Mobile phone data used for public health underrepresent vulnerable populations, finds new study

Cell phone knowledge are more and more utilized in public well being administration and illness outbreak response, as demonstrated through the COVID-19 pandemic when location knowledge had been used as a proxy for human motion and contacts and knowledgeable publicity notification apps. Nevertheless, a brand new examine led by researchers at Penn State revealed that telephone knowledge could not precisely replicate under-resourced or notably weak populations, who are sometimes underrepresented in different knowledge as nicely.

If this bias is just not acknowledged or complemented with further knowledge, the researchers stated, a reliance on telephone knowledge in public well being efforts may enlarge well being inequities. They revealed their findings at present (July 6) in PLOS Digital Well being.

“Populations with restricted entry to well being care are additionally typically neglected in different knowledge sources, together with censuses,” stated Nita Bharti, affiliate professor of biology within the Penn State Eberly Faculty of Science and chief of the analysis staff. “New, handy knowledge sources like cellphones can provide essential insights into these populations, however it’s crucial that we determine and measure their biases.”

Information gaps exist in all contexts and will be simply seen in small, rural populations, in keeping with Bharti. On this examine, the researchers investigated telephone possession, mobility and entry to well being care in a cell, rural inhabitants in Namibia as a case examine to measure cell phone knowledge representativeness in populations that repeatedly expertise vaccine-preventable infectious illnesses.

Namibia is a middle-income nation in southern Africa, and Bharti stated cell phone knowledge from the area are used to information public well being selections round malaria and different infectious illnesses. Most Namibians stay in city areas with dependable entry to well being care, however this isn’t the case for rural or distant populations. The analysis staff performed detailed surveys of greater than 250 folks at two settlements in a distant space of the Kunene province. Residents are largely nomadic, transferring seasonally to herd cattle, and the space to the closest well being clinic is substantial.

The researchers discovered that telephone possession was comparatively low, with solely 31% of individuals proudly owning a telephone—in comparison with the estimated 95% in city areas within the nation in 2013—and solely 59% having used a telephone of their lifetime. Telephone house owners and customers had been much more prone to be males, to journey to extra areas and to have higher entry to well being care.

“We discovered that, inside these already weak populations, probably the most weak folks had been underrepresented in these telephone knowledge as a result of they did not personal telephones or have entry to telephones,” stated Alexandre Blake, graduate pupil in Bharti’s lab at Penn State and first writer of the paper.

“One widespread strategy to make up for lacking knowledge is to easily scale it up and assume that lacking knowledge are the identical as recorded knowledge. However we distinctly discovered that the folks lacking in telephone knowledge are much less cell with decreased entry to well being care. And with respect to creating public well being selections, these are crucial variations.”

Cellphones additionally offered a skewed notion of mobility amongst telephone house owners, in keeping with Blake. As a result of telephone house owners continuously traveled to areas with no telephone reception, lots of their actions wouldn’t be captured in telephone knowledge.

“Even for those who personal a telephone, you’ll be able to solely be tracked in areas the place you get sign,” Blake stated. “So, telephone knowledge, particularly from distant areas, will solely seize a particular phase of the inhabitants and might document solely a few of their actions. If telephone knowledge had been used to foretell the potential unfold of an infectious illness in a area just like the one we studied, most actions and contacts can be missed. With out accounting for knowledge biases, actions primarily based on telephone knowledge can be deceptive and ineffective for outbreak response efforts trying to restrict the spatial unfold of a illness.”

As a result of cell phone knowledge could not precisely signify the populations and areas that the majority want public well being enhancements, the researchers urged that counting on these knowledge to tell public well being selections can truly be dangerous and probably enlarge well being inequalities. They careworn the significance of acknowledging and measuring bias in all kinds of knowledge—not solely these used for public well being—in addition to utilizing a number of kinds of knowledge with non-overlapping biases when drawing conclusions.

“All knowledge have biases however are nonetheless worthwhile sources, and telephone knowledge are not any exception,” Bharti stated. “Acknowledging that knowledge should not slightly below consultant and exhibiting that they’re in actual fact biased helps our subject transfer in the direction of accurately decoding knowledge, measuring biases and searching for methods to measure what’s lacking.”

In accordance with the researchers, small, distant populations play an essential however typically neglected position within the transmission and persistence of infectious illness. Restricted entry to well being care can result in delayed detection of outbreaks, and overlooking these teams can sluggish the elimination of vaccine-preventable transmissible pathogens.

“Equitable entry to well being care is a fundamental human proper, and addressing well being inequities in underrepresented populations is crucial for public well being progress,” Bharti stated.

“You do not have to look to low- or middle-income nations to search out underrepresentation in weak teams. We might see the identical absence of weak teams in broadly used knowledge if we seemed, for instance, at a rural a part of Pennsylvania or Mississippi or in city areas, like New York Metropolis or Los Angeles. There are gaps and biases in all knowledge that underrepresent the segments of populations most in want of improved well being companies. Failing to acknowledge these biases can direct sources away from these teams and result in public well being interventions that enlarge inequities.”

Along with Bharti and Blake, the analysis staff consists of Ashley Hazel on the College of California, San Francisco, and John Jakurama and Justy Matundu on the Kaoko Info Middle in Namibia.