Health Site: SEO Case Study

Organic Traffic Growth Through Ranking Optimisation & Algorithmic Devaluation Recovery

The Starting Point

This company provides in-home medical services for a variety of health conditions. This is a local business that covers many areas in different cities across the USA.

This is a website that falls into the YMYL (Your Money, Your Life) category according to the Search Quality Evaluator Guidelines of Google and was negatively impacted as a consequence of the Core Algorithm Update that specifically targeted websites in the Health/Medical groups.

The first bit of data that sorely stood out around this was that a huge percentage of the sites impacted were specifically in the medical, health, fitness, healthy lifestyle space as stated before. Here is a pie chart showing how I personally categorized all of these sites:

In August 2019 we conducted an SEO audit to pinpoint the root cause of the issue. At this point we know that The site shows a significant loss in traffic since March 12th. There was no reason to believe that any manual actions have been taken or that they will be taken any time soon, however, there’s enough evidence that indicates that the website suffered multiple algorithmic devaluations, keyword removals and drop in rankings. 

An Algorithmic Devaluation usually accompanying a quality update or a broad algorithm change. Works at the core level and can occasionally influence rankings over a longer period of time. Applied as a result of the broader shift in the quality assessment.

To contextualize our decision making on this project, this is a rundown of what we knew before analysing the site and what our SEO audit revealed:

What We Knew Before Then

  • It seemed as many of the affected sites were in the health and medical niches (hence, the “Medic” update).
  • Sites across the web have experienced a severe downturn in rankings.
  • Rankings were affected from page one down. (This was surprising – most of the previous updates had less of an impact on page 1.)
  • A lot of big sites with enormous authority and very high-quality have also been devalued. We had speculated that this would suggest a mistake on Google’s part…

What We Found Out After The Audit

  • ‘The March Update’ affected sites from a variety of niches.
  • The effects of this were particularly potent for sites in the broad health niche with subpar authority and trust signals.
  • This change has been considered by some as a deliberate step towards the philosophical vision Google had been laying out since the first mention of YMYL in 2013.
  • The update accidentally coincided with an update of Google’s Quality Rater Guidelines. (The document put additional emphasis on how to E-A-T the YMYL sites.)
  • The content was a very big part of the quality assessment. In particular – content cannibalisation.
  • The changes were seemingly there to stay (no rollbacks through the aftershocks in September – quite the contrary) and there were no quick fixes.

How We Fixed The Site

An algorithmic devaluation is a product of data-driven change. It essentially means that what you were previously doing is no longer deemed the thing that users want when they search for the terms that you were previously ranking for. It no longer is the right thing.

At a higher level, we followed this simple process:

  • Collecting data
  • Making changes
  • Understanding the impact of the changes
  • Collecting data
  • Making changes

Once we gathered enough data in step one we established a set of rules and criteria for on-page optimisations based on what Google had recommended so that the site would comply with the E-A-T’s minimum requirements.

With that in mind, we started going through the site, post by post, restructuring the content in two different ways:


Consolidating Pages

Here you identify pages (through manual review) covering the same topics and combine them. Once the content is consolidated, redirect the page with fewer keywords to the one with more.

A few examples of what posts you can consolidate:

  • 5 Popular XYZ devices That Work
  • 5 Best XYZ Devices of 2020
  • Best XYZ Devices That Actually Work
  • 11 Things That Cause XYZ and Their Remedies
  • What Causes XYZ?
  • The Best Essential XYZ
  • Top XYZ You Can’t Live Without



Here you select pages matching the below criteria and redirect them to their corresponding categories:

  • Very minimal traffic in the last 12 months (<0.5% of total).
  • No external inbound links.
  • Not needed (don’t remove your ‘About us’ or ‘Privacy Policy’ page, ok?).
  • Not ranking for any keywords.
  • Older than 6 months (don’t remove new content!).
  • Can’t be updated or there is no point in updating them (e.g. outdated products, etc).
  • Strip the website from any content that could affect the overall quality of the site.
  • Make sure every single page on the site serves a purpose.


Improving the E-A-T Signals

Around “The Medic” update, you could hear a lot about E-A-T (Expertise – Authoritativeness – Trustworthiness). Google really values unique, high quality content, written by an authoritative expert. It also is quite good at determining the authority and quality, along with all the other relevancy signals.

Here’s what was implemented:

  • Create site’s social media properties and link them with “sameAs” schema markup.
  • Format the paragraphs better and write shorter bitesize paragraphs – authority sites would not make these readability mistakes.
  • Do not overload CTAs – having call-to-action buttons is important, but having them in a user-friendly way is even more important!



  • Improve your personas – Creating their “authors” online authority helps them improve the overall site’s authority and increases the expertise.
  • Link to your About Us page from the main menu – It really does not hurt!
  • Build your About Us page so it proves your expertise and authority – this is a good example.
  • EAT – About Us page
  • Include Contact Us page – there should be a way for your visitors to get in touch!
  • Here’s a really good example (without even using a contact form!):
  • EAT – Contact Us Page
  • Create additional Disclaimer Page – A good practice is to create an additional Disclaimer Page linked from the footer menu and referenced wherever the disclaimer should be mentioned.
  • Improve your author pages – here’s a really good example.
  • Improve the quality of content – The quality of content for YMYL pages (Your Money or Your Life – sites directly impacting user’s financial status or well-being) should be absolutely trustworthy.
  • There are quality rater guidelines for this.
  • EAT – YMYL Recommendations
  • Heading Tags

It really helps Google grasp the more important bits of the content and the sections’ semantic hierarchy.  Learn more about heading structure in my Evergreen Onsite SEO Guide.

Currently, the content structure is a bit mixed and it’s unclear which normally forces search engines to recrawl the site several times, more than necessary to finally understand what the site is about. Also, it takes longer for search engines to see the changes, therefore, rewards in rankings may take up to several months instead of weeks or even days.

As we have already discussed, there were lots of pages targeting the same cluster of keywords which leads to keyword cannibalization that unfortunately, it’s currently affecting the site’s performance.

Most Effective Digital Marketing Tools for Brands


“Topic clusters rearrange the architecture to look more like the image below, where clusters of content that cover a topic area link to a central pillar page that definitively — yet broadly — outlines the topic. By linking all internal content within that topic to a pillar page, search engines such as Google, Bing, or Yandex can easily scan all the content and understand that there is a semantic relationship between the pages’ content. The cluster setup also signals to search engines that there is real breadth and depth in the content, which gives the pillar page more authority on the topic. Algorithms like Google’s RankBrain reward this orderly linking with higher search placement.”

This structure should be replicated via internal links and URL hierarchical structure, however, since the URLs are already indexed and have some organic traffic, we do not want to change that, instead, what we do is, we put contextual links with rich anchor text point to the pillar pages. This will show relevancy levels allowing Google to determine: A) What pages are most relevant so that they can get as many keywords as possible B) Differentiate between supporting content and cornerstone content.

All these elements must be correctly set up in compliance with the circle method to give power to the pillar pages that will be targeting the main keywords. The circle method creates a circular silo of blog posts around a pillar page. This silo of blogs posts links directly to the pillar page, creating massive relevancy signals to search engines.

1. Blog posts about a singular topic related to your target pillar page.

2. Every blog post must link to another blog post within the content silo.

3. Every blog post must link back to the pillar page.

4. Blog posts should only link to one pillar page. Linking to additional silo pages breaks the circle of relevancy.

5. Duplicate this for every pillar page you would like to rank.

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