Older adults' digital health use varies by race, other factors

Though older adults in the United States use multiple types of digital health technologies (DHTs), race, sex, age and other demographic factors influence utilization, according to new research.

As digital health tools are increasingly deployed to support various healthcare industry goals, including value-based care, healthcare stakeholders must be wary of digital determinants of health that could curb the adoption and use of these technologies. Published in JAMA Network Open, the research letter assesses the utilization of digital health technologies among older adults and the factors associated with that use.

University of Michigan and Veteran Affairs Ann Arbor Healthcare System researchers assessed data from an internet and phone survey conducted in August 2021 as part of the National Poll on Healthy Aging. The recurring national poll surveys adults aged 50 to 80 randomly selected from the NORC AmeriSpeak panel, a nationally representative probability panel of U.S. households. The respondents answered questions about prior and current use of digital health technologies, including patient portals, telehealth and mobile health (mHealth) applications, and the devices that support their use, such as tablets, desktops, laptops and wearable devices.

Of the 2,110 survey respondents, 95.6% reported using a device. Among them, 53% were female, 10.8% were Black, 12.2% were Hispanic and 70.1% were white.

Most respondents (81.4%) reported using a digital health device, with 64.5% using a patient portal, 49.1% using a telehealth tool and 44% using an mHealth app. Female respondents (53.4%) were more likely than male respondents (46.6%) to use digital health technologies. Additionally, adults ages 50 to 59 were more likely to report digital health technology use than those 60 and older.

Further, a majority of white adults (70.2%) reported using digital health technologies. However, only 11.4% of Black and 11.9% of Hispanic adults reported the same.

"Various factors may contribute to this finding, including medical mistrust among Black patients leading to decreased engagement with the health system and increased reliance on DHTs," the researchers wrote.

Not only that, but the study also shows that respondents with higher educational attainment, higher income, private insurance and living in an urban area were more likely to report using digital health technologies.

"This study highlights the need to carefully consider the unique characteristics of older adults when developing and deploying DHTs to avoid worsening the digital divide," the researchers concluded.

A prior analysis of the National Poll on Healthy Aging showed similar trends regarding patient portal utilization among older adults.

Published in 2023, the analysis revealed that patients who used the patient portal for patient data access increased from 51% in 2018 to 78% in 2023. However, the analysis also shows older adults with incomes below $60,000 annually and Black and Hispanic older adults have lower patient portal utilization rates than their high-income and white peers.

The digital divide is among the most trenchant barriers to digital healthcare access. Previous studies have shown how this social determinant of health curbs telehealth utilization, leaving those who lack digital health literacy and have limited access to needed technology behind.

Overcoming the digital divide could unlock various benefits for older adults, including allowing them to age in place.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.