1. 10th Annual World Internet Project Meeting 2009
Health and the Internet: Autonomy of the user From Connected to Networked Citizens
Dr. Francisco Lupiáñez-Villanueva
ICTs Interdisciplinary Research Group (i2TIC) Internet Interdisciplinary Institute (IN3) Universitat Oberta de Catalunya (UOC)
Dr. Rita Espanha
Professor of ISLA - Lisbon
Researcher at CIES-ISCTE
(Portugal)
10th Annual World Internet Project Meeting 2009
Macao, July 8-10

2. Health and the Internet in the Network Society
Research projects
Health and the Internet in the Network Society
Portugal
Catalonia
Health in the Information Era
in Portugal
Directed by
Dr. Cardoso and Dra. Espanha
Internet, Health and Society: Analysis of Internet Use in Catalonia Health System
Directed by Prof. Castells
Researcher: Dr. Lupiáñez-Villanueva

3. Common Research Objectives
Identify, characterise and explain the determinants of the ICT and the Internet use carried out by citizens and health professionals within the health system.
Analyze in what way and to what extend ICTs, specially the Internet, are appropriated by citizens and health professionals within the health system.

5. Citizens, Health and the Internet - Highlights
Consequences on
Shape and being shaped by ICT
Shape and being shaped by autonomy
More health information available (quality and use)
More communication tools available
Online health services
Personal Health Management
Patient – Health Professional relationship
Citizens /Patients relationship
Healthcare demands
Health status
Access
Uses
Asses
Standards
Values
Efforts
Empowerment
Participation
E-readiness (DIGITAL oriented)
AGE – EDUCATION – LABOUR – GENDER (ANALOGUE oriented)

6. Citizens, Health and the Internet - Highlights
Intensive use of health information
Determinants of health: Age, Education and Labour
Determinants of e-readiness index: Age, Education, Labour and Gender
Connected are more likely to be in better health conditions and more likely to use private healthcare services
Disconnected are more likely to be worse health and use public healthcare services

7. Hart JT. The inverse care law. Lancet 1971; 1: 405–12.
“The availability of good medical care tends to vary inversely with the need of the population served”
Hart JT. The inverse care law. Lancet 1971; 1: 405–12.
The Inverse Care Law
In areas with most sickness and death, general practitioners have more work, larger lists, less
hospital support, and inherit more clinically ineffective traditions of consultation, than in the
healthiest areas; and hospital doctors shoulder heavier case-loads with less staff and equipment,
more obsolete buildings, and suffer recurrent crises in the availability of beds and replacement
staff. These trends can be summed up as the inverse care law: that the availability of good
medical care tends to vary inversely with the need of the population served.
Hart JT. The inverse care law. Lancet 1971; 1: 405–12.

8. DOES IT STILL WORK IN THE TRANSITION TO THE NETWORK SOCIETY?
The Inverse Care Law
In areas with most sickness and death, general practitioners have more work, larger lists, less
hospital support, and inherit more clinically ineffective traditions of consultation, than in the
healthiest areas; and hospital doctors shoulder heavier case-loads with less staff and equipment,
more obsolete buildings, and suffer recurrent crises in the availability of beds and replacement
staff. These trends can be summed up as the inverse care law: that the availability of good
medical care tends to vary inversely with the need of the population served.
Hart JT. The inverse care law. Lancet 1971; 1: 405–12.

9. OR COULD IT BE LEAPFROGGED?
The Inverse Care Law
In areas with most sickness and death, general practitioners have more work, larger lists, less
hospital support, and inherit more clinically ineffective traditions of consultation, than in the
healthiest areas; and hospital doctors shoulder heavier case-loads with less staff and equipment,
more obsolete buildings, and suffer recurrent crises in the availability of beds and replacement
staff. These trends can be summed up as the inverse care law: that the availability of good
medical care tends to vary inversely with the need of the population served.
Hart JT. The inverse care law. Lancet 1971; 1: 405–12.

10. World Internet Project Data Base 2007

11. World Internet Project Data Base 2007
Identify and characterise the Internet users who look for online health information into the E-readiness index to Network Society.
Non-hierarchical K-means cluster analysis was carried out to develop a typology of the Internet users:
We will now identify and characterise the Internet users who access online information about health issues into the e-readiness citizen to Network Society (Lupiáñez-Villanueva, 2009), on a global scale, using as methodology a selection of Internet users from the World Internet Project database Due to the amount of data and the amount of Internet activities collected in the database, non-hierarchical K-means cluster analysis was carried out to develop a typology of the Internet users. The goal to proceed with cluster analysis not only respond to a need to simplify data, but also to be able to draw a set of levels where we could accommodate citizens according to their respective stages of development of their digital competences. This typology of Internet users could be understood as an e-readiness index to the Network Society.
To simplify data
To be able to draw a set of levels where we could accommodate citizens according to their readiness to the Network Society

12. Basic Connected Citizen Advanced Connected and Social oriented Citizen
From
Basic Connected Citizen
Advanced Connected and Social oriented Citizen
Advanced Connected and Individual oriented Citizen To
Networked Citizen
Valid 8271
Missing 7084
Basic Connected Citizen: they are at the button of the Internet uses.
Advanced Connected and Social oriented Citizen: they use the Internet to do a lot of activities, especially those related with social and leisure aspects.
Advanced Connected and Individual oriented Citizen: they also use the Internet to do a lot of activities, especially those related with individual and personal aspects.
Networked Citizen: they are leading almost all the Internet uses
Source:
WIP 2007
Categories
1- Several times a day
2- Daily
3- Weekly
4- Monthly
5- Less than monthly
6- Never
Source: WIP 2007

13. Basic Connected Citizen they are at the button of the Internet uses.
Advanced Connected and Social oriented Citizen
they use the Internet to do a lot of activities, especially those related with social and leisure activities.
Advanced Connected and Individual oriented Citizen
they also use the Internet to do a lot of activities, especially those related with individual and personal aspects
Networked Citizen
they are leading almost all the Internet uses
Source: WIP 2007

14. Source: WIP 2007

18. Source: WIP 2007

19. Characterization E-readiness Index
Source: WIP 2007

20. Characterization E-readiness Index
Source: WIP 2007; p<0’001

21. Characterization E-readiness Index
Source: WIP 2007; p<0’001

22. Characterization Health information
Source: WIP 2007; p<0’001

23. Characterization Looking for Health information on the Internet
Source: WIP 2007; p<0’001

24. Citizens, Health and the Internet - Global
Determinants of health: Age, Education and Labour
Age Characterization of e-readiness index suggests…
Networked Citizens are more likely to be in better health conditions due to their age.
Connected Citizens are more likely to be in worse health conditions.
Disconnected Citizens…

25. The inverse care law still works in the Network Society

26. Thank you very much for your attention
Presentation available at:

27. 10th Annual World Internet Project Meeting 2009
Health and the Internet: Autonomy of the user From Connected to Networked Citizens
Dr. Francisco Lupiáñez-Villanueva
ICTs Interdisciplinary Research Group (i2TIC) Internet Interdisciplinary Institute (IN3) Universitat Oberta de Catalunya (UOC)
Dr. Rita Espanha
Professor of ISLA - Lisbon
Researcher at CIES-ISCTE
(Portugal)
10th Annual World Internet Project Meeting 2009
Macao, July 8-10