The Effects of the COVID-19 Pandemic on Age-Based Disparities in Digital Health Technology Use: Secondary Analysis of the 2017-2022 Health Information National Trends Survey

Abstract

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

Objective: This study aimed to analyze the long-term effects of the COVID-19 pandemic on the multifaceted landscape of digital health technology used across diverse age groups among US citizens.

Methods: We conducted the retrospective observational study using the 2017-2022 Health Information National Trends Survey to identify the influence of the COVID-19 pandemic on a wide range of digital health technology use outcomes across various age groups. The sample included 15,505 respondents, which were categorized into 3 age groups: adults (18-44 years), middle-aged adults (45-64 years), and older adults (more than 65 years). We also designated the time point of March 11, 2020, to divide the pre- and post-pandemic periods. Based on these categorizations, multivariate linear probability models were 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 with adults, with a 26.28% lower likelihood of using the internet for health information (P<.001) and a 32.63% 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 disparities 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 (11.21%, P<.001) and make appointments (10.03%, P=.006) and using wearable devices to track health (8.31%, P=.01).

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 US health care system during the pandemic. Policy makers and health care providers should focus on addressing these disparities to ensure equitable access to digital health resources for US baby boomers.

Keywords: COVID-19; age-based disparities; digital divide; digital health technology use; health equity; health policy; mobile phone.

Figure 1

Unadjusted trends of digital health technology use by age groups: (A) look for health information, (B) communicate with health providers, (C) look up test results, (D) make appointments, (E) use health apps, and (F) use wearable devices to track health. All statistics are weighted to reflect the complex sampling strategy of the survey. Source: authors' own analyses of the 2017-2022 Health Information National Trends Survey.

Figure 2

Predicted trends of digital health technology use by age groups: (A) look for health information, (B) communicate with health providers, (C) look up test results, (D) make appointments, (E) use health apps, and (F) use wearable devices to track health. All statistics are weighted to reflect the complex sampling strategy of the survey. Values are predicted by a linear probability model with SE derived from the jackknife replication method. In each regression, we control for the demographic, socioeconomic, and health covariates shown in Table 1, in addition to year fixed effects. Source: authors’ own analyses of the 2017-2022 Health Information National Trends Survey.