May 19, 2010
Health disparities…differences in the health status of some of us compared to others–have many links to communication. We could place more emphasis on efforts to address some of these as part of health care reform.
One communication contributor to health disparities is a lack of equal access to health information. In particular, a digital divide has been identified as leading to differences in people’s awareness and understanding of ways to promote health and treatments for various diseases.
The digital divide has been discussed for years in terms of the affordability and availability of computers. This contributed to programs to increase access to computers in public schools and public libraries. Access to sources of health information is an important goal–one that may be enhanced by improving the nation’s infrastructure. I was struck by a colleague’s recent revelation on our way to a meeting in a rural community in Pennsylvania. He said that he seldom uses the internet from home. In his location, internet access still depends on the use of a dial-up modem. The slow and painful effort to get online just isn’t worth it. Libraries and schools in his area suffer from the same challenges.
The effort to reduce the digital divide by increasing access to online health resources is a good start but reminds me of the ‘just build it and they will come’ fallacy. Once we get on the computer, and we use our favorite search engines to look for health information, how do we decide whether the information is useful and relates to us? How do we understand the information? How do we harness resources to apply the information when we do understand it? That includes having sites for care and providers for care. …that includes having the ability to pay for care, time off to receive care, and transportation to sites for care.
Health disparities becomes a communication issue with many facets and many audiences to consider. If we approach health disparities as only an issue relating to access to information, we risk placing blame for continuing and/or growing disparities on people experiencing the disparities.
In a world where access to health information was supported by access to services, products, and care–our individual perceptions still may lead to disparities. Understanding related to the information and choices to apply the content depends on some knowledge of health terms and ability to translate the metaphors so often used to commmunicate in health information. Understanding also depends on the cultural and social lens through which we view the information. And on our own goals–including where we place responsibility for health.
Some of us assume more personal responsibility for our health than others. Some of us believe more in the role of family history and genetics than others. Some of us believe that the environment plays a greater role in our health than our own behavior. And some of us believe in a role for spirituality and religious faith. When we combine these into our health perspective, sometimes health disparities emerge… Can erasing a digital divide make a difference in these issues? Perhaps if we communicate about them directly, online and in other settings where we talk about health.
I thought this post was a great eye-opener in the aspect of health care and technology availability for individuals. Being posted in 2010 I found it a little surprising that the issue of individuals not being able to obtain internet access is still very common. In today’s electronically driven world I feel like many individuals just assume that everyone has internet access. The idea that people are unable to read about their health care or find the answer to any kind of health question just seems so abstract. Although within the post very strong points were made that the individuals who do have access to internet or finding information about their health and healthcare aren’t much better off than those who do not. Internet users are able to view all the different articles providing information on their health, but the reality is it’s very difficult for an everyday individual to properly asses their health problems, when they have little knowledge in this field. Also after reading the various information people start to believe they may have all these different kinds of illnesses and or diseases. Along with believing they’ll have every side effect which may come with a medication proscribed by their doctor, because the internet gives a list of all bad things that could happen to you while taking it.
This is why I feel access to health information through technology use is a double edged sword. On the one hand there are many perks, such as fast answers, a semi lead way into furthering your knowledge dealing with health issues, and personal stories shared by individuals about their own experience dealing with a health issue. This aspect of the article helps deal with Uncertainty Management theory, which states that to preventing this from happening you should educate yourself about the topic and find the facts to answer what was puzzling you. This being said, access to the internet could help prevent this issue for many individuals. Although along with the benefits there are negatives, false information, a sense of fear from the overload of facts dealing with an issue and the lack of proper communication. As noted in the post, the question of “can erasing a digital divide make a difference in these issues.” Although many believe the issue is access to information, the issue still remains that the lack of proper communication with healthcare providers and resources for the people is still highly absent. Those two factors are very important, which makes the healthcare system more of a political argument.
Social justice is defined as promoting equal rights for both powerful and powerless members of a society. Within the article post you question if all people are given equal rights, because certain people do not receive the same privileges as others, dealing with health benefits. People who live within a more poor community are not given the same resources as those with a comfortable financial balance. Not only is the technological aspect absent so are things providing them with proper health care, being able to live in a place that provides a healthy life style. This is an issue occurring within today’s community. Along with social justice, procedural justice, this involves judging the fairness of the process of making outcome allocation decisions. Even though some individuals might have the ability to access health facts through technology, it doesn’t mean they have the ability or resources to purchase the things necessary to help them. They might find they have certain symptoms but that doesn’t change anything if they can’t fix these issues that become presented to them.
An example of this deals with my mother and her own doctor. She found out through doing research that she had symptoms which lead her to believe she had something wrong with her that was more serious than simple sickness. When she went to the doctor they said they could run different tests to see what she may have that went along with the different symptoms she stated she was having. Although she found out later that even through are health insurance the blood work done was a very high amount which she really didn’t have. Healthcare providers make it seem as if everything can be fixed and it won’t cost extra money, if you have insurance. When really after the doctor appointment, any blood work you may need and then medicine they recommend once they know what you have, it really adds up. Many individuals can’t really afford those expenses, such as my mother, who had experienced being able to have access to information, but not really the things she needed after.
Easier access to health information via the internet is not the answer to the digital divide in the context of health communication. I agree that unless an individual was interested in looking up health information before the internet, they won’t suddenly catch interest after. I don’t believe the internet changes peoples’ interests, it only changes the ability they have to access interests they already have. At this time, I think the majority of individuals get their health information from televised news and newspapers, while the internet is used to supplement these sources. While the internet has limitless potential as a tool of communication, it is still relatively new and therefore will not be relied on as much as other sources (at least not yet). I think the best way to continue to bridge the digital divide in health communication is to introduce ideas through television, and use the television as a means to promote seeking information on the internet.
I was having a conversation with my dad a couple of months ago. He was given a sheet of paper from his doctor that contained a list of websites related to high-blood pressure. I have only seen my dad use a computer three times in my life, and not one of those times involved using the internet, so I knew he was not happy about getting the list.“Why can’t they just tell me this information in person anymore. It’s not like it used to be,” he lamented.
This got me thinking about how people like my dad are having a harder time getting health information. Before, people would be able to get health information from a doctor. Now more and more doctors just assume that patients have access to the internet and tell their patients to find out more information online. This gives people without internet a harder time to find information and a feeling of disparity. Nevertheless, the internet is here to stay and people have to learn how to use it. That is why I am proposing that health clinics offer biweekly workshops that teach people how to use the internet and to find reliable health sources. This will help narrow the large technology gap which in turn will lead to more healthy individuals.
While equal access to health information sounds amazing, it is definitely not a reality. Like with everything there are people who want to know and understand certain details and others who could careless and never take the initiative to learn. You can’t force someone to know about health and opportunities unless they take the initiative themselves. While talking about the mountains of Appalachian several students raised the concern that they were from that area and have seen the struggling families. However, I ask you, how those students were were able to make it at the largest university and how were they able to become successful?
Dr. Parrott talks about health being a personal responsibility and I would agree with this. You can’t tell me people from Appalachian don’t believe there is something more than living in poverty. They have seen the affects of tobacco and other drugs, so why don’t they do something about it? The government provides aide and even offers scholarships, that students like myself will never see because my parents both took the responsibility when having children and work to support their families.
I come from a family of six and while we do not live in Appalachian or poverty stricken area, I seen my father work two jobs at once to support us as well as my mother finding work within the school district. I pay for my own education through loans and work a part time job during the school year, then turn around to work full time during the summer months. It is not a cake walk, but I am taking the proactive stance to work towards my goals just as people should do if they really cared about their health. There are people willing to discuss options and plans; you just have to take the first step. I understand not having the funds to deal with health which is what I am hoping our government finds a way to fix and I believe we should provide more organizations to go to lower class areas who are willing to speak on the issue of health.
But I was always taught, “you control your own destiny.” Therefore, digital divide causes problems as far as not having information available everywhere such as a computer, but if people really wanted to learn they could find someone willing to help. Asking questions after question provides you with answers. So if you don’t have access to a computer, and don’t understand the literacy, find someone willing to explain it. Sounds easy and I know the reality isn’t, but one has to be willing to try. The only one to blame is yourself and we could eliminate these disparities overtime.
I agree that the digital divide is the most contributing factor to health disparities and inequality. However, if everyone were to receive access to computers and other forms of technology, who will provide them with the skills and training to use them? I believe that is the real question. Sadly, if people are not equipped with the technological skill sets, then the digital divide will continue to widen. We must come up with ways to reach those with lower socioeconomic statuses, provide them with the technology, and train them how to use it to their own advantage.
There are definitely advantages to health communication through technology such as increasing access to medical information and increasing Dr./patient communication. I agree, however, that this type of health communication can lead to an increase in the “digital divide”. In terms of personal choice and culture, we should not assume that everyone can or wants to use technology as a mode of obtaining health information. My grandmother has never been comfortable using computers and the internet, even after I offered to help her learn. Even though not everyone will want to work on increasing their health literacy in terms of technology, basic technology and health literacy skills training should be offered along with access to computers. The combination of access and education will not necessarily eliminate the digital divide, but it would increase the opportunities for everyone to use technology as a health resource.
I believe that the digital divide is a huge contributing factor to health disparities. Though not having access to a computer or the internet may seem strange to some, it is common everyday life to others. Growing up in the city, it was strange for me to find out that my boyfriend’s family did not have the internet. They live in a small farm town just outside of a major city. This information made me realize that not having the internet isn’t all that uncommon. Not having the internet leads to a number of health disparities. It leads to a lack of access to health information. It also attributes to health illiteracy. When these people do find access to the internet, say in college (like my boyfriend), or in a library, it will be more difficult to distinguish credible information from non-credible information. I believe that eliminating the digital divide would do wonders for relieving some of the country’s health disparities.
I totally agree that not having access to the Internet has caused a huge problem. Not only does it make the people who have access more knowledgeable, it makes those without it left behind. Today’s world is based mostly on technology. It is essential that people have at least basic skills to be functional in society. The problem is not only the accessibility of computers, but also of Internet connections. Once this problem is fixed, we can begin to solve the problem of the digital divide.
Erasing the digital divide is an extremely important step in improving the overall health of our nation. The wealth of information concerning health related topics on the internet is too valuable not to be accessed by the people that need the information. People also do not only have access the to information they need, but the possibility of an online support group for a specific illness or condition they are suffering from. Another thing to consider is that even if internet access was available in rural and impoverished areas, internet literacy is still a big factor to consider. The access to the internet is the first step, and the ability to be proficient in internet use is the next step to erasing the digital divide.
I agree with Cody, although I understand that folks with less education, money, or our seniors may not have access to the internet. We have spoken frequently in my health comm. class about the challenges of communication in the health care setting. But I tend to agree more that the individual must be responsible for educating him or her self about a particular illness. Like many, I have aging grandparents who struggle to keep up with technology and teminology. I want them to get the best care that they can but they need to understand how to get that care, and it starts with education which they lack. It is clear to me that they just don’t want to catch up. We have dicussions now and then about this issue and they feel overwhelmed by the amount of information and intimidated by the computer. They rely on the health care system to carry them. So, I can fully understand why workers in the health industry get frustrated. I think that we need to meet them half way, if we don’t care enough ourselves, how can they care? The information is there to help us, but if we are unwilling to receive, it makes no difference.
When looking at technology communication – they are doing a lot to begin bridging the divide. Copper wire is being laid in more and more places to get internet from here to there faster every day. There is a huge digital gap I agree, but as said in the blog, there are still MANY contributions to health disparities. Whether it be because of your religious beliefs, because you can’t read any type of print, because you don’t get internet access, or because you watch too much TV – health disparities will, more than likely, always be a problem. I do believe that the digital divide may be the biggest cause, but once everyone has the same “lightening fast” internet (if it ever happens), how are we going to teach all the people who did not use internet before how to look for good websites? How are we going to teach them how to tell real information from false information? What about people who can’t speak English – does this mean we have to translate everything? What about the people who can’t afford a computer? I feel that because there will always be health disparities and the only thing people can do is try to bridge gaps as best they can. Give away old computers to less fortunate, have free classes that teach about the internet. Start making websites in different languages. While in class we watched a documentary by Diane Sawyer on the Poverty of the Appalachian Mountains. By the looks of most of the people, the phrase “Doctors Appointment” probably did not come up too much. These people barely had money to eat – I feel that worrying about fast internet is one thing these families were not worried about. Yes, the digital divide is a big thing, but for these people, I believe it was more than just the lack of internet causing a health disparity. In the chapter, “What’s Politics Got To Do with It?”, there is a section titled: Medical Research and Disparities. In this section, it points out that the bigger the university, the more money it will receive. Although those are the places with the most doctors and the most resources to do research, it is causing a disparity because the bigger universities continue to get more money, even bigger, and more credit while the smaller universities do not have that option.
When I was reading up on this topic of digital divide in the realm of health, I came across these interesting findings from a recent Pew Internet Survey. http://www.pewinternet.org/Reports/2010/Chronic-Disease.aspx
The study shows that although healthy U.S. adults (81%) are more likely to use the Internet rather than adults with a chronic disease (62%), once they have access to the Internet, having a chronic disease will not only increase Internet usage but it also gives these individuals a strong way to connect and generate content that they are more likely to share with similar others.
Apart from making attempts to bridge the divide with adequate skills-training, I think it is also important to demonstrate the beneficial effects that will come out of such access…The ability to narrate, create and share one’s health experiences. Social connectedness could be a good motivating factor, like all the social media sites have shown. Increasingly, people with diverse age and skill backgrounds are on sites like Facebook, because they are motivated to be a part of the online community.
Communication may relate to health disparities through the various networks and communication tools we use to communicate about our health. As Dr. Parrott mentions in her blog, the digital divide may decrease health disparities among the population through access to health information on the internet, but it is not always accurate, easy or quick to find. Some people who are not very “computer savvy” may find it very frustrating to deal with the internet and find accurate or credible information.
It seems that a lot of people are not educated strongly on their specific health conditions or diagnosis. Health literacy is an important part of communication and its relation to health disparities. Since culture plays a role in how we communicate about our health and obtain information there needs to be internet websites that individuals of various cultures can I identify with to gain accurate and credible information. I definitely think that a lot of people in all cultures and backgrounds of life communicate about their health based on what they already know, that being family history and genetics. Like Dr. Parrott says, “some of us assume more personal responsibility for our health than others.” Why is that? Is it because some of use are health illiterate or too shy to ask questions at a doctor’s visit? I agree that this may be how health disparities can surface.
The internet needs to be accommodating for a diverse population of people who are health literate and illiterate. My grandparents who are retired have internet access but they are not very “computer savvy” and when I asked them the number one way they tend to look up information relating to their health conditions they said they would look to the Merck Manual for health information or network with friends, family, or acquaintances to gain narrative information.
I believe that the communication technologies we use to communicate about our health can relate to disparities mostly through not knowing if it is a credible source.
It’s interesting how Dr. Parrott touches on the fact that many of us simply do not take responsibility for our own health. Is that really a health disparity? Taking responsibility for your health is a choice. I am a healthcare worker and it amazes me when I speak with patients how many of them really do expect the healthcare industry to take care of them. I am always surprised to see how many patients do not even know the names of their maintenance medications.
Most healthcare professionals are very busy and down time is a luxury they do not have. I’m sure they would love to take time out of each day to make sure that John Doe is doing well and staying on top of his health, but that’s obviously not realistic. It doesn’t matter what kind of tools we have available if we do not care enough to utilize them.
Health disparities are no doubt a major issue in the health world today and the digital divide is definitely a contributor to this. Unfortunately, the digital divide is not just about having access to the internet because I really don’t think that this is as large of an issue as people may think. There is free access in schools, the workplace, libraries, and other outlets that even people with a low socio-economic status can have access to. In my opinion and based on what we have learned in class, the major reason there is such a large digital divide is because of health literacy. As a testimony to this, my parents and grandparents have the same access to the internet that I have but they are limited by their lack of ability to interpret and navigate internet resources.
If we want to reduce the digital divide as an effort to reduce health disparities then we must focus on improving health literacy. Some ideas on how to improve health literacy would be classes or workshops provided by the community to show people who need help how to interpret health information, physicians taking some time to introduce patients to relevant sites, and more sites that tailor their messages to fit all audiences by using lay terms or providing a glossary for understanding medical terms. It will be interesting to see how the digital divide is affected in the future when no generations will have existed before this ever developing high-tech age.
Digital Divide is a huge problem in our country but for some reason it seems to be on the back burner of many people’s minds. Even if everyone has access to broadband internet, it still does not guarantee that they will know how to use it, or know how to search for health information. I feel like the real problem is health literacy. Without the health knowledge needed to search for information online, one may not even know where to begin. The web sometimes can be very overwhelming and if you do not know the difference between credible and non-credible sources, then you are just a fish swimming in the large ocean.
I think that one way to combat health disparities is to first have broadband access be universal so that everyone has access to it. The next step though will be to make the internet accommodating to the audience. There should be websites that are geared towards people who are health illiterate, so that it can be understandable for them. this could be anything from giving step by step instructions for a search on a website, or keeping the reading level of the website low. Digital Divide is an issue in this country that we need to address immediately so that there are no health disparities.
I BELIEVE THAT IT IS IMPORTANT THAT ALL ASPECTS OF HEALTH COMMUNICATION ARE EXAMINED IN REGARDS TO HEALTH DISPARITIES. PEOPLE TEND TO ASSOCIATE HEALTH DISPARITIES WITH THE DIGITAL DIVIDE, BUT I FEEL THERE ARE OTHER ASPECTS TO CONSIDER. BECAUSE THE INTERNET IS A PRIMARY SOURCE OF COMMUNICATION, THAT IS WHERE PEOPLE LOOK FIRST. HOWEVER, THERE ARE OTHER ASPECTS TO CONSIDER. FOR INSTANCE, I GREW UP IN AN URBAN AREA WHERE THERE WERE NOT ALOT OF COMPUTERS FOR STUDENTS. AN INDIVIDUAL WROTE A GRANT, WHICH FUNDED COMPUTERS, BOOKS AND INTERNET FOR THE COMMUNITY CENTER. ALTHOUGH WE HAD COMPUTERS, THERE WERE NOT ALOT OF PEOPLE EDUCATED ON HOW TO ACTUALLY USE THEM. WITH THAT BEING SAID, IT IS NECESSARY THAT THE SOCIO ECONOMIC BARRIERS ARE TACKLED SO THAT HEALTH LITERACY CAN INCREASE AND DISPARITIES DECREASED. THERE IS A PROCESS THAT MUST BE FOLLOWED. PEOPLE MUST BE EDUCATED ABOUT THE HEALTH FIELD AND THE INTERNET. THEY MUST UNDERSTAND THE DIFFERENT PROGRAMS AND FUNCTIONS THAT EXIST IN EHEALTH COMMUNICATION. PROVIDING THE COMPUTERS IS NOT ENOUGH TO REDUCE THE DIFFERENCES IN PEOPLE’S HEALTH STATAUS. I BELIEVE THE DIGITAL DIVIDE IS A GOOD START, BUT OTHER FACTORS SHOULD BE EXAMINED IN DEPTH AS WELL. THE CHALLENGE IS FINDING USEFUL WAYS TO EDUCATE PEOPLE IN DIFFERENT AREAS SO THAT THEY UNDERSTAND WHAT THEY ARE BEING TAUGHT AND UTILIZE THAT INFORMATION.
As you stated in your blog, bridging the digital divide may decrease disparities in health among different groups by providing access to health information online. However, just providing internet access doesn’t mean certain groups will automatically be able to find accurate information regarding their symptoms, diagnosis, and effective treatments. For example, simply googling the word “cancer” returns approximately 196 million results. For someone who doesn’t have the knowledge or experience to weed through inaccurate sites and judge credibility of others, the results of using a search engine can seem very overwhelming. Thus, the need is not to focus solely on providing access to information, but the focus needs to be on tailoring sites with useful information for certain and specific groups and making them widely known and available. As we discussed in our health communication course, culture plays a central role in the identities people form about themselves and their health. Unfortunately, many websites don’t account for these cultural identities and how they relate to people’s health. Therefore, as discussed in our course, websites should use cultural grounding to tie important health information to certain groups. For example, growing up in a socio-economically depressed Appalachian community, I witnessed many families who had no health insurance, and thus, no health care. I think a website tailored to the needs of Appalachian communities with relevant health information and terminology would be beneficial, as well as listing resources for health care such as free clinics and nurse hotlines that are available to those without insurance.
…great ideas…
The digital gap contributes to the lack of equal access to health information; however, it will not solve all of the issues among individuals seeking health information. Last quarter, I took an e-health course, and the theme of the course revolved around the digital divide and the inequality to health access that was a result of it. We learned that it is safe to conclude that individuals with access to broadband internet service may have more access to health information on the web; nevertheless, we cannot guarantee that the user understands the information being presented. Therefore, although the digital divide is an issue in health care, closing the gap will not make a difference if health literacy is deficient.
As mentioned in the article, the digital dived has been discussed in terms of availability and affordability of computers, however, I think that if the digital divide was discussed in terms of age, different results would emerge. There are many older adults who may not be as comfortable using the computer to seek information; in contrast, there are younger adults who would prefer to seek information online. This illustrates that there may be older adults who can afford or have internet access, yet they choose not to use the web to seek health information.
I think that by erasing the digital divide in terms of affordability and availability, some issues in health will be still be present. Just because one has access does not mean that the internet will be the preferable source of information, nor does it mean that the user will understand the information presented.
..now if only we could convince others of this reality…