Intersectional differences regarding benefits and opportunities towards digital health technologies

Introduction

Digital health technologies (DHTs) have been shown to improve quality of care and promote equity across social determinants of health (SDOH), thereby preventing a digital divide. Attitudes can be understood as a key prerequisite for technology adoption (here, DHTs) and its subsequent use. However, few studies examine cumulative effects of SDOH on attitudes towards DHTs. Using MAIHDA, we examined cumulative effects of gender, educational attainment, and generation on attitudes towards DHTs.

Methods

Data came from the cross-sectional online HECoS survey (N = 1,850). 30 strata were differentiated. A sum score based on 12 items was grouped into two subscales, including Benefits and Opportunities towards DHTs (DHT-BO). For MAIHDA, DHT-BO was dichotomized at the 80th percentile (≤80% = 0; >80% = 1) and analyzed with a logistic model.

Results

The greatest benefits and opportunities were reported by male members of Generation Z with higher educational attainment; the lowest by female Baby Boomers with medium educational attainment. The proportion of variance was high for opportunities (PCV = 100%). Intersectional effects contributed minimally to group differences. Attitudes towards DHTs are mainly shaped by additive SDOH effects. Women reported significantly lower DHT-BO (OR 0.70) as did members of Generation X (OR 0.70) and Baby Boomers (OR 0.53). Educational attainment had no significant influence on perceived DHT-BO.

Discussion and Conclusions

Results suggest that intersectional SDOH factors explain only minimal differences in DHT-BO. Participants may be familiar with digital tools, suggesting SDOH differences are underestimated or diminished through digital transformation within societies. New SDOH differences may become more relevant, as they might be shaped by other predictors, e.g. digital (health) competences, which should be considered in further studies. Our findings could support targeted interventions to promote competent and critical DHT use.

Key messages

• Social determinants of health influenced Benefits and Opportunities towards DHTs in a more additive than intersectional manner.

• In particular, women of the Baby Boomer generation showed the lowest perceived benefits and opportunities towards DHTs, regardless of educational attainment.