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 in the course of the COVID-19 pandemic when location knowledge have been used as a proxy for human motion and contacts and knowledgeable publicity notification apps. Nonetheless, a brand new research led by researchers at Penn State revealed that cellphone knowledge could not precisely replicate under-resourced or significantly weak populations, who are sometimes underrepresented in different knowledge as properly.

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

“Populations with restricted entry to well being care are additionally typically ignored 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 group. “New, handy knowledge sources like cell phones can supply vital insights into these populations, however it’s crucial that we determine and measure their biases.”

Information gaps exist in all contexts and may be simply seen in small, rural populations, based on Bharti. On this research, the researchers investigated cellphone possession, mobility and entry to well being care in a cellular, rural inhabitants in Namibia as a case research to measure cell phone knowledge representativeness in populations that usually 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 choices 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 group carried out detailed surveys of greater than 250 individuals at two settlements in a distant space of the Kunene province. Residents are largely nomadic, shifting seasonally to herd cattle, and the space to the closest well being clinic is substantial.

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

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

“One frequent approach 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 individuals lacking in cellphone knowledge are much less cellular with decreased entry to well being care. And with respect to creating public well being choices, these are crucial variations.”

Cell phones additionally offered a skewed notion of mobility amongst cellphone homeowners, based on Blake. As a result of cellphone homeowners steadily traveled to areas with no cellphone reception, a lot of their actions wouldn’t be captured in cellphone knowledge.

“Even if you happen to personal a cellphone, you may solely be tracked in places the place you get sign,” Blake stated. “So, cellphone knowledge, particularly from distant areas, will solely seize a particular phase of the inhabitants and may document solely a few of their actions. If cellphone knowledge have 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 cellphone knowledge can be deceptive and ineffective for outbreak response efforts making an attempt to restrict the spatial unfold of a illness.”

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

“All knowledge have biases however are nonetheless beneficial assets, and cellphone knowledge aren’t any exception,” Bharti stated. “Acknowledging that knowledge are usually not just below consultant and exhibiting that they’re the truth is biased helps our area transfer in the direction of accurately deciphering knowledge, measuring biases and searching for methods to measure what’s lacking.”

Based on the researchers, small, distant populations play an vital however typically ignored 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 primary human proper, and addressing well being inequities in underrepresented populations is important for public well being progress,” Bharti stated.

“You do not have to look to low- or middle-income nations to seek out underrepresentation in weak teams. We’d see the identical absence of weak teams in extensively used knowledge if we appeared, 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 providers. Failing to acknowledge these biases can direct assets away from these teams and result in public well being interventions that amplify inequities.”

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