MODULE 7

The impact of social inequality on internet access and use; The role
of internet in perpetuating social inequality and the digital divide-
what it is and how can it be bridged?
The relationship between technology and work has long been of
interest to sociologists. The current information technology revolution
has renewed this debate again. As industrialization has progressed,
technology has assumed an ever greater role in the workplace- from
factory automation to the computerization of office work.
The spread of information technology is already influencing
education in schools. The knowledge economy demands a computer
literate workforce and it is increasingly clear that education will play
a major role in meeting this need.

 Although the number of students with regular access to a computer

is rising, the picture is quite uneven, even across the relatively
wealthy countries of OECD.
 An OECD1 Study undertaken in 2003, assessed the educational
performance of 15 year old students and found that regular
computer use led to better scores, especially in mathematics. So
students who had used computer for several years scored higher
than students who used it for relatively shorter time. They provide
a chance to the children to work independently, to research topics
with the help of online resources and to benefit from educational
software that allows them to progress at their own pace. Pupils can
use computers to complete tasks within the standard curriculum,
such a producing a research project or investigating current events.
Almost 3 out of 4 students in the OECD countries frequently used
1
The Organisation for Economic Co-operation and Development
 a computer at home, but only 44% did so at school.
 According to social scientists, these data would be seen as evidence
of the growing divide between IT-rich and IT-poor households. If
schools do not provide better access to computing, then the social
class divide in education looks likely to become wider. Internet
access has already become the new line of demarcation between
the rich and the poor.
 Important questions to be asked: Are the teachers who teach in
neighbourhood schools able to successfully integrate the new
information technologies into lesions in a way that is meaningful
and educationally sound?
The internet now appears to be transforming education in an even
more profound way than television did. IT enthusiasts claim that
computers need not result in greater national and global
inequalities as their main strength lies in their ability to draw
people together and to open up new opportunities.
Schools in Asia and Africa that are lacking textbooks and qualified
teachers can benefit from the internet they claim. Distance learning
programmes and collaboration with colleagues overseas could be
the key to overcoming poverty and disadvantage . Take for instance
- This approach was pioneered by the University of Phoenix in the
United States. It is the second most accredited university in the
USA. It has 420,000 students enrolled at the university, who meet
and interact predominantly across the internet. It has around 40 e-
campuses. It is entirely online. It makes the actual geographical
location and the physical classrooms as well as the teachers
become insignificant. The students can also access the electronic
classroom at any point of time.
 Life learning is very important in order to cope with the new
challenges of life in the information age. People should be able to
pick up necessary IT skills to take advantage of the technological
sweep in the societies.
 Yet others already fear the emergence of a “computer underclass”
within western societies. As the global economy becomes
increasingly knowledge based, there is a real danger that poorer.
Similarly in the developed countries, the digital communications
industry is facilitating unprecedented levels of global internet use,
online social interaction, and financial inclusion.
LESSENING THE DIGITAL DIVIDE
AGE NO BAR

 The global playing field for the digital communications industry

has changed significantly over the years, due to advancing
digitalization. We have moved well beyond the time when the
focus for regulators was simply on the competitive dynamic
between individual telecommunications industry players. Now,
regulators must understand and assess a complicated landscape
populated by both ageing incumbents and the younger, digitally-
focused players interacting with the industry and providing
unprecedented access to an array of services.

 About 71% of the world’s population will have a mobile phone

subscription by 2025, according to a report published in 2018 by
the trade group GSMA, and nearly 1.8 billion people will begin
using the mobile internet over the next eight years. The explosive
growth of social media use, together with the advent of new smart
devices, is exponentially increasing demand for wireless data. A
fundamental resource needed to meet this demand is spectrum -
which is relatively scarce, and subject to the significant influence
of policy-makers. In 2017, mobile spectrum auctions raised about
$25 billion in funding for the public sector, according to the
GSMA report.

 Conventional spectrum management strategies are based on so-

called static allocation, where spectrum is licensed in discrete
portions according to a radio standard. In recent years,
developments in digital signal processing and semiconductor
technologies, and the advent of artificial intelligence-based
 networks, have led to more agile, cooperative, and cognitive
wireless platforms. The trade-offs involved in deploying these
innovations must be carefully evaluated, and novel, dynamic
spectrum allocation policies - which enable the ad-hoc utilization
of spectrum, rather than letting it sit unused in rigid structures -
must be formulated in order to unlock their potential. As standards
evolve, they should also better accommodate the changing
technological landscape - in order to eliminate the fragmentation of
development, and to help to reduce capacity bottlenecks.

 Policy-makers must incentivize incumbent telecom industry

stakeholders, to enable the faster adoption of new technologies.
Regulators need to tread carefully, however, in order to ensure fair
play among service providers. The ultimate performance indicator
is sustainability; policy-makers should play a proactive role in
promoting energy-efficient, sustainable technologies so that
industry transformation can have a positive impact on society.

UNEQUAL ACCESS

 More than half of the world’s population does not have access to
the internet. The use of digital technologies is at an all-time high,
and adoption of the so-called internet of things (IoT) will lead to
billions of additional devices being connected to the internet.
However, digital access remains unequally distributed. While
some people enjoy broadband speeds of 1 Gigabit per second and
are gearing up for the next wave of connected devices, more than
half the world’s population of roughly 7.6 billion does not have
access to the internet. According to a 2016 World Economic
Forum white paper, Internet for All: A Framework for Accelerating
Internet Access and Adoption, 15% the global population was
living without electricity, and 31% lived outside of coverage areas
with 3G mobile connectivity or better (mobile is the main means
of internet connectivity for most people). There are concerns
about the growing divide both within and among countries with
respect to reaping the benefits of information and communication
technology, particularly in respect to those living in remote rural
 areas. While full economic and social benefits do not always reach
all members of society, in particular groups such as women and
disabled people, better addressing internet access and adoption
calls for coordinated efforts focused on infrastructure,
affordability, education and content creation.

 Poverty is another fundamental, related issue. The Forum’s white

paper reported that affordability remains a major constraint for
many people not using the web, including not just the nearly 13%
of the world’s population living below the international poverty
line, but also billions of others with limited economic means. Only
29 countries enjoyed affordable broadband for 100% of their
population, according to the white paper. Basic literacy is also still
a problem in many countries. The white paper noted that 15% of
adults worldwide were considered illiterate.

UNEQUAL ACCESS

 More than half of the world’s population does not have access to
the internet. The use of digital technologies is at an all-time high,
and adoption of the so-called internet of things (IoT) will lead to
billions of additional devices being connected to the internet.
However, digital access remains unequally distributed. While
some people enjoy broadband speeds of 1 Gigabit per second and
are gearing up for the next wave of connected devices, more than
half the world’s population of roughly 7.6 billion does not have
access to the internet. According to a 2016 World Economic
Forum white paper, Internet for All: A Framework for Accelerating
Internet Access and Adoption, 15% the global population was
living without electricity, and 31% lived outside of coverage areas
with 3G mobile connectivity or better (mobile is the main means
of internet connectivity for most people). There are concerns
about the growing divide both within and among countries with
respect to reaping the benefits of information and communication
technology, particularly in respect to those living in remote rural
areas. While full economic and social benefits do not always reach
all members of society, in particular groups such as women and
 disabled people, better addressing internet access and adoption
calls for coordinated efforts focused on infrastructure,
affordability, education and content creation.

 Poverty is another fundamental, related issue. The Forum’s white

paper reported that affordability remains a major constraint for
many people not using the web, including not just the nearly 13%
of the world’s population living below the international poverty
line, but also billions of others with limited economic means. Only
29 countries enjoyed affordable broadband for 100% of their
population, according to the white paper. Basic literacy is also still
a problem in many countries. The white paper noted that 15% of
adults worldwide were considered illiterate.

 Cultural differences can also account for differing levels of content

adoption; there is a need for localized, relevant and understandable
content, in order to attract users and serve local needs. According
to the Forum’s white paper, about 80% of online content is only
available in one of 10 languages, while only about 3 billion people
speak one of those 10 languages as their first. Greater internet
coverage also has the potential benefit of enabling applications for
the internet of things that could address problems in developing
countries, such as those related to traffic congestion, food hygiene
and disaster prevention.

 The global financial system should be enabling access to high-

quality, affordable products and services that protect customers
from risk, enable adequate savings and investment, and support the
creation of jobs. The health of the system is critical for long-term
economic growth and development; however, the financial crisis of
2008 and ensuing downturn revealed a number of vulnerabilities,
severely diminished public trust, and impinged on the ability to
deliver value. Developing a better understanding of the
implications of innovation, and of the potential benefits and impact
of new regulation, will be necessary to enable the system to realize
its full potential.
 The Organisation for Economic Co-operation and Development
 (OECD) reported in 2016 that a 20th century bias for skilled, rather
than unskilled human workers has evolved into a complete
replacement of workers with computers.  The OECD pointed out
that even mid-level jobs that require some skill tend to be
routine-based, and thus potentially automated. This deletion of
mid-level jobs, combined with an expansion of low-skilled service
positions, and heightened demand for high-skilled workers, is
leading to increased social polarization.
 According to a 2016 report from the International Labour
Organization, 200 million people were unemployed globally at
that time and more than 300 million additional jobs were needed
by 2020 in order to provide a livelihood for the next generation of
workers.
  In a 2013 paper, Carl Benedikt Frey and Michael Osborne of the
University of Oxford estimated that in the course of the next
decade or two, nearly half of all occupations may be affected by
automation and technology. New approaches to job creation and
skills development, in both the private and public sectors, are
therefore urgently needed.
 The Internet of Things, or IoT, differs from conventional
technology in that it benefits from convergence and
generalization, rather than deep, soloed specialization. IoT’s best
practitioners leverage convergence to drive innovation, creating
opportunities at the intersection of existing industries and
technologies.    IoT draws upon engineering, business, and social
sciences. Meanwhile it builds on technologies like radio design,
computer science, cryptography and machine learning, in order to
support applications ranging from automotive diagnostics and
infrastructure monitoring, to wearable devices. When it comes to
the social sciences, IoT can change how people value and perceive
personal data and privacy.   To master this evolving vocabulary and
become a competitive force in IoT, companies must tap into
 knowledge from related areas in order to cultivate a new type of
innovation. IoT is not about re-imagining a known discipline, it’s
about using existing disciplines as a set of building blocks to create
something bigger.
 The technological disruption of labour markets creates challenges
and opportunities for a wide variety of people
 The vast number of educated, motivated people who are
nonetheless unemployed, underemployed, or stuck in low-quality
employment highlights the need for better ways of connecting
talent to economic opportunity. Though it may depend on the
specific challenges shaping a particular labour market, related
efforts should generally involve enabling people from a variety of
circumstances and backgrounds to gain access to better
professional networks. Young people in particular could benefit
from new digital platforms, which can enable connections and help
unlock greater potential for accessing talent.
DIGITALISATION = WIDENED GENDER GAP
 The World Economic Forum’s 2018 edition of its Future of
Jobs report highlighted the need to effectively manage the
transformation of work, as new technologies re-configure work and
replace workers entirely. At the same time, it is essential to make
the opportunities that continue to exist to obtain increasingly in-
demand jobs in high-skilled, technology-intensive fields accessible
based purely on merit - regardless of age, gender, or origin.
 The Forum’s 2017 Global Gender Gap Report revealed the degree
to which gender-polarized educational specialization is fuelling
industry-level gender imbalances. The gender gap in science,
technology, engineering and mathematics (STEM) education
remains wide, for example. STEM-related fields include
engineering, manufacturing and Construction (EMC), and
information and communication technology (ICT). According to
the 2017 Global Gender Gap Report, globally, 19% of male
university graduates pursue EMC degrees, and 7% pursue ICT
degrees. By way of contrast, only 6% of female graduates pursue
EMC degrees, and 3% study ICT. It is critical that as they examine
the scale of STEM gender gaps, decision-makers pay close
 attention to where these gaps are situated; currently, efforts to close
the gender gap in terms of software skills is not matched by
equivalent attention to women’s unequal participation in EMC-
related specialization, for example. This imbalance undercuts the
ability of employers to include women on an equal footing when
recruiting in tech-specialized fields.
 Still, there is more to addressing inclusion than simply reforming
education; research has shown that qualified women often exit
technology industries because they have concerns about the
workplace environment. Other analyses have highlighted a lack of
ethnic diversity and ageism prevalent in some of today’s most
lucrative and fast-growing industries. In 2016, for example, a judge
conditionally certified a class action lawsuit against Google
alleging that it declined to hire qualified job candidates because
they were too old. 
 Industries could benefit from a better gender balance among employees,
including among senior leaders. As the Fourth Industrial
Revolution takes hold, it will affect female and male workers in
distinct ways. Adequately preparing to adapt to related, disruptive
changes will include tackling gender gaps - which could in turn
unlock new growth opportunities for companies. Household work,
for example, could be further automated, and relieve some of the
current dual burden for working women. Changes to what have
traditionally been men’s roles are also likely to reshape the division
of labour at home, and a more holistic approach could be taken to
workforce planning. Harnessed in the right way, new, more
 flexible work patterns and other trends could in theory, result in a
more gender-balanced workplace.
 However, there is a real risk that disruptive change impacting
business models, and generating a labour market where jobs are
being displaced, could actually worsen existing gender
inequalities.

Internet use is driving a greater wedge in our communities,

increasing existing inequalities between rich and poor, a new study
reveals.
Internet use is driving a greater wedge in our communities, increasing existing inequalities
between rich and poor, a new study reveals.

The study, by Dr Ellen Helsper from the London School of Economics and Political Science
(LSE) and Dutch researcher Dr Alexander van Deursen, shows that educated people on high
incomes derive the greatest benefits from using the internet.

This is borne out by their ability to get better deals online, including products and holidays, use
the internet more successfully to expand their social life and find romantic partners, and also
become more informed politically and in general.In contrast, low-income people from socially
deprived backgrounds do not receive the same benefits, regardless of access and internet skills.

Dr Ellen Helsper says that gender doesn't influence who benefits most online, but occupation
does.

The study of more than 1100 people was conducted in The Netherlands, a country with a well-
developed digital infrastructure and near-universal access.Its findings have been published in
the Communication and Information Technologies Annual and form part of an LSE project on
digital inclusion.The researchers looked at different socio-economic groups and how their use
of the internet impacted on their economic and social wellbeing, as well educational, political
and institutional outcomes.

Overall, 75 per cent of those surveyed said the internet enabled them to buy cheaper products,
68 per cent said they traded goods via the internet and 62 per cent used it to book more
affordable holidays. The benefits were weighted in favour of those with a higher social status.

Disabled people, along with retired and unemployed individuals and care givers, receive the
fewest benefits overall by being online.

Men, particularly those aged 16-35, are more likely to find partners through online dating than
women, the study showed, and people in urban areas also benefited more than those living in
rural locations.j
At every level, our global narrative is increasingly coloured by self-
interest. More and more states are seeking to withdraw from
international agreements, for example. Businesses are investing in
new technology to move forward and drive growth, but are not always
as enthusiastic when it comes to bringing their people along for the
ride.

And as individuals, we often chase our dreams without giving enough

thought to building more sustainable and inclusive economies and
societies as we do so. This gradual erosion of our shared obligation to
progress more equitably is creating a deeply divided world. But it
doesn’t have to be like this: we can create shared prosperity through a
wholehearted embrace of digital technology.

Perhaps this seems debatable. After all, the role of technology in

increasing general inequality has been the subject of heated
discussions in recent times. And yet it’s undeniable that this very
technology also enhances peoples’ access to every key enabler of
economic opportunity – be it information, learning, or finance. But
it’s not for technology to determine the destiny it will shape. It is,
after all, nothing more than a tool we have created. As such, we can
choose the future our tool will craft for us. It’s up to us to make the
choices now that will let technology unify, equalise and empower us
all in the days to come.

There is still a long way to go before our planet is truly connected

Central to this belief is the immense potential for progress that lies in
connecting more and more people through the internet and access to
technology. Like the Sub-Saharan farmers who are now able to
manage risks and significantly increase their yield because they can
access reliable and timely weather forecasts, for example, or Latin
America’s hitherto unbanked population that can now prove their
creditworthiness using data gathered from their use of telecom
services. Or rural artisans from India who are today able to compete
in the global fashion market thanks to digital supply chain
innovations. How many farmers are able to avail the digital platform
in such a way?

The big hurdle now is scaling up these success stories. We must bring
online the 52% of the world’s population who are not yet connected
to the internet. We must bridge the massive disparities in internet
connection speeds globally. Men still outnumber women as web users
in every part of the world - this must change, too. And it can, if there
is a concerted effort on the part of global corporations, governments,
civil society and investors to bring online the forgotten half of our
world. A significant first step would be to categorise the internet as
infrastructure as basic as roads, sewage, water and electric systems.

The biggest advantage of this digital unification will come when we

all learn to create and produce using technology, rather than merely
consume it. I don’t mean simply training our workforce of today,
although they will obviously benefit from this essential career skill. I
am particularly keen that we begin earlier; that we teach our children
to code. Digital has become the language of our world. In the future,
not knowing the language of computers will be as debilitating as
illiteracy. If we can bring this ‘superpower’ to everybody across the
global, economic, social, professional, gender and age divides, then i
believe it has the potential to become the great equaliser of our
humanity and the amplifier of our potential.

While digital skills can amplify individual potential in an equitable

way, the creation of and participation in vibrant digital ecosystems
can play a huge role in empowering us as a globe. One recent
example is the Government of India’s Aadhaar online identity
verification system, which, despite some early teething troubles, today
rivals Facebook in its usage by Indians. Scaled to include over one
billion people, Aadhaar allows governments, businesses, startups and
developers to use a brand new digital infrastructure to solve some of
the country’s hardest problems through paperless, cashless and even
presence-less service delivery.

But what can be done to reduce digital inequalities? To tackle digital

inequalities it is not enough just to offer cheaper and faster physical
access to the internet. This will definitely reduce the gap between
those who connect and those who do not, but it does not automatically
translate into improved engagement with digital technologies. Digital
inclusion is also about having the right access, skills, trust and
motivation to go online with confidence. Moreover, digital inclusion
means the capacity to use ICTs in ways that promote inclusion and
well-being to fully participate in digital society, in particular in areas
such as education, public safety, and public health.

For this reason, there are numerous digital inclusion initiatives across

the country. However, much more could be done to tackle digital
inequalities, since unequal access and use of ICTs can create new
forms of social segregation, while also compounding existing forms
of inequality and injustice. Promoting digital skills and digital literacy
programmes have been shown to yield positive effects on
employability, social inclusion and well-being.
Digital Inequality and Low-Income Households

 Research on digital inequality has shifted toward

frameworks that consider multiple dimensions and levels,
including social supports and other neighborhood-level
factors.
 Low-income households have lower rates of in-home
Internet connectivity compared with higher-income groups.
Connectivity rates are particularly low among HUD-assisted
renter households, who are also more likely to depend
exclusively on smartphones and other handheld devices to
access the Internet in the home.
 Low-income households are most likely to cite affordability
constraints as a substantial barrier to in-home broadband
adoption. Eighty percent of respondents to the 2015–2016
ConnectHome baseline survey who lacked Internet access at
 home cited Internet costs as one reason they lacked in-home
Internet access, and 37 percent cited device costs.
 As information, services, and resources increasingly move
online, digital inequality has come to both reflect and
contribute to other persistent forms of social inequality.
Disparate access to the Internet and digital devices
corresponds closely with longstanding inequalities in
income, education, race and ethnicity, age, immigration
status, and geography (see “Community Development and
the Digital Divide") At the same time, the negative
consequences of being underconnected are growing,
and researchers and policymakers are increasingly concerned
that underconnection is fueling other socioeconomic
disparities.3 Indeed, Internet access, and particularly
broadband Internet access, has become an important tool for
taking full advantage of opportunities in education,
employment, health, social services, and the production and
dissemination of knowledge and digital content. Yet those
who are most in need of social services are often least able to
get online to access those services, and low-income children
— who are four times less likely to have access to
broadband at home than their middle- and upper-income
counterparts6 — are particularly vulnerable to the long-term
detrimental effects of constrained access to technology-
enriched education. These trends suggest that digital access
will play an increasingly central role in socioeconomic
inclusion.
 Building on the idea that digital inclusion is an
important part of broader efforts to create strong,
inclusive communities and improve opportunities
and quality of life for all Americans, we can look at a
series of frameworks, points of reference, and data
for developing strategies to address current
relationships between low-income housing and
digital inequality.

Digital Inequality Frameworks

 Dominant approaches to thinking about and measuring digital
inequality have evolved since the commercialization of the
Internet in the mid-1990s. Early concerns about digital inclusion
 highlighted a “digital divide” between those who did and did not
have access to new forms of information technology. Studies
rooted in this framework sought to identify gaps in access to the
Internet and computers by income, geography, age, education,
and other types of inequality, both within and between
countries. As digital penetration in the United States has
increased, however — growing from 1 in 4 U.S. families having
Internet service at home around 2000 to nearly 3 in 4 by 2012
— additional relevant dimensions of digital inequality have
emerged. Although the presence or absence of Internet access
remains an important dimension of digital inequality, the
concept of a binary digital divide, which highlights absolute
inequalities between the included and excluded, does not
account for the fact that many technological inequalities are
relative, continually shifting as new technologies emerge. As a
result, the concept of digital inequality has evolved in two key
directions over recent years to focus on the complex ways in
which digital access varies.
 Multidimensional Digital Inequality. One key way in which
digital inequality frameworks shifted was by focusing on the
multiple dimensions of digital inequality, highlighting how
access to, and the use of, digital technologies varies even among
people with formal access to the Internet. This multidimensional
approach draws attention to five key aspects of digital
inequality, each of which shapes Internet use as well as returns
to use.13
 First, multidimensional approaches to digital inequality focus on
variations in equipment, or the technology people use to access
the Internet. This aspect of digital inequality includes the extent
to which households have computers, software, and connections
that allow them to effectively engage with online content. The
advent of always-on broadband connections has given rise to
qualitatively different kinds of Internet use that involve more
time online, a greater variety of activities, and the creation of
new content. Similarly, smart phones and desktop and laptop
computers offer different kinds of mobility and ease in
accessing educational, employment, health, and social service
 opportunities. As a result, procuring household access to
Internet connections with acceptable speed and reliability, as
well as to devices capable of handling a variety of computing
activity, is an important component of addressing digital
inequality.
 Multidimensional approaches also emphasize variations in the
autonomy of Internet use. Autonomy includes whether users
access the Internet from work or home, whether their use is
monitored, their frequency of use, whether they must compete
with others for time and access, and the extent to which their use
is circumscribed by filters or other constraints. Attention to how
autonomy shapes digital experiences underscores the relevance
of in-home Internet access; the heightened control over the
environment and usage frequency associated with in-home
access tends to provide the greatest opportunities for learning,
increasing earnings, and participating in the production of
digital content. Having Internet at home also allows families to
access Internet from a private — and therefore safe — space,
particularly in contexts where safety is a concern.
 Multidimensional perspectives of digital inequality also address
variations in the level of skill that people bring to their Internet
use. Skill encompasses users’ digital literacy, “their capacity to
respond pragmatically and intuitively to online challenges and
opportunities,” and their ability to master new technologies and
mobilize information resources to meet everyday goals and
concerns. Those with higher levels of digital skill typically
incorporate more technology into their learning, exhibit more
confidence in online engagements, are less hesitant about
finding trusted information online, and are better able to take
advantage of emerging technologies. Studies have suggested
that inequalities in skill levels are larger than inequalities in
physical access to the Internet, that skill gaps have grown even
as gaps in physical access have closed, and that most
newcomers to the Internet would need assistance to go online.
 Variation in the level of social support on which Internet users
can draw constitutes a fourth dimension of digital inequality.
Such support can include formal technical assistance, technical
 assistance from friends and family, and emotional reinforcement
from friends and family. This dimension involves fostering
institutional and social networks that can support effective
digital connectivity.
 Finally, a multidimensional perspective emphasizes variations in
the purposes for which people use technology. This dimension
involves the ways in which people use the Internet to increase
their economic productivity and their political and social capital.
This realm can also include inequalities in the creation of digital
content; although the Internet has the potential to be an
egalitarian public sphere, differences in control over digital tools
and usage of online information can contribute to digital
production gaps.
 Multilevel Digital Inequalities. In addition to highlighting
multiple dimensions of digital inequality, digital inequality
frameworks have also paid increasing attention to how social
dynamics at different levels of society influence Internet access
and use. This multilevel perspective builds on earlier digital
inequality literature that focused on individual-level
characteristics, behaviours, and outcomes, to also consider how
family, community, neighbourhood, and network factors
contribute to digital inequalities. Studies of the influence of
local environments on people’s willingness to adopt the Internet
and related technologies have highlighted two key approaches to
thinking about the multi-level dynamics of digital inequality.

1 Does not include those who use the Internet without a paid
subscription. High-speed Internet indicates that a household has
Internet service other than dial-up.
2 It includes households that own or use a desktop, laptop,
netbook, or notebook computer at theirhome.
3 It includes households that own or use only a handheld
computer, smart mobile phone, or other handheld wireless
computer at their home.
 4.The first approach focuses on place-based influences,
including neighbourhood level effects on digital access and the
roles that communities play in shaping digital behaviours.
 5. Local digital and social infrastructures can influence how
 residents engage with digital resources, including through
affecting: the local cost, speed, and availability of Internet
connectivity and devices; the available opportunities for training
and support that facilitate meaningful digital connectivity; and
the involvement of community partners and digital-inclusion
organizations as part of broader citywide and regional digital
initiatives.
 6. Spaces such as libraries and community organizations can
provide access to in-person support, classes and workshops, and
social contexts that encourage the development of hands-on
digital skills.
 7. Factors such as segregation and concentrated poverty can also
create disparities in Internet access and use even in areas where
broadband networks are available.
 Ultimately, examining these place-based influences can help
clarify the ways in which community-based organizations and
support structures help people gain meaningful access to
technology.
 A second approach to thinking about multilevel digital
inequality focuses on the effects of social networks on digital
access. This approach emphasizes the role that human-to-human
interactions play in shaping digital adoption, situating
broadband use within broader communications networks and
social resources.35 The social networks framework suggests that
people’s social relationships influence the value they place on
Internet adoption. For example, the price that people are willing
to pay for Internet access tends to rise as more people in one’s
social network start using it. These dynamics, particularly within
networks consisting of people of similar status, can increase
inequality by significantly reducing adoption rates in less
privileged groups. The concept of network dynamics encourages
new thinking about how coordinated efforts to bring social
networks online might foster heightened digital engagement
among disadvantaged populations over time.
 In short, research on digital inequalities has shifted over the past
several decades from frameworks focused on capturing
inequalities between the connected and unconnected to more
 nuanced frameworks that consider digital inequalities along
multiple dimensions and at multiple levels of society. These new
frameworks call for strategies that address multiple aspects of
digital inequality, including affordable devices and broadband
access, digital literacy training, and publicly accessible
computing centres with helpful staff and support.
 Digital Inequality and Low-Income Housing Trends
 HUD-assisted households include populations that tend to face
digital disadvantages, such as families earning less than $25,000
per year, individuals without a high school degree, and
minorities. HUD-assisted housing also serves both urban and
rural populations; school-aged youth and the elderly; people
with disabilities; and households facing a range of institutional,
organizational, and social contexts. Although assisted housing
providers are well positioned to address many of the central
challenges that shape digital inequality today, relatively little
research has examined specific associations between low-
income housing and Internet access. This section reviews recent
data detailing the relationship between low-income housing and
digital inequality.
 Internet Connectivity Trends: One dimension of digital
inequality focuses on Internet connectivity, defined here as in-
home adoption of high-speed Internet. Connectivity disparities
— by both income and geography — align in important ways
with low-income housing patterns.
 Household income is strongly associated with in-home Internet
connectivity levels, with low-income households being less
connected than higher-income households. Although 67 percent
of all U.S. adults aged 18 and older had broadband Internet
access at home in 2015, this rate was 41 percent among adults
with a household income below $20,000 and 90 percent among
adults with a household income of more than $100,000.
Evidence also suggests that the gap between low- and high-
income households with a broadband connection at home may
have increased slightly in recent years; while the rate of
households with at-home broadband who earn less than $20,000
per year dropped by 5 percent (from 46% to 41%) between 2013
 and 2015, the rate for households earning more than $100,000
dropped by only 3 percent (from 93% to 90%) during the same
period. As a result, modest declines in broadband adoption from
2013 to 2015 were concentrated among low- to middle-income
households. Highlighting the relevance of income for digital
inequality, even after accounting for age, a 90-year-old in the
top quartile of income was more likely to have an in-home
Internet connection in 2013 than a person of any age in the
bottom quartile of the income distribution.
 Place-based characteristics are also associated with disparities in
rates of in-home Internet connectivity. Broadband continues to
be less available in rural areas than in urban areas, particularly at
higher speeds. Although most areas have Internet service at
speeds of at least 10 Mbps today, and almost all areas offer dial-
up Internet access, the presence of infrastructure capable of
supporting broadband speeds of more than 25 Mbps, including
fiber-optic technology, is still divided along urban/ rural lines.
Many rural areas have only one Internet service provider, and
some rural areas have access to only satellite and cellular
modem service or have no broadband availability at all. Other
place-based dynamics complicate the urban/rural divide;
broadband availability is associated not only with population
density but with a community’s proximity to a major urban area.
As a result, small-town residents tend to have less broadband
availability than ex-urbanites despite living in much more
densely populated areas. At the same time, disparities in urban
and rural broadband access are less severe than they once were;
recent investments in broadband infrastructure have made fast
4G wireless broadband available to more than 98 percent of
Americans.

Although broadband availability may be higher than before,
evidence of disparities in place-based broadband adoption
persists, and broad urban/rural divides are less instructive in
understanding these dynamics. Substantial variation in adoption
rates, Internet quality, and connection speeds exists within cities
and is correlated with household income. Examples from several
cities suggest that income can be more important than
 population density in explaining Internet adoption rates in
certain areas. An analysis of Chicago found that neighbourhood-
level factors such as segregation and concentrated poverty
influenced access to in-home Internet connections, and
qualitative work has suggested that Internet adoption may be
more limited for residents of low-income urban areas: Internet
service providers may not offer strong coverage of some low-
income housing areas or may charge high installation fees to
initiate service in unserved buildings or neighborhoods.Figure 1
draws on 2013 American Community Survey (ACS) data to
show how home high-speed Internet service in the United States
varies by household income.
 Examining merged 2014 ACS and HUD administrative data
offers insight into the relationship between housing and in-home
Internet access. These data indicate that connectivity rates
among HUD-assisted households are very low; only 43 percent
of HUD-assisted renters subscribed to high-speed Internet
service at home compared with 69 percent of unassisted renters
and 80 percent of owners (table 1). The connectivity rate for
HUD-assisted renters is even lower than the rate for all U.S.
households earning less than $25,000 per year (43% and 47%,
respectively), a finding that suggests that HUD-assisted renters
are among the nation’s most disconnected households.
 Another source of insight into connectivity in low-income
housing is baseline survey data from the ConnectHome pilot
program, HUD’s initiative to extend affordable broadband
access, technical training, digital literacy programs, and devices
to HUD-assisted households in 28 ConnectHome pilot
communities across the nation. The survey collected data on in-
home Internet access in 22 of these communities in 2015 and
2016. These data include information about levels of Internet
access, the types of Internet connections available, the types of
devices used to connect to the Internet, the reasons for any lack
of Internet access, the existence of previous Internet access,
awareness of the ConnectHome program, and the receipt of free
or low-cost Internet through ConnectHome. These data found
that 34 percent of surveyed households have a high-speed
 Internet subscription in addition to a desktop computer, laptop
computer, or tablet at home. Another 35 percent of surveyed
households are underconnected; these households may have
access to the Internet only through a smartphone device and
with a smartphone data plan, or they may rely on another
combination of devices and connection types, such as a tablet
with a data plan only, or a high-speed Internet connection with
only a smartphone device. Finally, 31 percent of households
have no Internet access at home.
 Device Trends. Another dimension of digital inequality focuses
on access to Internet-enabled devices at home, as households
can only take full advantage of Internet access if they have
devices that enable them to effectively connect to the Internet
and its content. Although desktop and laptop computers offer
households important access to tools, information, and skill-
building opportunities, they can be prohibitively expensive for
many families. On the other hand, smartphones offer advantages
such as mobile connectivity, but being limited to smartphone-
only Internet access is associated with data cap limits, risk of
service cancellations or suspensions due to financial constraints,
and difficulty performing essential tasks such as applying for
jobs or writing papers on a smartphone’s small screen.
 Device access is a substantial barrier to in-home Internet use for
many low-income households. People from higher-income
households are more likely to own a computer than those from
lower-income households. At the same time, a much higher
percentage of lower-income households rely solely on
smartphones for Internet access compared with more affluent
households (fig. 2). In 2015, 21 percent of adults with an annual
household income below $20,000 had a smartphone but no
broadband at home, compared with 6 percent of adults with a
household income above $100,000. Evidence also suggests that
the gap between low- and high-income households with
smartphone-only access may have increased slightly in recent
years; between 2013 and 2015, the percentage of adults with
smartphone only access in households with annual incomes
below $20,000 increased from 13 percent to 21 percent, while
 the percentage of adults with smartphone only access in
households with incomes above $100,000 grew only from 4
percent to 6 percent.
 Device ownership also presents a substantial barrier to in-home
Internet use for HUD-assisted households (table 1). Only 44
percent of HUD-assisted renters own a desktop, laptop, netbook,
or notebook computer.61 This rate is much lower than the
national average of more than 78 percent and lower than even
the 54 percent of households earning less than $25,000 per year
that own a desktop, laptop, netbook, or notebook computer.
Among HUD-assisted renters, computer access is particularly
limited for public housing and multifamily households, with
only 36 percent of HUD-assisted multifamily households
owning a desktop, laptop, netbook, or notebook computer.
HUD-assisted households are also more likely to be
smartphone-only users; 14.1 percent of HUD-assisted
households access the Internet only through smartphones or
other handheld computers compared to 6.5 percent of total U.S.
households. High rates of dependence on smartphones are found
across voucher, public housing, and multifamily households.
Together, these trends further suggest that HUD-assisted renters
are among the most disconnected households in the country.
 Data from the 2015–2016 ConnectHome baseline survey
indicate that, of the 69 percent of HUD-assisted ConnectHome
households with some Internet access in the home (including by
smartphone), only 65 percent have a desktop or laptop computer
or a tablet in their home, meaning that 35 percent of the
ConnectHome households that have some Internet access in the
home lack access to a device that can fully take advantage of
connectivity. At the same time, about three-quarters of HUD-
assisted ConnectHome households with some Internet access at
home use a smartphone to access the Internet.
 Barriers to Obtaining Home Broadband Internet Service.
According to a 2015 Pew Research Center survey, 43 percent of
all U.S. adults age 18 and older cited cost as the most important
reason for not having home broadband service; 33 percent cited
the monthly subscription cost as the main barrier, and 10 percent
 stated that a computer was too expensive. Additionally, 12
percent of nonadopters stated that their smartphone was
sufficient, 10 percent responded that they had other options to
get online outside the home, and 5 percent stated that Internet
service was either unavailable or insufficient. Other studies of
households without home broadband access have cited similar
rationales, including lack of relevance, usability obstacles,
limited availability, device access, and price.
 The population of non-adopters can be categorized into two
groups: those who do not use the Internet at all and those who
use the Internet away from home; in 2013, these groups
consisted of 15 percent and 9 percent of U.S. adults,
respectively. Among those who do not use Internet at all, only
19 percent cited device or Internet connection cost as the reason.
However, among those who use the Internet away from home —
a population that tends, on average, to earn lower incomes — 44
percent cited financial reasons as the main limiting factor.
 Non-adopters can also be classified into two additional groups:
never-adopters, who have never had in-home Internet access,
and unadopters, who once had in-home Internet access but no
longer do. In 2013, unadopters accounted for 12 percent of all
non-adopting households and were significantly more likely
than their never-adopter counterparts to cite cost, the availability
of Internet access outside the home, and computer shortcomings
as reasons for discontinuing service. In the end, price sensitivity
is “most prominent among those who have had service in the
past, and/or are interested in getting it in the future.”
 Perhaps unsurprisingly, those with the lowest incomes are most
likely to cite cost as the main barrier to having broadband access
at home. A series of studies shows that low-income households
tend to recognize the value and relevance of connectivity, and
their ability to pay, rather than their willingness to pay, is the
main reason for not having home broadband service. Among
this population, affordability barriers include not only monthly
subscription costs but also devices and hidden fees; access to
low-cost computers was often just as important to these
households as access to low-cost Internet options.
 Cost is also a substantial connectivity obstacle for HUD-assisted
households that do not have in-home Internet access. Eighty
percent of respondents to the 2015–2016 ConnectHome baseline
survey who lacked Internet access at home cited Internet costs
as one reason they lacked in-home Internet access, and 37
percent cited device costs. Other reasons cited for lacking in-
home Internet access were the ability to use the Internet away
from home, lack of interest in using the Internet, being
uncomfortable with using computers or the Internet, having
difficulty obtaining service, and living in housing that is not
wired for service. At the same time, HUD-assisted households
have a high incidence of being unadopters; the ConnectHome
baseline survey revealed that 35 percent of surveyed households
without home Internet access had such access in the past76
compared with 12 percent of all non-adopting households.77
 ConnectHome: Confronting Digital Inequality in Low-
Income Housing
 Because HUD-assisted households have low connectivity rates,
limited device access, and other specific barriers to Internet
access, HUD-assisted housing offers a promising platform to
significantly increase digital inclusion rates and improve
residents’ quality of life. HUD’s ConnectHome initiative offers
affordable broadband access, devices, technical training, digital
literacy programs, educational and workforce related content,
and organizational support to families living in HUD-assisted
housing. ConnectHome is a public-private collaboration that
creates a platform for community leaders, local governments,
nonprofit organizations, and private sector stakeholders to
produce locally tailored solutions for reducing digital inequality.
The initiative has already made progress toward distributing
devices, establishing Internet connections, and providing digital-
literacy training in its 28 pilot communities. As ConnectHome
communities advance their digital inclusion efforts, HUD is
evaluating progress, learning about the benefits of expanded in-
home Internet access for HUD-assisted residents, and gathering
information about what Internet penetration looks like in these
low-income households.
 ConnectHome advances digital inclusion in ways that align with
current frameworks for thinking about digital inequality. By
incorporating connectivity, device access, and digital literacy, as
well as opportunities for communities to build coalitions among
local organizations, foster social networks, and integrate Internet
access with job training and other social programs,
ConnectHome offers a platform to address digital inequality as a
challenge that is both multidimensional and multilevel. Indeed,
many of the efforts advanced as part of ConnectHome address
inequalities in equipment, autonomy, skill, purpose of use, and
support, and provide opportunities to engage with family,
community, neighborhood, and network dynamics that can
shape digital inclusion.
 To address equipment inequalities, and because affordability is a
significant barrier to access for HUD-assisted residents,
ConnectHome helps bring free and low-cost Internet and
computing devices to HUD-assisted families. ConnectHome
prioritizes broadband Internet options as well as in-home access
to devices that are powerful enough to accommodate a variety of
computing and online activities. By bringing Internet access
directly to the homes of HUD-assisted residents,8ConnectHome
also limits the extent to which long commutes, usage restrictions
and monitoring, wait times, and limited hours constrain the
learning opportunities associated with autonomous use.
 ConnectHome addresses inequalities in digital skills by
promoting affordable digital literacy resources. Individual
ConnectHome pilot communities have already begun
establishing digital literacy trainings, ranging from basic classes
on how to set up a computer, create an email address, and
browse the Internet safely and securely, to more advanced
courses on how to build a computer, code, and provide technical
assistance to others. These digital literacy trainings also speak to
inequalities in purpose of use, or the extent to which digital
activities are able to increase economic productivity and
political and social capital. Specifically, these digital literacy
trainings have covered topics such as employment, health,
education, social services, and home safety, and several
 ConnectHome communities have engaged HUD-assisted
residents in advanced digital literacy training, including through
the Jobs Plus and Section 3 programs, to provide job training for
technology careers, refurbish devices for HUD-assisted
households, and develop technical assistance teams for their
communities.
 ConnectHome also encourages building regional and local
partnerships and engaging local stakeholders, which can build
social supports for residents. These efforts include developing
local collaborations between housing authorities, computing
centers, schools, libraries, and nonprofits. Various
ConnectHome pilot communities have fostered social supports
within HUD-assisted housing communities as well, by engaging
resident councils in digital inclusion efforts and establishing
Internet cafes, technical assistance teams, and social-support
spaces for digital participation.
 Finally, ConnectHome supports the development of community-
specific implementation plans that account for local needs,
stakeholders, and interests. The program provides communities
with strategies to coordinate with government programs such as
Choice Neighbourhoods and Family Self-Sufficiency initiatives
in ways that support local efforts to advance digital access and
expand economic, political, and social opportunities for low-
income households. By encouraging housing authorities to
partner with libraries, nonprofits, and local schools to create
community-based support networks, and by bringing
communities and families online together, ConnectHome efforts
can also harness the power of social networks to reinforce the
value of being online.

The Digital Divide, ICT,

and Broadband Internet
ICT - Information Communications Technologies
The Digital Divide, or the digital split, is a social issue referring to the differing amount of information
between those who have access to the Internet (specially broadband access) and those who do not
have access. The term became popular among concerned parties, such as scholars, policy makers,
and advocacy groups, in the late 1990s.

Dimensions of the Divide

Broadly speaking, the difference is not necessarily determined by the access to the Internet, but by
access to ICT (Information and Communications Technologies) and to Media that the different
segments of society can use. With regards to the Internet, the access is only one aspect, other factors
such as the quality of connection and related services should be considered. Today the most
discussed issue is the availability of the access at an affordable cost and quality.

The problem is often discussed in an international context, indicating certain countries are far more
equipped than other developing countries to exploit the benefits from the rapidly expanding Internet.
Here is the latest State of the Internet Report from Akamai, showing average and maximum
connection speeds, Internet Penetration and Broadband adaption, Mobile usage, as well as trends in
this data over time.

The digital divide is not indeed a clear single gap which divides a society into two groups. Researchers
report that disadvantage can take such forms as lower-performance computers, lower-quality or high
price connections (i.e. narrowband or dialup connection), difficulty of obtaining technical assistance,
and lower access to subscription-based contents.

Bridging the Gap

The idea that some information and communication technologies are vital to quality civic life is not
new. Some suggest that the Internet and other ICTs are somehow transforming society, improving our
mutual understanding, eliminating power differentials, realizing a truly free and democratic world
society, and other benefits.

In many countries, access to the telephone system is considered such a vital element that
governments implement various policies to offer affordable telephone service. Unfortunately some
countries lack sufficient telephone lines.

Literacy is arguably another such element, although it is not related to any new technologies or latest
technological devices. It is a very widely shared view in many societies that being literate is essential
to one's career, to self-guided learning, to political participation, and to Internet usage.

Unfortunately, in the world there are still 757 million adults including 115 million youths who cannot
read or write a simple sentence. Explore the interactive literacy data to see which countries are most
affected.

There are a variety of arguments regarding why closing the digital divide is important. The major
arguments are the following:

1. Economic equality
Some think that the access to the Internet is a basic component of civil life that some developed
countries aim to guarantee for their citizens. Telephone is often considered important for security
reasons. Health, criminal, and other types of emergencies might indeed be handled better if the person
in trouble has an access to the telephone. Another important fact seems to be that much vital
information for people's career, civic life, safety, etc. are increasingly provided via the Internet. Even
social welfare services are sometimes administered and offered electronically.

2. Social mobility
Some believe that computer and computer networks play an increasingly important role in their
learning and career, so that education should include that of computing and use of the Internet.
Without such offerings, the existing digital divide works unfairly to the children in the lower
socioeconomic status. In order to provide equal opportunities, governments might offer some form of
support.

3. Democracy
Some think that the use of the Internet would lead to a healthier democracy in one way or another.
Among the most ambitious visions are that of increased public participation in elections and decision
making processes.

4. Economic growth
Some think that the development of information infrastructure and active use of it would be a shortcut
to economic growth for less developed nations. Information technologies in general tend to be
associated with productivity improvements. The exploitation of the latest technologies may give
industries of certain countries a competitive advantage.

Rural areas access

The accessibility of rural areas to the Internet is a test of the digital divide. But nowadays there are
different ways to eliminate the digital divide in rural areas. Use of Power lines (PLT and PLC) and
satellite communications offer new possibilities of universal access to the Internet, and lack of
telephone lines will not limit access. Lower access prices are required to bridge the ICT divide.

Disabilities
Disabilities of potential Internet users constitute another type of divide and care should be taken to
avoid that persons with disabilities be left out of Internet access.

"The power of the Web is in its universality.

Access by everyone regardless of disability
is an essential aspect."

-- Tim Berners-Lee, W3C Director and

inventor of the World Wide Web

Restrictions vs Freedom
Powerful interests want to censor free speech, block the sharing of information,
hinder innovation and control how Internet users get online. Care is necessary.
When our freedoms in the networked world come under attack, the Electronic
Frontier Foundation is the first line of defense. EFF was founded in 1990, well
before the Internet was on most people’s radar, and continues today to confront
cutting-edge issues defending free speech, privacy, innovation, and consumer rights.
THE EUROPE 2020 INITIATIVE

International Links, Resources and Partners

 The Europe 2020 Initiative
The Digital Divide can and should be made smaller. This idea has found eco in many
countries and organizations. One of the organizations that has taken an active and
leading role in this effort is the European Union, with the Europe 2020 initiative that
consists of a ten-year jobs and growth strategy for the EU.

“Technology is only as powerful as it is accessible.

Broader access brings education, information, and
a sense of community that can help combat AIDS,
malnutrition, ignorance and neglect. The power of
a connected and enlightened world community
is just beginning.”

-- Hector Ruiz, ex-Chairman of the Board

and ex-President of AMD

Five headline targets have been agreed for the EU to achieve by the end of 2020.
These cover employment; research and development; climate/energy; education;
social inclusion and poverty reduction.

Will Technology In Healthcare Make The Rich Healthier

And The Poor Sicker?
The Future Tech Evolution: Affordable to All?Thinkstock

The Have-nots, the Haves and the Have-mores in Healthcare

It is the future. People have been genetically engineered to stop aging after turning 25. But
time is the new currency, and people need to pay money to live beyond 25.

Sounds familiar? That could be because this is the plot of the 2011 movie ‘In Time’, starring
Justin Timberlake. It portrays a dystopian world where the rich can become immortal, but the
poor struggle to literally live. Come to think of it, this isn’t actually going to happen in our
‘real’ future. Or is it?

We live in a world of income inequality. The expression ‘the haves and the have-nots’ has
probably been used since the 1700s, but today it might be more apt to say ‘the have-nots, the
haves and the have-mores’ – meaning that this inequality has only worsened with time! This
problem, as the renowned World Bank economist Branko Milanovic argues, also applies to
countries, in the sense that a person’s income and global status is determined at their birth,
based not only on their parents’ income class, but also on their country of citizenship.

Why does this matter for healthcare? Poverty affects a person’s ability to access care – or, in
the case of most developing countries, access to the best quality care. We are still trying to
address these issues; in fact we are succeeding in doing so, enabled by technological
advances such as telehealth, mHealth and Artificial Intelligence serving remote areas in
Africa and China.

But what does the future hold?

Winter Is Coming, And That Means It Is FAFSA Season

With the fast pace of technological evolution, the realm of healthcare is likely to see advances
like genetic editing, personalized medicine, smart hospitals, smarter cities with tech-enabled
public health initiatives, and probably several more. Will access to these curative
technologies be accessible and affordable to all?

The pharma industry prices its prescription drugs at a very high cost, justifying this with the
amount of money spent on research to develop them, and the high failure rate of potential
drug candidates. Given this trend, is it likely that smart hospitals will promise a higher quality
of care and faster hospital discharges with better outcomes, but at a higher price than regular
hospitals? In the same way, will staying in a smart city be more expensive from an income
tax or local tax perspective, because public health initiatives ensure a better quality of life
there? Some may argue that insurance companies will benefit from their members availing
themselves of high-quality care services, and would therefore be happy to foot the bill. But
will insurance companies also increase premiums or co-pays for access to high-quality care?
The Rich and the Rest: Current Scenarios

Some of these situations can be very well illustrated with present-day examples: some
populations struggle to access basic care, while in contrast the ‘other’ world has access to
advanced but expensive treatments, to stay not only healthier, but even younger. Anti-aging
drugs, procedures, and devices are one such example.

Or consider the field of women’s health, where limited access to reproductive health in turn
perpetuates the problem of economic inequality. Granted, women’s health has been a
neglected area for a very long time, and for a variety of reasons, but this in itself offers a lurid
picture of what could happen with technology in the future if this issue is neglected. It is time
we stopped to consider this spectrum of women’s health: on the one hand some women have
access to expensive treatments like laser therapy, botox and hormone replacement therapies
for prevention of ageing processes, while other women may not have access even to basic
skilled birth care. According to a United Nations Population Fund report, fewer than 20% of
the poorest women in Cameroon, Guinea, Niger, and Nigeria have access to skilled birth care.

So does the future offer a similar prospect, where rich people in developed regions could
tailor and augment their human bodies to their liking and to enhance their abilities, and could
even order synthetic organs (think artificial pancreas) or lab-cultured organs (think stem cell
therapy) online, while the poor could lack access to basic drugs? Will we need the Bill and
Melinda Gates Foundation to have a team similar to their ‘Neglected Tropical Diseases’ team
providing funding in areas like this, where the pharmaceutical industry hasn’t come up with
solutions?

The Implications of Neglecting the ‘Health Tech Access Divide’

If the economic divide results in a healthcare access divide, this is likely to create another
dimension of the haves vs. the have-nots issue. With higher spending capacities, the haves
could access better technology, like bionic rather than regular prostheses, giving them better
capabilities. They could – theoretically and without getting into the ethical and moral
considerations – have genetically designed super-babies. They could also avail themselves of
deep brain stimulation or other neurological advances to improve their IQ or mental prowess.
Those at higher risk of cancers could avail themselves of gene editing tech to prevent cancer
occurring, and the list could go on. All this, while the have-nots might have to manage with
present-day treatments which fit their budgets. Wouldn’t that be a plausible real-world
version of the dystopia portrayed in ‘In Time’?

The economic divide is likely to give rise to another divide between humans – one not based
on caste or religion, but this time on how healthy, or how much more physically and perhaps
mentally capable, they are. This will further perpetuate the divide, allowing the haves to grow
to have-mores, and the have-nots to perhaps shrink to have-nothings! All our current efforts
to reduce the income gap and diminish economic inequality will probably be futile by that
point.

Are We Creating a ‘Digital Divorce’ in Health Tech?

As we have just started 2018, it is important to think about the implications of these
innovations and technology, and the impact they will have on the future. The internet may
have created equality across the world, but the future of health tech could just do the
opposite, creating a digital divide. The real question, as always, is whether we have our
priorities right. As a healthcare industry thought leader, having observed the industry for
more than two decades, and watching it transform from a slow-moving industry into a fast-
changing, technology-adopting digital one, I feel responsible for highlighting this issue: are
we, healthcare practitioners and thought leaders, moving in the right direction?

In my humble opinion, technological advances must focus on making the benefits of such
innovations available to the masses. The mantra of growth by volume might just be a
necessity here. Furthermore, the current problems of rising healthcare costs and countries
struggling to rein them in could be reproduced in this future scenario, if the benefits are not
made available to all at lower costs.

If making innovations available to the masses globally at affordable costs is not made a
priority objective, only some innovations will work to improve inequalities in access. The
rest will actually aggravate the problem of access, further compounding the basic problem of
the income divide. Multiple stakeholders may need to come together, including innovators,
manufacturers, payers and governments, to make this possible, perhaps in novel ways and by
leveraging unique, unprecedented business models.

This article was written with contributions from Siddharth Shah, Industry Analyst from the
Visionary Healthcare program of Frost & Sullivan’s Transformation Health practice.