Libraries as a power of change
Theme: Empowering communities
Combating digital health inequalities in the time
of COVID
Bob Gann
Digital Health Literacy Advisor
Health Education England & CILIP
United Kingdom
@Bob_Gann

When we are online we can…
• Shop for food and essential supplies
• Keep in touch with friends and family
• Work from home
• Take part in online classes
• Apply for benefits and financial support
• Manage our own health
• Access reliable health information

40% of the world is not online
4.5 billion people are
active internet users
4 billion unique mobile
users
But 40% of the world is
not online
Global digital population 2020.
Statista Mozilla Internet Health Report 2019

COVID-19 has exposed the digital divide
Over 87% in developed world are online, 47% in
developing nations, and only 19% in least
developed nations (UNESCO, 2019)

Digital exclusion in the UK
8% of the population are not
online at all
22% of population of the UK do
not have essential digital skills
needed for everyday life
Those who are digitally
excluded are more likely to be
older, lower income, less
educated, homeless, refugees
UK Consumer Digital Index

Age and gender are major determinants of digital
exclusion
In Lebanon nearly all young
people (18-29) use the
internet frequently, but only
half of older people (over 60).
Older people are the major
users of healthcare services.
The Arab World’s Digital Divide Sept 2020
www.arabbarometer.org/2020/09/the-mena-digital-divide/

Age and gender are major determinants of digital
exclusion
Globally, far fewer women
than men are online.
Women are the informal
gatekeepers to family health.
Men are 21% more likely to be online than
women, rising to 52% more likely in the world’s
least developed countries.
(The gender gap in internet access. World Wide
Web Foundation, March 2020)

Why are people digitally excluded?
• Access (including broadband
connectivity & affordability)
• Skills (both basic digital skills
and information literacy)
• Communication (language,
disabilities)
• Lack of interest, trust &
motivation

Three ways to combat digital health
inequalities
1. Fight misinformation through access to high quality
knowledge
2. Improve digital literacy skills
3. Provide accessible and empowering digital
technologies

1. Fight misinformation through access to
high quality knowledge

Health information is increasingly digital
• Over 80% of internet users have searched for health information (Amante, 2015)
• One in seven Google searches are for health information – a billion searches a
day (Google Health Vice President David Feinberg 2019)
• There are over 300,000 health related apps (Pohl, 2017)

Tackling fake news and misinformation

Trusted sources for quality health information
WHO Myth busters
IFLA tips on fake news
UNHCR
information
for refugees

Trusted source: NHS website www.nhs.uk

2. Improve digital literacy skills

Online Centres in UK
• 5000 online centres in local
community settings
• Half of these are libraries
• Provide safe, supported
environments where people can
access technology and learn
digital skills

Public libraries: Universal Health Offer
• Expert staff
• Trusted community
spaces
• Health information
resources
• Signposting
• Creative and social
activities
• Assisted digital
access

Digital skills training
Building basic digital skills & digital health literacy
For citizens… …and for digital champions

Being online, poverty and human rights
“Overall roll out of broadband
Internet in the UK may be high but
many poorer and more vulnerable
households are offline”.
“Digital assistance has been
outsourced to public libraries and
civil society organisations, at a
time when budgets have been
severely cut”.
Philip Alston, UN Special Rapporteur on
Extreme Poverty and Human Rights
2019

3. Provide accessible and empowering
digital technologies
Video consultations, digital assistants, virtual reality

Access to safe remote care
• During COVID most health
consultations done remotely
• Patients spared cost, stress, time,
inconvenience and risk of infection
• Those without technology unable to
take up
• Digital devices provided to care
homes for residents to access
video consultations

Voice activated digital assistants
• People who lack digital skills or have sight
or dexterity problems can use voice
recognition
• Loan schemes for voice activated devices
including Amazon Echo (Alexa) & Google
Home
• Set up spoken reminders for medication,
appointments etc
• Access websites, apps and social
communication
• NHS website content available via Alexa

Virtual reality helping people connect with a positive world
• Digital Heroes programme in
Wales
• Intergenerational mentoring
between schoolchildren & care
home residents
• Reduction in anti-psychotic
medication and falls
• Ambulance call-outs reduced
by 28%
Digital Communities Wales

Libraries combating digital health inequalities
• Distributing digital devices and data SIMS to
those most in need
• Training digital champions in communities via
video conferencing
• Signposting to digital tools and resources
including free online training
• Facilitating adoption of National Health Service
self management tools and apps
• Mapping availability of free public wi-fi
• Digital inclusion toolkit
https://digitalinclusionkit.org/author/leeds-city-council/

Thank you
More information:
Gann, B. (2019) Transforming lives: combating digital health inequality IFLA Journal 45(3):
189-97 https://www.ifla.org/files/assets/hq/publications/ifla-journal/ifla-journal-45-
3_2019.pdf
Davies AR, Honeyman M, Gann B. (2021) Addressing the digital inverse care law in the
time of COVID-19: potential for digital technology to exacerbate or mitigate health
inequalities. Journal of Medical Internet Research 23(3) www.jmir.org/2021/4/e21726
Email: bob.gann@nhs.net
Twitter: Bob_Gann