skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.


Title: Connecting in Crisis: Investigating Equitable Community Internet Access in the US During the COVID-19 Pandemic
Although internet access and affordability are increasingly at the center of policy decisions around issues of the “digital divide” in the US, the complex nature of usage as it relates to structural inequality is not well-understood. We partnered with Project Waves, a community internet provider, to set up connectivity across the urban landscape of a city in the Eastern United States to study factors that impact the rollout of affordable broadband internet connectivity to low-income communities during the COVID-19 pandemic. The organization endeavored to meet structural challenges, provide community support for adoption, and stave off attendant privacy concerns. We present three dimensions of equitable use prioritized by the community internet provider: safety from COVID-19 through social distancing enabled by remote access, trusted connectivity, and private internet access. We use employee interviews and a phone survey of internet recipients to investigate how the provider prioritized these dimensions and who uses their service.  more » « less
Award ID(s):
2030451
PAR ID:
10523570
Author(s) / Creator(s):
; ;
Publisher / Repository:
ACM
Date Published:
Journal Name:
ACM Journal on Computing and Sustainable Societies
ISSN:
2834-5533
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Abstract ObjectiveOnline patient portals become important during disruptions to in-person health care, like when cases of coronavirus disease 2019 (COVID-19) and other respiratory viruses rise, yet underlying structural inequalities associated with race, socio-economic status, and other socio-demographic characteristics may affect their use. We analyzed a population-based survey to identify disparities within the United States in access to online portals during the early period of COVID-19 in 2020. Materials and MethodsThe National Cancer Institute fielded the 2020 Health and Information National Trends Survey from February to June 2020. We conducted multivariable analysis to identify socio-demographic characteristics of US patients who were offered and accessed online portals, and reasons for nonuse. ResultsLess than half of insured adult patients reported accessing an online portal in the prior 12 months, and this was less common among patients who are male, are Hispanic, have less than a college degree, have Medicaid insurance, have no regular provider, or have no internet. Reasons for nonuse include: wanting to speak directly to a provider, not having an online record, concerns about privacy, and discomfort with technology. DiscussionDespite the rapid expansion of digital health technologies due to COVID-19, we found persistent socio-demographic disparities in access to patient portals. Ensuring that digital health tools are secure, private, and trustworthy would address some patient concerns that are barriers to portal access. ConclusionExpanding the use of online portals requires explicitly addressing fundamental inequities to prevent exacerbating existing disparities, particularly during surges in cases of COVID-19 and other respiratory viruses that tax health care resources. 
    more » « less
  2. null (Ed.)
    The digital divide—and, in particular, the homework gap— have been exacerbated by the COVID-19 pandemic, laying bare not only the inequities in broadband Internet access but also how these inequities ultimately affect citizens’ ability to learn, work, and play. Addressing these inequities ultimately requires having holistic, “full stack” data on the nature of the gaps in infrastructure and uptake—from the physical infrastructure (e.g., fiber, cable) to speed and application performance to affordability and neighborhood effects that ultimately affect whether a technology is adopted. This paper surveys how various existing datasets can (and cannot) shed light on these gaps, the limitations of these datasets, what we know from existing data about how the Internet responded to shifts in traffic during COVID-19, and—importantly for the future—what data we need to better understand these problems moving forward and how the research community, policymakers, and the public might gain access to various data. Keywords: digital divide,iInternet, mapping, performance 
    more » « less
  3. Abstract Objective Through the coronavirus disease 2019 (COVID-19) pandemic, telemedicine became a necessary entry point into the process of diagnosis, triage and treatment. Racial and ethnic disparities in health care have been well documented in COVID-19 with respect to risk of infection and in-hospital outcomes once admitted, and here we assess disparities in those who access healthcare via telemedicine for COVID-19 . Materials and Methods Electronic health record data of patients at New York University Langone Health between March 19th and April 30, 2020 were used to conduct descriptive and multilevel regression analyses with respect to visit type (telemedicine or in-person), suspected COVID diagnosis and COVID test results. Results Controlling for individual and community-level attributes, Black patients had 0.6 times the adjusted odds (95%CI:0.58-0.63) of accessing care through telemedicine compared to white patients, though they are increasingly accessing telemedicine for urgent care, driven by a younger and female population. COVID diagnoses were significantly more likely for Black versus white telemedicine patients. Discussion There are disparities for Black patients accessing telemedicine, however increased uptake by young, female Black patients. Mean income and decreased mean household size of Zip code were also significantly related to telemedicine use. Conclusion Telemedicine access disparities reflect those in in-person healthcare access. Roots of disparate use are complex and reflect individual, community, and structural factors, including their intersection; many of which are due to systemic racism. Evidence regarding disparities that manifest through telemedicine can be used to inform tool design and systemic efforts to promote digital health equity. 
    more » « less
  4. We use data collected between April 2020 and March 2021 from the Understanding America Survey, a nationally representative internet panel of approximately 1,450 households with school-age children, to document the access of American households to K–12 education during the COVID-19 crisis. We also explore disparities by parent race/ethnicity, income, urbanicity, partisanship, and grade level (i.e., elementary school vs. middle/high school). Results shed light on the vectors of inequality that occurred throughout the pandemic in access to technology, instruction, services (e.g., free and reduced-price meals), and in-person learning opportunities. Our work highlights the equity implications of the pandemic and suggests the importance of encouraging widespread in-person learning opportunities and attendance by the beginning of the 2021–2022 school year for addressing COVID-19’s educational effects. 
    more » « less
  5. The U.S. community corrections system supervises and provides services for nearly 4.4 million individuals. This study explored agency responses during the COVID-19 pandemic using data from 347 surveys of community supervision directors. We examined whether agency and local geographical factors were associated with increased use of telehealth services for mental health, substance use disorders, and criminal behavior. We also assessed whether these factors were significant predictors of changes in agencies’ supervision strategies. Findings indicated a positive association between prepandemic access to telecommunications technology and use of telehealth services, with observed differences regarding urbanicity and type of agency. Agencies with more COVID-19 mitigation strategies tended to avoid in-person contact. Given the vast needs and increased risks present within the community supervision population, it is important to understand the barriers and facilitators associated with innovation and change in the post-COVID-19 era to inform future reform efforts. 
    more » « less