AccScience Publishing / IJPS / Online First / DOI: 10.36922/ijps.1817
RESEARCH ARTICLE

Gender disparities in telehealth use among older adults in the United States during the COVID-19 pandemic

Xiayu Summer Chen1* Kun Wang2
Show Less
1 School of Social Work, University of Illinois Urbana-Champaign, Champaign–Urbana, Illinois, United States of America
2 Department of Social Work, College of Community and Public Affairs, The State University of New York at Binghamton, Binghamton, New York, United States of America
IJPS 2024, 10(4), 114–124; https://doi.org/10.36922/ijps.1817
Submitted: 12 September 2023 | Accepted: 6 December 2023 | Published: 9 July 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The coronavirus disease 19 (COVID-19) pandemic underscored the significance of telehealth as a health-care delivery method, particularly for the vulnerable older adult population. Nonetheless, disparities in accessing and utilizing telehealth services persist, influenced by demographic and socioeconomic factors such as gender. This study aims to investigate the utilization of telehealth services among older adults in the United States, focusing on gender-related disparities and associated factors. Using the Round 10 and COVID-19 supplement data from the National Health and Aging Trends Study, the study examined 3,257 participants (male: 42.06%; female: 57.94%). We compared the use of telehealth services before and during the pandemic and conducted a series of logistic regression models to assess factors linked to telehealth utilization by gender. Overall, there was a significant shift toward greater use of telehealth among females during the pandemic, with multimorbidity significantly influencing the relationship between gender and telehealth utilization. For males, those who had multimorbidity (odds ratio [OR] = 2.03; 95% confidence interval [CI] = 1.07 – 3.84), owned a tablet before COVID-19 (OR = 1.89; 95% CI = 1.13 – 3.14), and learned new technologies during the pandemic (OR = 2.29; 95% CI = 1.37 – 3.82) had higher odds of telehealth use. For females, those with worse self-reported health scores (OR = 1.28; 95% CI = 1.03 – 1.59), owned a tablet (OR = 2.07; 95% CI = 1.32 – 3.23), and learned new technology (OR = 3.37; 95% CI = 2.17 – 5.24) during the pandemic demonstrated increased odds of telehealth use. Gender-based differences in telehealth utilization were evident, highlighting the need for targeted interventions that enhance older adults’ access to telehealth services and mitigate digital disparities.

Keywords
Digital technology
Social work
Telehealth
Gender disparity
Coronavirus disease 19
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
References

Abdallah, L., Stolee, P., Lopez, K.J., Whate, A., Boger, J., & Tong, C. (2022). “Virtual care yes, but it has to be in addendum”: A qualitative study of COVID-19’s impact on older adults’ perceptions of virtual care. JMIR Aging, 4(4):e38546. https://doi.org/10.2196/38546

 

Abufaraj, M., Eyadat, Z., Al-Sabbagh, M.Q., Nimer, A., Moonesar, I.A., Yang, L., et al. (2021). Gender-based disparities on health indices during COVID-19 crisis: A nationwide cross-sectional study in Jordan. International Journal for Equity in Health, 20(1):91. https://doi.org/10.1186/s12939-021-01435-0

 

Acilar, A., & Sæbø, Ø. (2023). Towards understanding the gender digital divide: A systematic literature review. Global Knowledge, Memory and Communication, 72(3): 233-249. https://doi.org/10.1108/GKMC-09-2021-0147

 

Ackerman, M.J., Filart, R., Burgess, L.P., Lee, I., & Poropatich, R.K. (2010). Developing next-generation telehealth tools and technologies: Patients, systems, and data perspectives. Telemedicine Journal and E-Health, 16(1):93-95. https://doi.org/10.1089/tmj.2009.0153

 

Alexander, G.C., Tajanlangit, M., Heyward, J., Mansour, O., Qato, D.M., & Stafford, R.S. (2020). Use and content of primary care office-based vs telemedicine care visits during the COVID-19 pandemic in the US. JAMA Network Open, 3(10):e2021476. https://doi.org/10.1001/jamanetworkopen.2020.21476

 

Amon, J.J. (2020). Ending discrimination in healthcare. Journal of the International AIDS Society, 23(2):e25471. https://doi.org/10.1002/jia2.25471

 

Bokolo, A.J. (2021). Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic. Irish Journal of Medical Science, 190(1):1-10. https://doi.org/10.1007/s11845-020-02299-z

 

Campos-Castillo, C., & Anthony, D. (2021). Racial and ethnic differences in self-reported telehealth use during the COVID-19 pandemic: A secondary analysis of a US survey of internet users from late March. Journal of the American Medical Informatics Association, 28(1):119-125. https://doi.org/10.1093/jamia/ocaa221

 

Chang, J., Lai, A., Gupta, A., Nguyen, A., Berry, C., & Shelley, D. (2021). Rapid transition to telehealth and the digital divide: Implications for primary care access and equity in a post- COVID Era. Milbank Quarterly, 99:340-368. https://doi.org/10.1111/1468-0009.12509

 

Choi, N.G., Dinitto, D.M., Marti, C.N., & Choi, B.Y. (2022). Telehealth use among older adults during COVID-19: Associations with sociodemographic and health characteristics, technology device ownership, and technology learning. Journal of Applied Gerontology, 41(3):600-609. https://doi.org/10.1177/07334648211047347

 

Dorsey, E.R., & Topol, E.J. (2016). State of telehealth. The New England Journal of Medicine, 375(2):154-161. https://doi.org/10.1056/NEJMra1601705

 

Ekeland, A.G., Bowes, A., & Flottorp, S. (2010). Effectiveness of telemedicine: A systematic review of reviews. International Journal of Medical Informatics, 79(11):736-771. https://doi.org/10.1016/j.ijmedinf.2010.08.006

 

El-Serag, R., & Thurston, R.C. (2020). Matters of the heart and mind: Interpersonal violence and cardiovascular disease in women. Journal of the American Heart Association, 9(4):e015479. https://doi.org/10.1161/JAHA.120.015479

 

Foster, A., Horspool, K.A., Edwards, L., Thomas, C.L., Salisbury, C., Montgomery, A.A., et al. (2015). Who does not participate in telehealth trials and why? A cross-sectional survey. Trials, 16:258. https://doi.org/10.1186/s13063-015-0773-3

 

Ftouni, R., AlJardali, B., Hamdanieh, M., Ftouni, L., & Salem, N. (2022). Challenges of telemedicine during the COVID-19 pandemic: A systematic review. BMC Medical Informatics and Decision Making, 22(1):207. https://doi.org/10.1186/s12911-022-01952-0

 

Gandrup, J., Ali, S.M., McBeth, J., Van der Veer, S.N., & Dixon, W.G. (2020). Remote symptom monitoring integrated into electronic health records: A systematic review. Journal of the American Medical Informatics Association, 27(11):1752-1763. https://doi.org/10.1093/jamia/ocaa177

 

Hassija, C., & Gray, M.J. (2011). The effectiveness and feasibility of videoconferencing technology to provide evidence-based treatment to rural domestic violence and sexual assault populations. Telemedicine and e-Health, 17(4):309-315. https://doi.org/10.1089/tmj.2010.0147

 

Kruse, C., & Heinemann, K. (2022). Facilitators and barriers to the adoption of telemedicine during the first year of COVID-19: Systematic review. Journal of Medical Internet Research, 24(1):e31752. https://doi.org/10.2196/31752

 

Litchfield, I., Shukla, D., & Greenfield, S. (2021). Impact of COVID-19 on the digital divide: A rapid review. BMJ Open, 11(10):e053440. https://doi.org/10.1136/bmjopen-2021-053440

 

Mao, A., Tam, L., Xu, A., Osborn, K., Sheffrin, M., Gould, C., et al. (2022). Barriers to telemedicine video visits for older adults in independent living facilities: Mixed methods cross-sectional needs assessment. JMIR Aging, 5(2):e34326. https://doi.org/10.2196/34326

 

Mitzner, T.L., Sanford, J.A., & Rogers, W.A. (2018). Closing the capacity-ability gap: Using technology to support aging with disability. Innovation in Aging, 2(1):igy008. https://doi.org/10.1093/geroni/igy008

 

Neil-Sztramko, S.E., Coletta, G., Dobbins, M., & Marr, S. (2020). Impact of the AGE-ON tablet training program on social isolation, loneliness, and attitudes toward technology in older adults: Single-group pre-post study. JMIR Aging, 3(1):e18398. https://doi.org/10.2196/18398

 

Organisation for Economic Co-operation and Development (OECD). (2018). Bridging the Digital Gender Divide: Include, Upskill, Innovate. France: OECD. Available from: https://www.researchgate.net/publication/329144075 [Last accessed on 2023 Apr 20].

 

Pifer, R. (2021). Why are Women more Likely to use Telehealth? HealthCare Dive. Available from: https://www. healthcaredive.com/news/women-more-likely-telehealth-patients-providers-covid-19-pandemic/608153 [Last accessed on 2023 Apr 20].

 

Shibli, H., Aharonson-Daniel, L., & Feder-Bubis, P. (2021). Perceptions about the accessibility of healthcare services among ethnic minority women: A qualitative study among Arab Bedouins in Israel. International Journal for Equity in Health, 20:117. https://doi.org/10.1186/s12939-021-01464-9

 

Stormacq, C., Wosinski, J., Boillat, E., & Van den Broucke, S. (2020). Effects of health literacy interventions on health-related outcomes in socioeconomically disadvantaged adults living in the community: A systematic review. JBI Evidence Synthesis, 18(7):1389-1469. https://doi.org/10.11124/JBISRIR-D-18-00023

 

Tyers-Chowdhury, A., & Binder, G. (2021). What we Know about the Gender Digital Divide for Girls: A Literature Review [Evidence Brief]. United States: UNICEF. Available from: https://www.unicef.org/eap/media/8311/file/what%20we%20know%20about%20the%20gender%20digital%20divide%20for%20girls:%20a%20literature%20review.pdf

 

Volders, E., Bolman, C.A.W., De Groot, R.H.M., Verboon, P., & Lechner, L. (2020). The effect of active plus, a computer-tailored physical activity intervention, on the physical activity of older adults with chronic illness(es)-a cluster randomized controlled trial. International Journal of Environmental Research and Public Health, 17(7):2590. https://doi.org/10.3390/ijerph17072590

 

Weiner, J.P., Bandeian, S., Hatef, E., Lans, D., Liu, A., & Lemke, K.W. (2021). In-person and telehealth ambulatory contacts and costs in a large US insured cohort before and during the COVID-19 pandemic. JAMA Netw Open, 4(3):e212618. https://doi.org/10.1001/jamanetworkopen.2021.2618

 

Whiteman, A., Wang, A., McCain, K., Gunnels, B., Toblin, R., Lee, J.T., et al. (2021). Demographic and social factors associated with COVID-19 vaccination initiation among adults aged ≥65 years-United States, December 14, 2020- April 10, 2021. Morbidity and Mortality Weekly Report, 70(19):725-730. https://doi.org/10.15585/mmwr.mm7019e4

 

World Health Organization. (n.d.). Gender. Available from: https://www.who.int/health-topics/gender#tab=tab_1 [Last accessed on 2023 Sep 12].

 

Zhang, D., Shi, L., Han, X., Li, Y., Jalajel, N.A., Patel, S., et al. (2021). Disparities in telehealth utilization during the COVID-19 pandemic: Findings from a nationally representative survey in the United States. Journal of Telemedicine and Telecare, 30:90-97. https://doi.org/10.1177/1357633x211051677

 

Zoorob, D., Hasbini, Y., Chen, K., Wangia-Anderson, V., Moussa, H., Miller, B., et al. (2022). Ageism in healthcare technology: The older patients’ aspirations for improved online accessibility. JAMIA Open, 5(3):ooac061. https://doi.org/10.1093/jamiaopen/ooac061

Share
Back to top
International Journal of Population Studies, Electronic ISSN: 2424-8606 Print ISSN: 2424-8150, Published by AccScience Publishing