Open AccessNeighborhood Broadband and Use of Telehealth Among Older Adults: Cross-sectional Study of National Survey Data Linked With Census Data
Author(s) -
Safiyyah Okoye,
John Mulcahy,
Chanee Fabius,
Julia Burgdorf,
Jennifer L. Wolff
Publication year - 2021
Publication title -
jmir. journal of medical internet research/journal of medical internet research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.446
H-Index - 142
eISSN - 1439-4456
pISSN - 1438-8871
DOI - 10.2196/26242
Subject(s) - telehealth , the internet , context (archaeology) , internet access , odds , residence , gerontology , medicine , telemedicine , demography , environmental health , psychology , geography , logistic regression , health care , sociology , computer science , world wide web , political science , archaeology , law
Background The COVID-19 pandemic has amplified the role of telehealth in health care delivery. Regional variation in internet access and telehealth use are well-documented, but the effect of neighborhood factors, including the pervasiveness of broadband internet, on older adults’ telehealth usage in the context of internet access is not known. Objective This study aimed to investigate how individual and neighborhood characteristics, including the pervasiveness of neighborhood broadband internet subscription, are associated with engagement in telehealth among older adults with internet access. Methods In this cross-sectional study, we included 5117 community-living older adults aged ≥65 years, who participated in the 2017 National Health and Aging Trends Study with census tract–level data for participants’ places of residence from the American Community Survey. Results Of an estimated 35.3 million community-living older adults, 21.1 million (59.7%) were internet users, and of this group, more than one-third (35.8%) engaged in telehealth. In a multivariable regression model adjusted for individual- and neighborhood-level factors, age, education, income, and the pervasiveness of neighborhood broadband internet subscription were associated with engagement in telehealth, while race, health, county metropolitan status, and neighborhood social deprivation were not. Among internet users, living in a neighborhood at the lowest (versus highest) tertile of broadband internet subscription was associated with being 40% less likely to engage in telehealth (adjusted odds ratio 0.61, 95% CI 0.42-0.87), all else equal. Conclusions Neighborhood broadband internet stands out as a mutable characteristic that is consequential to engagement in telehealth.