Low Income Status Increases Telehealth Usage for Racial, Ethnic Minorities

Although low-income racial and ethnic minority communities are at greater risk for health inequities that affect telehealth usage, Hispanic communities are more likely to use telehealth, according to results of a study published in the Journal of Medical Internet Research.

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Investigators also found that non-Hispanic Black individuals continue to struggle with inequities regarding access to telehealth services.

In the study, investigators aimed to examine the differences in telehealth usage among individuals who are at or below the federal poverty level. They analyzed age, gender, race, ethnicity, education, employment status, household size, and income.

Investigators conducted the observational study by using the COVID-19 Research Database to analyze factors that contributed to inequities in telehealth usage. Data were gathered from March 2020 to April 2021.

There were approximately 100 million unique individuals with 3.4 billion claims from the Office Ally database. Additionally, investigators used the Analytics IQ PeopleCore Consumer database, which was nationally representative of 242.5 million United States adults aged 19 years and older.

The medical claims were analyzed to determine the demographic and socioeconomic factors that influenced telehealth usage among individuals in low-income racial and ethnic populations. A multiple logistic regression analysis was used to determine the odds of these individuals using telehealth within the study period.

There were 2,850,831 patients included in the study, with approximately 60% female, 75% with a high school education or less, 49% unemployed, and 62% identified as non-Hispanic White.

The results demonstrated that approximately 9.84% of individuals had 1 or more telehealth claims during the study period, with Asian and Hispanic individuals more likely to use telehealth than non-Hispanic white individuals and Black individuals.

Furthermore, investigators found that individuals who were employed were approximately 15% more likely to use telehealth than those who were unemployed. Individuals who identified as male were also 12% less likely to use telehealth than those identifying as female.

Patients who had a high school education or less were 5% less likely to use telehealth than those with a bachelor’s degree or higher. Individuals who were aged 18 to 44 years old were 32% more likely to use telehealth than individuals in the aged 65 years or older group.

As for income, investigators found that it is a contributor for telehealth usage for households of more than 2 individuals. For households with 1 to 2 members, income and telehealth usages were not significant.

In households with 3 to 10 individuals, telehealth usage varied by income. Investigators found that telehealth usage for individuals in a 3-person household ranged from 5% to 10% for a household income of $3000 and $42,000, respectively.

Investigators also emphasized that to improve telehealth and health care use, characteristics of ethnic and racial subgroups should be carefully considered because poverty affects individuals differently.

Reference

Williams C, Shang D. Telehealth usage among low-income racial and ethnic minority populations during the COVID-19 pandemic: retrospective observational study. J Med Internet Res. 2023;25:e43604. doi:10.2196/43604