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An Analysis of Factors Underlying E-Health Disparities

Published online by Cambridge University Press:  01 October 2008

Extract

The potential public and individual health consequences of unequal access to digital technologies have been recognized in the United States for at least a decade. Unequal access to the Internet and related technologies has been characterized as a “digital divide”; naturalistic trends toward broader access across the population and targeted intervention to increase access are described as progress toward “digital inclusion.” The problem of the digital divide has been characterized as one of healthcare justice. The idea that everyone should have access to the telecommunications grid—telephone and computer—is a central tenet of the U.S. universal service policy. With the diffusion of broadband technologies, the issue of digital access includes not only access to the Internet but also access to new levels of service, such as broadband, to support a wide range of emerging applications.

Type
Special Section: The Newest Frontier: Ethical Landscapes in Electronic Healthcare
Copyright
Copyright © Cambridge University Press 2008

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References

1 Eng TR, Maxfield A, Patrick K, Deering MJ, Ratzan SC, Gustafson DH. Access to health information and support: A public highway or a private road? JAMA 1998;280:1371–5; McGinnis JM, Deering MJ, Patrick K. Public health information and the new media: A view from the Public Health Service. In: Harris LM, ed. Health and the New Media. Mahwah, NJ: Lawrence Erlbaum Associates; 1995:127–41.

2 U.S. Department of Commerce. Falling through the Net: Toward Digital Inclusion. Washington, DC: U.S. Government Printing Office; 2000; available at http://www.ntia.doc.gov/ntiahome/fttn00/contents00.html (accessed 2 Dec 2007); U.S. Department of Health and Human Services. Communicating Health: Priorities and Strategies for Progress. Washington, DC: U.S. Government Printing Office; 2003; available at http://www.health.gov/communication (accessed 2 Dec 2007).

3 Bauer K. Distributive justice and rural healthcare: A case for e-Health. International Journal of Applied Philosophy 2003;17(2):241–52.

4 U.S. Department of Commerce. Falling through the Net: A Survey of the “Have Nots” in Rural and Urban America. Washington, DC: U.S. Government Printing Office; 1995; available at http://www.ntia.doc.gov/ntiahome/fallingthru.html (accessed 2 Dec 2007).

5 Fox S. Digital Divisions. Washington DC: Pew Internet & American Life Project; 2005; available at http://www.pewinternet.org/PPF/r/165/report_display.asp (accessed 2 Dec 2007); Horrigan JB, Smith A. Home Broadband Adoption 2007. Washington, DC: Pew Internet & American Life Project; 2007; available at http://www.pewinternet.org/PPF/r/217/report_display.asp (accessed 2 Dec 2007).

6 Madden M, Fox S. Finding Answers Online in Sickness and in Health. Washington, DC: Pew Internet & American Life Project; 2006; available at http://www.pewinternet.org/PPF/r/183/report_display.asp (accessed 2 Dec 2007).

7 Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, DC: The National Academies Press; 2003; available at http://books.nap.edu/catalog.php?record_id=10260 (accessed 2 Dec 2007); U.S. Department of Health and Human Services. 2005 National Healthcare Disparities Report. AHRQ Pub. No. 06-0017. Washington, DC: U.S. Department of Health and Human Services; 2005; Viswanath K, Kreuter MW. Health disparities, communication inequalities, and eHealth. American Journal of Preventive Medicine 2007;32(Suppl. 1):S131–3.

8 U.S. Department of Health and Human Services. Healthy People 2010, Vol. 1: Understanding and Improving Health and Vol. 2: Health Objectives for Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office; 2000; available at www.healthypeople.gov (accessed 2 Dec 2007).

9 See note 8, U.S. Department of Health and Human Services 2000.

10 See note 2, U.S. Department of Health and Human Services 2003.

11 National Committee on Vital and Health Statistics. Information for Health: A Strategy for Building the National Health Information Infrastructure. Washington, DC: U.S. Government Printing Office; 2001; available at http://www.ncvhs.hhs.gov/reptrecs-arc.htm (accessed 2 Dec 2007).

12 Institute of Medicine. Speaking of Health: Assessing Health Communication Strategies for Diverse Populations. Washington, DC: The National Academies Press; 2002; available at http://books.nap.edu/catalog.php?record_id=10018 (accessed 2 Dec 2007); Neuhauser L, Kreps G. Rethinking communication in the e-health era. Journal of Health Psychology 2003;8(1):7-23.

13 Thompson TG, Brailer DJ. The Decade of Health Information Technology: Delivering Consumer-Centric and Information-Rich Health Care. Washington, DC: U.S. Government Printing Office; 2004; available at www.hhs.gov/healthit/documents/hitframework.pdf (accessed 2 Dec 2007).

14 See note 5, Horrigan, Smith 2007.

15 U.S. Department of Health and Human Services. Expanding the Reach and Impact of Consumer e-Health Tools. Washington, DC: U.S. Government Printing Office; 2006; available at www.health.gov/communication (accessed 2 Dec 2007).

16 Institute of Medicine. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press; 2004; available at http://books.nap.edu/catalog.php?record_id=10883 (accessed 2 Dec 2007); The White House. The Federal Response to Hurricane Katrina: Lessons Learned. Washington, DC: U.S. Government Printing Office; 2006; available at http://www.whitehouse.gov/reports/katrina-lessons-learned/index.html (accessed 2 Dec 2007); see note 2, U.S. Department of Health and Human Services 2003.

17 Kutner M, White S. The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: U.S. Department of Education, National Center for Education Statistics; 2006; available at http://nces.ed.gov/naal/health.asp (accessed 2 Dec 2007).

18 One Economy Corporation. Research summary. Washington, DC: One Economy Corporation; 2004; The Children's Partnership. Online Content for Low-Income and Underserved Americans: The Digital Divide's New Frontier; 2000; available at www.childrenspartnership.org/AM/Template.cfm?Section=Reports1&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=8194 (accessed 2 Dec 2007); The Children's Partnership. Online Content for Low-Income and Underserved Americans: An Issue Brief; 2002; available at www.childrenspartnership.org/AM/Template.cfm?Section=Reports1&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=9568 (accessed 2 Dec 2007); The Children's Partnership. The Search for High-Quality Online Content for Low-Income and Underserved Communities: Evaluating and Producing What's Needed; 2003; available at www.childrenspartnership.org/AM/Template.cfm?Section=Reports1&CONTENTID=6646&TEMPLATE=/CM/ContentDisplay.cfm (accessed 2 Dec 2007).

19 See note 1, Eng et al. 1998.

20 See note 2, U.S. Department of Health and Human Services 2003.

21 Baur C. Using the Internet to move beyond the brochure and improve health literacy. In: Schwartzberg J, VanGeest JB, Wang CC, eds. Understanding Health Literacy: Implications for Medicine and Public Health. Chicago: AMA Press; 2005.

22 See note 16, Institute of Medicine 2004; see note 8, U.S. Department of Health and Human Services 2000.

23 U.S. Department of Health and Human Services. Quick Guide to Health Literacy; 2006; available at www.health.gov/communication (accessed 2 Dec 2007).

24 Berkman ND, DeWalt DA, Pignone MP, Sheridan SL, Lohr KN, Lux L, et al. Literacy and Health Outcomes. Summary, Evidence Report/Technology Assessment No. 87. Prepared by RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016. AHRQ Publication No. 04-E007-1. Rockville, MD: Agency for Healthcare Research and Quality; January 2004; see note 16, Institute of Medicine 2004.

25 See note 21, Baur 2005; see note 15, U.S. Department of Health and Human Services 2006.

26 See note 8, U.S. Department of Health and Human Services 2000.

27 U.S. Department of Commerce. National Telecommunications and Information Administration. Falling through the Net: Defining the Digital Divide. Washington DC: U.S. Government Printing Office; 1999; available at www.ntia.doc.gov/ntiahome/fttn99/ (accessed 2 Dec 2007).

28 See note 5, Fox 2005.

29 Madden M. Internet Penetration and Impact. Washington, DC: Pew Internet & American Life Project; 2006; available at http://www.pewinternet.org/PPF/r/182/report_display.asp (accessed 2 Dec 2007).

30 See note 5, Fox 2005.

31 See note 5, Fox 2005; see note 5, Horrigan, Smith 2007.

32 See note 5, Horrigan, Smith 2007.

33 See note 5, Horrigan, Smith 2007.

34 See note 5, Fox 2005; Horrigan JB. Why It Will Be Hard to Close the Broadband Divide. Washington, DC: Pew Internet & American Life Project; 2007; available at http://www.pewinternet.org/PPF/r/220/report_display.asp (accessed 2 Dec 2007); see note 2, U.S. Department of Health and Human Services 2003.

35 University of Southern California, Annenberg School Center for the Digital Future. The Digital Future Report: Ten Years, Ten Trends. Los Angeles, CA: University of Southern California; 2004.

36 Stanley L. Beyond access. San Diego Digital Divide Study; 2001.

37 See note 5, Fox 2005; Horrigan JB. A Typology of Information and Communication Technology Users. Washington, DC: Pew Internet & American Life Project; 2007; available at http://www.pewinternet.org/PPF/r/213/report_display.asp (accessed 2 Dec 2007).

38 Cole J. Now is the time to start studying the Internet age. Chronicle of Higher Education 2004;50(30):B18.

39 See note 34, Horrigan 2007.

40 Lorence D, Park H. Web-based consumer health information: Public access, digital division and remainders. Medscape General Medicine 2006;8:2–4.

41 Hesse B, Nelson DE, Kreps GL, Croyle RT, Arora NK, Rimer BK, et al. Trust and sources of health information. Archives of Internal Medicine 2005;165:2618–24.

42 See note 41, Hesse et al. 2005.

43 Fox S. Online Health Search 2006. Washington, DC: Pew Internet & American Life Project; 2006; available at http://www.pewinternet.org/PPF/r/190/report_display.asp (accessed 2 Dec 2007).

44 Lieberman D, Jones Benet D, Lloyd-Kolkin D, Kreuter M, Cheah W, Ortzman M. Literature Review about Prevention Content Literature. Paper produced for the Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services. Washington, DC: U.S. Department of Health and Human Services; 2004.

45 Tu HT, Hargraves JL. Seeking Healthcare Information: Most Consumers Still on the Sideline. Issue Brief 61. Washington, DC: Center for Studying Health System Change; 2003; available at http://www.hschange.org/CONTENT/537/ (accessed 2 Dec 2007).

46 See note 17, Kutner, White 2006.

47 Greene J, Hibbard J, Tusler M. How much do health literacy and patient activation contribute to older adults’ ability to manage their health? Paper produced for the AARP Public Policy Institute. Washington, DC: AARP; 2005.

48 See note 44, Lieberman et al. 2004.

49 U.S. Department of Education. A First Look at the Literacy of America's Adults in the 21st Century. Washington, DC: National Center for Education Statistics; 2005; available at http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006470 (accessed 2 Dec 2007).

50 See note 49, U.S. Department of Education 2005.

51 See note 49, U.S. Department of Education 2005.

52 Berland G, Elliott M, Morales L. Health information on the internet: Accessibility, quality, and readability in English and Spanish. JAMA 2001;285(20):2612–21; Birru MS, Monaco VM, Lonelyss C, Drew H, Njie V, Bierria T, et al. Internet usage by low-literacy adults seeking health information: An observational analysis. Journal of Medical Internet Research 2004;6:e25; Kusec S, Brborovic O, Schillinger D. Diabetes websites accredited by the Health on the Net Foundation Code of Conduct: Readable or not? Studies in Health Technology and Informatics 2003;95:655–60; Zarcadoolas C, Pleasant A, Greer DS. Understanding health literacy: An expanded model. Health Promotion International 2005;20:195–203.

53 See note 52, Birru et al. 2004.

54 Zarcadoolas C, Blanco M, Boyer JF, Pleasant A. Unweaving the Web: An exploratory study of low-literate adults’ navigation skills on the World Wide Web. Journal of Health Communication 2002;7:309–24.

55 See note 18, The Children's Partnership 2000; see note 18, The Children's Partnership 2002; see note 18, The Children's Partnership 2003; see note 26, One Economy Corporation 2004.

56 See note 52, Berland et al. 2001.

57 National Alliance for Caregiving and AARP. Caregiving in the U.S.; 2004; available at http://www.aarp.org/research/reference/publicopinions/aresearch-import-853.html (accessed 2 Dec 2007).

58 Freimuth VS, Mettger W. Is there a hard-to-reach audience? Public Health Reports 1990;105(3):232–8.

59 See note 12, Institute of Medicine 2002.

60 Brug J, Oenema A, Campbell M. Past, present and future of computer-tailored nutrition education. American Journal of Clinical Nutrition 2003;77(4 Suppl):1028S–34S.

61 See note 15, U.S. Department of Health and Human Services 2006.

62 See note 15, U.S. Department of Health and Human Services 2006.

63 See note 15, U.S. Department of Health and Human Services 2006.

64 Baur C, Deering MJ. E-health for consumers, patients and caregivers. In: Harman LB, ed. Ethical Challenges in the Management of Health Information, 2nd ed. Sudbury, MA: Jones and Bartlett Publishers; 2006.

65 See note 15, U.S. Department of Health and Human Services 2006.

66 See note 15, U.S. Department of Health and Human Services 2006.