Analysis of Health Conditions Based on a National Health Information Trends Survey: Implications from Internet and Transport Access (Preprint)

BACKGROUND Internet access to health information & transportation to health care services are two very important ways to promote health and ameliorate health disparities. Despite the general widespread availability of transportation and Internet, disparities still exist among specific groups, particularly among traditionally undeserved (rural/remote) and minority populations. A better understanding of the spatial patterns of transportation and Internet access, along with their relationship to people’s general health status, may help improve our current health care system and programs. OBJECTIVE The purpose of this study was to explore the spatial distribution of people who have difficulties with transportation to health care and Internet access. We also examined the relationship between self-reported health status and transportation and Internet access barriers. METHODS We used data from the 2018 Health Information National Trends Survey (HINTS), a nationally representative sample of US households, to examine the association between transportation and Internet access with individual’s general health status. A geographic information map was generated to examine the geographic variation of both transportation to health care and Internet access barriers in the United States. RESULTS Individuals with limited transportation to health care and Internet access are associated with a lower level of health status, and Internet access seems to have a larger influence on general health status. Similarly, people who lived in a rural area were more likely to associate with fair or poor health status compared to those who lived in urban area. Respondents who were without health care insurance coverage were less likely to have an excellent or very good health status. Women tended to have better general health status then men, which is consistent with previous studies. In addition, people who had employment, higher education, higher income, and are of White race are more likely to have a higher level of general health status. Geographically, the East South Central and East North Central Divisions tended to have the lowest level of Internet and transportation access to health care, especially the states of Missouri, Tennessee, Mississippi and Alabama. CONCLUSIONS This analysis showed the mixed effects of transportation and Internet access on individual’s’ general health status. Both of the barriers are significant factors for people with health issues, and access disparities exist at the state level and between urban and non-urban areas. Additional work and policy is needed to ensure that Internet and transportation resources and services are prioritized for undeserved populations and areas.