Digital Divide in Health Information Seeking: Rural and Urban Differences in the Use of Online Health Tools in the United States
Author(s)
William Y. Zhou1, Luisa Franzini, PHD2.
1Student, Walt Whitman High School, Bethesda, MD, USA, 2School of Public Health, University of Maryland, College Park, MD, USA.
1Student, Walt Whitman High School, Bethesda, MD, USA, 2School of Public Health, University of Maryland, College Park, MD, USA.
OBJECTIVES: This study examines rural/urban differences in internet access and use of online health information tools among U.S. adults aged 18 to 64. As digital platforms become increasingly important in healthcare, understanding variation in access and usage is essential for informing health system design and delivery strategies.
METHODS: We analyzed nationally representative data from the 2022 and 2023 National Health Interview Survey (NHIS) Sample Adult Interview. Outcomes included (1) internet access and, among those with access, whether individuals (2) searched for health information online, (3) communicated with healthcare providers online, and (4) accessed medical test results online. Multivariate logistic regression models were adjusted for demographic, socioeconomic, and health-related factors. NHIS sample weights were applied to ensure national representation.
RESULTS: Of 22,898 adults surveyed, 97% reported having internet access. Among those with access, 3,458 were rural residents and 18,620 were urban. Rural residents were significantly less likely than their urban counterparts to use online health tools: 58% of rural residents searched for health information compared to 71% of urban residents; 35% communicated with healthcare providers online compared to 54% of urban residents; and 40% of rural residents accessed medical test results online compared to 57% of urban residents, all p<0.001. In multivariate logistic regression models adjusted for demographic, socioeconomic, and health-related factors, rural residence was associated with lower odds of engaging in each activity: health information seeking (OR = 0.63), provider communication (OR = 0.51), and test result access (OR = 0.55), all p<0.001. Among rural users, higher educational attainment and insurance status were positively associated with more frequent use of online health tools. Income, however, was not independently associated with health information seeking.
CONCLUSIONS: Rural/urban differences in online health tool use remain substantial in 2023. Expanding access to internet-based health services may require targeted strategies that address gaps in education and insurance coverage.
METHODS: We analyzed nationally representative data from the 2022 and 2023 National Health Interview Survey (NHIS) Sample Adult Interview. Outcomes included (1) internet access and, among those with access, whether individuals (2) searched for health information online, (3) communicated with healthcare providers online, and (4) accessed medical test results online. Multivariate logistic regression models were adjusted for demographic, socioeconomic, and health-related factors. NHIS sample weights were applied to ensure national representation.
RESULTS: Of 22,898 adults surveyed, 97% reported having internet access. Among those with access, 3,458 were rural residents and 18,620 were urban. Rural residents were significantly less likely than their urban counterparts to use online health tools: 58% of rural residents searched for health information compared to 71% of urban residents; 35% communicated with healthcare providers online compared to 54% of urban residents; and 40% of rural residents accessed medical test results online compared to 57% of urban residents, all p<0.001. In multivariate logistic regression models adjusted for demographic, socioeconomic, and health-related factors, rural residence was associated with lower odds of engaging in each activity: health information seeking (OR = 0.63), provider communication (OR = 0.51), and test result access (OR = 0.55), all p<0.001. Among rural users, higher educational attainment and insurance status were positively associated with more frequent use of online health tools. Income, however, was not independently associated with health information seeking.
CONCLUSIONS: Rural/urban differences in online health tool use remain substantial in 2023. Expanding access to internet-based health services may require targeted strategies that address gaps in education and insurance coverage.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD34
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas