Not all elderly Americans will surf to health

Providing health information on the internet may not be the "cure all" that it is hoped to be. It could sideline especially those Americans older than 65 years old who are not well versed in understanding health matters, and who do not use the web regularly. So says Helen Levy of the University of Michigan in the US, who led the first-ever study to show that elderly people's knowledge of health matters, so-called health literacy, also predicts how and if they use the internet. The findings appear in the Journal of General Internal Medicine.

Substantial resources and attention have been invested recently in health information technology in the US, for example by providing electronic medical records online. It is unclear, however, whether elderly patients are willing and able to put this innovation to full use. Levy's team therefore sought to establish if there is a link between people's levels of health literacy and their use of the internet to find information.

Data was analyzed from the 2009 and 2010 Health and Retirement Study, a nationally representative survey of more than 20,000 Americans 65 years and older. Approximately 1,400 of the participants were queried about how often they used the internet for whatever purpose and, in particular, how often they searched for health and medical information. Their health literacy was assessed using the revised Rapid Estimate of Adult Literacy in Medicine questionnaire. They also rated how confident they felt about filling out medical forms.

The analysis revealed that the internet was a port of call to gain health information for 31.9 percent of the elderly participants who were well versed in health matters, while only 9.7 percent of those with low health literacy used it. Elderly Americans with low health literacy are less likely to use the internet at all. If members of this group do surf the web, it is generally not to search for medical or health information. Health literacy was therefore found to be a significant predictor of what people do once they are online.

The analysis also showed that a person's level of health literacy is a more important predictor of whether he or she will use the internet to get medical or health information rather than his or her cognitive functioning. Levy therefore suggests that 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.

"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."