Disadvantaged but Not Disconnected: Everyone Goes Local

1. Disadvantaged but Not Disconnected: Everyone Goes Local Diana McDuffee, NC AHEC LIS Network Director, Christie Silbajoris, NC Health Info Project Director University of North Carolina at Chapel Hill

3. Program Logic Model Inputs/Assumptions: • Many people are using the web to find health information • Public access to the Internet is readily available throughout North Carolina • Public librarians provide assistance to their users in finding health information on the web • Economically disadvantaged individuals and their intermediaries (caregivers, health professionals) use the Internet to find health information.

4. “ Half of American adults have searched online for health information. Fully 80% of adult Internet users have searched for one of 16 major health topics online. This makes the act of looking for health or medical information the third most popular activity online, after email and researching a product.” Pew Internet & American Life Project, Internet Health Resources Report, July 2003 Many people are using the web to find health information

5. Public access to the Internet is readily available throughout North Carolina Between 2002 and 2004 the proportion of North Carolinians who use the Internet anywhere increased from 65% to 71%. 59% NC homes have computers connected to the Internet. Wilson, Tracking Home Computers and Internet Access in North Carolina 1999-2004, e-NC Authority, 2005

7. Public librarians provide assistance to their users in finding health information on the web • All public libraries in NC have computers available for public access to the Internet • 38% of Internet users report having used the Internet at a public library. (Wilson, e-NC Authority) • The NCLIVE (NC State Library Digital Library) has prominent links to MedlinePlus and NC Health Info along with links to both free and licensed health databases • Survey of public libraries in 2000 indicate that as many as 40% of questions received at the reference desk are health related. (Silbajoris and Hull, Health Sciences Library, UNC-Chapel Hill, 2000)

8. Economically disadvantaged individuals and their intermediaries (caregivers, health professionals) use the Internet to find health information. From the Pew reports: • 20% of Internet users in the Southeast earn less than $30,000 annually • Of the top 16 health topics searched on the web, Health insurance information ranks 7th and Medicaid/Medicare ranks #14th • 38% of Americans with disabilities go online and 87% of this group have searched for a health topic. • 21% of home caregivers have searched for Medicaid/Medicare information online

9. e-NC Authority Surveys • Usage of the Internet in rural areas is greater than the national average. • Lower income respondents report more Internet usage than their national counterparts. • High School dropouts are more likely to use the Internet in North Carolina than in the rest of the nation. Wilson, Tracking Home Computers and Internet Access in North Carolina 1999-2004, e-NC Authority, 2005

10. From NC Health Info data: From a very small sample of NC Health Info survey respondents: • 13.4% public users reported “no health insurance; 3.1% reported Medicaid • 8.8% health professionals reported using site for a patient that is uninsured or Medicaid eligible • Several questions sent to “Ask a Librarian” indicated concern about insurance, cost of service or seeking provider who takes medicare/medicaid

11. Ask Librarian Request I've been told to have a dexascan. The one at my local hospital in Boone costs over $700. Are there any less expensive testing facilities in nearby counties? Thank you.

12. Next Steps • Advocate for disadvantaged • Collect more data • Be Prepared to defend assumptions