Abstract

Over 50% of people in poverty in the United States no longer have a landline telephone, and this same population is more likely to have a no-contract cell phone plan requiring the continuous purchase of minutes. As a result, the poor may increasingly experience short-term phonelessness, which may disrupt access to healthcare and other services. To explore this we conducted 37 client interviews and 7 staff interviews at two free health clinics. Cell phone disconnection was a regular occurrence that delayed access to care and threatened client privacy. Temporary disconnection also contributed to lost employment, lost welfare benefits, and strains on social support networks—all of which are critical for optimizing health. Results are interpreted through a lens of technology maintenance, which argues that the poor will struggle to maintain digital access after ownership and public availability are realized. The potential worsening of health inequalities and related policy implications are discussed.

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