Disseminating Relevant Health Information to Underserved Audiences: Implications of the Digital Divide Pilot Projects*

Article excerpt

Objective: This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries.

Method: The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences.

Results: The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health.

Implications: The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations.

Many of the people who are most at risk of poor health outcomes from cancer and other serious health problems are members of underserved populations, populations that are generally made up of individuals who are of low socioeconomic status, possess low levels of health literacy, are elderly, are members of marginalized ethnic and minority groups, or have limited formal education. These underserved and vulnerable populations often have limited access to relevant health information, especially information widely available over the Internet [1]. These same vulnerable populations are also subject to serious disparities in health care and generally have much higher rates of morbidity and mortality due to serious health threats, especially from cancers, than the rest of the public [2]. New strategies and policies need to be developed to help underserved and vulnerable populations access relevant health information and to help them use such information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health [3].

Health information is essential in health care and health promotion, because it provides both direction and rationale for guiding strategic health behaviors, treatments, and decisions [4]. The digital divide has been identified as a special problem in health care that can lead to significant disparities in care. Many studies show that certain minority groups and low-income, low-education populations in the United States suffer a disproportionate cancer burden and have limited access to electronic information about health [2]. However, too little is known about different disenfranchised groups' interests in, access to, and abilities to use health information.

The US Department of Commerce and other groups have documented the digital divide that separates those who have access to computer technology and the vast storehouse of information available through the Web from those who lack access [5]. A White House report indicates that the gap between people who have access to the latest Information Age tools and those who do not is widening, and the digital divide is growing along racial and ethnic lines [6]. This White House report suggested several steps they intended to take to break down the digital divide. One of their goals was to make access to computers and the Internet as universal as access to the telephone is today. The Healthy People 2010 report for the first time has a section on health communications, with goals for access to health communication and computer-mediated health information [7].

The digital divide is a special problem in health care. Many of the characteristics that identify those on the "have not" side of the digital divide also apply to those who suffer the negative effects of health disparities (e.g., people with less education, with low income, and in ethnic minorities). …