JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic accelerated the adoption of digital health technology, but it could also impact age-based disparities as existing studies point out. Compared with the pre-pandemic period, whether the rapid digitalization of health care system during the pandemic widened the age-based disparities in a long period remains unclear.

Objective:

This study analyzes the long-term effects of the COVID-19 pandemic on the multifaceted landscape of digital health technology use across diverse age groups among U.S. citizens.

Methods:

We conduct the retrospective observational study utilizing the 2017-2022 Health Information National Trends Survey (HINTS) to identify the influence of COVID-19 pandemic on a wide range of digital health technology use outcomes across various age groups. The sample includes 15,558 respondents, which are categorized into three age groups: adults (18-44 years), middle-aged (45-64 years), and older adults (65+ years). We also designate the time point of March 11, 2020, to divide the pre- and post-period. Based on these categorizations, multivariate linear probability models are used to assess pre-post changes in digital health technology use, controlling for demographic, socioeconomic, and health-related variables among different age groups.

Results:

Essentially, older adults were found to be significantly less likely to use digital health technology compared to adults, with a 26.3% lower likelihood of using the internet for health information (P<.001) and a 32.6% lower likelihood of using health apps (P<.001). The usage of digital health technology for all age groups had significantly increased after the onset of the pandemic, and the age-based disparity became smaller in terms of using the internet to look for health information. However, the disparities have widened for older adults in using the internet to look up test results (-11.2%, P<.001), make appointments (-10.0%, P=.006) and using wearable devices to track health (-8.3%, P=0.012).

Conclusions:

Our study reveals a significant increase in the use of digital health technology among all age groups during the pandemic. However, while the disparities in accessing online information have narrowed, age-based disparities, particularly for older adults, have widened in most areas such as looking up test results and making appointments with doctors. Therefore, older adults are more likely left behind by the rapidly digitalized U.S. healthcare system during the pandemic. Policymakers and healthcare providers should focus on addressing these disparities to ensure equitable access to digital health resources for U.S. baby boomers.