The internet is a great resource for individuals of all ages. It can serve as a valuable tool for older adults, in particular, to access timely health information. However, national data suggests that older adults are, on average, less likely to access the internet compared with other adults.  Over two-thirds of American households access the internet (68.5%), yet this percentage decreases to 33.6% when looking at adults aged 65 years and older in particular [1]. Furthermore, research shows that only one in five of adults aged 65 years and older (19.5%) used the internet to keep track of personal health information, such as care received, test results, or upcoming medical appointments in 2007 [2].

The internet has become so central to our lives that there are Healthy People 2020 objectives surrounding this topic in an attempt to reduce some of the disparities that have been identified [3]. For example, just a few of the many Healthy People 2020 Health Communication and Health Information Technology objectives include:

• Increase the proportion of persons with access to the internet;  and
• Increase the proportion of persons who use electronic personal health management tools, such as the internet, to keep track of personal health information and to communicate with their provider.

 Using data from PHMC’s Community Health Data Base 2010 Southeastern Pennsylvania (SEPA) Household Health Survey, the following article looks at older adults 60 years of age or older living in the SEPA region who reported that they never use the internet.

Demographic Characteristics among Older Adults

In Southeastern Pennsylvania (SEPA), 41.4% of older adults (60+) never use the internet, representing more than 325,000 older adults in our region.

• A little more than half of older adults living in Philadelphia (55.6%) never use the internet compared with just over a third (35.7%) of older adults living in Delaware, Montgomery, Bucks, or Chester counties.

• Women 60 years of age or older (48.8%) are more likely to report never using the internet than men in the same age group (34.3%).

• Almost three-quarters of all Latino adults 60 years of age or older (72.2%) never use the internet compared with 62.0% of Black older adults and 38.8% of White older adults (Figure 1).

• As age increases, the percentage of older adults who never use the internet also increases – 21.6% of adults aged 60 to 64, 37.1% of adults aged 65 to 74, and 65.9% of adults aged 75 or older never use the internet (Figure 2).

• Older adults living below the Federal Poverty Level are much less likely to use the internet than their counterpart living above 150% of the Federal Poverty Level.  Almost three-quarters of all older adults living below 150% of the Federal Poverty Level (75.6%) never use the internet compared with 34.7% of older adults living at or above the poverty level.*

• Older adults who work full or part time are more likely to be internet users than are older adults who are not working. One in five working older adults (19.7%) never use the internet, which contrasts with older adults who are unemployed (32.7%), retired (49.8%), homemakers (51.6%), and unable to work (65.5%). 

• As educational attainment increases, the percentage of older adults who never use internet decreases. Four in five older adults with less than a high school education (82.4%) never use the internet compared with 58.7% of older adults with a high school education, 41.2% of older adults with some college education, and 14.4% of older adults with a college or post-college education (Figure 3).

• Older adults who never use the internet are more likely to live alone (34.3%) compared with older adults who use the internet at least occasionally (17.8%).  Older adults who live alone and never use the internet may have increased difficulty obtaining necessary health information.

Health Status and Internet Use among Older Adults

Health concerns may present barriers to internet use, as older adults in poorer health are less likely to be internet users. Almost two-thirds of older adults in fair/poor health (62.7%) never use the internet compared with 36.8% of older adults in excellent/very good/good health.

• Older adults who never use the internet are twice as likely to have depression (15.8%) compared with older adults who use the internet at least occasionally (7.7%).

• One in three older adults who have at least one IADL limitation never use the internet (33.8%) compared with 12.0% of older adults who have at least one IADL limitation who use the internet at least occasionally. IADL (Instrumental Activities of Daily Living) limitations include the ability to perform household chores, shop for groceries, and prepare meals. 

• Older adults who never use the internet are more likely to have at least one ADL limitation (15.1%) compared with older adults who use the internet at least occasionally (4.7%). ADL limitations refer to limitations in Activities of Daily Living, such as bathing, dressing, eating, and getting in and out of bed.

One recent study found that individuals who are younger, have a greater level of education, are non-Hispanic, and/or have better general health report increased computer usage [4]. The study argues that future interventions to increase internet use to improve health outcomes should focus on the Hispanic older adult community. This article suggests similar findings.

The role of internet access in health is emphasized by the US Department of Health and Human Services which has set a target of three quarters of Americans with internet access by the year 2020.  The 2010 Southeastern Pennsylvania Household Health Survey data show that nearly 20% of adults of all ages in our region do not currently use the internet. For more information on the Health People 2020 goals, please click here.

For more information about the findings presented in this article, please contact Rose Malinowski Weingartner at rosemw@phmc.org or Nicole Dreisbach at nicoled@phmc.org.

To download this article as a PDF, please click here.

To access CHDB’s presentation at the 2011 American Public Health Association Annual Conference on this topic, please click here.