BACKGROUND
The COVID-19 pandemic has amplified the important role of telehealth to safe continuity of care. Regional variation in internet access and telehealth use are well-documented, but how neighborhood factors, including pervasiveness of broadband internet, affects older adults’ telehealth in the context of internet access is not known.
OBJECTIVE
To assess how individual and neighborhood characteristics, including pervasiveness of neighborhood broadband internet subscription, affect engagement in telehealth among older adults with internet access.
METHODS
Cross-sectional study of 5,117 community-living older adults who participated in the 2017 National Health and Aging Trends Study with census-tract level data for participants’ place of residence from the American Community Survey.
RESULTS
Of an estimated 35.3 million community-living older adults, 21.1 million (59.7%) were internet users, and of this group, more than 1 in 3 (35.8%) engaged in telehealth. In a multivariable regression model that adjusted for individual and neighborhood-level factors, age, education, income, and pervasiveness of neighborhood broadband internet subscription were associated with engagement in telehealth: race, health, county metropolitan status, and neighborhood social deprivation were not. Among internet users, living in a neighborhood at the lowest (versus highest) tertile of broadband internet subscription was associated with being 40% less likely to engage in telehealth (aOR=0.60, 95% CI: 0.42, 0.87), all else equal.
CONCLUSIONS
Neighborhood broadband internet stands out as a mutable characteristic that is consequential to telehealth participation.
Results of a cross-sectional study on health-related problems of community-living older adults using the GeriatrICS, an ICF-based assessment tool
