The Digital Divide in Health-Related Technology Use: The Significance of Race/Ethnicity

Mitchell, Uchechi A.; Chebli, Perla; Ruggiero, Laurie; Muramatsu, Naoko

doi:10.1093/geront/gny138

Cited by 200 publications

(144 citation statements)

References 47 publications

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“…The study of digital inequality investigates how different ethnic and racial groups access and use new technology and how their differing digital engagements lead to the amplification or reduction of social disadvantages (Chen, 2013). For example, it is well documented that because of health-related social inequalities, minorities are more likely to access online health information but less likely to use e-health services (Mesch, et al, 2012;Mesch, 2016;Mitchell, et al, 2019), a service that is essential during the ongoing COVID-19 pandemic . As this indicates, digital resources may both reinforce existing racial inequalities or provide new avenues through which some inequalities may be mitigated.…”

Section: Race and Ethnicitymentioning

confidence: 99%

Digital inequalities 2.0: Legacy inequalities in the information age

Robinson¹,

Schulz²,

Blank³

et al. 2020

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2020 marks the 25th anniversary of the “digital divide.” Although a quarter century has passed, legacy digital inequalities continue, and emergent digital inequalities are proliferating. Many of the initial schisms identified in 1995 are still relevant today. Twenty-five years later, foundational access inequalities continue to separate the digital haves and the digital have-nots within and across countries. In addition, even ubiquitous-access populations are riven with skill inequalities and differentiated usage. Indeed, legacy digital inequalities persist vis-à-vis economic class, gender, sexuality, race and ethnicity, aging, disability, healthcare, education, rural residency, networks, and global geographies. At the same time, emergent forms of inequality now appear alongside legacy inequalities such that notions of digital inequalities must be continually expanded to become more nuanced. We capture the increasingly complex and interrelated nature of digital inequalities by introducing the concept of the “digital inequality stack.” The concept of the digital inequality stack encompasses access to connectivity networks, devices, and software, as well as collective access to network infrastructure. Other layers of the digital inequality stack include differentiated use and consumption, literacies and skills, production and programming, etc. When inequality exists at foundational layers of the digital inequality stack, this often translates into inequalities at higher levels. As we show across these many thematic foci, layers in the digital inequality stack may move in tandem with one another such that all layers of the digital inequality stack reinforce disadvantage.

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Section: Race and Ethnicitymentioning

confidence: 99%

Digital inequalities 2.0: Legacy inequalities in the information age

Robinson¹,

Schulz²,

Blank³

et al. 2020

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“…7 Such patients are also less likely to supplement their knowledge by using publicly available online resources. 8 For these patients, going "virtual" risks making their understanding of radiation and the management of treatment-related adverse effects even more difficult, particularly for those with LEP or LHL. 9 RO departments will have to be conscious of this problem to prevent exacerbation of existing disparities as they develop their posteCOVID-19 telemedicine processes.…”

mentioning

confidence: 99%

Equity in Radiation Oncology Post-COVID: Bridging the Telemedicine Gap

Franco

Perni

Wiley

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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The SARS-CoV-2 virus has caused a worldwide pandemic, affecting nearly every aspect of the lives of individuals, communities, and nations. For radiation oncology (RO) departments, the need for social distancing has translated into policies limiting in-person interactions and restricting companions. These restrictions have been distressing for many but may take a particular toll on patients with low health literacy (LHL) and limited English proficiency (LEP). As the world of medicine after COVID-19 comes to rely more heavily on technology to connect patients and providers, disparities in access and barriers to use of health information technology may create an additional layer of complexity for patients receiving radiation. Thus, if telemedicine technology becomes the new posteCOVID-19 normal, it is important that we approach these new processes with a health equity lens. We may otherwise compound the already disproportionate effects that the virus has had on underserved minority racial and ethnic communities. Although cancer treatments within the United States have improved over the past decade through advances in radiation, surgical, and systemic treatments, not all patients have benefited equally. Ethnic and racial minorities underrepresented in medicine (UIM) continue to experience worse outcomes compared with their white counterparts. 1 This problem is deepened by the higher levels of LHL

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“…At the same time, our analysis suggests that health services research, translational medicine, and/or CBPR are types of research that could be further developed within the context of the six health condition areas that were reviewed. Whereas the focus on implementation science and translational research at the NIH has been increasing (92,93), our findings suggest that future research could focus on understudied approaches in Hispanic/Latino health, including, but not limited to, deeper understanding of effectiveness of currently recommended therapies and potential differences among heritage groups (56,(94)(95)(96); participation and/or increased inclusion in genetics/genomic studies (97)(98)(99); innovative strategies to implement recommended guidelines of care, and especially those move beyond the "sideways" approach (100); the intersection (101-103) of social determinants of health other factors on disease risk and the effectiveness of clinical or multi-level interventions (104)(105)(106)(107); design and analysis of multi-level or multi-sectoral (108)(109)(110) interventions; implementation and dissemination studies in real-world settings (92,111); the role of health information technologies on health-care delivery and health outcomes (112)(113)(114)(115)(116)(117)(118); the impact of interventions or policies designed to reduce health and health-care disparities (119)(120)(121)(122)(123)(124)(125)(126); and the effects of national or local policies on healthcare services and health outcomes (e.g., natural experiments) (127,…”

Section: Discussionmentioning

confidence: 99%

Funding of Hispanic/Latino Health-Related Research by the National Institutes of Health: An Analysis of the Portfolio of Research Program Grants on Six Health Topic Areas

Avilés-Santa

Hsu

Lam

et al. 2020

Front. Public Health

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Avilés-Santa et al. NIH Funding Hispanic/Latino Health poses opportunities to evaluate knowledge gained and their clinical application, explore new research questions, or to update some methods or instruments. The findings of the present study suggest opportunities to expand research in understudied mechanisms of disease that could explain differences in prevalence of conditions like diabetes and cancer among different heritage groups. In addition, our findings suggest that the impact of interventions or policies designed to reduce health disparities, innovative multi-level interventions, implementation and dissemination studies, the role of health information technology on health outcomes, and the intersectionality of individual, sociocultural, geographic, and other factors on health outcomes, among others, are understudied approaches, which could potentially advance research in Hispanic/Latino health and contribute to the achievement of better health outcomes in this diverse population.

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The Digital Divide in Health-Related Technology Use: The Significance of Race/Ethnicity

Cited by 200 publications

References 47 publications

Digital inequalities 2.0: Legacy inequalities in the information age

Digital inequalities 2.0: Legacy inequalities in the information age

Equity in Radiation Oncology Post-COVID: Bridging the Telemedicine Gap

Funding of Hispanic/Latino Health-Related Research by the National Institutes of Health: An Analysis of the Portfolio of Research Program Grants on Six Health Topic Areas

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