TPRC 2024: The 52nd Research Conference on Communications, Information and Inter

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Abstract:
This paper investigates the impact of the Affordable Connectivity Program (ACP)the largest and most successful consumer broadband subsidy program in the U.S.on health outcomes. Using repeated cross-sectional survey data from the National Health Interview Survey (NHIS), four health outcomes are examined in this paper: 1) Use of telehealth services; 2) Looking up health information online; 3) Communication with doctor's office online; and 4) Retrieve test results online. A difference-indifference model is fitted to estimate the impact of ACP on telehealth use, finding no evidence. Logistic regression time fixed effects models were estimated to predict the health outcomes in ACP eligible and ineligible populations. The results indicate that ACP eligible adults have lower odds of using the internet for any of these health-related activities compared to the rest of the population. However, after controlling for demographic characteristics, no evidence of a difference in odds is seen for health information search, communicating with a medical provider, or retrieving test results. Adults with a bachelor's degree, women, those who live in a metro area, or have a higher income to poverty ratio, have higher odds of using the internet for all of these health-related activities. Increase in age, being of Hispanic origin or Black are associated with lower odds. Adults enrolled in Medicaid have higher odds for telehealth and communicating with a provider, but lower odds for health information search.

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Abstract:
The literature utilizes many terms to discuss people in society who are most likely to be at a higher risk of "death, property loss, and injury".[i] These groups of people are referred to as marginalized or vulnerable populations. Historically, vulnerable populations have been disproportionately affected by disasters. Some examples of vulnerable populations include the elderly and people with disabilities.[ii] The most significant challenge at the intersection of vulnerable populations and emergency information is receiving and accessing the messaging.[iii] As a result, emergency communication to the elderly and people with disabilities may be insufficient. Given this reality, with early messaging about COVID-19 focusing on its severity for older populations and those with underlying conditions, did those most vulnerable to COVID-19 receive timely and accessible emergency messaging?
Methods. Modifying an existing measure of the effectiveness and accessibility of emergency communications, we collected data from people with disabilities and older adults about their perceptions of COVID-19 as a threat, how and when respondents first heard of COVID-19, preferences for receiving COVID-19 information, barriers experienced in accessing COVID-19 information; protective actions taken in response to the COVID-19 information received; and demographics. We reported the frequencies of all variables and used Chi-Square tests to measure the statistical significance of relationships between variables.
Results. 77% of respondents indicated they first learned about COVID-19 before March 2020, with many reporting awareness as early as January 2020. While 72% of respondents indicated that they took protective actions based on the information received. Of the respondents who indicated that they did not take protective actions, 67% did not take protective actions (such as masking or quarantining) cited inadequate information as the reason not to act. The barriers to accessing COVID-19 information were the lack of sign language interpreters or poorly placed interpreters (37%), followed by the lack of or poor quality captions (33%), inaccessible websites and digital media (17%), and too complicated information (9%). Respondents <65 years old were 1.65 times more likely to become increasingly concerned with how COVID-19 could affect them compared to their counterparts >65. Respondents >65 years old were 1.81 times more likely to have expressed that they used digital formats than those <65 years old.
Conclusion. In answering the guiding research question, results revealed that the information was timely but not consistently accessible. Making digital media accessible to people with vision disabilities, using captions and interpreters on live and recorded video, is key to ensuring inclusive public health information dissemination. It is critical to evaluate these results with a policy lens to understand the broader implications of inaccessible messaging. The FCC and the Department of Justice have published laws and regulations concerning accessible emergency information. However, as the results show, they are not always heeded. These findings lend themselves to empirically supported regulatory input to advance inclusive practices.