As the number of cases of the coronavirus grows across the United States, access to accurate and reliable health information has been on the top of everyone’s mind.
There has been a surge in people searching the internet for the latest details on symptoms, prevention tips and testing locations from sources such as the Centers for Disease Control and Prevention and local public health correspondents. Accurate information about the spread of this pandemic has become a public health concern, yet for many Americans, there is a glaring barrier — the fact that lack of digital access separates those who can access health information in the home and those who cannot.
If you are lucky enough to have access to a home computer, you are among the 73 percent of Americans who can conveniently search for health information, schedule doctor’s appointments or access personal health records. Intelligent conversational assistants, or smart speakers, such as Google Home or Alexa have emerged as a prominent form of information and communication technologies, providing health information in our homes that may help with the disparaging health care costs that plague routine activities like simple diagnosis or check-ins.
Some 24 percent of adults in the United States now own a smart speaker, according to NPR’s Smart Audio Report. As devices such as Alexa have expanded their health care skills and are now compliant with the Health Insurance Portability and Accountability Act, researchers predict that we will see this number increase exponentially.
Yet many in the United States who make up low-income communities are at a disadvantage to personally manage their health in-home with such devices — a result of the digital divide that has existed since the emergence of the internet. While the number of those in the United States who now have access to home broadband has increased from previous years, according to the Pew Research Center, those who sit at or below the poverty line are a much smaller subset of that number, and this number decreases dramatically for lower-income individuals over the age of 65.
The communities that could benefit most from health-related technology interventions are often confounded with many barriers that make these simple solutions a far-off privilege. Not only are most health technologies designed in neglect of those who are poor, ethnic minorities or elderly, but typically these technologies can only be afforded and maintained by the affluent majority, widening the digital gap and furthering inequalities that leave those with lower literacy, impeded financial access and a lack of technology familiarity behind.
Among the more commonly addressed issues such as digital literacy and usability, the challenge of affordable digital access in lower-income communities has yet to be universally addressed. Oftentimes, these communities sit within what are known as digital deserts: areas where few providers offer efficient broadband, causing current download speeds to mirror early internet dial-up. The numbers of individuals who own or have access to personal Wi-Fi are alarmingly lower in low-income or minority communities than other neighborhoods, leaving seniors in these neighborhoods at a great disadvantage.
Washington Park in Chicago’s South Side is one of the most medically underserved areas in the United States despite sitting at one of the most predominant hospitals in the state. Many lower-income black residents of this area often experience higher and disproportionate rates of chronic illnesses and diseases while not having the privilege of affording potential technological interventions, such as Alexa or Google Home, that would give them convenient access to medication management or quick answers to health questions.
Many senior residents of the Washington Park neighborhood travel by Pace or CTA bus to the University of Chicago hospital once every few months to doctors’ appointments. For many, talking to doctors at the University of Chicago is their primary way of managing their health conditions and is currently the more-affordable solution despite the costs of medical premiums and co-pays.
As a part of my current research examining health technology design for older black adults, I’ve had the opportunity to sit with many seniors who live across Washington Park, where currently the ownership and access to digital broadband sits at 37 percent of neighborhood households. My research engages a senior village that houses almost 80 lower-income, older black adults. Where several openly available computers once sat there are now empty rooms, a result of funding cuts to senior programs over the last five years.
Although there are a vast number of efforts focusing on the development of accessible technological health interventions for older adults, this focus has been limited in how access is defined. Oftentimes, technology research and development has associated “access” with interaction abilities — pushing for more equitable experiences through universal modalities for those with varying abilities in sight, hearing and touch.
“Hackathons” and innovation challenges for older adults are promoted to support the functional needs often associated with the aging population, reinforcing technology access as a concept that addresses disability and physical capabilities. Access to health technology also means considering financial affordance to move toward universal digital access, which could completely transform the ways many marginalized communities approach the self-management of health.
Major cities have begun to push forward digital access initiatives such as the Digital Access and Equity initiative in Baltimore, Md., Comcast’s Internet Essentials in Detroit, Mich., and the Connect Your Community project in Cleveland, Ohio. We need to see more efforts for universal digital access similar to the ways there has been a push for universal access to learning technologies.
There are city initiatives such as Connect Chicago that provide internet and technology access and support for local Chicago residents through public libraries. Yet, this does not address the existing limitations placed on in-home devices that are used as health aids, such as smart speakers and personal computers.
Digital access in the homes of these seniors affords a sense of convenience and efficiency for residents who face barriers to navigating outside of their home. Simply suggesting that these residents look to local community centers as a source of digital access is also problematic, as many of these centers are underfunded compared to their more-affluent neighboring areas.
With the internet now being one of the most important tools in our everyday lives, digital access has now become a health care issue. Metropolitan cities such as Chicago, Baltimore, Cleveland and Detroit are feeling the brunt of the digital divide and deserve city programs that disseminate resources such as digital broadband to areas that are currently starved of this infrastructure. We need dedication from local city departments and agencies to refund computer labs and push free digital access in the homes of more community residents.
Dr. Christina Harrington is an assistant professor in the College of Computing and Digital Media at DePaul University and an Encore Public Voices Fellow, and she is the director of the Equity and Health Innovations Design Research Lab, where her work focuses on envisioning health and racial equity for marginalized communities through design.
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