give visibility to their “will to health” (Higgs et al. 2009), identify with the “exemplary profiles of the ‘heroes of ageing’” (Featherstone and Hepworth 2005), and keep their collective identity while playing their roles as partners of the “healthy nation” (Rose 2001) and as citizens of São Paulo (Duque 2022).

However, if participants do not actually follow the “medical recommendations” that they circulate on WhatsApp, how do they get the health information that they need? That was a question addressed during the interviews. In Brazil, the numbers of internet users who searched for health information and services in 2021 varied from 13 to 74% when considering the lowest and highest levels of education (Cgi.br 2022). We considered the best scenario for this analysis by selecting only participants who held a bachelor’s degree (and who attended at least one activity related to the active aging agenda: 19 total, aged 51–76). They will be called respondents.

When respondents were interested in information on how to age with better health, they were more likely to follow doctors on YouTube. But when they had a health issue and needed to decide what to do, they left the internet and sought medical advice. As a woman aged 70 argued, “There is a lot of misleading information, so I prefer to follow my doctor’s recommendations.” For a man aged 56, the problem was that “We go online predisposed to believe.” For a woman aged 51, searching for health information can be scary, especially when you have a symptom:

Some of the things that were written there … it’s good and it’s not … there are things that you read and say: I am dead! I fit into every description. It happened to me. It was written there: if you see the flies and the flashes … That’s it! I was already desperate! My retina has detached, I will die! I was so nervous! Then I went to the doctor. No, it’s okay, you had a little bruise, but it didn’t reach the retina …

It is true that, as “relative newcomers,” older adults might not have the digital literacy or confidence to evaluate the information that they find online (Brashier and Schacter 2020), which includes health information. However, they may also prefer to share decision-making with doctors who they trust, with a positive influence between trust and their preferences for involvement (Butterworth and Campbell 2014). Both cases applied to respondents, even for the six who still used the internet to search for health information. They might have prepared for a medical consultation or sought more information about the diagnosis or medication prescribed by the doctor. But “Dr. Google” did not empower them to decide over their health. Respondents were more likely to be seen as informed citizens than as empowered citizens (Santana et al. 2011). As a woman aged 63 explained.

Normally I go to the doctor. I won’t go on the internet. But today, if I have anything, I will definitely want to learn more about it and I will go on the internet. It would not be my first choice to solve a problem related to illness and health, but I would certainly be interested in researching.

Getting a medical appointment can take time. For example, for the two respondents who relied on the Brazilian Public Health System (SUS), a medical appointment in primary care could take from five to 43 days, depending on the unit in which the patient was based (Rede Nossa São Paulo 2019). Things could go faster for respondents with a private health insurance plan, but nothing would compare to the convenience of having a doctor available on their smartphones. The problem is that only private doctors (not covered by a health insurance plan) are more likely to share a direct channel of communication, such as WhatsApp, with patients. Even the few respondents who could afford these doctors did not want to burden them with their everyday health issues, as they wanted to keep these valued connections for real emergencies. For one reason or another, respondents were more likely to go back to WhatsApp groups, where they searched for friends with expertise in the healthcare area for medical guidance.

By doing this, they obtained health information that they could trust. The nature of the medical advice they got was at the same time friendly (based on their personal connections) and professional (based on expertise). A woman aged 64 illustrated how a personal connection could lead to medical expertise. She came across the information that older people should take the herpes zoster (shingles) vaccine, but she was not sure whether that applied to her. She had an appointment with her doctor in two weeks, so she did not want to disturb him even on WhatsApp. As she explained, “I don’t like to burden him.” Instead, she sent a message to a friend and asked her to ask her son whether she should take the vaccine. It did not take her long to get an answer. She explained that her friend’s son was not just a doctor but an infectious disease specialist at one of the most respected hospitals in São Paulo. As summarized by another woman, aged 55, being friends with a doctor is “a privilege.”

4.5 Warming health information

When seeking medical advice, respondents counted on friends with expertise in the healthcare area to make sense of the health information they found online. These friends had knowledge respondents did not and was easily accessible to them on WhatsApp. Knowledge and accessibility are two key features attributed to “warm experts,” a term that refers to a more experienced user who “mediates between the technological universal and the concrete situation, needs and background of the novice user with whom he is in a close personal relationship” (Bakardjieva 2005, p. 99). In parallel with the indirect system of influence in the two-step flow theory (Katz and Lazarsfeld, 2017), this mediation results in a “two-step access” model in which warm experts can select, suggest, and facilitate access to technology (Leong 2017).

The support of non-professional experts, mainly relatives and friends, has become central for older adults to adopt or expand the use of digital devices and applications in a meaningful way (Hänninen et al. 2021; Olsson and Viscovi 2018). Although warm experts are identified as technology mediators, the ethnographic research showed that they can also work as information mediators. In opposition to “Dr. Google,” qualified friends on WhatsApp can warm health information found online. Their level of digital skills might not differ from that of respondents, but their expertise in the healthcare area allows them to support respondents in putting order and making sense of the information overload (Boczkowski 2021) and disorder (Wardle 2018), at least on this field of knowledge.

The paradox here is that friendship can also lead to misinformation. Curation in WhatsApp groups showed that participants might be influenced to trust content based on how much they trust the friend who shared it. In this case, however, there is no recognition of an expertise related to the topic shared. In one way or another, being qualified or not, close relationships on WhatsApp play a key role in what can be seen as a “two-step access” to information. On the one hand, a trustworthy friend can influence fake news consumption and dissemination. On the other, a “doctor friend” can facilitate the medical advice older adults might need and value when assessing health information.

5 Conclusion

This study provides an ethnographic approach to understanding the reasons why a group of older adults in São Paulo engage with online information, how they manage mis/disinformation, and the social influences behind their behavior. We found that sharing is motivated by active aging and reinforced by the local cultural context. Sharing is a form of participation that bonds participants together as third-agers and as citizens of the work-oriented São Paulo. Fake news should be seen as a side effect of the valued and intensive work of curators. In addition to this, sharing fake news can denote that someone has gotten old (as it is associated with age). Participants developed some strategies to avoid this risk. For instance, they could wait until someone checked the veracity of the piece of information. But they were more likely to evaluate content based on how much they trusted the friend from whom they received it, resulting in an indirect system of influences similar to the one addressed by the two-step flow theory.

The particularity is that influence was not based on friends’ expertise in the topic shared. The exception was for health-related content. Interviews showed that respondents might seek friends with expertise in the healthcare area to validate the health information they came across online, especially when they had a health issue and needed medical advice. In contrast to “Dr. Google,” these “doctor friends” available in WhatsApp groups “warmed” health information, helping respondents to navigate through information overload and disorder. This behavior may reflect their lack of digital skills, even considering their higher educational background, or express their deference to medical authority. Whatever the reason, we highlight the contribution that qualitative studies can make in understanding sharing behavior in old age. By adding context to this discussion, future research can help to challenge the causal association between age and fake news.


Corresponding author: Luiz Peres-Neto, Autonomous University of Barcelona, Barcelona, Spain, E-mail:
Article Note: This article underwent double-blind review.

About the authors

Marilia Duque

Marilia Duque is an Associate Researcher in the Anthropology of Smartphones and Smart Ageing project at University College London (UCL) and a researcher at Institute LiteraCity. She holds a PhD in Communication. Her research focuses on digital literacy and its impacts on ageing and health in Brazil.

Luiz Peres-Neto

Luiz Peres-Neto is a Serra Húnter Lecturer at the Department of Journalism and Communication Science and an Associate Researcher at the Institute of Communication (InCom) at the Autonomous University of Barcelona, Spain. His research interests focus on media and politics, political communication, ethics, and human rights perspectives in communication and new technologies.

  1. Research funding: Coordination for the Improvement of Higher Education Personnel (Capes Foundation, Brazil).

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Received: 2022-04-30
Accepted: 2022-08-18
Published Online: 2022-09-19

© 2022 the author(s), published by De Gruyter, Berlin/Boston

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