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Hatzakis, Jr M. The New Agora on the Internet. JAMA. 1999;281(8):762. doi:10.1001/jama.281.8.762
In ancient Greece, the agora was a central marketplace where products
and services were traded and people met to vote, hear lectures, and
gather with friends and neighbors. Improved transportation has replaced
the classic agora with scattered malls and business complexes. However,
a new agora is being created on the Internet.
For most people, the Internet provides a convenient way to access a
variety of goods and services. But for those with even minor
disabilities, access to education, employment, goods and services,
assembly with peers, or contact with physicians over electronic media
may provide a lifeline.
As physicians, we are not always taught about the impact acute
and chronically disabling diseases will have on various aspects of the
impaired patient's quality of life such as employment, education,
shopping, contact with loved ones, or even contact with their
physicians. Of the 35 million US citizens with a disability, 38% have
mobility limitations, 32% have respiratory or circulatory disease,
cancer, or diabetes, and 15% have sensory and intellectual
limitations.1 Computer and Internet technology are now
powerful enough to offer people with impairment access to others with
similar medical conditions, as well as to medical information,
education and training, goods and services, and employment.
Employment is vital to the individual with chronic disease, and studies
have shown that it is high on the list of factors that contribute to
how people perceive their quality of life.2,3 Yet, only
26.1% of those with significant disabilities are
employed.4 At the same time, telecommuting is growing
rapidly; nearly 10% of US workers now telecommute, and that number has
grown more than 15% a year for the last several years.5
This trend, combined with improvements in assistive devices, as well as
cheaper access and new telecommuting technology, will make reputable
online educational and employment resources a great asset to a person
with a disability.
Legislators, recognizing the potential of Internet resources for those
with disabilities, have introduced legislation that supports electronic
resources for employment. President Clinton recently unveiled an
initiative that includes the Work Incentives Improvement Act, intended
to protect Medicare coverage for those returning to work, provide a
$1000 tax credit to cover work-related costs, and funding for
cost-effective access to information and telecommunications
Access to employment gives a person with a disability not only the
potential for financial independence, but also greater self-esteem and
more control over his or her health care. Access to loved ones and
peers allows people to better adapt to their illnesses; greater access
to health care and medical information permits more effective disease
prevention. Many of us in medicine recognize that this new agora of
services the Internet provides will benefit the health care industry;
but those with a disability stand to benefit far more than any of us.