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Sunday, April 11, 2021

Access to telemedicine poses challenge for African Americans

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After DorShann Lewis, a Black working mother in Fishers, had her baby late last year, she relied on virtual visits to see her doctor.

“It was much more convenient,” she said. “I didn’t have to deal with the mask and just the overall fear. And just having the flexibility to be at home and to know that I was safe at home with the kids.”

The COVID-19 pandemic has jump-started telemedicine — remote health care services that take place on a computer or phone.

But many Hoosiers who don’t have a computer, or who lack stable internet access at home, risk being left behind. And new research shows that Black communities are the most likely to lack complete access to telemedicine services.

Data analysis by the research group SAVI at IUPUI shows that more than a quarter of Black Hoosiers do not have a computer or reliable internet service at home.
Analyst Unai Miguel Andres said the disparity is so big that we should pause and think.

“It is important to understand who is benefiting from these services and who is not,” he said of the data compiled for Side Effects Public Media and the Indianapolis Recorder. “And I think looking at this access to a computer, internet … or both can provide a really good lens on who might be left out.”

At the MLK Center, executive director Allison Luthe sees the impact of this connectivity gap.

“Even recently, with all of the rental and utility assistance that’s available, the emergency assistance and even unemployment assistance, you have to be able to do that online,” she said.

But it is not just that. Since the pandemic started, telemedicine services have increased 154% across the U.S., according to the Centers for Disease Control and Prevention (CDC). And Indiana is no exception.

“So, if you look at last year’s numbers, we were lucky to complete about 20 visits a day … and now we complete almost 2,000 visits a day,” said Dr. Michele Saysana, chief medical officer for virtual care at IU Health.

She said a lot of these services can be handled over the phone. But as institutions develop new virtual health options to enhance the quality of care, not having access to the internet could mean that Black Americans will be missing out.

Dr. Patrick McGill, vice president of Community Health Network, agrees. 

“We do see the disparities between race as it comes to access with reliable telephone and internet access …” he said. “Some of our minority patients preferred telephone versus video. And so whether that’s related to comfort, whether that was related to usability of the system, whether that was related to reliable internet access versus telephone access, we haven’t been able to tease those out.”

Community Health Network aims to address this disparity. It asks patients about a range of factors that can influence health, including access to reliable housing, food and transportation. 

McGill said it is adding two new questions: Do you have access to reliable telephone service? Do you have access to reliable internet access or access to reliable internet?
But why does this disparity in internet access — seen in rural areas as well as cities — exist in the first place?

“Rural communities tend to lack adequate access to the technology,” said Roberto Gallardo, director of Purdue University’s Center for Regional Development. In urban areas, it tends to be an issue of affordability.

He said many families can’t afford a home internet subscription as well as a cellular phone data plan. Given that choice, they opt for the phone plan. 

To bridge this gap, Gallardo said the first thing needed is reliable data.

“It’s very hard to get accurate, granular data,” he said. “The federal data set is the closest we have but it is known to overestimate coverage or access. Another big, big dark area that exists is that there is no cost data. We don’t know how much is being charged in certain areas, and for what technologies.” 

The federal government included $7 billion in the second stimulus package to improve internet access. Some internet providers have also offered assistance programs for low-income families during the pandemic. 

Luthe of the MLK Center said these programs are a step in the right direction but are not always as helpful as they sound.

“Even the ones that came out and let folks have a free Wi-Fi hotspot, you had to have no outstanding balance,” she said. “So for some folks, they had an old bill, or a previous bill at a previous address that had to be cleared up before they could get internet access.”

It is like a vicious cycle — with one hurdle leading to another, she said.

This story was reported as part of a partnership between WFYI, Side Effects Public Media and the Indianapolis Recorder. Contact Farah Yousry at fyousry@wfyi.org or 857-285-0449. Follow her on Twitter @Farah_Yoursrym.

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