In the land of access and inclusion, the focus is usually on the built environment and services. But there is also virtual access and inclusion to consider. The pandemic has highlighted a lack of equitable access to the internet and therefore access to health services. This is particularly the case for rural dwellers. The issues of health, the digital divide and rural dwellers is discussed in a report from the US.
The context of the report is the social determinants of health and the digital divide. Broadband access and digital literacy are key for connecting to services such as employment, education and health services. While broadband infrastructure and computer hardware are necessary, true equitable access also requires focus on digital literacy and proficiency. However, there are other issues related to poor health outcomes.
According to the report, rural residents are subject to additional social determinants including physician shortages, persistent poverty, and food insecurity. Excessive travel times, inadequate transportation options, environmental exposures are also problematic. And broadband internet services that are often poor quality, unaffordable, or unavailable.
“Super-determinants” of health are poor transportation, lack of broadband access, and living with a disability. That’s because they cause disadvantage across other areas of life.
The title of the report is Underfunded Infrastructure Impact on Health Equity. The study focuses on north America, but Australian rural dwellers share many of the same issues.
The report recommends engagement and involvement by community members. Community health workers live and work in vulnerable communities, and they understand the real lives of people. Consequently, community health workers should lead community involvement in coming up with solutions.
The report explains the social determinants of health, the cost of inequity, and the need for digital literacy training.
Four key findings in the report
- Households with consistent broadband have increased health literacy, greater access to clinical and social services, make better informed healthcare choices, and stay closer connected to support systems of friends and family.
- A holistic approach led by health advocates from the local community has the best chance of improving health outcomes and successfully overcoming barriers caused by social determinants.
- Strategies for reaching vulnerable populations should center on community health workers (CHWs) who are trusted and respected members of that population. CHWs have an ability to better understand the reality of
how people live and the obstacles that keep them from success.
- Program leadership should include meaningful representation from local community organizations with valuable experience in health equity and extensive community networks.