Keywords: digital divide, information inequality, Internet access

The complexity of the issues that make up the digital divide problem is better understood today. It is no longer sufficient to see it simply as a disparity of access to computer technology. Rather, there is recognition that having meaningful support for using the technology is also an essential ingredient for getting online. The digital divide is a global problem, but even in the technology rich United States the situation is troubling. Recent studies have shown that within the United States, public libraries play a key role in helping the digitally disadvantaged get connected to the Internet and learn how to use it to serve their needs. As more individuals are connected online, those who are not, however, are increasingly in danger for becoming more marginalized within society. Health care professionals need to be aware that they may well be working with individuals who are increasingly outside of the mainstream of the digital revolution and who cannot take advantage of Internet resources that could positively impact their health.

Defining the Digital Divide

Implications for Health

Healthy People 2010 (U.S. Department of Health and Human Services, 2000) in its discussion of disparities in Objective 11, Health Communication, addresses the problems of inadequate health literacy (discussed too in the last OJIN Information Resources column) and limited digital access. "The digital divide becomes more critical as the amount and variety of health resources available over the Internet increase and as people need more sophisticated skills to use electronic resources. Equitably distributed health communication resources and skills, and a robust communication infrastructure can contribute to the closing of the digital divide and the overarching goal of Healthy People 2010 to eliminate health disparities."

Americans and the Digital Divide

From 1995 through 2000 the U.S. National Telecommunications and Information Administration (NTIA) issued four reports in a series called "Falling through the Net." The 1995 report focused on the disparity of telephone service between the haves and have-nots in rural and urban America and provided some data relating to personal computer/modem ownership. There was recognition of the increasing importance of access to computers with modems as a new measure of "universal service."

The second NTIA report (1998) specifically spoke of the "digital divide" and provided data that showed the gap widened between 1994 and 1997 for selected groups with regard to computer ownership and usage. Those groups lagging the furthest behind were Blacks and Hispanics and those in lower income levels. The profile of the have-nots reported in the third NTIA report, Defining the Digital Divide (1999), painted a similar picture. However, a widening gap was reported with regard to White and Black/Hispanic households and also with regard to education and income level. Affluent families, regardless of race, were increasing their connection to the Internet, suggesting the possibility that with more affordable computers and connections that the disparity might diminish. Findings of Internet access by groups included:

• White households: 29.8%.
• Black households: 11.2%
• Hispanic households: 12.6%
• College-education individuals: 48.9%
• Individuals with only some high school education: 6.3%
• Two-parent households: 39.3%
• Female, single-parent households: 15%

In 2000, the fourth NTIA report, Toward Digital Inclusion, highlighted significant increases in access across all groups. "Groups that have traditionally been digital 'have nots' are now making dramatic gains." Nonetheless, those lacking access were more likely to be those with low income, less education, Blacks/Hispanics, the aged, and the disabled. The report also began to measure the prevalence of high-speed access to the Internet and stated that "Internet access is no longer a luxury item."

The most recent major Federal report was issued by NTIA and the Economics and Statistics Administration in 2002. Titled A Nation Online—How Americans are Expanding their Use of the Internet, the report documents substantial increases by Americans in the use of the Internet and computers. At the time this report was issued, it was estimated that two million more people became Internet users each month and that over half of the population was online. These increases again included the traditional "have-nots." Although the report highlighted tremendous gains, a chapter on the "unconnected" reported those disadvantaged in their access to be in the same groups identified over the previous years (p.73). Non-users included:

• People in households with low family incomes - 75.0 percent of people who live in households where income is less than $15,000 and 66.6 percent of those in households with incomes between $15,000 and $35,000.
• Adults with low levels of overall education - 60.2 percent of adults (age 25+) with only a high school degree and 87.2 percent of adults with less than a high school education.
• Hispanics - 68.4 percent of all Hispanics and 85.9 percent of Hispanic households where Spanish is the only language spoken.
• Blacks - 60.2 percent of Blacks.

The report was soundly criticized by a coalition of civil rights and policy groups for the overall rosy picture it painted. Critics were also incensed that, at the same time the Bush administration released their report, they announced plans to zero out two programs designed to address the digital divide. The critics, with funding from the Ford Foundation, reanalyzed the data and subsequently issued their own report. This report, Bringing a Nation Online - The Importance of Federal Leadership (Leslie Harris & Associates, 2002), emphasized the role the Federal government needs to play to insure that gains are made in connecting more Americans.

There is no one comprehensive report on current usage in the US. However, various sources give provide glimpses of overall use patterns:

• Nearly 75% of Americans now have Internet access from home. (Nielsen//NetRatings, March 18, 2004)
• From October 2002 to October 2003, senior citizens were the fastest growing age group online, increasing by 25% and making up 7% of active Internet users. The second fastest growing age group was 55-64 years (15% increase), followed by those 18-24 years (13% increase). (Nielsen//NetRatings, November 20, 2003)
• 23% of adult U.S. Internet users have used the Internet at places other than home or work: at school (27%), others’ homes (26%), and libraries (26%). These users were of two types: those who try to connect from wherever they are and those who are relatively poor and depend on places other than work or home for access. (Pew Internet & American Life Project, March 3, 2004).

The digital divide is not just an issue for individuals and groups within the US, but also for countries and regions within the world. A Nielsen//NetRatings report from February 20, 2003, provided a broad picture of disparities in digital access that exist around the globe. At that time, the United States accounted for 29% of the world’s Internet population, although actual population represented less than 5% of the world’s total. Other areas had the following percentages of the total Internet population: Europe with 23%, Asia/Pacific with 13%, Latin America with 2%, and the rest of the world comprising the remainder. Parent, Coppieters, & Parent (2001) related that there were more Internet users in New York City than on the entire African continent.

The United Nations (2003) held a World Summit on the Information Society in Geneva, Switzerland, in December 2003. In his remarks, U.N. Secretary General Kofi Annan stated the need to "transform the information age into an information society" by bridging the growing digital divide between the developed and developing worlds. He spoke of the several gaps making up the digital divide:

The so-called digital divide is actually several gaps in one.

There is a technological divide - great gaps in infrastructure.

There is a content divide. A lot of web-based information is simply not relevant to the real needs of people. And nearly 70 percent of the world's web sites are in English, at times crowding out local voices and views.

There is a gender divide, with women and girls enjoying less access to information technology than men and boys. This can be true of rich and poor countries alike: some developing countries are among those offering the most digital opportunities for women, while some developed countries have done considerably less well.

There is a commercial divide. E-commerce is linking some countries and companies ever more closely together. But others run the risk of further marginalization. Some experts describe the digital divide as one of the biggest non-tariff barriers to world trade.

And there are obvious social, economic and other disparities and obstacles that affect a country's ability to take advantage of digital opportunities.

We cannot assume that such gaps will disappear on their own, over time, as the diffusion of technology naturally spreads its wealth. An open, inclusive information society that benefits all people will not emerge without sustained commitment and investment. (www.itu.int/wsis/geneva/coverage/statements/opening/annan.html)

Issues beyond Access

Measuring those with and without Internet access is not enough. Blau (2002) points out how limited a digital divide discussion is when seen only in those terms. First, the gap is hard to measure as the type of access can vary greatly—by location (home or work or school), by connection (dial-up or high-speed), by computer (operating system and speed). Second, it is clear that having access does not mean that it is meaningful access. There can still be significant barriers to use, including lack of familiarity with computers, inadequate skills in looking for information, inability to interpret and use content.

The Children’s Partnership (2000) undertook an audit to determine what online content issues faced low-income and underserved Americans, what they termed "the digital divide's new frontier." They found underserved communities faced significant barriers related to content. These included:

• Lack of most urgently needed local information
• Literacy barriers
• Language barriers
• Cultural diversity barriers

Making a Difference

Many who are working to address digital divide issues say that in fact giving people access is not enough. Rather, an individual needs to be exposed within their community to the value of computers and Internet access and then be able to receive meaningful support in their use, including training, encouragement, and technical support.

The 1997 NTIA report spoke of the important role that schools, libraries, and other community access centers (CACs) should play in providing access to the "least connected" in society. Blau (2002) speaks of access as being "better understood as a social or community issue, where the need for social support and resources comes into sharper focus. Understood in this broader context, libraries and other community-based institutions are essential components of any strategy that recognizes the factors that keep people from the benefits of the Digital Age "(p. 52).

The Bill & Melinda Gates Foundation released a report in February 2004 on the role public libraries play in addressing the digital divide. The study, Toward Equality of Access, was jointly sponsored by a number of national civic groups and the Federal government’s Institute of Museum and Library Services. It found that, while only 28 percent of public library systems offered public Internet access in 1996, 95% of all library buildings provided access in 2004. Of the 14 million Americans regularly relying on this access, many are from socioeconomic groups less likely to have access at home or work. For example, African Americans and Hispanics are twice as likely to use library computer than Asian Americans and Whites. Similarly, families making less than $15,000 per year are two to three times more likely to rely on library access than families earning over $75,000. The impact is great in rural communities as well as nearly 80 percent of library systems serve rural areas and small towns.

In addition to providing access to hardware and software and a connection to the Internet, libraries were found to be providing a broader support role by virtue of library staff who routinely provide training and assistance in use of the technology and in learning how to find useful information. The Gates (2004) report found this access to the poorest communities in particular is threatened by funding cuts that reduce library staff, services, or building hours, as well as the capability to do needed hardware/software upgrades and keep systems running. The report maintains that public libraries make a difference in the effort toward equality and advocates for a continuing commitment to insure that "if you can reach a public library, you can reach the Internet (p.32)."

Conclusion

The digital divide is wide, particularly when viewed on a global scale, and deep as it affects select disenfranchised groups. As Blau (2002) highlights, as more people become connected, the problem becomes even more acute for those left out. Not only are they are out of the mainstream of all the communication and transactions taking place online, but that this exclusion is likely to lead to them becoming even more marginalized within society.

As the Internet plays a greater role in our daily life, health professionals in particular need to be aware that their clients or target audiences may not be able to take advantage of this medium. Chatterjee (2002) calls for those health professionals working in the community to seek out collaborations with public libraries and other non-profit agencies that do provide computer access and support, particularly among the disadvantaged. We can all play a role as citizens to be a voice for maintaining support for our local public libraries and for global initiatives directed at reducing inequities.

THE AUTHOR

Barbara F. Schloman, PhD, AHIP
Assistant Dean, Library Information Services
Libraries & Media Services
Kent State University
Kent, OH 44242
E-mail Address: schloman@kent.edu

Disclaimer: Mention of a Web site does not imply endorsement by the author, OJIN, or NursingWorld. Links to Web sites are current at the time of publication, but are not subsequently updated.

REFERENCES

Bill & Melinda Gates Foundation. (2004). Toward equality of access: The role of public libraries in addressing the digital divide. Retrieved April 8, 2004, from www.gatesfoundation.org/nr/Downloads/libraries/uslibraries/reports/TowardEqualityofAccess.pdf

Blau, A. (2002). Access isn’t enough. American Libraries, 33(6), 50-52.

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Children’s Partnership. (2000). Online content for low-income and underserved Americans: The digital divide’s new frontier. Retrieved April 4, 2004, from www.childrenspartnership.org/pub/low_income/low_income.pdf

Leslie Harris & Associates. (2002). Bringing a nation online: The importance of Federal leadership. Retrieved April 4, 2004, from www.benton.org/publibrary/nationonline/

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United Nations. (2003, December 10). Address by UN Secretary-General to the World Summit on the Information Society, Geneva, Switzerland. Retrieved April 4, 2004 from www.itu.int/wsis/geneva/coverage/statements/opening/annan.html

U.S. Department of Health and Human Services. (2000). Objective 11: Health communication. In Healthy people 2010: Understanding and improving health (2nd ed.). Washington, DC: U.S. Government Printing Office. Retrieved April 4, 2004, from www.healthypeople.gov/document/HTML/Volume1/11HealthCom.htm

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