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The great digital divide in healthcare: Older Americans may be left behind

Less than a third of elderly adults use Web for health information and unlikely to use electronic health records; low health literacy widens gap

ANN ARBOR, Mich. —   When it comes to the benefits of electronic health records, older Americans may be left behind, says a new University of Michigan study.

Less than a third of Americans age 65 and over use the Web for health information and barely 10 percent of those with low health literacy – or ability to navigate the health care system – go online for health-related matters, according to the nationally-representative study that appears in the Journal of General Internal Medicine.    

“In recent years we have invested many resources in Web-based interventions to help improve people’s health, such as electronic health records designed to help patients become more active participants in their care. But many older Americans, especially those with low health literacy, may not be prepared for these new tools,” says lead author Helen Levy, Ph.D., research associate professor at the U-M Institute for Social Research.

“Our findings suggest that there’s a digital divide when it comes to health care. Older adults with low health literacy especially represent a vulnerable population that’s at high risk of being left behind by the advance of technology.”

Over the last five years, uptake of electronic health records in the U.S. has increased dramatically as a result of government initiatives and investment by healthcare providers. Many providers, including the U-M Health System, now offer patients access to parts of their own medical records via online health portals that include everything from reminders of when they are due for wellness visits and screening tests, to immunization records and lab results, as well as key information on obtaining and using their prescription medications correctly and safely.  

“Health information technology promises significant benefits, but it also comes with the risk that these benefits won’t be shared equally,” says senior author Kenneth Langa, M.D., Ph.D., a professor of Internal Medicine at the U-M Medical School and research investigator at the Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System.

“The Internet is becoming central to health care delivery, but older Americans with low health literacy face barriers that may sideline them in this era of technology. Programs need to consider interventions that target health literacy among older adults to help narrow the gap and reduce the risk of deepening disparities in health access and outcomes.”

Also contributing to the study was Alexander T. Janke, B.S., of the School of Medicine at Wayne State University.

Researchers analyzed data from the Health and Retirement Study, a long-running data collection effort of the U-M Institute for Social Research whose primary sponsor is the National Institute on Aging.

Other affiliations: Both Langa and Levy are members of the Institute for Healthcare Policy and Innovation. Langa is also a member of the U-M Institute for Social Research, Institute of Gerontology and School of Public Health. Levy is also with the U-M Gerald R. Ford School of Public Policy and School of Public Health.

Disclosures: None

Funding: Levy receives financial support from the National Institute on Aging (grant numbers NIA K01AG034232 and NIA P01AG026571). Langa acknowledges financial support from the National Academies Keck Futures Initiative (grant number NAKFI IB5). The Health and Retirement Study is sponsored by the National Institute on Aging (grant number NIA U01AG009740).

Reference: “Health Literacy and the Digital Divide among Older Americans,” Journal of General Internal Medicine.       

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