Report: Racial, Digital Disparities Widen in Pennsylvania

The expansion of telehealth during the coronavirus pandemic was welcome news for many older Pennsylvanians who found that getting to doctor offices and clinics was challenging.

But the sudden shift to virtual health care also brought into focus the reality that many residents lack technological literacy or access to high-speed internet—both problems that disproportionately affect the state’s older population.

This digital divide is one of the inequities highlighted in a new report, “Disrupting Disparities in Pennsylvania: Retooling for Geographic, Racial and Ethnic Growth,” by AARP Pennsylvania and Drexel University’s College of Nursing and Health Professions. 

Local shortages of health care workers, areas with few pharmacies and lack of access to community-based supports are greatest in poorer rural areas of the state and among underrepresented Black and Latino communities.

The report found that those disparities are expected to widen as Pennsylvania continues to age rapidly, with older people concentrated in areas that lack adequate care and services.

The state ranks eighth in the percentage of the population over age 65—almost 19 percent—and that number is expected to increase exponentially in the coming years, especially in the more diverse southeastern part of the state.

Laura Gitlin, dean of the Drexel College of Nursing and Health Professions, called the report “an important wake-up call for public health in Pennsylvania.”

“The whole age structure of the United States and Pennsylvania is changing,” Gitlin said. “The good news is that we can live longer, but the point of this report is that not everybody is aging well or has the same opportunity to live as long as others.”

Impact of the pandemic

Angela Foreshaw-Rouse, outreach manager for AARP Pennsylvania, said the inequalities aren’t new but have been exacerbated in the past year.

Many community-based organizations that help older residents access health care and the internet were closed because of the pandemic, leaving people isolated and struggling to get appointments when COVID-19 vaccines were first rolled out.

“It’s critical that we help more people have literacy, technology and access to high-speed connectivity,” Foreshaw-Rouse said. “So much of our health is going to be based on how you’re connected.”

The report recommends immediate action in key areas:

• Monitoring racial, ethnic and geographic inequities in health care
  
• Providing high-speed internet access across the state, a necessary step for expanding the use of telehealth
  
• Training more health professionals in geriatric care
  
• Supporting direct-care workers in long-term and home-care settings with benefits and increased wages

“Disrupting Disparities” stresses the importance of working at the county level to meet differing needs of rural, urban, Black, Latino and white residents. 

The expansion of telehealth “remains an inequitable story unless funds and structures are put into place to overcome the digital divide,” Gitlin said.

The report can be found at states.aarp.org/pennsylvania/disrupting-disparities-pa.

Hilary Appelman is a writer living in State College.

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