The Digital Health Divide: Understanding Telehealth Adoption from the Lens of Geography and Race

Abstract

This study seeks to examine how telehealth services are used based on access to broadband. Furthermore, we examine how and why telehealth adoption varies by race and explore obstacles to telehealth use. Using a mail survey in two racially diverse communities in Southern Illinois, we analyze accessibility of high-speed internet, telehealth use, reasons for use and nonuse. Chi-square tests and logistic regression estimated how geographic location and race influence telehealth adoption. Respondents of Carbondale were significantly more likely to have more working computers in the household, to have household internet, to have a cellular data plan, to have wired broadband, to have higher internet download and upload speeds than their counterparts in Cairo. Overall, residents of Carbondale were more likely to use telehealth services than residents of Cairo. Additionally, non-black residents of Carbondale were the most likely to have used telehealth in the past two years with respect to five of the six types of telehealth services. Black respondents from both communities were more likely to use telehealth to save money than their non-black counterparts. The most noted reason for not using telehealth among respondents, regardless of race or geographic residence, was due to a concern that private information may not be protected. Our study findings underscore the importance of essential infrastructure for having access to health care as well as the digital trust.