Category Archives: Blogs

eHealth Literacy as a catalyst to overall digital literacy among the elderly

Susannah Fox has invited Jessica Mark to post on

This is a guest post by Jessica Mark, and Outreach Program Manager, Health Communication and eHealth Team in the Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services

The result of this invitation is entitled Making Strides Toward Improving Health Literacy Online where Jessica Mark highlighted part of the work done by the Office of Disease Prevention and Health Promotion. I really enjoy her post so I commented this:

Wonderful post! I wonder if eHealth literacy could be also a tool to integrate the elderly into Information Society / Network Society. It could be a tool to engage them within the tremendous potential of the Internet for other aspects of their lives. Health contents could be just an excuse to capture their attention (e-awareness) and help them to be online (e-readiness)

and Jessica Mark replied:

Francisco, thank you! I love the idea of eHealth literacy as a catalyst to overall digital literacy too. I’d love to hear/talk more about how that might work.

First of all, I would like to quote the main message of Prof. Jan van Dijk‘s book “The Deepening Divide: Inequality in the Information Society

“The digital divide is deepening where it has stopped widening. In places where most of peopel are motivated to gain access and physical access is spreading, differences   in skill and usage come forward. The more information and communication technology is immersed in society and pervades everyday life, the more it becomes attached to all exiting social divisions. It tends to strengthen them, as it offers powerful tools for everyone engaged. This occurs in the context of the evolving information society and network society. This type of society makes both digital and social divisions even more critical” (…) The digital divide is conceived of as a social and political problem, not a technological one. Physical access is portrayed as only one kind of (material) access among at least four: motivational, material, skills, and usage” (p.2-3)

As a part of his framework for understanding the digital divide, Prof. van Dijk has developed “A Causal and Sequential model of Digital Technology Access by individuals in Contemporary Societies” (p.24). I have included HEALTH as a field of participation in Society.


“The core argument of the book sets particular relationships between four states of affairs, in a process creating more or less information and communication inequality in using digital technologies (p.14):

  1. A number of personal and positional categorical inequalities in society
  2. The distribution of resources relevant to this type of inequality
  3. A number of kinds of access to ICTs
  4. A number of fields of participation in society

1 and 2 held to be the causes, and 3 is the phenomenon to be explained, together with 4, the potential consequences of the whole process (…). The core argument can be summarized in the following statements, which comprise the core of a potential theory of the digital divide (p.15):

  1. Categorical inequalities in society produce an unequal distribution of resources.
  2. An unequal distribution of resources causes unequal access to digital technologies.
  3. Unequal access to digital technologies also depends on the characteristics of these technologies.
  4. Unequal access to digital technologies brings about unequal participation in society.
  5. Unequal participation in society reinforces categorical inequalities and unequal distribution of resources.

The general term access to digital technologies has been divided into four specific, successive kinds of access to digital technology, computes, and the Internet connections (p.21):

  1. Motivational access (motivation to use these technologies)
  2. Material or physical access (possession of computers and Internet connection or permission to use them and their contents)
  3. Skills access (possession of digital skills: operational, informational, and strategic)
  4. Usage access (number and diversity of application, usage time)

I have posted before about the importance of eInclusion and eHealth and Inverse Care Law 2.0 talking about the successive kinds of access to digital technology but I have not posted about what are the reasons for not having access to the Internet at home to explain why eHealth literacy could be a catalyst to overall digital literacy among the elderly.

Eurostat’s survey on ICT usage in households and by individuals (2010) stated that the main reasons not to access the Internet at home in almost all countries are related with MOTIVATIONAL ACCESS (does not need to; does not want to) and SKILLS ACCESS

Using Spain as an example I have crossed these reasons by Age:


Individuals between 55-74 emphasised the importance of SKILLS ACCESS and MOTIVATIONAL ACCESS. Following the framework and the figures above mentioned, eHealth literacy could be a catalyst to overall digital literacy among the elderly because:

  1. Health could be a motivation for the elderly to use the Internet (e-awareness)
  2. This motivation could be used as a trigger to learn how to use this technology (e-readiness)
  3. Health professional and/or health care workers as well as relatives and/or friends could facilitate this learning process (ehealth literacy)
  4. Use of the Internet for health could open new fields of participation in society for the elderly.
  5. These new fields of participation in society could diminish categorical inequalities and unequal distribution of resources.

Thanks Susannah Fox and Jessica Mark for your inspiring post and comments

No eHealth without eInclusion in Europe – Eurostat 2010

Recently, EUROSTAT has published the results from ICT usage household survey 2010. I have been analysing these data developing a Digital Health Care Demand in Europe and I would like also to share my analysis of  “individuals who  used the Internet for seeking health information on injury, disease or nutrition” (European Union 27 Member States), inspired by The Power of Mobile written by Susannah Fox. In my case, I would like to emphasis the raise of the inverse care law 2.0 to justify that there is no eHealth without eInclusion, in other words quoting Europe’s Digital Competitiveness Report 2010:

“In addition, while health-on-the-web may empower in various ways those who have access to the internet, the flip side of this is that those without internet access may become relatively more disadvantaged in health matters. For them, the experience may be more one of disempowerment through inability to take advantage of new opportunities. Factors linked to existing health divides, including lower health literacy and less proactive health attitudes, continue to contribute significantly to unequal health experiences and outcomes among less advantaged socio-economic groups. There is already some evidence that these groups may be experiencing a ‘double jeopardy’ as a result of an intertwining of these traditional health divides with the new digital divides.”

Firstly, since 2004 the percentage of individuals who used the Internet for seeking health information on injury, disease or nutrition (total individuals and individuals who have used the Internet in the last three months) has increased, even though from 2009 we can see a slower increase, specially in those who used the Internet. These trends facilitate the identification of a first gap between users and non-users.


To better capture this gap, I have divided the analysis in two part. On the one hand, considering the total individuals we can see the differences between groups of age and level of education.



Furthermore, we can also identify this gap if we focus on age and education together:




On the other hand, considering  individuals who have used the Internet in the last three months, you can see that there is still a difference between groups of age, level of education and both together:






It has to be remarked that most of these trends show that the divides are not going to disappear with time, in some cases these divides will get wider.  Therefore some groups may be experiencing a ‘double jeopardy’ as a result of an intertwining of these traditional health divides with the new digital divides. THUS, THERE IS NO eHEALTH WITHOUT eINCLUSION. Social care, Health care, Health Professionals and Social workers may work together and play a role not just in eHealth or on eInclusion but both to avoid ‘double jeopardy’ and  the inverse care law 2.0.

Note: I have developed the same analysis for all Member States and the gaps are even wider in some countries.

Open call for blogs on death and dying for agnostics and atheists

Today I have started my day reading [Air-L] blogs on death and dying for agnostics and atheists and I can’t stop thinking about it.

Hi AoIRers!

My father was diagnosed 6 months ago with Stage III esophageal cancer. After one round of radiation and chemotherapy, he recently decided to enter hospice. He’s a retired psychology professor and as a social scientist he’s trying to gather as much information as possible about the process of dying from the personal perspective of an agnostic or atheist. He’s most interested in finding agnostics and atheists facing death who are blogging (or have blogged) about their experiences. I haven’t had much luck identifying blogs that fit this somewhat narrow parameter. He has set up a blog
in the hopes he can start a conversation with others in similar circumstances.

If you have any suggestions for specific websites, blogs, search terms, etc., please email me off list at


Stephanie J. Coopman, Ph.D.
Communication Studies
Advising Liaison, College of Social Sciences

Faculty in Residence, Accessible Technology Initiative

San Jose State U
San Jose, CA 95192-0112

The mailing list
is provided by the Association of Internet Researchers
Subscribe, change options or unsubscribe at:

Join the Association of Internet Researchers:

Reading this message and the second post entitled Good Day I have realised again the complexity around health and its relationship with moral and beliefs issues and also to what extend the Internet is embedded in everyday life and furthermore death.

I hope the spread of this message could help Stephanie and Bob.

Internet Research 9.0: Rethinking Community, Rethinking Space. Key speaker: Mimi Ito

Notes from the conference: Internet Research 9.0: Rethinking Community, Rethinking Space. Copenhagen October 15 – 18, 2008. Mimi Ito: Hanging Out, Messing Around and Geeking Out: Youth Participation in Networked Publics.

Mimi Ito is a cultural anthropologist studying new media use, particularly among young people in Japan and the US. Her research right now focuses on digital media use in the US and portable technologies in Japan. Her last works published are: Networked Publics and Beyond Barbie® and Mortal Kombat: New Perspectives on Gender and Gaming. I strongly recommend the reading of her blog.

Her presentation was based on Digital Youth Research project:

Since the early 1980s, digital media have held out the promise of more engaged, child-centered learning opportunities. The advent of Internet-enabled personal computers and mobile devices has added a new layer of communication and social networking to the interactive digital mix. While this evolving palette of technologies has demonstrated the ability to capture the attention of young people, the innovative learning outcomes that educators had hoped for are more elusive. Although computers are now fixtures in most schools and many homes, there is a growing recognition that kids’ passion for digital media has been ignited more by peer group sociability and play than academic learning. This gap between in-school and out-of-school experience represents a gap in children’s engagement in learning, a gap in our research and understandings, and a missed opportunity to reenergize public education. This project works to address this gap with a targeted set of ethnographic investigations into three emergent modes of informal learning that young people are practicing using new media technologies: communication, learning, and play +info.

Mimi Ito stars with the team members of the project and with the objectives:

The first objective is to describe kids as active innovators using digital media rather than as passive consumers of popular culture or academic knowledge.

The second objective is to think about the implications of kids’ innovative cultures for schools and higher education and to engage in a dialogue with educational planners.

The third objective is to advise software designers about how to use kids’ innovative approaches to knowledge and learning in building better software.

Then she explains the methodology based on ethnographic research in both local neighborhoods in Northern and Southern California, and in virtual places and networks such as online games, blogs, messaging, and online interest groups. Mimi Ito also remarks the amount of data collected: 594 semi structure interviews; 79 informal interviews; 67 groups; 28 diary studies; 4146 questionnaires and also more than 5000 hours of observation of 10468 profiles; 15 on-line forums; 389 videos; 50 events and classroom observation.

After that she introduces to the audience the term networked publics as “an alternative to terms such as audience or consumer. Rather than assume that everyday media engagement is passive or consumptive, the term publics foregrounds a more engaged stance. Networked publics takes this further; now publics are communicating more and more through complex networks that are bottom-up, top-down, as well as side-to-side. Publics can be reactors, (re)makers and (re)distributors, engaging in shared culture and knowledge through discourse and social exchange as well as through acts of media reception”.

Mimi Ito remarks that Youth Networked Publics like traditional youth publics are based on: local scale of interaction, many to many and peer to peer forms of participating, sharing and learning. But unlike traditional youth publics are also based on: accesibility 24/7, persistence, networked peer space, access to more specialized and niche publics, broader contexts for publication and privacy.

Networked publics are sources of diversity about identity, culture and practice. Further beyond  access issues, Mimi Ito identifies two main drivers:

1. Friendship-driven learning and participation: peer to peer sharing and reputation.

Kids prefer to hang out, participate, socialize off-line but time, space and structural restrictions encourage them to go on-line. Research results reveals that most of the kids prefer to meet people first off-line and after that face to face meeting go on-line. Otherwise, you can be consider as a freak or a geek by your own friends “Meeting people first on-line is not cool”.

Mimi Ito uses the term peer pressure to identify some practice among kids “If I put someone in my top ten friend on Facebook or MySpace, that someone is supposed to do the same with me”. On-line reputation has consequences on off-line reputation. Another way of peer pressure was the consequences of private data available on SNS as amplifiers of “drama” thinking about the changes on engaged or falling in love in the personal profile.

Finally, Mimi Ito states that kids share social practice… they help each other to create, produce and distribute content through social technology.

2. Interest-driven learning and participation. Still a minority of youth is driven by interest. Two case studies based on FANSUBBING and ANIME MUSIC VIDEOS.

After the explanation of these two case studies Mimi Ito finishes her talk with some considerations about the diversity in genres of youth participation on-line;  peer based learning, participation and reputation; the scale of networked communities and the youth access to broader audiences; new forms of litarecy and media social practice used by youth to produce knowledge without the constrictions of the adul world.

I really enjoy Mimi Ito speech and her work but I wonder why her research project does not take into account the traditional categories like education level, parents’ wages, family structure,… Do they matter? Am I old fashion?

Update – Video Mimi Ito Keynote @ IR9.0

For sale: Health revolution by John Grohol

I strongly recommend reading John Grohol’s post from e-patient blog entitled For Sale: Revolution Health. In short health is more than a bussines even in the network society era.

Why is Steve Case’s online health venture already looking to sell itself, just a year and a half after it launched? Yet another tale of hubris in the e-health sector.

Back in 1999, I left the mental health site I founded — the largest site of its kind at the time — to join to help them build a mental health center. Within 6 months I left, frustrated by the lack of interest in actually publishing independent, world-class health information and the focus on pushing as many ads as possible in front of visitors.

Continue reading

Welcome to a new blogger: Michael Hardey

My Google Analytics has detected a new incoming link to my blog. When I have checked the site I have read a first post entitled Doctor in store? a very interesting reflection about doctors as consumer products and its implications for web 2.0 sites related with health. After reading the post I have looked for the author and… Michael Hardey appears.

Why is it important? First, Michael Hardey is a very well-know researcher who has published on many academic journals and has the recognition of the Academy. That means that something is going on about research and web 2.0 when the best researchers start blogging. Second, we do not have to wait to his next paper to see his thoughts about many interesting issues related to eHealth.

Welcome to the bloggosphere and thanks for sharing your reflections!