Full Citation
Title: Disparities in digital access among American rural and urban households and implications for telemedicine‐based services
Citation Type: Journal Article
Publication Year: 2022
ISBN:
ISSN: 0890-765X
DOI: 10.1111/jrh.12614
NSFID:
PMCID:
PMID:
Abstract: Purpose To examine characteristics associated with disparities in digital access (i.e., access to high-speed Internet via a computer or smartphone) in American rural and urban households given that digital access has a direct impact on access to telemedicine-based services. Methods Using the 2019 American Community Survey, we analyzed the proportions of geographic area, race/ethnicity, and socioeconomic status according to device and high-speed Internet access. Maximum likelihood logit estimators estimated how these factors influenced device and high-speed Internet access. Findings Of 105,312,959 households, 32.29% were without a desktop or laptop computer with high-speed Internet (WDW), 21.51% were without a smartphone with a data plan for wireless Internet (WSW), and 14.02% were without any digital access (WDA). Nonmetropolitan households were significantly more likely to be WDA than metropolitan households (odds ratio [OR] = 1.87; 95% confidence interval [CI]: 1.83-1.91). Relative to non-Hispanic Whites, non-Hispanic Blacks (OR = 1.60; 95% CI: 1.56-1.64), American Indian or Alaska natives (OR = 2.00; 95% CI: 1.82-2.19), or Hispanics (OR = 1.70; 95% CI: 1.66-1.74) were significantly more likely to be WDA. When compared to households with private health insurance coverage, households WDA were significantly more likely to have no insurance (OR = 2.44; 95% CI: 2.36-2.53) or public insurance coverage (OR = 3.78; 95% CI: 3.70-3.86). Households with any digital access reported higher income and more family members living at home. Using the same predictors, similar findings were reported for households WDW or WSW. Conclusions Significant disparities in digital access exist among nonmetropolitan households, racial/ethnic minority households, and lower-income households. The lack of digital access has implications for the accessibility of health care services via telemedicine and thus could exacerbate health disparities.
Url: https://doi.org/10.1111/jrh.12614
User Submitted?: No
Authors: Curtis, Megan E.; Clingan, Sarah E.; Guo, Huiying; Zhu, Yuhui; Mooney, Larissa J.; Hser, Yih‐Ing
Periodical (Full): The Journal of Rural Health
Issue: 3
Volume: 38
Pages: 512-518
Data Collections: IPUMS USA
Topics: Housing and Segregation, Population Mobility and Spatial Demography
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