JMIR Publications

ABSTRACT

Background:

Internet use for health information is important given the rise of eHealth integrating technology into healthcare. Despite perceived widespread use of the Internet, a persistent “digital divide” exists in which many individuals have ready access to the Internet and others do not. To date, most published reports have compared characteristics of Internet users seeking health information vs. non-users. However, there is little understanding of the differences between Internet users seeking health information online and users who do not. Understanding these differences could enable targeted outreach for health interventions and promotion of eHealth technologies.

Objective:

This study aims to assess population-level characteristics associated with types of Internet use, particularly for seeking online health information.

Methods:

The 2015-2016 California Health Interview Survey (CHIS) datasets were used for this study. Internet use was classified as: those who have never used the Internet (Never use), those who have ever used the Internet but not to search for health information in the last 12-months (Use not for health), and those who have ever used the Internet and have used it to search for health information in the last 12-months (Use for health). Weighted multinomial logistic regression was used to assess sociodemographic and health characteristics associated with types of Internet use. Findings are reported as odds ratios (OR) with 95% confidence intervals (CI).

Results:

Among 42,087 participants (weighted sample of 29,236,426), 19% reported Never Use of the Internet, 27.9% reported Use not for health, and 53.1% reported Use for health. Compared to Never Use, Use for health individuals were more likely to be younger (OR: 0.1 [CI: 0.1, 0.2] for ≥60 years vs <60 years), female (OR: 1.6 [CI: 1.3, 1.9] compared to males), non-Hispanic White (OR: 0.54 [CI: 0.4, 0.7] and OR: 0.2 [CI: 0.2, 0.4] for Latinos and African Americans, respectively), and have a higher socioeconomic status (400%+ Federal Poverty Guidelines OR: 1.3 [CI: 1.4, 2.4]). Overall, characteristics for the Use not for health and Use for health groups were similar, except for those with lower levels of education and respondents not having visited a physician in the last year. For these two characteristics Use not for health were more similar to Never Use.

Conclusions:

Findings indicate that a digital divide characterized by sociodemographic and health information exists across three types of users. Results reflect previous studies about the divide specifically with regards to disparities in use and access related to age, race/ ethnicity, and socioeconomic status. Disparities in health seeking online may reflect existing disparities in healthcare access extending into a new era of health technology. Findings support the need for interventions to target Internet access and health literacy among Never Use and Use not for health groups.