Enabling New Lifestyles in Cities - A debate at LLGA | Cities Summit

During the Parallel Session, Enabling New Lifestyles, participants gathered to talk about the changing face of public health issues in cities today, and what new solutions are emerging. The panelists drew on their experience working with STD screening, technology for aging in place, and accelerating community health outcomes. In all cases, technology is playing a critical role in public health concerns and solutions, alike. During the session, a few key characteristics of such technologies emerged:

LLGA2013 15.5.213 Parallel Session D

 (1) Provide in-the-moment interventions

  Participants saw plenty of ways in which mobile technology, advanced sensors, digital displays, and other digital tools have   provided a new opportunity for on-the-spot interventions.

For example, Alexander Börve, an orthopaedic surgeon and creator of iPhone app iDoc24, discussed the proliferation of “hookup” apps that help connect users for casual sex purposes. In high-density urban centers, individuals can publish and browse profiles through a variety of mobile apps — Tinder, Grindr, BangWithFriends, among others — to connect with instant dates, outside of traditional spaces, such as bars and clubs. The shift has interrupted many public health programs ability to provide safe-sex education and intervention, he noted, by removing a specific location where information and access can be provided at the point of contact between potential partners.

Instead of viewing such apps as a problem, however, the group saw opportunities to leverage the popularity and pervasiveness of these apps for encouraging positive behaviors such as STD and HIV testing, providing information about safe sex, and perhaps—in the case of infections such as chlamydia, for which public health officials try to notify partners of infected individuals—improving anonymous data collection and outreach.

Esther Dyson, of EDVenture and HICCUP, discussed the promise of a coordinated public health campaign, that could attempt to provide dozens of interventions into the average community member’s day. Among other ideas, technology tools could be used to provide on-the-spot feedback to program participants and community members about various behaviors — encouraging walking and biking, discouraging elevator use, etc. — through mobile apps, informational displays, and more.

(2) Leverage on-the-ground, non-digital relationships

Technology tools can provide a certain amount of access to community members, helping provide information at just the right moment. But that information needs to be actionable, too.

Participants discussed the need for technology tools to tap into existing networks of physical-world providers and infrastructure—health clinics, transit systems, bike lanes, emergency care, food service providers, property managers, and schools—to ensure that when information is given, it’s connected to programs with funding, resources, and expert knowledge that can provide an intervention that promotes or protect’s the user’s health.

Laura Mitchell, of GrandCare Systems, spoke about the way in which her company’s technology links senior’s personalized care needs, determined by doctors and overseen by medical professionals, with off-the-shelf technology to help seniors age in place. The technology is a critical piece of the puzzle. It helps alert family and providers when something unusual or unexpected happens. But those family and providers are needed to help put real-world plans into action when something is wrong.

(3) Use technology to reduce cost of care

Across the board, many participants were optimistic about the opportunity of technology to provide an inexpensive baseline of care for more people, helping reduce baseline costs and reserving more costly, expert-necessary care of those who actually need it.

For example, Dyson, whose HICCUP campaign doesn’t provide funding to partners, suggested that coordination of existing funding and programs could be tied together. How might that work?

Börve, whose STD Triage app allows users to have a photograph of their genitalia evaluated by experts for possible infections, noted that 69 percent of their users do not have an STD. Despite the high number of infections — 20 million new std infections in the U.S. each year— there is also a large amount of overscreening. At one university health clinic, only 40 of 1,500 students who were screened tested positive. There is a cost for paying for screening services, and the benefits of screening extend beyond just the individual who is treated for a positive result. By using low-cost interventions, like the screening app, clinics and public health officials can focus spending on patients with known cases and on preventive measures.

Similar advantages also exist for elder care, where regular, remote monitoring can help flag potential issues before they become untreatable, and reduce unnecessary doctor visits for routine checkups and screenings.

(4) Address the digital divide

As technology becomes an increasingly important tool for cities to help manage and address public health, it will also be important to ensure that all residents have access to those tools.

Participants discussed some strategies for ensuring fair access for to these new tools, from public WiFi, to text-message based alerts, to encouraging pay-as-you-go  packages for Internet access from mainstream providers (which would allow low-use customers, such as seniors and many other potential customers, to access inexpensive important services without subsidizing heavy-bandwidth users).

Several of the participants also discussed the importance of working on age-appropriate interfaces, designed to make technology accessible to users with limited sight or familiarity with technology, when such services are aimed at seniors.

Celeste LeCompte is an independent researcher and journalist, focused on innovation and the environment, based in San Francisco and Guangzhou, China.