Telehealth Use Increasing Among Older Adults in Urban Areas
Statistics show that more women and members of diverse groups are relying on telehealth, which is a positive step toward better health equity
Since the beginning of the COVID-19 pandemic in March 2020, there has been a steady increase in telehealth and telemedicine appointments across the country, where care is delivered to patients via video or telephone.
Recent studies have reported that those living in urban areas are more likely to use telehealth than those living in rural areas.
New data shows which groups used telehealth the most during the pandemic. According to a recent National Center for Health Statistics report, in 2021, more than 1 in 3 adults reported using telemedicine in the previous year, and use was more prevalent among women, older adults, and those living in urban areas.
Specifically, data from the 2021 National Health Interview Survey showed that women were much more likely than men to use telemedicine, at 42% and 31.7%, respectively.
Usage also increased with age, as 43.3% of adults aged 65 and over took advantage of telemedicine compared with only 29.4% of those between 18 and 29.
Women make up the majority of older adults in every country due to their higher life expectancy, and it's not different in the U.S., where the average life expectancy for women is 81 years, five years longer than the average for males. So women using telehealth services more than men is consistent with that data.
In recent years, health care has experienced an explosion in digital innovations designed to improve longevity and quality of life. One of these innovations includes telemedicine intervention, which has traditionally been used in rural areas, but is now growing in popularity in urban areas. One company, m-Health Solutions, which offers remote monitoring of patients and diagnostic abilities, has experienced growth in the area of urban telemedicine services.
Recent studies have reported that those living in urban areas are more likely to use telehealth than those living in rural areas; the survey confirms that telemedicine use rose in increasingly urban areas, with 40.3% of adults in central counties of large metropolitan areas compared to only 27.5% of adults in most rural counties.
Seeing that older women are using telehealth is not only encouraging, but also serves to dispel the widespread notion that older adults are not open to technology.
Unlike women and those living in urban areas, older adults, more specifically, older women whose health care costs increase disproportionately in their later years because they are living longer, might see the most benefit from telehealth.
But previous research shows that older people often have the least access to technology because of poor engagement, ageist stereotypes, and lack of inclusion in product design.
Seeing that older women are using telehealth is not only encouraging, but also serves to dispel the widespread notion, often used to justify inaction, that older adults are not open to technology.
In addition, most people over 65 have cell phones, and increasing numbers of older adults are accessing the Internet. These facts support the survey's conclusion that older people are one of the top groups using telemedicine interventions.
Lastly, the survey showed a new culture of health care self-sufficiency among older adults. The goal is to reach across gender, race, and income barriers.
Telehealth Among Older and Diverse Groups
The shift to telemedicine that the COVID-19 pandemic caused has resulted in an even more significant disparity in health outcomes for specific groups like older people and those with chronic conditions, ethnic minorities, etc.
Even the survey shows how those representing ethnic minorities lag in using telehealth, with Hispanic (32.8%), Asian (33.0%), and Black (33.1%) adults compared to non-Hispanic white (39.2%) adults.
But what's noteworthy is that during the pandemic, the group using telehealth the most was American Indian or Alaska Native (40.6%) adults.
Fortunately, it seems that efforts are starting to pay off since public health interventions have included reducing racial/ethnic disparities in health care. But the work does not end here.
Telehealth has and will continue to change the way care is delivered.
The intersections of race, class, and gender need serious consideration because, for example, the usage among adults with family incomes below or near the poverty line was lower.
The key to achieving good health depends on geographic location, level of education, income and ethnicity, more so than access to health care. These factors are collectively known as the social determinants of health (SDoH), describing "the conditions in which people are born, grow, live, work and age," as defined by the World Health Organization (WHO).
Public health has long championed SDoH, and it is time we look at telehealth through that lens to achieve health equity.
Urgent Need For Telemedicine
Telehealth has and will continue to change the way care is delivered. A study from Massachusetts General Hospital found that patients reported solid personal connections with providers when using telehealth visits.
Telemedicine can give patients more control over their health, but groups are being left behind despite its use. The widespread use and popularity of telehealth among older and American Indian adults is a start toward promoting health equity across diverse groups.