When the pandemic first struck, technological capabilities that already existed quickly became a critical and increasingly common part of people's lives. It became routine to work or attend school from home, or for visits to the doctor's office to be conducted via video chat. We have yet to see whether these trends will persist beyond the pandemic, but there are studies that suggest they will. A study by the Commonwealth Fund, from October 2020, suggests a future with more telehealth than pre-pandemic. Another, a Google Consumer Survey from the same month, found that 14 to 23 million Americans “are planning to move as a result of remote work.”
Collaborative technologies such as Zoom and Microsoft Teams have transformed how we work, visit the doctor, and go to school. But can they also shift demographic trends in migration, fertility, morbidity, and mortality? And if so, how?
It is a decidedly mixed bag. Take migration: When we think about the movement between cities, states, and regions, collaboration technologies facilitating remote work can increase migration—leading to moves away from employment centers. Relatedly, these same technologies can keep those already living in suburban and rural areas from moving, as remote work allows them to stay connected to urban job centers without living in them.
There is also the issue of equity. While these technologies can increase access to jobs and health care providers, and even improve the quality of jobs and care, unequal access to technology could limit the benefits gained. Mobile health (Mhealth) technologies, for instance, can bridge health divides across lower- and higher-resourced countries, reducing inequality. But not everyone has equal access to things like high-speed Wi-Fi, or even computers (PDF). We talk about a “digital divide” across regions and groups of people—this divide can be exacerbated as more domains of life require newer and faster technologies.
Technologies can increase access to jobs and health care providers, and even improve the quality of jobs and care. But unequal access could limit the benefits gained.Share on Twitter
How these technologies influence health is also complex. Pre-pandemic, there was already evidence of health improvements in lower-resourced countries, where mobile phone use is associated with better access to health care. While Mhealth interventions have the potential to improve health outcomes, their efficacy is not always systematically evaluated. In higher-resourced countries, there is a different problem: It is not always clear that telehealth is reaching people who otherwise would not get health care. It may be used primarily as a convenient, efficient, and cost-effective substitute for in-person care. For instance, a recent RAND study showed that increases in the use of telehealth during the pandemic among people with insurance occurred mostly among those who are more affluent and live in metropolitan areas—groups that already have access to quality health care and providers. Other evidence shows that while remote access to telehealth would be most beneficial to people in rural areas, uptake has been greater in metro regions in the United States.
Collaboration technology can potentially impact fertility by fostering better maternal and fetal health outcomes. In lower-resourced countries, for instance, collaboration technology could encourage greater schooling by improving access, which could provide women with greater autonomy over their fertility, particularly in regions where they may traditionally not have had it. Even in higher-resourced areas, more schooling—particularly through college—could result in a later age at marriage and delayed or reduced childbearing.
Remote work can deliver a host of less obvious, but no less important, health benefits as well—and these benefits could lead to reduced mortality over the longer run. Less commuting could reduce exposure to pollutants by reducing commute times. Traffic-related pollution levels declined after the early pandemic shutdowns occurred in the UK, suggesting that reductions in work-related traffic could improve air quality. Remote work also allows people to live farther from city centers, where air quality is notably better. Commuting, especially longer commutes by car or public transportation, is also associated with lower well-being. All of this can result in better physical and mental health. For both quality of health care and work, more choices often mean better matches and outcomes. More job choice usually results in a higher income, which is also associated with improved health. And, of course, if telehealth provides more choice in access to health care, that could improve health outcomes as well.
It will be important to track changes to the use of collaboration technologies to see how they affect demographic indicators and inequality over the long run.Share on Twitter
There is already some evidence that trends in telehealth might find a new normal: higher than pre-pandemic levels, but less than the peaks we saw during full shutdown. Trends in work might show greater and even more persistent change. Some industries have recognized the cost savings of remote work and do not have plans to go back to the brick-and-mortar office anytime soon. The education sector is seeing a similar new equilibrium. A recent RAND study suggests that remote school is not going away. In fact, about 20 percent of school district administrators in the United States said their school system already had online schools that were going to continue beyond the pandemic, or that they were planning to start one. A recent article in The New York Times describes how some school districts are requiring remote schooling one day a week to retain teachers and prevent pandemic-related burnout of educators. It will be important to track changes to the use of collaboration technologies as COVID-19 subsides to see how they affect demographic indicators and inequality over the long run.
Esther M. Friedman is a research associate professor at the Institute for Social Research at the University of Michigan and an adjunct behavioral social scientist at the nonprofit, nonpartisan RAND Corporation. Andrew Parker is a senior behavioral scientist at RAND. Friedman and Parker performed this work as demography fellows at the RAND Center for Global Risk and Security.
Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.