Digital Divide
Background
The Internet has emerged as a major source of information in the United States. About 63% of the American population is online which roughly translates to about 128 million people, age 18 years or older[1]. Almost 80% of online users have looked for health information at one time or other on a variety of topics including diet, fitness drugs, hospitals, new treatments, alternative medicines and doctors. The number of websites on health runs into tens of millions. For example, a casual search for cancer yields almost more than 15 million hits.
Background
The Internet has emerged as a major source of information in the United States. About 63% of the American population is online which roughly translates to about 128 million people, age 18 years or older[1]. Almost 80% of online users have looked for health information at one time or other on a variety of topics including diet, fitness drugs, hospitals, new treatments, alternative medicines and doctors. The number of websites on health runs into tens of millions. For example, a casual search for cancer yields almost more than 15 million hits.
However, despite the increasing penetration of the web and amount of health information online, there are significant factors that influence its widespread adoption as a source of health information. First, there exists a “digital divide,” with people from higher income and education groups demonstrating greater access and usage of Internet- and other technology-based information compared to those who are from lower SES groups [3]. Second, even if access is improved, fewer websites in health information seeking are designed to cater to the needs of those in the lower SES groups, who are more likely to have lower literacy skills. For example, a recent analysis reported a mismatch between the increasing number of low-literacy users and the number of websites on colorectal cancer that could meet their needs [4]. Third, online use for health is influenced by broadband access and experience in usage, and those with less education, income and who are older are less likely to have broadband connections at home [5].
In spite of the long-standing evidence in inequality in access, some researchers are now suggesting that these differences will disappear due to technological advances6. This is a reasonable speculation given saturation level diffusion of such technologies as electricity and telephone and the deepening penetration of cell phones. This proposition of eventual equalization and the amelioration of the invidious effects of the divide are questionable however. It may be argued that as information technologies grow cheaper, access becomes less important of an issue with increase in affordability and greater penetration of computers or TV sets at home. The communication environment, however, is dynamic with constant improvement in technology and services being offered. With improvement comes greater demand for more high-end equipment -- high-speed computers or high definition television. For example, the creation of websites with sophisticated multi-media software places a greater demand to upgrade equipment periodically, which places a disproportionate burden on lower SES groups. And, the question of what type of access is needed to keep up to date with the current information and communication environment becomes the focus of study.
