Disparities in digital access among American rural and urban households and implications for telemedicine-based services.
Disparities in digital access among American rural and urban households and implications for telemedicine-based services.
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DOI：
10.1111/jrh.12614
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发表时间：
2022-06
影响因子：
4.9
通讯作者：
Hser, Yih-Ing
中科院分区：
文献类型：
--
作者：
Curtis, Megan E.;Clingan, Sarah E.;Guo, Huiying;Zhu, Yuhui;Mooney, Larissa J.;Hser, Yih-Ing
为了检查与数字访问差异相关的特征（即，在美国农村和城市家庭中，通过计算机或智能手机接入高速互联网），因为数字接入对获得远程医疗服务有直接影响。使用2019年美国社区调查，我们根据设备和高速互联网接入分析了地理区域，种族/民族和社会经济地位的比例。最大似然logit估计估计这些因素如何影响设备和高速互联网接入。在105，312，959户家庭中，32.29%没有带高速互联网（WDW）的台式机或笔记本电脑，21.51%没有带无线互联网数据计划（WSW）的智能手机，14.02%没有任何数字接入（WDA）。非大都市家庭比大都市家庭更有可能成为WDA（OR=1.87; 95%CI：1.83-1.91）。相对于非西班牙裔白人，非西班牙裔黑人（OR=1.60; 95% CI：1.56-1.64）、美洲印第安人或阿拉斯加原住民（OR=2.00; 95% CI：1.82-2.19）或西班牙裔（OR=1.70; 95% CI：1.66-1.74）更有可能是WDA。与拥有私人医疗保险的家庭相比，家庭WDA更有可能没有保险（OR=2.44; 95% CI：2.36-2.53）或公共保险（OR=3.78; 95% CI：3.70-3.86）。有任何数字接入的家庭报告收入更高，更多的家庭成员住在家里。使用相同的预测因素，WDW或WSW家庭也报告了类似的发现。非大城市家庭、少数种族/族裔家庭和低收入家庭在数字接入方面存在显著差异。缺乏数字接入对通过远程医疗获得保健服务产生影响，从而可能加剧健康差距。
To examine characteristics associated with disparities in digital access (i.e., access to high-speed internet via a computer or smartphone) in American rural and urban households given that digital access has a direct impact on access to telemedicine-based services. Using the 2019 American Community Survey, we analyzed the proportions of geographic area, race/ethnicity, and socioeconomic status according to device and high-speed internet access. Maximum likelihood logit estimators estimated how these factors influenced device and high-speed internet access. Of 105,312,959 households, 32.29% were without a desktop or laptop computer with high-speed internet (WDW), 21.51% were without a smartphone with a data plan for wireless internet (WSW), and 14.02% were without any digital access (WDA). Non-metropolitan households were significantly more likely to be WDA than metropolitan households (OR=1.87; 95% CI: 1.83–1.91). Relative to non-Hispanic Whites, non-Hispanic Blacks (OR=1.60; 95% CI: 1.56–1.64), American Indian or Alaska Natives (OR=2.00; 95% CI: 1.82–2.19), or Hispanics (OR=1.70; 95% CI: 1.66–1.74) were significantly more likely to be WDA. When compared to households with private health insurance coverage, households WDA were significantly more likely to have no insurance (OR=2.44; 95% CI: 2.36–2.53) or public insurance coverage (OR=3.78; 95% CI: 3.70–3.86). Households with any digital access reported higher income and more family members living at home. Using the same predictors, similar findings were reported for households WDW or WSW. Significant disparities in digital access exist among non-metropolitan households, racial/ethnic minority households, and lower-income households. The lack of digital access has implications for accessibility of health care services via telemedicine and thus could exacerbate health disparities.
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