Four steps of the public health approach are to

• examine communities, conduct surveillance activities;
• identify health concerns and their sources;
• identify and mobilize community resources to address health concerns that people view as most relevant to their interests; and
• evaluate interventions and implement successful programs on a larger scale.

Public health informatics has a similar scope of work but applies technology specifically as tools for public health practitioners to engage communities and individuals in behavioral and environmental change processes. Technology is integrated appropriately to:

• describe the magnitude of health problems and their sources;
• analyze risk factors;
• identify community strengths from which strategies may be defined and tools created to intervene, prevent problems, and promote health and well-being; and
• continuously evaluate, refine, and implement what works.

A question posed frequently when we discuss creative ways to use emerging technologies for public health endeavors is "what about people who don’t have computers or access to the Internet? How do we keep them from getting left behind?" This is a very important issue, with implications for many of us in the fields of public health, health education, and health communications. However, delivery of health messages and programs has always been a challenge when working with "hard-to-reach" populations. The challenge is figuring out how to meet people where they are, using creative approaches and involving the recipients of messages and programs in the earliest planning stages.

The PHI Laboratory is committed to exploring the best ways to bridge gaps in access and acceptability of technology in support of public health goals. We are encouraged by the increased national dialogue and research efforts taking place to understand the characteristics of the digital divide and how it is affecting various groups of Americans. An important and timely Healthy People Objective (11.1) is to bring the proportion of households with access to the Internet at home from 26 percent (as measured in 1998) to 80 percent by 2010. The Department of Commerce and the National Telecommunications and Information Administration have held summits, issued three reports outlining the information gaps present in rural and urban America with respect to telephone, Internet, and other communications disparities. In December 1999, the Secretary of Commerce held a Digital Divide Summit and announced a new web site, digitaldivide.gov