November 26, 2012

Rural e-patients face access challenges

David Gorn, a reporter for California Healthline, contacted me after the release of the Pew Internet/California HealthCare Foundation’s Mobile Health 2012 report and asked if there were interesting findings on rural Americans. Indeed there are and I wish I’d thought to include them since they tell an important story about who is still cut off from online health resources.

I provided the data for Gorn’s story, “Smartphones Might Aid Health Effort in Rural California,” and now I’m sharing the data here, too, since I think there are important realities to discuss when we look at technology trends in health: rural residents lag behind suburbanites and urbanites.

So there’s no confusion, here is the exact question wording and results for each group:

Do you use the internet, at least occasionally?/Do you send or receive email, at least occasionally?/Do you access the internet on a cell phone, tablet or other mobile handheld device, at least occasionally? (We now combine all three to come up with our estimate of internet users — for more on this decision, see this short report.)

  • 81% of urban adults use the internet
  • 84% of suburban adults use the internet
  • 74% of rural adults use the internet

Note: this represents a statistically significant difference for urban/suburban vs. rural residents.

Do you have a cell phone… or a Blackberry or iPhone or other device that is also a cell phone?

  • 85% of urban adults have a cell phone
  • 86% of suburban adults have a cell phone
  • 77% of rural adults have a cell phone

Again, a statistically significant difference for urban/suburban vs. rural.

Some cell phones are called “smartphones” because of certain features they have. Is your cell phone a smartphone, such as an iPhone, Android, Blackberry or Windows phone, or are you not sure?

  • 56% of urban cell phone owners say they have a smartphone
  • 57% of suburban cell phone owners say they have a smartphone
  • 38% of rural cell phone owners say they have a smartphone

Yes, that is a statistically significant difference for urban/suburban vs. rural.

Do you ever use your cell phone to look for health or medical information online?

  • 32% of urban cell phone owners say yes
  • 32% of suburban cell phone owners say yes
  • 18% of rural cell phone owners say yes

Yep, statistically significant difference for urban/suburban vs. rural.

Do you receive any text updates or alerts about health or medical issues, such as your doctors or pharmacists?

  • 10% of urban cell phone owners
  • 10% of suburban cell phone owners
  • 11% of rural cell phone owners

Note: no statistically significant differences.

On your cell phone, do you happen to have any software applications or “apps” that help you track or manage your health, or not?

  • 12% of urban cell phone owners
  • 11% of suburban cell phone owners
  • 11% of rural cell phone owners

Note: no statistically significant differences. And there are no statistical differences among groups when it comes to the types of health apps they have on their phones.

Now, this isn’t “news” to anyone who has been following the FCC’s rural broadband initiative or Pew Internet’s previous reporting on the digital divide. But I think the data is an important reminder for anyone interested in the impact of the internet on health and health care. Imagine being a newly-diagnosed patient in a rural area, where you don’t have access to all the information and community that many of us take for granted. How would your life be different?

Join the discussion on e-patients.net