In today's world, access to modern information and communication technology (ICT) is more than a convenience - it's a necessity. However, not everyone has this access, leading to a significant societal divide: the digital divide. This gap in digital access affects various demographics, particularly underrepresented groups such as Black Americans. As technology continues to revolutionize healthcare, it's evident that the digital divide is more than just an issue of connectivity - it's a matter of health equity.
Understanding the Digital Divide
The term "digital divide" refers to the gap between individuals who have access to modern ICT and those who don't or have restricted access. This divide isn't a new phenomenon - it initially represented the difference in telephone access and has since evolved to encapsulate the disparity in internet access, particularly broadband.
According to a 2019 report, approximately 5 million rural American households and 15.3 million urban or metro areas still don't access broadband internet. Furthermore, the Pew Research Center noted that 24% of adults with household incomes below $30,000 a year don't own a smartphone, and 40% don't have home broadband services or a computer. As of 2021, it was reported that 80% of White adults had a computer and broadband compared to Blacks and Hispanics, while 63% of Black adults reported that lack of high-speed internet was a major barrier for Telehealth usage. This exemplifies how this disparity has profound effects on various aspects of life, including healthcare access and quality.
Digital Health Equity and the 'Super Social Determinant' of Health
Digital health equity is becoming a frequent topic of discussion, particularly when addressing health disparities among Black Americans. The term "super social determinant of health" has been used to describe digital literacy and internet connectivity. This reflects the significance of technology in modern healthcare, from patient portals and remote patient monitoring to electronic instructions and digital therapeutics.
However, this reliance on digital technology means that the digital divide also translates into a health divide. Individuals with inadequate hardware, poor technical knowledge, or lack of connectivity face barriers in accessing quality healthcare. Added to these is the factor of health literacy. A lack of understanding about health information and services often intertwines with digital illiteracy, compounding the difficulties for those navigating the healthcare system. This issue is particularly prominent among older adults, who may be less familiar with digital technologies and may have additional health needs. For example, data shows that areas with lower broadband connectivity feature residents with higher rates of obesity, diabetes, unnecessary hospitalizations, and sick days than national averages.
Addressing the Digital Divide: Government and Nonprofit Initiatives
Efforts to bridge the digital divide and promote health equity have been undertaken by both government bodies and nonprofit organizations. The 'Obama Phone' program, unofficially named after its rapid expansion during the Barack Obama presidency, is one such initiative. This program provides low-income Americans with free cell phones, voice minutes, texting, and internet data usage.
The rationale behind the Obama Phone program is that the cell phones would pay for themselves by helping needy Americans to connect with prospective employers, medical professionals, family members, and emergency services. While this initiative has seen some success, barriers like cost, eligibility criteria, and awareness still limit its impact.
Another notable program is the Affordable Connectivity Program, which had over 10 million U.S. households enrolled by early 2022. This program provides long-term benefits for consumers with household incomes 200% of the Federal Poverty Guidelines. However, these programs alone can't entirely bridge the divide.
Inspiration and Change, Inc: Advancing Digital Health Equity
Nonprofit organizations also play a crucial role in mitigating the digital divide's effects. A shining example is Inspiration and Change, Inc., with its Digital Health Equity Program. This program works to empower underrepresented end users through free education on computer usage, cell phone usage, and telemedicine, alongside assistance in signing up for free equipment.
Furthermore, Inspiration and Change, Inc. is committed to expanding its reach and tackle barriers such as access to broadband, hardware, and software; health literacy, particularly related to digital health; and data privacy protections. By addressing the digital divide, we can help to ensure that the technological revolution in healthcare benefits all, not just a privileged few. Only then can we truly promote health equity among Black individuals, giving them equal opportunities to lead healthy, fulfilling lives. As we move forward, it's clear that organizations like Inspiration and Change, Inc. will play an integral role in turning this vision into reality.
About the author
This blog post was written by Volcano Consulting, LLC Deputy Public Health Consultant, Liz Ventura. Liz is earning a Master of Public Health from the University of South Florida.