How stress affects the way we understand health information
An interview on how to make health information more accessible. Plus: Do you know how to read your medical bill?
Welcome to Doing Well. Today:
An interview on increasing access to health information
Word of the week: health(y)
How to check for errors on your hospital bill
Happy Tuesday. Let’s get started!
We Asked: How can we access good health information under tricky circumstances?
The internet is full of health information—good and bad. But not all of us have the same access to it. Data from 2024 showed that a third of the world’s population hadn’t used the internet at all in the previous three months. When you measure meaningful connectivity—that is, not just whether someone has been online recently but whether they have access to safe, secure, and reliable internet service; a device that can connect to it; the money to afford connectivity; and the digital skills to navigate the internet—many, many more people are effectively disconnected.
Even those of us with good internet access can’t always tell useful information from harmful content, and in overwhelming or stressful situations, it’s even more difficult to find the health information we need.
SolarSPELL is an Arizona State University initiative that aims to address those challenges. It does this through a small, solar-powered device that sends out an offline Wi-Fi signal. Once connected to that signal with a cell phone, tablet, or computer, you can download educational resources on a wide range of topics, from health to agriculture. Accessing this curated library doesn’t require the internet.
Last week, SolarSPELL was named one of TIME‘s Best Inventions. We spoke to Laura Hosman, the cofounder and director of SolarSPELL, and Heather Ross, the codirector of SolarSPELL Health, about the connection between trustworthy information and health and the most effective ways to deliver information in stressful or low-resource situations. Our conversation has been edited for length and clarity.
Short on time? Here’s what to know:
To measure who has access to digital health information, you can’t just ask who can theoretically connect to the internet—instead, you need to ask who has meaningful connectivity. Consider: Is access consistent and reliable? Is the information understandable, relevant, and trustworthy? Do people have the skills to use the internet effectively and sort useful information from junk?
We aren’t good at understanding information in moments of stress. During a doctor’s appointment or after an emergency, for example, we may only be able to take in a small portion of what’s communicated. It can be helpful to ask for information to be written down, repeated, recorded, or sent to you.
Crisis responders, health care providers, and others sharing information in times of stress should make sure they communicate using plain language, give no more than two or three pieces of information at a time, and ask people to “teach back” to confirm understanding. They should provide resources people can easily reference later on.
Mia Armstrong-López: How do gaps in access to information affect our health?
Laura Hosman: If you’ve never had free and easy access to information, people don’t necessarily know how to go to a trusted source. Having access to information, knowing what information you’re looking for, assess[ing] trustworthiness, and then using it in your life is a skillset that needs to be developed. It’s a foundational skillset that improves education, health, livelihoods.
Heather Ross: This really hit me hard when I realized that, when we are in communities where people do have some internet access, if you ask them they’ll say, “Oh, yeah, I use the internet every day.” And then you dig into that just a little bit further, and folks will tell you they search on Google and they have enough data to click on the first link. Most often, they don’t know that the first link is an ad. And then they’ve run out of data in the bundle that they’ve been able to afford for the week.
MAL: You’re identifying a number of challenges. One is a lack of access in general, one is restricted access, and another is access to a lot of information, but no ability to differentiate what is trustworthy. How can people develop the skills to identify trustworthy information?
Laura Hosman: The approach that we’re taking is a library: curating information that is trustworthy, up-to-date, relevant for the people who’ll be using a library. The SolarSPELL Initiative at Arizona State University empowers learners globally with both offline digital libraries and the skills people need to thrive in the digital age. People can get connected to the library over offline Wi-Fi in a minute or less if they’ve ever used a smartphone before.
MAL: How are you applying this library approach to health?
Heather Ross: Our health library was first imagined to serve nursing and health students [in places without consistent internet access]. We have libraries in Malawi, South Sudan. [In many parts of the world], nursing students go out for intensive rotations in rural and isolated hospital[s] or clinic[s]—they often don’t have robust internet connectivity. They may not have electricity or running water. Historically, they would go to the library at their school, check out an armload of textbooks, and hope that those books contain the information they need. Now, our health library includes textbooks, videos, audio files, patient-facing information, instructional materials—and they’ll take these libraries out to the field with them.
That’s where the health libraries started. We then had interest in the United States. Hopi Cancer Support Services told us their community health representatives were needing more education on cancer screening and treatment, and because of limited broadband access and no medical libraries, they were having a hard time accessing that information. We were able to develop a focused and culturally relevant library.
Here in Phoenix, the Phoenix Fire Department’s Community Assistance Program and crisis responders had a need to share information with people who experienced trauma or crisis. They have a lot of written materials—those materials were not always super accessible for people with lower literacy skills and people who had experienced upheaval. We’ve been working to curate a collection of crisis response materials.
MAL: Let’s say there’s been a crisis—how could crisis responders use SolarSPELL to connect people with resources?
Heather Ross: When people have a house fire, the crisis responders will come with the firefighters who are putting out the fire and providing first-aid. The crisis responders will help people get connected to equipment, clothes, a hotel to stay in. Here’s how you would reach out to your insurance company … All of your records have just been lost, here’s how you replace your driver’s license, your insurance card. Traditionally, they would have handouts, and if someone had a home, they would put that in a safe and reliable place in their home.
But I was standing out on the street a few years ago at a house fire with the crisis responders. This woman had a large family—and thankfully everyone was able to get out of the fire. But she had, like, her tote bag, because she had just gotten called home from work because the house was gone. I watched them hand over this packet of useful information, and I remember her holding this packet and looking around like, Where can I put this? And she put it in her tote bag. I thought, That is literally the only thing this lady has left. How quickly is all of that information going to be lost? If it could have gone onto her phone, how much more accessible could it be? That’s what set us down this path.
We [also] heard from the crisis responders that when there is a crime scene, oftentimes it will take hours before we can remove children from the crime scene, because nobody can leave while there’s an ongoing investigation. Crisis responders were telling us that they would actually take their personal cell phone and bring up YouTube videos [for] kids—and this could go on for hours. We understood there was a need that SolarSPELL could meet by developing a child trauma toolkit that includes storybooks, age-appropriate videos, interactive games, digital coloring pages. As we rolled this out to crisis responders, it significantly improved their stress levels and reduced burnout.
MAL: When you’re in a crisis situation, it’s difficult to take information in. How does stress affect our ability to understand and sort through information?
Heather Ross: Anxiety and stress absolutely bottom-out our ability to take in information, understand it, remember it, make use of it. That’s why it’s important that meaningful information is available to people when they can make use of it—in the moment of trauma or crisis is not going to be that time. How can we get that information onto someone’s personal device in a manner and a place that people are going to find it when they need it?
[If you’ve] been to a doctor’s office, experienced getting bad news, stressful information, engaging with public safety officials—we know that we only hear a small percentage of what is said. So it’s a way that we can ensure that people get the information when they’re ready for it.
MAL: How can we improve our ability to consume information under stress?
Heather Ross: Being aware in the time of stress to say, “I’m not going to remember this, let me put it over there so I can come back to it.” For public safety workers, health care workers, other advocates, neighbors, family members—we can also support that by saying, “You know what? Let’s grab that and put it over there, because you’re going to want to come back to that in a week.”
I teach health literacy communication to police recruits, and that’s one of the things I try to help them understand: Whenever they walk in the room, it’s probably already somebody’s worst day—and they often increase the stress level. They’re not meaning to, but that’s just the fact of it. So recognize that person isn’t going to be able to take in, remember, and make use of the information that they’re going to need later. Speak slowly, speak simply, give no more than two or three pieces of information at a time, and ask people to tell you back what you just said. Then ask: OK, how are you going to use this information now?
It’s really valuable to give people information either written on paper or in a digital format, and to use techniques like circling, underlining, highlighting important information, turning down a page in a pamphlet, dog-earing the page that they may need to come back to later.
Want to get involved in SolarSPELL? You can volunteer, intern, partner, or donate.
Well-Informed: Related stories from the ASU Media Enterprise archives
Libraries like SolarSPELL’s health library require careful upkeep as the information we need and our relationship to it change. In this essay from Zócalo Public Square, Ignacio Albarracín explores the future of libraries and the social role they play.
Well-Versed: Learning resources to go deeper
Looking for a curated library with reliable answers to your burning scientific questions? Check out ASU’s Ask A Biologist, which has answered more than 45,000 biology questions—many of them directly related to health.
Well-Read: News we’ve found useful this week
“Updated 2025 Fall Vaccine Guide,” by Katelyn Jetelina, Oct. 8, 2025, Your Local Epidemiologist
“Social Ties Help You Live Longer. What Does That Mean for Introverts?,” by Dana Smith, Oct. 9, 2025, The New York Times
“Why Do Women Live Longer Than Men? A Study Offers Clues to Close the Gap,” by Allison Aubrey, Oct. 6, 2025, NPR
Well-Defined: Word of the week
Health is a word we use all the time, but it’s surprisingly difficult to define. Some definitions only include the absence of illness or infection, but the World Health Organization goes a step further, defining health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Why is it important to agree upon a definition of health? In short, because health isn’t just facilitated by doctors or hospitals—it’s shaped by the resources we have in our daily lives, including the food we can afford, the information we can access, the water we drink, the air we breathe, and many other determinants that aren’t in the control of individuals. When our communities are healthier, we’re all healthier.
-Mel Moore, health communication assistant
Well-Engaged: How to double-check your medical bills
Did you know an estimated 1 in 5 Americans got a medical bill they disagreed with or could not afford in the past year? That’s why it’s important to know how to read your medical bills—and, if needed, correct them.
To do so, start by taking a look at your bill and verifying your personal information and the name and address of your health care provider are correct. Take note of your account number, which is assigned to you by your health care provider—you’ll need this if you contact them with billing questions.
Next, make sure the date you received the service and the service itself are recorded accurately. Sometimes these can be listed very generally or have procedure codes you aren’t familiar with. If you have questions, contact your health care provider for clarification.
The costs of services or supplies add up to the number at the end of your bill—the ticket price for your care. But what you actually have to pay will depend on several different factors.
The first is the allowed amount: AKA the maximum dollar amount your insurance plan will cover for a service. You may also see this called an “eligible expense,” “negotiated rate,” or a “payment allowance.” Next, there may be payment adjustments, which are discounts your provider agrees on with your insurance. Then, there’s the insurance payment: the dollar amount your insurance has agreed to pay, after you’ve paid your part. Your patient payment will also be listed, which is what you may have already paid, possibly through copay directly to your provider. Finally, the “balance due” or “patient responsibility” is what you still owe your provider.
Is your head spinning yet? Here’s an example:
Let’s say the total cost of the services you received was $100.
Your insurance has negotiated a discount down to $90, and under your plan, insurance will pay $50. $90 - $50 = $40
You already paid $20 in a copayment when you received the service. $40 - $20 = $20
You’re left owing $20
What if you think there’s an error on your bill? You can contact your health care office’s billing department or your insurance. You can also use the consumer assistance program in your state, or request a patient advocate.
Places to check for errors on a hospital bill include:
Dates and number of days you received treatment, especially if you were admitted around midnight or early in the morning
Zeroes: make sure each fee has the correct number of zeroes
Double or duplicate charges
Generic or brand-name medicine: Which were you charged for and which did you actually use?
Routine supplies (gloves, hospital gowns, sterilization equipment): You should not be billed for these
Even before you get your bill, consider keeping notes about the services you receive and when you receive them. Sometimes called a “health care ledger” or personal health record, these notes will help you review your bill later.
-Mel Moore, health communication assistant
Expert review provided by Leslie Morgan, clinical assistant professor, ASU Edson College of Nursing and Health Innovation