The Digital Divide and Health Disparities in China: Evidence From a National Survey and Policy Implications.
The Digital Divide and Health Disparities in China: Evidence From a National Survey and Policy Implications.
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DOI：
10.2196/jmir.7786
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发表时间：
2017-09-11
影响因子：
7.4
通讯作者：
Shi L
中科院分区：
文献类型：
--
作者：
Hong YA;Zhou Z;Fang Y;Shi L
尽管移动工具的普及，数字鸿沟依然存在。数字鸿沟与健康差距之间的关系反映了在获取资源和健康结果方面的社会地位；然而，有关这种关系的数据来自中国等发展中国家的数据有限。本研究的目的是研究中国老年人（≥45岁）目前的移动工具使用率（互联网使用和手机拥有率）、个人和社区层面的访问预测因素，以及移动工具访问与健康结果之间的关系。我们从一项具有全国代表性的调查——中国健康与退休纵向研究（CHARLS）中提取了横断面数据，该调查的重点是老年人口（年龄≥45岁）。我们使用了两级混合逻辑回归模型，控制了社区和个人水平上未观察到的异质性进行数据分析。除了个人层面的社会经济地位（SES），我们还纳入了社区层面的资源，如社区设施、卫生保健设施和社区组织。健康结果通过自我报告的健康和基于有效量表的无残疾来衡量。在18,215名参与者中，6.51%的人在过去一个月使用过互联网，83%的人拥有手机。在多元模型中，互联网使用与社会经济地位、农村或城市居住、邻里便利设施、社区资源和地理区域密切相关。手机拥有量与社会经济地位和农村/城市居住密切相关，但与社区设施和社区资源关系不大。互联网使用是自我报告的健康状况的一个重要预测指标，即使在控制了个人和社区层面的潜在混杂因素后，手机拥有情况也与残疾显著相关。这项研究是第一批研究中国数字鸿沟及其与健康差距关系的研究之一。数据显示，中国存在显著的数字鸿沟，尤其是在老年人口中。互联网接入仍然仅限于社会经济地位较高的人；然而，手机已经被普通大众所采用。数字鸿沟不仅与个体SES有关，也与社区资源有关。未来的电子健康（eHealth）计划需要考虑移动工具的可访问性，并为不同的社会群体制定适合文化的计划。
The digital divide persists despite broad accessibility of mobile tools. The relationship between the digital divide and health disparities reflects social status in terms of access to resources and health outcomes; however, data on this relationship are limited from developing countries such as China. The aim of this study was to examine the current rates of access to mobile tools (Internet use and mobile phone ownership) among older Chinese individuals (aged ≥45 years), the predictors of access at individual and community levels, and the relationship between access to mobile tools and health outcomes. We drew cross-sectional data from a national representative survey, the China Health and Retirement Longitudinal Study (CHARLS), which focused on the older population (aged ≥45 years). We used two-level mixed logistic regression models, controlling for unobserved heterogeneity at the community and individual levels for data analysis. In addition to individual-level socioeconomic status (SES), we included community-level resources such as neighborhood amenities, health care facilities, and community organizations. Health outcomes were measured by self-reported health and absence of disability based on validated scales. Among the 18,215 participants, 6.51% had used the Internet in the past month, and 83% owned a mobile phone. In the multivariate models, Internet use was strongly associated with SES, rural or urban residence, neighborhood amenities, community resources, and geographic region. Mobile phone ownership was strongly associated with SES and rural/urban residence but not so much with neighborhood amenities and community resources. Internet use was a significant predictor of self-reported health status, and mobile phone ownership was significantly associated with having disability even after controlling for potential confounders at the individual and community levels. This study is one of the first to examine digital divide and its relationship with health disparities in China. The data showed a significant digital divide in China, especially in the older population. Internet access is still limited to people with higher SES; however, the mobile phone has been adopted by the general population. The digital divide is associated with not only individual SES but also community resources. Future electronic health (eHealth) programs need to consider the accessibility of mobile tools and develop culturally appropriate programs for various social groups.
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影响因子：
3.3
作者：
Lei X;Strauss J;Tian M;Zhao Y
通讯作者：
Zhao Y
影响因子：
4
作者：
Li LW;Liu J;Zhang Z;Xu H
通讯作者：
Xu H
DOI：
10.1093/geronb/gbu018
发表时间：
2014-09-01
影响因子：
6.2
作者：
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通讯作者：
Hale, Timothy M.
影响因子：
20.8
作者：
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通讯作者：
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影响因子：
4.4
作者：
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通讯作者：
Viswanath, K.