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«How the American Public Benefits Opportunity for All from Internet Access at U.S. Libraries The U.S. IMPACT Study A research initiative examining the ...»

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Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries | 97 In addition to discussing the extent of use in each of these activity clusters and the characteristics of users as found from analysis of survey results, case study interviews with patrons, librarians, and key staff members from peer agencies are also discussed in order to provide greater understanding of how library technology resources are used toward the goals of improving quality of life and longevity and to reduce disparities in access to health information.

Besides serving individuals seeking health and wellness information on behalf or themselves or others, public access technology also supports Healthy People 2010, an initiative developed by the U.S. Department of Health and Human Services (HHS) to set standard national health objectives. The two overarching goals of Healthy People 2010 are designed to identify the most significant preventable threats to health and to establish national commitment to reduce

these threats (HHS 2009). They include:

Increase Quality and Years of Healthy Life: The first goal of Healthy • People 2010 is to help individuals of all ages increase life expectancy and improve their quality of life.

Eliminate Health Disparities: The second goal of Healthy People 2010 is • to eliminate health disparities among different segments of the population.

The use of library computers and Internet resources by healthy individuals, as well as those suffering from disease or disability, supports both of the goals outlined in Healthy People 2010.

Some people using library computer resources make decisions that improve their health, such as changing their diet and exercise habits, which will lead to increased quality and years of healthy life. The computer and Internet services provided by public libraries also contribute to the elimination of health disparities because they provide free access to health information for people who do not have access to computers and the Internet in their home, workplace, or somewhere other than a public library. In this way, libraries have become a nontraditional, and perhaps overlooked, component of the national public health system.

Most Prevalent Users for Health and Wellness Needs Many important linkages exist between health and access to information technology. Lydia, an experienced library and public access technology user, provides an illustration of the multiple and overlapping ways library computers 98 | Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries and Internet connections are used for health and wellness needs. Currently 29 years old, Lydia grew up with computers and uses the library most days because she cannot afford to maintain Internet service in her home. Along with 37 percent of public access technology users, Lydia looks for information about illnesses (Appendix Table 38). As she explains, “I’m bipolar, so I’ve researched my disease. I’ve had cancer [too], so I like to research a lot of stuff on [the library’s computers].” She has also found support from others for her health

conditions through the library computers:

I had breast cancer so I’m able to talk with groups of women who’ve had breast cancer. It’s easy. It’s free. You can talk all you want and if you’ve had enough… I don’t like chat rooms per se, but this is more of a therapy and it’s free on the computer, instead of having to travel miles when you don’t have a vehicle to some group in person. It’s kind of nice, when you’ve had a disease you don’t want to talk about it all the time.

When you’re on the computer you don’t have to see them face-to-face but you can actually understand what they’re talking about. That’s an easier way for me.

Use of library online services to help others with health and wellness needs was reported by 56 percent of the respondents in the area of health and wellness (Appendix Table 39).

Overall Health and Wellness Use In the study, 37 percent of respondents used library computers and Internet access to work on health issues.

Use on behalf of others is also high in this area, with 56 percent of health and wellness users reporting that they use library computers and Internet connections to find health or wellness information for a relative, friend, colleague, or someone else.

The use of library technology for health or wellness needs among all users of library

online services is highest among:

• Lower income and impoverished people;

• 45–64 year olds;

• Women; and

• People who speak languages other than English at home.

Analysis of the social and economic characteristics of users of library computers for health and wellness activities shows a pattern of higher use among people with household incomes below the federal poverty guidelines. Other factors

also appeared to suggest higher rates of use for this purpose:

Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries | 99

• The odds of library computer use in this area were highest among older age groups, with the highest odds of use between the ages of 45 and 64 years.

–  –  –





• The odds of respondents who indicated that a language other than English was spoken in their homes were greater by a factor of 1.31 of using the library services for health purposes.

Related to social and economic characteristics of users discussed previously, some of the differences between people in terms of their use of library technology for health and wellness activities are attributable to whether the user has alternatives for accessing the Internet. The use of library technology for the most frequent types of health-related activities is generally higher among users who depend on public library Internet connections than those who also have access at home, school, work, or someplace else.

Activities Associated with Health and Wellness Figure 13 shows health-related activities accomplished with library computers and Internet connections and how use for these purposes is different between users with and without alternative locations for accessing the Internet. The top three health uses are learning about an illness, disease, or medical condition;

getting information about diet or nutrition; and learning about medical procedures. Though use of library technology for many of these activities was essentially the same between those with or without alternative access to the Internet, use for learning about medical procedures and learning about exercise and fitness were somewhat higher among those with access at home, school, or work. Like other areas where this is the case, the convenience of having other library materials readily available to supplement Internet searches may be one driver leading to those with access elsewhere showing higher use in some areas.

100 | Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries Figure 13: Health and wellness activities by availability of alternative access Improving Health Making healthy lifestyle choices in eating habits and exercise routines are two key activities public access technology users were asked about. The activities contribute toward meeting the first goal of Healthy People 2010 to increase quality and years of healthy life, and it is one for which many public access technology users find support using library computers and Internet connections.

Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries | 101 Diet and Nutrition Learning about diet or nutrition was the second most frequently reported activity reported by those who use library computers for health and wellness purposes, with 60 percent of those users reporting having looked for this type of information (Appendix Table 40). Among users seeking diet information, 83 percent said that the use of library technology online services helped them decide to make a change to their diet, a positive first step toward improving health (Appendix Table 41).

Diet and nutrition: 60 percent of users of library computers for health and wellness purposes are learning about diet and nutrition.

Of all library computer users, those most likely to seek out diet and nutritional

information are:

• People with household incomes below the poverty guidelines;

• Latinos or Hispanics;

• Mixed races, Blacks or African Americans, and American Indians or Alaska Natives;

• 45–64 year olds;

• Women;

• People with education beyond high school; and

• People who speak languages other than English at home.

→Outcome: 83 percent of those who researched diet and nutritional information using library internet connections decided to make changes to their diets.

The results of further analysis show that, holding other characteristics of the users constant, the use of library computers and Internet connections for

seeking diet and nutritional information is higher among certain groups:

• Users with household incomes below the federal poverty guidelines have increased odds of seeking out diet information using library computers by a factor of 1.55 compared with those earning more than 300 percent of the poverty guidelines.

• The odds of Latino or Hispanic users seeking diet information are higher than those of non-Latinos and non-Hispanics by a factor of 1.57, whereas the odds of use for this purpose is higher by a factor of 1.45 for those identifying with two or more races, a factor of 1.40 for Blacks or African Americans, and a factor of 1.37 for American Indians or Alaska Natives than for Whites.

–  –  –

Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries | 103 Seeking information about exercise or fitness is also higher among certain

groups:

• The odds of users with income below 100 percent of the federal poverty guidelines learning about exercise using library computers and Internet connections are higher by a factor of 1.48 compared with those earning more than 300 percent of the poverty guidelines. The odds for users earning between 200 and 300 percent of the poverty guidelines are also higher than those earning more than 300 percent of the poverty guidelines by a factor of 1.41.

• Latino or Hispanic users have greater odds of seeking exercise information than non-Latinos and non-Hispanics by a factor of 1.59, whereas users identifying with two or more races have odds higher by a factor of 1.56, Blacks or African Americans by a factor of 1.50, and American Indians or Alaska Natives by a factor of 1.53 than Whites.

Asians have lower odds of engaging in this activity than Whites by a factor of 0.69.

• Users who speak a language other than English at home have odds of seeking exercise information higher than users from English-only households by a factor of 1.53.

Unlike use for seeking diet information, there is no significant difference in the odds of use for fitness purposes between men and women. However, they are similar in that users between the ages of 45 and 64 years have greater odds of using library computers to seek exercise information than both older and younger people and users who have attended or graduated from college have likewise higher odds of use for this purpose than those with just a high school diploma.

Lorenzo, a homeless teenage user from Oakland, California, uses library computers to help with his exercise program. As he explains, “I've looked up running because I love running so I know about high school and college websites about running. I just look up good training things and what to eat and in general, running stuff. And I look up some of my friends that ran races. My old race results, stuff like that.” Having recently graduated from high school, Lorenzo’s main source for getting training information now is through the public access computers at the Oakland Public Library.

The high follow through in deciding to make changes to both diet and exercise habits indicates a potential for significant impact from access to library technology resources and services on national, state, and even local health 104 | Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries goals, particularly among people who have limited access to health information 23 MILLION LEARN from other sources.

ABOUT MEDICAL

Nearly everyone agrees that diet and fitness are key components to improving CONDITIONS health and living longer. Like the Healthy People 2010 initiative, many

THROUGH LIBRARY

government agencies, nonprofit organizations, schools, and many other groups COMPUTERS have invested significant resources in making information available through the Internet to help people make better nutritional and exercise choices. Public 15 MILLION library Internet access is especially important in the area of health, as home

INVESTIGATE

access is often lowest among those with the most to gain from diet and fitness MEDICAL information.

PROCEDURES

–  –  –

Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries | 105 Medical conditions: 83 percent of those using library online resources for health and wellness activities are learning about a disease, illness, or medical condition.

Of all library computer users, those most likely to seek this type information are:

• People with household incomes below the poverty guidelines;

• 55–64 year olds; and

• People who speak languages other than English at home.

Overall, 83 percent of health and wellness users search for information on illnesses, diseases, or other medical conditions (Appendix Table 44). Further analysis shows that seeking this type of information is higher among certain

populations:

• The odds of seeking information about medical conditions increases as income decreases, with those with household income below the federal poverty guidelines higher by a factor of 1.49 than those with income more than 300 percent of the poverty guidelines.



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