Who Anchors AI Overviews in Health? Baidu, Google, and the Geography of Authority

Abstract

Artificial intelligence is being rapidly incorporated into traditional search systems, yet scant work audits the information disparities across platforms, geography, and languages. We address this gap by comparing Google and Baidu's AI Overview systems for health queries, and measure informational anchors that emerge. Auditing 1,920 health queries across 12 countries and 4 languages, we find that Google and Baidu exhibit vertical integration, routing users toward their own company platforms in AI Overviews rather than a diverse set of primary sources. Smaller, lower-localization countries receive fewer domestically sourced references for health queries. Issuing the same query in a country's official language rather than English raises the share of locally sourced citations approximately 3.5- to 13.5-fold. Comparing queries across health topics of varying severity and controversy, including Traditional Chinese Medicine as an example, we also show that health disclaimers are multidimensional and vary across language and culture. We discuss how generative search influences access to health information, and the urgent need for culturally-aware oversight of these systems that influence critical health decisions.