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Research and development

Why digital inclusion matters to health

30 June 2022
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4 min read

Rachel Coldicutt, Director of Promising Trouble, explores how free or reduced cost internet access could improve health outcomes.

Rachel Coldicutt
Rachel Coldicutt
Director of Promising Trouble

For many of us in 2022, browsing the internet is something we do every day, without stopping to ever question it. However, for those unable to access a secure, reliable connection to book a GP appointment or make a benefit claim, it is a barrier to a healthy life.

Working with Promising Trouble, we’re exploring how free or reduced cost internet access could improve health outcomes and quality of life for people who live in social housing across Lambeth. Rachel Coldicutt, Director of Promising Trouble, explains more.

How is internet access related to health?

Even before the ‘new normal’ following the COVID-19 pandemic, there were clear indicators that internet access had become essential for a healthy life, not just a nice to have. 

Without a secure and reliable home internet connection, people become digitally excluded, worsening health inequalities through the differences in care that they receive and the opportunities they have to lead healthy lives. 

For example, many formal health and support services like GP surgeries and outpatient appointments are increasingly dependent on people having digital access. If appointments are face-to-face, appointment management and triage often take place digitally. 

For people with caring responsibilities, limited mobility and other health conditions, being able to use the internet makes it easier to do grocery shopping, manage prescriptions and access their bank account.

A 2020 report from the King’s Fund found that internet access and digital skills are also a gateway to better jobs and economic participation. They enable access to wider public services including housing and education, and help to combat social isolation, making it easier for people to stay in touch with friends and family and keep track of what is happening in their community.

Add to this the shift towards remote office-based work, the increasing digitisation and unbundling of information, and the fact that being online enables access to cheaper goods and services and it becomes clear that internet access is now an essential part of full participation in daily life with huge health benefits.

A 2020 report from the King’s Fund found that internet access and digital skills are also a gateway to better jobs and economic participation.

An expensive barrier

One of the biggest barriers to internet access is affordability. 

For people who don’t have broadband at home, using the internet might require relying on a pay-as-you-go mobile connection that needs to be rationed throughout the month. 

The majority of inner-city areas in London do have (at least) super-fast broadband available for connection, but that availability does not equal affordability. 

While “social tariff” packages which are capped at a low price for Universal Credit claimants are becoming more commonplace, this means-tested model is not an equitable one, particularly as the cost of living is rising. 

Ofcom’s 2021 report into social tariffs and broadband affordability shows that even without the additional burden of inflation and rising energy costs, broadband is a significant expense for many households. Ofcom estimates that 11% of households on a low income or claiming a means-tested benefit struggle to pay for broadband, a figure they suggest might be artificially reduced by low survey response rates. 

And even social tariffs do not come cheap. Against 2021 income levels, an “average household” is expected to spend 1.3% of their disposable income on broadband but a household on a social tariff will pay proportionately much more (around 3.6% of their disposable income), often for a slower connection. 

“Social tariff” packages, which are capped at a low price, are becoming more commonplace, but this means-tested model is not an equitable one, particularly as the cost of living is rising. 

What can we do about it? 

With this affordability barrier in mind, we’re working with Impact on Urban Health to explore how to roll out free, or significantly more affordable, broadband for social housing residents in Lambeth and Southwark. 

Once in place, we hope to collaborate with residents to understand the overall benefits they gain from living with a secure, reliable home internet connection and how these benefits have impacted their health.

It’s easy to imagine that this is a technical problem, but in many cases the technical infrastructure to deliver the connectivity is already in place. This is a problem of market failure, but seeing as rectifying market failure can be a slow process, we’re exploring a number of ways to solve this problem: 

  • Taking inspiration from programmes run by Community Tech NY and the Detroit Digital Justice Project, we’re looking into whether it’s possible to set up alternative local infrastructure in densely populated urban areas and what needs to be in place to make it happen.
  • We’re also exploring whether spare capacity in existing infrastructure can be redirected to provide internet access for people without home broadband. What would stop this happening, and what might make it possible? 
  • And finally, at a policy level, we’re looking into whether broadband could be reclassified as an essential utility, rather than a non-essential expense. 

Throughout Summer 2022, we’ll start piloting and will continue talking to residents and stakeholders, so if you’re interested in getting involved, we’d love to hear from you at hello@promisingtrouble.net.