JMIR Publications

ABSTRACT

Background:

Despite the potential benefits of using eHealth, sociodemographic disparities exist in eHealth usage which threatens to further widen health equity gaps. The literature has consistently shown age and education to be associated with eHealth usage and there are mixed findings for racial/ethnic disparities. However, previous disparities may have narrowed as healthcare interactions shifted to virtual modalities for everyone because of the COVID-19 pandemic.

Objective:

The current study provides an updated examination of sociodemographic disparities that contribute to the health equity gap related to using eHealth for information seeking, using three time points.

Methods:

Data for this study came from the nationally representative 2018 (N=3,504), 2020 (N=3,865), and 2022 (N=6,252) time points of the Health Information National Trends Survey. Logistic regression was used to regress use of eHealth for information seeking on race/ethnicity, sex, age, education, income, health status, and year of survey. Given the consistent association of age on the dependent variable, analyses were stratified by age cohort (Millennials, Generation X, Baby Boomers, Silent Generation) to compare across groups of similar age.

Results:

For Millennials, being female (OR=2.35; all ORs shown are significant), attaining some college (OR=4.66) or a college degree (OR=5.39), and reporting an annual income of $50,000-$74,999 (OR=3.75) or $75,000+ (OR=5.55) was associated with use of eHealth for information seeking. For Generation X, being female (OR=1.79), having attained some college (OR=2.00) or a college degree (OR=5.32), reporting an annual income of $50,000-$74,999 (OR=4.63) or $75,000+ (OR=4.09), better self-reported health (OR=0.67), and completing the survey in 2022 (vs. 2018; OR=1.80) was associated with use of eHealth for information seeking. For Baby Boomers, being female (OR=1.68), of older age (OR=0.96), attaining a high school degree (OR=2.23), some college (OR=3.23) or a college degree (OR=7.70), reporting an annual income of $50,000-$74,999 (OR=1.54) or $75,000+ (OR=2.71), and completing the survey in 2020 (OR=1.56) and 2022 (OR=4.04) were associated with use of eHealth for information seeking. Among the Silent Generation, being of older age (OR=0.93), attaining some college (OR=2.77) or a college degree (OR=3.76), reporting an annual income of $50,000-$74,999 (OR=2.63) or $75,000+ (OR=2.92), and completing the survey in 2022 (vs. 2018; OR=5.76) were associated with use of eHealth for information seeking.

Conclusions:

Baby Boomers may have made the most gains in using eHealth for information seeking over time. The lack of significant findings by race/ethnicity may indicate a closing of racial/ethnic disparities. Sex, education, and income disparities held strong across all age groups. This aligns with long-standing health disparities for individuals with lower socioeconomic status and for males who are less likely to seek out healthcare compared to women. The largest number of disparities were observed in the Baby Boomer cohort, though findings suggest they have increased their eHealth usage over time.