Digital health literacy in older adults: the role of socio-economic factors and social support

Background

Digital health literacy (DHL) is a key determinant of successful self-management of non-communicable diseases in the digital era. In today’s DHL development, older adults are the most vulnerable group as they face a combination of overlapping socio-demographic, technological, and social barriers. Our study aimed to identify the role of socio-economic factors and social support in DHL among older adults.

Methods

A cross-sectional study was conducted among 577 older adults (56.7% aged 65-74; 79.3% women). They completed self-reported measures including the eHealth Literacy Scale (eHEALS), the MacArthur Subjective Social Status Scale (SSS), and the Oslo Social Support Scale (OSSS-3). We used multiple linear regressions to analyse the data.

Results

Of the entire sample, 51.6% had university education, 76.3% lived in an urban area, and 57.1% lived with a spouse. The vast majority of the sample (95.5%) had access to the internet at home. The mean DHL score achieved 30.22 + 7.02. Higher DHL was significantly associated with higher education (β=.15; p ≤ 0.001), higher perceived social status (β=.14; p ≤ 0.01), having access to the internet at home (β=−.24; p ≤ 0.001), living in an urban area (β=−.11; p ≤ 0.05), and having a higher level of perceived social support (β=.09; p ≤ 0.05). The final model explained 15% of the total variance of DHL. The age, gender, and marital status were not associated with DHL in older adults.

Conclusions

Public health interventions aimed at improving DHL among older adults should be designed with particular attention to their socio-economic context. Intervention strategies should prioritise underprivileged groups of older adults with lower education, lower perceived social status, or living in rural areas. Tailoring and co-creating the DHL interventions with older adults, incorporating their social support networks, can bridge the digital health divide. [Funding: VEGA 1/0097/24 and NextGenerationEU No. 09I01-03-V04-00101].

Key messages

• Digital health literacy is vital for managing chronic diseases, but older adults remain most at risk due to multiple, overlapping socio-economic, technological, and social barriers.

• Digital health literacy interventions should focus on disadvantaged older adults, be responsive to their socio-economic context, and co-created alongside them and their support networks.