Many of you may have found yourself thinking a very prejudice thought that I once had: poor people don’t have technology. I blame poverty porn and partly the fact that I still think of computer, cell phones and technology in general as luxury items though their ubiquity is obvious. Those poor, poor people scrounging for food in the trash with nary a cellphone or internet connection in sight. Reading about SMS campaigns in Tanzania, Mexico, Bangladesh and many others made me realize I was still holding on to this prejudice long after it ceased to be the case. After all, did Gangham Style teach me nothing? Did I not realize that young people in Korea go without food and other necessities to make sure they can purchase a smart phone and drink at Starbucks. Many “developing” countries have cell phone rates that exceed the population rate. Granted this may be the result of people owning multiple devices, but 6 billion cell phones aren’t just in the hands of the upper and middle classes. Clearly, it’s time to accept that fact that everybody has a cell phone and there’s a chance for public health campaigns to realize they can reach everybody, even the poor people.
This table just shows the distribution by income of cell phone text message users. There are gaps in cell phone ownership, across socioeconomic status but they just keep getting smaller every year.
So everybody has a cellphone, now what? Receiving text messages is such a common phone function that we might forget that even the most basic of phones send and receive text messages. Phone plans and rates differ but it’s feasible to reach millions of those in poverty using text messages. But what about the future? What’s gonna happen when Bengalis and and receive over 400 texts a day like Americans and the thrill of the public health text message campaign has died down? Over 65% of Americans own smartphones and from the chart below you’ll see that smartphone usage in India has been growing steadily since 2000. Imagine if by 2020 over 50% of cellphone users in India are Smartphone users (1). Now what do we do with that information?
I think it’s safe to say that the development of public health apps and websites that are mobile phone friendly are key for the future (4). Imagine if public health apps about smoking cessation, heart disease prevention, kitchen safety, or prenatal care could be translated into hundreds of languages and be made available to everybody. If every Android, iPhone and HTC came standard with alerts based on 10 simple questions like: Do you smoke? What your height and weight? Are you on any medications? Where do you live? Imagine if everybody’s phone just reminded them to drink enough water and put some spinach on their sandwich at lunch or take the stairs instead of the elevator. We look at our phones every five seconds anyway, what if instead of another cat meme on Facebook it was a remind to get screened for colon cancer? Every month could send disease prevention awareness alerts to everybody.
I think text message campaigns are great and they are seeing real results instantaneously. Now what’s the ext evolution? Comment below with what you think will be the public health campaign of the future and beyond.