Three Reasons Why SMS is Vital to Mobile Health

SMS mobile health infographic


I didn’t know much about SMS campaigns and cell phone mHealth until this week. The stats shared in this week’s materials, including the video, really blew me away. SMS has some marked benefits; these three really struck me:


1. SMS provides ripe opportunities to reach underserved populations.

Nine out of every ten Americans own a cell phone, regardless of race/ ethnic background, and 81% of Americans send or receive text messages. Mobile technology has comparable reach in people in both the majority as well as minority demographic categories, with >80% usage in those of lower-income and/ or lower-education brackets. Text messaging has exceptional reach with the younger adults, reaching almost 100% of those between ages 18 and 29 years old. In fact, those between 18 and 24 years old send or receive an average of 109.5 text messages per day

With this broad usage, to me it’s a no-brainer: utilizing short messaging systems is low-hanging fruit, particularly for reaching parts of the population who need it most.


2. SMS is easy and simple to implement.

Unlike other social media tools, which may require multiple iterations to display properly on various operating systems (OS), SMS speaks a common language. It requires no extra programming to be implemented on phones using iOS, Windows, Android, Blackberry, etc. Many cell phone carriers offer free unlimited text messaging, removing cost and messaging overages as barriers. It’s instantaneous and requires no further tools to access: it doesn’t require WiFi, an internet browser, or an external application (app). And contrary to perception, it can be a private and HIPAA-compliant means of communicating personal health information, as safe as email or fax.  


3. SMS reaches everyone, because everyone uses it.

67% of Americans check their phones even when there it is not buzzing or ringing. Two out of five Americans even sleep near the phones. This makes it a good fit for emergency notification and health safety notifications. With 58% of Americans owning smartphones, they become more than devices to call and text people; 60% use their smartphones to access the internet, and 52% use them to send or receive email. In other words, cell phones have become an integral part of daily life.


In addition, cell phones are everywhere worldwide as they are in America. In fact, out of 7 billion people in the world, 6 billion have access to a mobile phone. More people have access to a cell phone than to a toilet. In China, 95% of people own a cell phone, and as Dr. Catalani mentioned, many own more than one. On the “low” end, more than 80% of people in many African and South American countries own a cell phone.


And in 22 out of the 24 nations surveyed by the Pew Research Center, cell phone users send text messages. SMS therefore is a logical tool to promote prevention services like prenatal health and sanitation in some emerging nations.


So, I’m excited to see where SMS and mHealth will go in the next few years. Unlike other social media, SMS allows access to traditionally underrepresented peoples. And then I can put all my texting skills to good use, if my thumbs don’t get stiff first.



10 thoughts on “Three Reasons Why SMS is Vital to Mobile Health

  1. Great post, Debora.
    Did you make that Piktochart? It looks great! I made one with some of the Pew Research data as well for my blog post this week… but I think I like yours better! haha. Super cool software though. It’s amazing how easy it is to make some professional looking graphics.

    • Yup, that Piktochart is my original – thank you! That site’s pretty nifty. I especially like the google drive interaction, it takes graphing to another level.

  2. It took me a while to text (I started in 2011). However, now i see it as indispensable. I also agree that SMS is vital to mobile health. I would argue that we have not yet reached 10% of its potential.
    I remember going to Africa (Liberia) for the first time (2008) and being amazed that literally everyone had a cell phone.

  3. Playing devil’s advocate 🙂 , does SMS effectively reach everyone? The divergence between oral vs. written communication in society as well as illiteracy are important factors to consider when targeting a communications campaign. Often combinations of methodologies are advisable, for instance interactive voice response may be preferable among elderly populations while SMS works well among Gen X/Y and whatever comes after that. Nice post though!

    • Thanks for the counterpoint – I agree supporting multiple methods of communication, including voice and visual, are necessary. I could see voice SMS and other voice to text apps helping reach population where texting with tiny touch screens or buttons is difficult, either to do (clients who have physical barriers like fine motor skills, such as those with Parkinson’s or rheumatoid arthritis) or difficult to see (clients with low vision). Good food for thought!

  4. Debora, great looking infographic! I am going to try that tool as well. You really drove home your point about the broad reach of SMS with this statement: “More people have access to a cell phone than to a toilet.” Great job!

  5. I find it really depressing that such a high number of people have their phone next to them when they sleep! I’d also be interested to see the data on texting for other countries. I think the US may actually be behind the curve on the the up-take of this technology. I know that my relatives in the UK started using it as their preferred form of communication well before it was common in the US. This is reflected in the pay structures of many of our mobile phone plans here in the US. In the UK, if is much easier to get unlimited free messaging with your plan.

  6. Great piktograph image Debora! Yes its amazing how wide spread the usage is globally and in the US. In our reading for this week when they broke down the numbers I was floored. It makes total sense to go this route for medical and public health technology.

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