Neurological

The sharing of digital health information puts many older adults at a disadvantage

According to a recent study, many people aged 60 and over do not have access to digital health information (DHI), and this lack of access varies widely by race, ethnicity, and income.

Researchers from Florida Atlantic University in Boca Raton, Florida, in collaboration with colleagues from the Dana-Farber Cancer Institute in Boston, Massachusetts, and the University of Massachusetts Medical School at Worchester, studied the extent of computer ownership, Internet access and DHI use older adults. They interviewed 562 multiethnic people in South Florida who were 60 years of age or older. The group that included 100 blacks, 113 Afro-Caribbean, 129 Hispanic, and 220 whites. The investigators also conducted 4 focus groups with 49 people aged 60 and over.

Study results, published in the Journal of Racial and Ethnic Health Disparities, showed a deep gap between digital health in the elderly population, which was evident in both a community sample and focus groups

“We expected to find some differences in income and ethnicity, but the differences were deeper and bigger than we expected,” said lead study author Ruth Tappen, EdD, RN, of Christine E. Lynn College, Florida Atlantic University of Nursing.

Of the 562 respondents surveyed, 60% said they had some type of computer and 49% said they used the Internet. That proportion fell to 38% when respondents were asked whether they use the health-related information obtained from the internet. Of 284 participants who said they did not use the Internet, 23% said that, according to the investigators, they had never learned how or never tried.

“The very old ethnic or income patient has likely had no opportunity or need to acquire computer literacy during his working years and may still be lacking in computer literacy,” said Dr. Groping.

Racial, ethnic differences

Survey results revealed racial and ethnic differences. 68% of white participants reported frequent internet access, compared with 38% of blacks, 31% of Afro-Caribbean and 42% of Hispanics. In addition, 79% of whites said they own a desktop, laptop, or tablet computer, compared with 54% of blacks, 44% of Afro-Caribbean and 46% of Hispanics.

Investigators found a similar pattern of internet use for health-related information, albeit with lower proportions: 54% for whites, 34% for blacks, 26% for Afro-Caribbean, and 23% for Hispanics.

The likelihood of computer ownership varied significantly based on Medicaid status. One-third of Medicaid participants owned a computer compared to two-thirds of those who did not participate in Medicaid.

Results of the focus group

The results of focus group meetings also showed some differences. Interest in health-related information on the Internet was greatest among blacks, Afro-Caribbean and whites. In the Hispanic-American group, it was moderate at best. Black and Afro-Caribbean people expressed frustration at the lack of access to DHI, but valued alternative sources of information. White participants rated various DHI websites and sought help from vendors in applying information to their personal situation.

Investigators stressed that eliminating digital health gaps in older populations would require greater efforts to provide universal internet access, and found that municipal broadband networks can do this at the local level. Dr. Tappen and her colleagues claim the internet is a necessary utility like electricity and water. They suggest that it should be a free service backed by advertisements such as radio and television.

“Right now it is becoming very clear that even making an appointment for the COVID vaccine through online websites, even if they are user-friendly, has disenfranchised the elderly, those without the internet and those with no computer skills,” said Dr. Groping said. “As one colleague said, people needed ‘a car and a computer’ to get the vaccine. This is addressed for COVID, but we need to address it for other medical needs as well. “

Until Internet access becomes universal, creative use of printed matter, phone calls, personal groups, family support, one-to-one meetings and mailings is required for disadvantaged and older minority adults who continue to be affected by this GHI inequality. “It is time to put the patient in the center of integrated health systems, not on the periphery with technologies that make the system easier to operate,” wrote Dr. Fap and their employees.

Chad Ellimoottil, MD, director of the Telehealth Research Incubator at the Institute for Health Policy and Innovation at the University of Michigan at Ann Arbor, said access to DHI leads to better informed patients and collective decision-making, which ultimately improves the patient experience. “There is a risk that the digital health division will deteriorate as healthcare providers increasingly use telemedicine such as video conferencing, email and portal messaging to connect with patients,” said Dr. Ellimoottil. “Digital health gaps tend to affect elderly, minority, rural, and low-income patients the most. Closing the gap requires investment. “

He suggests that health systems devote time and resources to improving the usability of the health technology they offer. The first step is to get feedback directly from patients, said Dr. Ellimoottil.

Ashwini Nadkarni, MD, a psychiatrist at Brigham and Women’s Hospital in Boston, Massachusetts, said the digital divide is affecting access to virtual care for the most vulnerable patients. According to recent research into device use in the United States, 29% of adults with household incomes less than $ 30,000 a year do not have a smartphone, 44% do not have broadband at home, and 46% do not have a conventional computer.2 The majority of lower-income Americans are not tablets -Owner. As a result, access to vital medical care is limited.

“There are several ways to address digital disparities that could improve access to care,” said Dr. Nadkarni. “Firstly, telehealth practices could provide easily accessible teaching materials in multiple languages ​​that facilitate the use of video conferencing. Second, support staff who assist patients with virtual access could also help, e.g. B. a digital navigator for healthcare. “In addition, innovative programs are needed to build partnerships with wireless carriers to make smartphone ownership and mobile data plans more accessible.

References

  1. Fumble RM, Cooley ME, Luckmann R, Panday S. Digital Differences in Health Information in Older Adults: a Mixed-Method Study. Published online January 7, 2021. J Racial Ethnic Health Differences. doi: 10.1007 / s40615-020-00931-3
  2. Nadkarni A., Hasler V., AhnAllen CG, et al. Telehealth during COVID-19 – does everyone have equal access? Am J Psychiatry. 2020; 177: 1093-10 1094. doi: 10.1176 / appi.ajp.2020.20060867

This article originally appeared in the Renal and Urology News

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