What’s Public Health Got to Do With… Technology Access & Proficiency as a Social Determinant of Health?
By: James Fuccione, MPA
Senior Director – Massachusetts Healthy Aging Collaborative
We are all aging, but social determinants of health direct to a large extent the story of how we age, our life expectancy, and quality of life. A person’s ZIP code, economic status, education and access to a range of basic needs all contribute to various predictors of wellness through our lifespan. It is long overdue to add technology, not just as a social determinant of health, but as an overlapping theme that can either help address inequities or widen existing gaps.
Healthy aging and technology are closely tied together, which is yet one more reality heighted by the pandemic. A study supported by Point32 Health Foundation (formerly Tufts Health Plan Foundation) of how innovative responses to COVID-19 in six Massachusetts communities supported healthy aging found that older adults disproportionately impacted by the pandemic included those with limited proficiency or access to technology. At the pandemic’s outset, communities, government and organizations rightly prioritized meeting basic needs of older adults – food, medicine, and healthcare, among others – before shifting focus to social connection, stable housing, mobility, and other conditions that also affect wellbeing and the ability to navigate daily life. Technology access was part of all of these responses, whether categorized as primary or secondary.
What the study illustrated specifically was that older adults and their families who had access to technology were able to seek out a wider array of information, services, and social connections more quickly. Just as importantly, organizations were able to reach people in need more effectively where digital access was unimpeded. Services, food access, vaccine registration, public health information, public meetings, and virtual opportunities – in all its forms – found their way to those with digital access and skills.
Nationally, a report from Humana and Older Adults Technology Services (OATS) estimates that only 58 percent of adults age 65 and older have access to in-home wireline broadband, which leaves out roughly 21.8 million older people. Age is not the only gap as internet access is a wide-ranging equity issue. OATS and Humana research also found that, if you are over 65 and lack a high school diploma, live in poverty, are non-White or foreign-born, live alone, suffer from poor health or physical disability, are female, or live in a rural area, digital privation is more likely to add to existing disparities.
Access to technology, which encompasses a reliable and fast internet connection, a device, the knowledge to effectively use that device and awareness of online opportunities, has the power to exacerbate or reduce disparities.
The Massachusetts Healthy Aging Collaborative (MHAC) convenes a statewide network of partners advancing positive change on the issue. Little Brothers-Friends of the Elderly in Boston runs a successful program called Digital Dividends, which offers weekly intergenerational tech training and support in public and affordable senior housing. Coastline Elderly Services in New Bedford and several councils on aging employ the same intergenerational tactic or use older adults to train peers who may be less proficient. AgeSpan, an aging services organization in northeast Massachusetts, provides devices, one-on-one training tailored to the needs of every older adult along with broadband access. Libraries across the state offer hotspots on loan. The Massachusetts Association for the Blind and Visually Impaired (MABVI) began a tech training program in 2017 that is spreading in communities across the state to open access to printed and digital information, social connection and communication, transportation, healthcare information, and more. All of these examples, and so many more, connect older adults with opportunities around social determinants of health and create social connectedness.
Addressing digital equity across social determinants of health requires an age-friendly, cross-sector and community-wide approach. Intergenerational and local partnerships have already linked older adults with devices, skill-building and broadband connections. The Affordable Connectivity Program (ACP) from the Federal Communications Commission and propelled by the bipartisan Infrastructure Law can be a bridge to connect millions of older people. The broader recognition of technology’s role during the pandemic – from social connection to healthcare to civic engagement – along with federal funding support is stage-setting for a collaborative path forward.
Check out the May AFPHS Training to hear community and organizational examples of how older adults have been connected to technology. Also hear a statewide approach to establishing an age-friendly lens on digital equity and more on a collaborative pursuit of solutions.