Earlier this month at PubCon, Google’s Matt Cutts put websites that use intrusive ads on notice. “If you have ads obscuring your content, you might want to think about it. Do [users] see content, or something else that’s distracting or annoying?” When Matt Cutts offers advice, search marketers listen. Not so much because he helps webmasters better serve users (though he does), but because his advice often portends what type of sites and tactics are going to get steamrolled by an imminent change to Google’s ranking algorithm. Health marketers have long since discovered the necessity of organic traffic in aggregating a targeted audience. Marin Software recently pegged the cost of attracting health searchers through SEM at nearly $2 per click on average, higher than other competitive industries like finance and education, and well above sectors like travel and retail (which clock in at around 50 cents per click for paid traffic driving). Because of the cutthroat nature of finding qualified health information seekers online, tracking changes in Google’s ranking algorithm becomes an imperative. Let’s parse what Google’s new battle with ad-heavy sites might mean for driving organic health audiences. What exactly is Google trying to discourage? Cutts said Google is testing algorithms that determine “how much content is above the fold,” with an eye toward penalizing the search rankings of sites where the amount of real estate occupied by ads is above a certain threshold. Few health info seekers would take issue with this approach. Most of us have had the experience of performing a health search, clicking on a result, and then landing on a page where the article itself is shoehorned in amongst a barrage of banner ads and paid links, or where the sponsored content is pinned to the top of the page and cleverly disguised to look like editorial content. In the health space, there is often a tendency toward “ad creep” for smaller, independent sites. Monetizing every inch of real estate with display media and AdSense is tempting, but Google is signaling that a cluttered or confusing user experience could eventually cost you organic traffic. Even large branded pharmaceutical sites aren’t immune to this change, however; many such sites feature big interactive flash widgets at the top their pages (potentially seen as ads), with text content (seen as the primary article) pushed down below the fold. Though it may seem paradoxical, even a site that has the express goal of promoting a particular product could still risk being labeled “ad heavy.” Where’s the line? The tricky part for health marketers and designers is determining where the “ad heavy threshold” lies, and how to avoid crossing it. Axandra.com has a mockup of what an ad heavy layout might look like. Certainly having wall-to-wall ads is dangerous, but so is (from a business perspective) having no advertising content whatsoever. Google itself seems to offer conflicting advice on ad placement. The AdSense publisher help section suggests that “ads located above the fold” and “near rich content and navigational aids usually do well.” In fact, Google’s heat map for where to place AdSense ads on your pages is the poster child for a site with intrusive ads. You have to give Google credit for keeping the revenue side of operations separate from the editorial. And by separate I mean waging direct war with one another. But if there’s one thing I’ve learned in my years as a search marketer, it’s that you should always bet on Google putting end users ahead of ad revenue. For proof, just look to the Panda algorithm update earlier this year. Google took the huge step of dropping “content farms” down in the search rankings, even though this meant putting millions of dollars of AdSense revenue at risk. Article syndicators and content mills like eHow saw their traffic slashed, but a handful of health-focused sites like BetterMedicine recently lost search ranking as well. Next steps If you’re concerned about Google traffic to a health site you operate, or those on which your ads are running, a few simple guidelines should keep you clear from trouble.