Digital Health Leaving Elderly Behind

By Christine Kern, contributing writer

A new study shows health literacy is markedly lower among older Americans.

A University of Michigan study has found older Americans are not comfortable with electronic health records (EHRs) in large part due to low health literacy rates. The study, Health Literacy and the Digital Divide Among Older Americans, was conducted by Helen Levy, PhD, Alexander T. Janke, B.S., and Kenneth M. Langa, MD, PhD who set out to quantify the relationship between health literacy and the use of the Internet to access health information in the over-65 population subset.

According to study findings, less than one third of Americans over the age of 65 access the internet for health information and are unlikely to use electronic health records (EHRs), and less than ten percent of seniors with low health literacy go online for health-related matters.

Researchers analyzed data from the Health and Retirement Study, a long-running data collection effort of the U-M Institute for Social Research whose primary sponsor is the National Institute on Aging to reach their conclusions. It included 824 individuals in the general population and 1,584 Internet users.

According to lead author Levy, “In recent years we have invested many resources in Web-based interventions to help improve people’s health, such as electronic health records designed to help patients become more active participants in their care. But many older Americans, especially those with low health literacy, may not be prepared for these new tools.”

Particularly in light of the directives to improve interoperability and make health records electronically accessible to healthcare providers and patients, there has been a huge investment in health information technology. However, this study warns elderly patients may be unwilling and/or unable to capitalize on the recent innovations.

According to the study, seniors with low health literacy are less likely to use the internet for any purpose, but if they do turn to internet technology, generally is it not to search for medical or health information. Therefore, the researchers concluded, health literacy may be considered as a significant predictor of what people do once they are online.

“Health information technology promises significant benefits, but it also comes with the risk that these benefits won’t be shared equally,” says Langa, a professor of Internal Medicine at the U-M Medical School and research investigator at the Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System.

“The Internet is becoming central to health care delivery, but older Americans with low health literacy face barriers that may sideline them in this era of technology. Programs need to consider interventions that target health literacy among older adults to help narrow the gap and reduce the risk of deepening disparities in health access and outcomes.”

 “Health information technology, like any innovation in health care, offers both the promise of significant benefits and the risk that these benefits will not be shared equally,” warns Levy. “Low health literacy may attenuate the effectiveness of web-based interventions to improve the health of vulnerable populations.”

Ultimately, Levy said, health literacy proved to be a more important indicator of electronic health records usage than cognitive functioning, and thus “interventions specifically targeting health literacy among older adults may help prevent a widening of the ‘digital divide’ as patients are increasingly expected to obtain medical information online.”