Digital health, defined by Dr. Eric Topol as the convergence of medical record, mobile app, wearable, and genomic technologies, among others, helps improve access to, and quality of, healthcare. Many people now routinely search for doctors online, book appointments electronically, review genetic data, and consult physicians (even monitor their medical conditions) remotely. Accuracy and efficiency of diagnosis have improved as a result.

One of the greatest advantages of digital health is its potential to reduce health disparity by facilitating healthcare access for patients with low socioeconomic status. The unique combination of population diversity, population density, and access to premiere hospitals makes the NY metropolitan area an ideal landscape for implementing digital health tools. Moreover, because NY has extremely high levels of health disparity, there is a great need for digital health solutions.

NYC is Large, Dense, and Diverse

With a population of over 19 million, NYC is among the largest of all major regions, and is home to many of the most densely populated places in the US. New York’s population is also unique in terms of its diversity. Approximately 200 languages are spoken, and about half of all New Yorkers speak languages other than English at home. In fact, NYC has the largest Chinese population outside any city in Asia!

People who live in the city tend to be better educated and have higher incomes than the national average. At the same time, NY is widely known for its high levels of health and economic disparity. According to the Census Bureau and the NYC Department of Health and Mental Hygiene, the NY metropolitan area has the greatest gap between rich and poor in the US [1]. Those in New York City’s poorest neighborhoods have a life expectancy eight years shorter than those in wealthier neighbors, and mortality rates from almost all causes (with the exception of suicide) are considerably higher [2]. The size, density, and diversity of its population make the NY area a great hub for implementing digital health tools among individuals from a wide spectrum of cultural and educational backgrounds.

Disparities Can Be Seen on Subway Maps

To illustrate the extent of health disparity in the New York metropolitan area, Boston University School of Public Health has mapped health disparities to NYC subway stations. For example, the rate of heart disease mortality per 10,000 ranges from 20.9 (125th Street A train station) to 10.1 (Spring Street A train station) percent [3].

Thus, a 30-minute ride on the A train may equate to moving through approximately 10.8 percent difference in one of the major health outcomes metrics. Of note, members of racial and ethnic minorities are more likely to suffer from health disparity. NYC has a very diverse population that includes large ethnic and racial minority communities. For example, it has the largest Dominican population of any city outside of Santo Domingo, and the largest Puerto Rican population of any city in the world. The Black non-Hispanic population in NYC is 1.89 million, which is more than twice as much as any other city in the US.

Digital Health to the Rescue

Because digital health solutions may reduce healthcare costs and improve access to quality healthcare, they have great potential to reduce health disparities and to increase quality of life for all New Yorkers, particularly in light of the currently closing digital divide. For example, due to increased use of smartphones, Americans are using the Internet more often, and the greatest growth rate from 2000 to 2015 was observed among the lowest income group (defined as less than $30K) [4].

Moreover, among different racial and ethnic groups, African-Americans had the greatest growth rate between 2000 and 2012. Similarly, the digital divide between Latinos and Whites diminished from 2009 and 2012. The share of Latino adults who said they go online at least occasionally increased by 14% (from 64% to 78%.2). Among whites, internet use rates also increased, but only by half as much (from 80% to 87%) [5].

Thus, the rise in access to online information and in the use of smartphones among ethnic and racial minorities holds great promise for the implementation of digital health tools within these populations, thereby improving healthcare access for those who need it most.

Collaboration is Key

It is critical to collaborate with hospitals and medical centers when implementing digital health solutions, and the NY metropolitan area offers rich opportunities for such collaboration. Many prestigious medical institutions are located in the area, and two of its hospitals—NewYork-Presbyterian Hospital and NYU Langone Medical Center—were listed in the US News & World “2015–16 Best Hospitals” report [6].

Given high levels of health disparity and increasing technology adoption among ethnic and racial minorities, the NY metropolitan area can benefit greatly from digital health solutions. The need for digital health and the unique combination of population size, density, diversity, and access to the nations’ premiere medical institutions makes NYC a perfect landscape for implementing digital health tools.

 

 

 

References

1.     Income Inequality Data for Metro Areas. (n.d.). Retrieved January 28, 2016, from http://www.governing.com/gov-data/economy-finance/Metro-Area-Gini-Index-Map.html

2.     Health Disparities in New York City. (2004). Retrieved January 28, 2016, from http://www.nyc.gov/html/doh/downloads/pdf/epi/disparities-2004.pdf

3.     Galea, S. (2015, May 17). Health in New York and Chicago by Subway and L-Stops: A Pictorial Essay. Retrieved January 28, 2016, from http://www.bu.edu/sph/2015/05/17/health-in-new-york-and-chicago-by-subway-and-l-stops-a-pictorial-essay/

4.     Americans’ Internet Access: 2000-2015. (2015, June 26). Retrieved January 28, 2016, from http://www.pewinternet.org/2015/06/26/americans-internet-access-2000-2015/?utm_expid=53098246-2.Lly4CFSVQG2lphsg-KopIg.0&utm_referrer=http://www.pewinternet.org/

5.     Lopez, M. H., Gonzalez-Barrera, A., & Patten, E. (2013, March 7). Closing the Digital Divide: Latinos and Technology Adoption. Retrieved January 28, 2016, from http://www.pewhispanic.org/2013/03/07/closing-the-digital-divide-latinos-and-technology-adoption/?beta=true&utm_expid=53098246-2.Lly4CFSVQG2lphsg-KopIg.1&utm_referrer=http://www.pewinternet.org/2015/06/26/americans-internet-access-2000-2015/

6.     Comarow, A. (2015, July 21). The Honor Roll of Best Hospitals 2015-16. Retrieved January 28, 2016, from http://health.usnews.com/health-news/best-hospitals/slideshows/the-honor-roll-of-best-hospitals-2015-16/2

 

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