1. Local goes global on the Internet: New York Online Access to Health Kristine Alpi, MLS Samuel J. Wood Library Weill Medical College of Cornell University kma2002@med.cornell.edu

2. U.S. Hispanics Internet Use Growth from 1998 to 2000 At Home:8.7%  16.1% Outside Home:10.0%  11.6% Any Location:16.6%  23.7% 13.6% of Hispanics using the Internet outside home used it at the Public Library (2000) Source: U.S. Dept of Commerce. NTIA. 2000. Falling through the Net: Towards Digital Inclusion. http://www.ntia.doc.gov/ntiahome/fttn00/chartscontents.html

3. Primary Language and Location of HON Survey Respondents Feb-Mar 2001 Health on the Net survey on usage of the medical Internet Spanish was primary language of 7.69% of participants (n=2901) Location (n=2951): South America – 3.9% Mexico – 1.15% Central America – 0.47% Spain mixed with rest of Europe in data

4. Increase in Spanish-Language Health Web Sites New and updated government sites www.healthfinder.gov/espanol re-released by HHS on 10/1/01 www.cdc.gov/spanish/default.htm Rise and fall of commercial sites www.egalenia.com, www.tuotromedico.com, www.salud.comwww.tuotromedico.com

5. NOAH www.noah-health.org ENGLISH SPANISH

6. NOAH Spanish Health Topics

7. Top Ten Causes of Death in Hispanics for 1999 (prelim) 1. Heart Disease 2. Cancer 3. Injuries 4. Cerebrovascular Disease 5. Diabetes 6. Chronic Liver Disease 7. Assault 8. Chronic Lower Respiratory Disease 9. Pneumonia & Flu 10. Conditions originating in Perinatal period Source: Health. United States, 2001. Table 32.

8. Top Five NOAH Pages Requested (2001) Web Page Views 2/28 1. Stimulants Factsheet 2. Cancer 3. AIDS/HIV 4. Pregnancy 5. STDs Web Page Views 8/31 1. Stimulants Factsheet 2. AIDS/HIV 3. Sexuality 4. Cancer 5. Pregnancy

9. Subjects & Source Countries of Spanish NOAH Questions 1. Cancer (7%) 2. Diabetes (6%) 3. Sexuality (6%) 4. Tied at 4% - Pregnancy - Neurological/ Neuromuscular Cond. - Child Health 1. Unknown (40%) 2. Argentina (21%) 3. Spain (17%) 4. Mexico (11%) 5. Colombia (6%) 48% of messages were solicitations Source: Unpublished study of NOAH messages (7/2-10/5/01)

10. Spanish-Language Sources by Country (January 2000)

11. Spanish-Language Sources by Type (January 2000)

12. Mining International Web Sites In 2000, searched US State Health Dept web sites for Spanish Consumer Health Info Found 15 States with > 100 documents Now it’s time to search the international health agency web sites Number and type of resources Primary topics to be determined

13. Making NOAH Relevant for Local and International Users Clarify search engine requirements Accents, Boolean (and/or) in English only Drugs/Dosages depend on country Do sites convert when translating? Mine Spanish content buried in English sites (RxList, MEDLINEplus) Advocate for coverage of weak areas Healthcare provider info, Genetics, etc…

14. Continuing Issues Beyond Availability Some problems are still with us….. Cultural Appropriateness of Translations Quality Control Issues Coding of diacritical marks Unequal editing Literacy Levels Use of Images

15. Need Further Information? Contact Info for NOAH noahweb@nyam.org Visit NOAH on the web www.noah-health.org Contact the Author: Kris Alpi kalpi@att.net