Digitalization, Psychological Well-Being, and the Third-Level Digital Divide: Survey Study During the COVID-19 Pandemic in China

Abstract

Background: While rapid digitalization has helped society cope with the uncertainty of the COVID-19 pandemic, will it bring health equity to the digitally disadvantaged? Limited studies have explored how individuals' digital activities may impact their psychological well-being during the pandemic and whether these effects vary across different sociodemographic groups.

Objective: This study aims to examine how individuals' digital activities influence their psychological well-being and whether socioeconomic status moderates the relationship between digitalization and mental health.

Methods: This study was based on a sample of 2170 residents surveyed in Hubei, the early epicenter of the pandemic in China, between March 23 and April 9, 2020. We first examined the main effects of online behavior and community e-group involvement on psychological distress. Then, we used ordinary least squares regression models to analyze the 2-way interaction effects between internet usage and socioeconomic status (SES) variables-education, occupation, monthly income, and urban/rural residence-on psychological distress.

Results: First, the data reveal a pattern of digital divide during the pandemic. Participants with higher SES showed a greater propensity to use the internet for work and study purposes, as well as to engage in electronic groups (e-groups), compared with those with lower SES. By contrast, lower-SES respondents were more inclined to participate in entertainment and information-seeking activities than their higher-SES counterparts. Second, the data reveal the emergence of a third level of digital divide concerning psychological well-being. Specifically, the impact of online entertainment and communication activities on mental well-being varies based on employment status (b=-1.024, P=.03) and rural versus urban residence (b=-1.244, P=.046). These findings suggest that online entertainment and communication may have a more pronounced effect in reducing distress among individuals with lower SES than those with higher SES. Third, we observed a significant interaction between participation in community e-groups and rural versus urban areas (b=2.388, P=.047). This suggests that the impact of joining virtual communities on psychological distress is less pronounced among rural residents compared with their urban counterparts.

Conclusions: The study illustrates how digital activities affect mental distress, providing evidence of the third-level digital divide in psychological well-being. First, the impact of digital activities on mental distress varied according to the type of internet usage. Second, online activities offered greater psychological benefits to individuals in lower social positions compared with those with higher social status. Third, digital inclusion in community e-groups helped alleviate psychological distress, but "digitalized social capital" provided more significant benefits to urban residents than to rural residents. These results highlight how the digital divide affects health inequalities and underscore the need for a more nuanced understanding of information and communications technology policies and their impacts in the post-COVID-19 world.

Keywords: COVID-19; China; digital divide; digital inclusion; health disparity; internet usage; psychological distress; social inequality.