Healthcare, Empowerment, and the Digital Divide

A new survey just out by the U.S. National Center for Health Statistics shows that higher income white women are the primary seekers of health information on the Internet.  I won’t bore you with the breakdown of all of the stats – you can read them here. What troubles me about this survey are the underlying consequences.

Income, education, race, employment, and insurance status were factored into the survey. It is clear that the digital divide is growing but not necessarily the way the experts predicted a decade ago. The haves and have nots are inching further apart and many are being left behind. It’s not the cost of computers any longer – it’s tougher issues like health literacy, research and analytical skills, and resulting lack of empowerment.

It’s very hard to make informed decisions about healthcare if you don’t understand the information. People with advanced college degrees readily admit struggling with health literacy, so imagine how difficult it must be for someone who barely graduated high school to understand the jargon and weed through the plethora of health web sites and their often-conflicting information. The ability to analyze and choose sound information is also tenuous among those on the downside of this divide.

Internet guru Jakob Nielsen noted that 40 percent of users struggle with literacy skills and seniors are among those that struggle the most. He isn’t terribly optimistic about the empowerment divide either.

“Because they lack the initiative and skill to take matters into their own hands, some users remain at the mercy of other people’s decisions.”

It’s one thing when you’re shopping for a TV. It’s quite another when you need to find out about a new drug, or procedure, or want to know more about the disease your doctor just diagnosed.

Providers are turning to Health IT for record-keeping and consultations. Yet patients that lack tech prowess or health literacy may have difficulty accessing or understanding their own electronic health records. That further impacts health inequalities. And what about the small practices and clinics that can’t afford to switch over? It’s the patients that lose out.

There’s isn’t one ideal solution. Increased use of smartphone technology and applications may help some patients. More affordable computers could also be a factor. Increasing and expanding government programs designed to bridge the technology divide was recommended by an expert panel from the National Coordination Office for Networking and Information Technology Research and Development. That’s great, but where’s the money going to come from? Federal programs are being slashed, even more so now, thanks to the latest budget crisis and shifting priorities.

It’s not only the government that bears responsibility – corporations, educational institutions, practitioners and even those of us that write about health care need to step up to improve access, affordability, understandability, and empowerment. Otherwise, we’re left with a new digital underclass that loses the “informed” part of “informed consent.”