No internet, no vaccine: How lack of internet access has limited vaccine availability for racial and ethnic minorities

Racial and ethnic minority communities that lack internet access have beenleft behindin the race to get a COVID-19 vaccine. Theaverage monthly cost of internet access, about US$70, can be out of reach for those who can barely afford groceries.

Reporters and scholars have written about the effects oflack of internet accessinrural areas in the U.S.anddeveloping countries, but they have paid less attention to the harm of lack ofinternetaccess in racial and ethnic minority communities inmajor cities.

We areresearcherswhostudyhealth disparities.We are concerned that even when vaccinations are offered in these communities, those at greatest risk for COVID-19 may be unable to obtain appointments without the help offamily or friends. This includesracial and ethnic minority communities and older adults, the age group that is currently being vaccinated.

Our research suggests that lack of internet access may be an important reason. And for the almost13.8 million older adultsin the U.S. who live alone, asking for help may not be an option.

Where did you get most of your information about COVID-19? For those who lack internet access in a pandemic, such an information gap can impact their health and safety.#COVID19#RuralBroadband#DigtalDividehttps://t.co/nnCBM49gCG

— Neighborhood FORWARD (@NeighborForward)June 22, 2020

The computer as COVID-19 connector

During the pandemic, the internet has been an indispensablehealthtool to millions.

Telehealth services have provided asafe wayfor patients to make appointments for COVID-19 testing and other types ofmedical care. In fact, there was a154% increase in telehealth visitsduring the last seven days of March 2020 compared to the same period in 2019. This was most likely due to public health mandates that required a shift away from in-person care.

In addition, patients receive communications from their providers throughemail and other messaging systemsthat offer access to health care, health information and test results. And,departments of public healthand theCenters for Disease Control and Preventionhave relied on their websites, online events andsocial mediato educate the population about COVID-19. Access to the internet is essential during a pandemic.

这has been particularly true as the vaccine has been rolled out. Signing up for the vaccine has predominantly occurredonline. This means that far fewerolder adultsfrom underresourced racial and ethnic minority communities have been able to make appointments.

In 2018, more thanone in four Medicare beneficiarieshad no digital access at home. Those without digital access were more likely to be 85 years or older, members of racial or ethnic minority communities and from low-income households.

How internet access can determine health

Over the years, medical and public health experts have identifiedsocial factors—structural racism, a person's neighborhood, access to fresh food, exposure to toxins, income and education—that play a major role in health. These factors are often called thesocial determinants of health. Experts consider structural racism, or racism ingrained in social, business, educational and health policy and practice, to be one of the most damaging determinants. These factors in turn ultimately lead tomore disease and death,as they have with COVID-19.

Early data on the case numbers and deaths from COVID-19 showed that structural racism likely increasedexposure to the coronavirusamong racial and ethnic minority communities. And,racial gapsalso impeded access totestingand affectedquality of care.

The pandemic has also illuminated the risk of infection to ouraging population. However,researchhas placed less emphasis on howagingaffectssome populationsmore than others, such as the effects of structural racism and income.

Now, it appears thatinternet accessis emerging as a new and troublesomedeterminant of health. This appears to be particularly true for underresourced racial and ethnic minority communities andaging populations.

Although people can make appointments for a COVID-19 vaccine by telephone, call centers are frequently overwhelmed.Hold timescan be extremely long. Access to the internet, having an internet-enabled device and understanding how to use both have been necessary to sign up for the vaccine. Many advocacy groups andpublic health expertshave begun to see internet access as a fundamentalcivil rights issue.

During the fall of 2020, we looked at this issue in more depth with Black and Latino individuals who areHIV positive and at risk for a cardiovascular event. Inour research, we found that 17 out of 30 patients had no internet, no computer or lacked knowledge of how to use the internet or a computer. They, like many people with health issues or from underresourced racial and ethnic minority communities, are affected by numerous social determinants that amplify the negative health consequences they experience.

While online health services could be used to increase access and retention in care among vulnerable groups, not having accesswidens existing disparities.

Solutions exist, but they must be implemented

To address the internet gap, we believe that policymakers must identify lack ofinternet access作为一个屏障,防止其影响。这could include reserving vaccines in underresourced racial and ethnic minority communities for local residents and designating senior hours for those 65 and older.

Policymakers could also mandate timely reporting of demographic information, even withinmedical settings, to monitor equity. Public health administrators could also partner with organizations that work with vulnerable populations, such as Meals on Wheels, to deliver food and vaccines to individual homes.

Departments of public health also could work with organizations and trusted community leaders to produce culturally consistent multimedia information on vaccinations and other health topics. They could also arrange for billboards, freeway signs and posters at local restaurants.

In addition, health care professionals and organizations can help by teaching patients aboutgovernment subsidies and internet programs for low-income individualsfrom internet service providers. They can also provide training onhow to use the internet, which would be at least a good beginning for these vulnerable groups.

这article is republished fromThe Conversation基于知识共享许可协议。读了original article.