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Racial disparities in health information access: resilience of the digital divide

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Abstract

Policy initiatives of the late 1990s were believed to have largely eliminated the information “Digital Divide.” For healthcare consumers, access to information is an essential part of the consumer-centric framework outlined in the recently proposed national health information initiative. This study sought to examine how racial/ethnic characteristics are associated with Internet use and online health information. Using a cross-sectional nationwide study of reported Internet use and information search in 2000 and 2002, we studied a stratified sample of computer users from the Pew Internet & American Life Project surveys. Adjusted estimates of race/ethnicity and income effects on Internet use and search behaviors were derived from generalized estimating equations. Results show wide gaps in the use of computers between Hispanics and Whites (OR = 0.593 [0.440, 0.798]) and between African-Americans and Whites (OR = 0.554 [0.427, 0.720]) in 2000 significantly narrowed in 2002 (OR of Hispanic to white = 1.250 [0.874, 1.789]; OR of African-American to Whites = (0.793 [0.551, 1.141]). Gaps in access to the Internet, however, remained consistent between 2000–2002. Differences in health information seeking between Hispanics and Whites existed in both 2000 and 2002. 56% of White Internet users at some time searched for online health information, whereas 42% of Hispanic Internet users did so in 2000. By 2002, these percentages had increased to 13.4 and 15.8%, respectively. Data highlight the persistence of “Digitally Underserved Groups,” despite recent Divide reduction strategies.

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References

  1. Department of HHS, Eliminating minority health disparities, HHS Fact Sheet, July 12, 2004. HHS.

  2. Brailer, D. The decade of health information technology. HHS Report, July 21, 2004.

  3. Ibrahim, S. A., Siminoff, L. A., Burant, C. J., et al., Understanding ethnic differences in the utilization of joint replacement for osteoarthritis: The role of patient-level factors. Med. Care 40(1):I44–I51, 2002.

    Article  Google Scholar 

  4. Fiscella, K., Franks, P., Doescher, M. P., et al., Disparities in health care by race, ethnicity, and language among the insured: Findings from a national sample. Med. Care 40(1):52–59, 2002.

    Article  Google Scholar 

  5. Williams, R. L., Flocke, S. A., and Stange, K. C., Race and preventive services delivery among black patients and white patients seen in primary care. Med. Care 39(11):1260–1267, 2001.

    Article  Google Scholar 

  6. Harada, N. D., Chun, A., Chiu, V., et al., Patterns of rehabilitation utilization after hip fracture in acute hospitals and skilled nursing facilities. Med. Care 38(11):1119–1130, 2000.

    Article  Google Scholar 

  7. Shi, L., Experience of primary care by racial and ethnic groups in the United States. Med. Care 37(10):1068–1077, 1999.

    Article  Google Scholar 

  8. Guendelman, S., and Schwalbe, J., Medical care utilization by Hispanic children. How does it differ from black and white peers? Med. Care 24(10):925–940, 1986.

    Article  Google Scholar 

  9. Department of Health and Human Services. MMA Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003. Available at: http://www.cms.hhs.gov/medicarereform. Accessed on November 1, 2004.

  10. Department of Health and Human Services State Children's Health Insurance Program (SCHIP). Available at: http:// www.cms.hhs.gov/schip/. Accessed on November 1, 2004.

  11. Centers for Disease Control, The racial and ethnic approaches to community health (REACH 2010) program. Available at: http://www.cdc.gov/reach2010. Accessed on November 1, 2004.

  12. Government Programs Designed to Close the Divide, Fact Sheet: Government Programs Designed to Close the Divide: Falling Through the Net: Defining the Digital Divide, July 1999, NTIA report.

  13. Brailer, D., The decade of health information technology. HHS Report, July 21, 2004.

  14. Wagner, T. H., and Greenlick, M. R. When parents are given greater access to health information, does it affect pediatric utilization? Med. Care 39(8): 848–855, 2001.

    Article  Google Scholar 

  15. Bakken, S., Cimino, J. J., Hripcsak, G. Promoting patient safety and enabling evidence-based practice through informatics. Med. Care 42(2 Suppl):II49–II56, 2004.

    Google Scholar 

  16. Frosch, D. L., Kaplan, R. M., and Felitti, V. J. A randomized controlled trial comparing internet and video to facilitate patient education for men considering the prostate specific antigen test. J. Gen. Intern. Med. 18(10):781–787, 2003.

    Article  Google Scholar 

  17. Masi, C. M., Suarez-Balcazar, Y., Cassey, M. Z., et al., Internet access and empowerment: A community-based health initiative. J. Gen. Intern. Med. 18(7):525–530, 2003.

    Article  Google Scholar 

  18. Diaz, J. A., Griffith, R. A., Ng, J. J., et al., Patients’ use of the Internet for medical information. J. Gen. Intern. Med. 17(3):180–185, 2002.

    Article  Google Scholar 

  19. Bureau of Primary Health Care. The consolidated health center program. Available at http://bphc.hrsa.gov/pinspals/pins.htm, Accessed on November 1, 2004.

  20. Office of Minority Health. Closing the health gap/take a loved one to the Doctor Day. Available at: http://www.healthgap. omhrc.gov/. Accessed on November 1, 2004.

  21. Bureau of Primary Health Care. Health disparity Collaboratives. Available at: http://bphc.hrsa.gov/quality/Collaboratives.htm. Accessed on November 1, 2004.

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Acknowledgements

We thank Pew Internet and American Life Project for providing us with “Internet Health Resources” data files. Susannah Fox provided helpful insights and data from the Pew Internet & American Life Project. Neither Ms. Fox nor the Pew Internet Project advocate policy or issue outcomes.

This project was funded in part by grant number 046902 from The Robert Wood Johnson Foundation with additional support from the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. Consumer Web Watch (CWW), a project of Consumers’ Union, was a collaborator on the project. Analytical and data support for this study was also provided by the Center for Technology Assessment, PO Box 1154, State College, PA.

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Correspondence to Daniel P. Lorence.

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Lorence, D.P., Park, H. & Fox, S. Racial disparities in health information access: resilience of the digital divide. J Med Syst 30, 241–249 (2006). https://doi.org/10.1007/s10916-005-9003-y

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  • DOI: https://doi.org/10.1007/s10916-005-9003-y

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