– Older people of racial and ethnic minorities have significantly less access to digital health information than white patients, according to new research out of Florida Atlantic University (FAU) that draws concern for the digital divide.
The quantitative study, published in the Journal of Racial Ethnic Health Disparities, examined the extent of computer ownership, internet access, and digital health information use in patients ages 60 and above. The study is based on data collection of 562 individuals and a series of focus groups that explored the effects of these disparities.
Researchers found that older, less educated, and economically disadvantaged patients from racial and ethnic groups (African American, Afro-Caribbean, or Hispanic American) were up to five times less likely to have access to digital health information than younger, more highly educated, economically advantaged non-Hispanic White patients.
“Currently, digital health technology development is outpacing parallel efforts to conquer the digital health divide, which also has important implications for helping older adults get registered for the COVID-19 vaccine,” said Ruth Tappen, EdD, RN, FAAN, lead author and Christine E. Lynn Eminent Scholar FAU’s Christine E. Lynn College of Nursing.
“Portals that allow patients access to their electronic health records, decision aids that prepare patients to discuss options with their providers, making telehealth appointments with providers and so forth, needlessly, though unintentionally, excludes, marginalizes, and disenfranchises those who are older, have low incomes, have low health literacy, and/or are members of minority groups,” Tappen continued.
The chances of owning a computer or having internet access were one-fifth as likely in the African American group as it was for non-Hispanic White patients, and one-fourth as likely for the Afro-Caribbean group.
The Hispanic American cohort was one-third as likely to own a computer than White non-Hispanic patients. Hispanic Americans were also one-half as likely to have access to the internet compared to White-non-Hispanic patients.
Digital access varied based on health insurance as well. For instance, Medicaid beneficiaries were less than one-half as likely to use the internet or digital health information as those not enrolled in Medicaid. Medicaid beneficiaries were also half as likely to own a computer.
In the focus groups, the researchers found that interest in obtaining health-related information online was highest for African Americans, Afro-Caribbeans, and non-Hispanic White patients, while the Hispanic American group showed less interest.
Participants in the African American and Afro-Caribbean groups expressed frustration with their lack of access to digital health data, but they noted their appreciation for alternative sources of information.
Hispanic Americans critiqued information received from providers and drug inserts, and some said that positivity and trust in God contributed to getting well. Non-Hispanic White participants evaluated various digital health information websites, calling on providers for help in deciphering how health information can be applied to their personal situation.
The researchers emphasized that addressing the digital health divide in the older population requires attention at several levels.
At the policy level, lawmakers might make a greater effort to provide universal internet. Municipal broadband networks can achieve this at the local level, but Americans would benefit from a national connectivity plan, the study authors explained.
The researchers said that eventually, internet service needs to be treated as a necessary utility like water or electricity, not a luxury. On the other hand, the internet could become a free service funded by advertisements like broadcast radio and television, they noted.
Based on these findings, in order to ensure older Americans, especially older Americans from ethnic and racial minorities, are able to access health information, alternative patient engagement strategies must be employed, the authors said.
“Until internet access is universal, creative use of printed materials, telephone calls, in-person groups, family assistance, individual meetings, and mailings are needed for those disadvantaged and minority older adults who remain affected by this digital health information disparity,” said Tappen.
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