High-speed internet offers key connection to health, but millions lack it
By Michael Merschel, American Heart Association News
If you live in the right neighborhood and can afford it, 你可能会认为高速互联网是一种方便的方式，可以连接到值得一看的电视节目，或者让你在家工作的电话会议. You might take for granted that everyone has internet access.
但越来越多地，这是提供数百万人错过的医疗保健的重要途径.
"Telehealth is considered this amazing new tool," said Angela Siefer, executive director of the National Digital Inclusion Alliance, a nonprofit advocacy group based in Columbus, Ohio. "But really, it's only amazing for some folks."
People need broadband at home so that telehealth can be delivered. They need devices that can run the proper apps. And they need digital literacy skills to be able to use those apps. 她说:“如果其中任何一部分缺失了，那么它对那个人来说就不是一个很好的工具。.
Dr. Howard M. Julien, assistant professor of clinical medicine at Penn Medicine in Philadelphia, knows how significant that connection can be. During the early peak of the coronavirus in his city, "our entire practice was predominantly telemedicine for several weeks."
宽带互联网使互动视频成为可能，病人和医生可以看到彼此，医生可以分享检查结果，甚至进行部分身体检查. 它可以让病人在不前往医疗机构的情况下安全地提出问题，并让医生实时监控病人. It can reach places where doctors are in short supply.
但音视频交流“只有在互联网连接的基础上才能牢固或强大。, and accessibility that patients and individuals have to high-speed internet," said Julien, who also is a cardiologist at the Corporal Michael J. Crescenz VA Medical Center.
And millions of people don't have it.
How many isn't certain. Estimates range from 19 million to 42 million people in the U.S. without access to broadband, according to an editorial about telemedicine 该研究由Julien共同撰写，发表在6月份的美国心脏协会期刊《线上娱乐电子游戏网站》上.
西弗说，她的组织使用的是一个保守的数字，基于人口普查数据，显示有1800万美国人.S. households lack broadband, including mobile service. Of those, 4 million are in rural areas, and 14 million in urban.
大多数居民是黑人的社区是最有可能受到影响的社区之一. A Brookings Institution report 西弗指出，白人占多数的社区平均宽带采用率约为84%, that rate was just 67% in majority-Black neighborhoods.
That report says that white, Asian American, 以及拉丁裔或西班牙裔家庭的宽带采用率都高于全国平均水平, but other studies have found disparity. Pew Research Center data from 2019, for example, 显示西班牙裔成年人比黑人和白人同龄人更不可能拥有家庭宽带.
Low-income communities also are at a disadvantage.
"Broadband in the U.S. is expensive," Siefer said. Devices also are expensive. And the lower one's income, the more restrictive their data plan usually is.
But cost isn't the only problem. There's access. Often, poor urban neighborhoods and rural areas get left out. "If the infrastructure doesn't exist, they can't purchase it. Or maybe it exists, but it's really expensive," she said.
Politics plays a role. Community-owned service providers have succeeded in some places, but many states restrict them, 因为私营公司反对政府支持的准入，因为他们认为这是竞争. A Pew Research Center survey this spring found that although roughly half of U.S. 成年人表示，在疫情期间，互联网对他们个人来说是“必不可少的”, 62%的人认为确保每个人在家都有高速互联网连接不是联邦政府的工作.
西弗说，5G网络等新技术无法解决接入问题. 富裕的社区将首先看到这种升级，每个人都需要新的设备来利用它们.
尽管还没有针对解决方案进行强有力的研究，朱利安说有很多想法. Companies could be given incentives to connect remote areas.
While awaiting that, "Health systems can have halfway points, where hubs are created in between the health system and a rural environment," he said. 教堂或其他公共场所可以作为人们携带电子设备的场所, connect to the internet and meet with providers.
Siefer said distributing wireless hotspots can be a "very short-term solution. They're expensive. But they're also easy to set up."
She applauded the recent $50 million public-private effort Chicago Connected, which will bring broadband and training to families there.
And she cautioned solutions shouldn't be piecemeal. 她说，在一些地方，学校正在带头提供设备和宽带接入. 但这些设备通常被锁定为教育用途，这意味着家庭无法安装远程医疗应用程序.
Siefer wants the health care industry to be a larger part of the conversation. “许多医生和非常善意的人谈论这些应用程序和他们为解决问题而创造的技术解决方案，却没有意识到有人不会使用这些应用程序,“因为他们不能上网，或者没有被教过那些经常高速上网的人认为理所当然的数字技能.
That needs to change, she said, 因为一些最容易感染COVID-19重症病例的人是老年人, 非裔美国人以及可能正在经历贫困的人——他们可能会从远程医疗中受益，但其中一些人却无法连接到远程医疗.
"We can't keep waiting for magical technical solutions," she said. "We need to solve it now."
编者注:由于围绕冠状病毒的线上娱乐电子游戏网站迅速演变, 本文中提供的事实和建议自出版以来可能已经发生了变化. Visit Heart.org for the latest coverage, 并向疾病控制和预防中心以及当地卫生官员咨询最新的指导意见.
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