A cross-sectional study of socioeconomic inequality in health-related digital device access among older adults in China
Yutong Jiang, Mingsheng Chen, Lei SiBackground
Digital health technologies are increasingly embedded in health management and healthy aging, but unequal access may widen socioeconomic disparities among older adults.
Objective
To quantify socioeconomic inequalities in health-related digital device access or use among older adults in China and identify associated contributing factors.
Methods
We analyzed 9,960 adults aged ≥60 years from the 2023 China Longitudinal Aging Social Survey. Access was defined as respondents reporting either online health-management activity or ownership of at least one health-related digital device. Socioeconomic status (SES) was measured using province-relative household expenditure quintiles. Survey-weighted inequality was assessed using the Erreygers-corrected concentration index (ECI), and decomposed with a linear probability model.
Results
Overall, 45.1% (95% CI, 43.3%–46.9%) of older adults had access to health-related digital devices. Prevalence increased from 32.1% (95% CI, 28.4%–35.8%) in the lowest SES group to 56.7% (95% CI, 52.8%–60.7%) in the highest. The ECI was 0.189 (95% CI, 0.147–0.231; P < 0.001), indicating pro-rich inequality. The largest positive contributions were from internet utilization (24.0%), SES (21.7%), household registration (16.6%), and primary source of income (10.5%). Modeled contributions accounted for 100.03% of the observed ECI.
Conclusions
Health-related digital device access or use was concentrated among socioeconomically advantaged older adults in China. The primary ECI measures inequality by relative position within provinces and was lower than the national-ranking estimate. Contributions are statistical rather than causal. Equity-oriented strategies should combine affordable access with digital skills support, family and community assistance, and stronger support for rural and low-SES older adults.