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31 August 2022Investigating Digital Divide and Mobile Health in Asian Countries
Principal investigator: Dr WANG Xiaohui (Department of Media and Communication)
Nowadays humans become more and more dependent on smartphones, from emails, online shopping, social media to electronic banking, smartphones almost manage everything for us in our daily lives. According to a recent survey in the US, 11% of the Americans surveyed said they turn to social media to look for reliable health information. The COVID-19 pandemic also leads to a rapid rise of digital health technologies such as online consultations and online health management. Nevertheless, not all individuals benefit equally from assessing and consuming health information online. This phenomenon of inequality is called the “digital divide”, which is related not only to internet access but also to the existence of a gap between people who can and cannot effectively use new communication tools or comprehend new information.
Although the act of seeking health-related information online has received substantial research attention, but mainly in western countries. For example, analyses of the data from several surveys on the topics administered in the United States and Germany have provided valuable insights into the determinants and outcomes of such information-seeking behaviour in those populations. However, research investigating such behaviour in Asian countries has been sorely limited, especially with respect to health information seeking on smartphones. To address this research gap, Dr WANG Xiaohui of CityU’s Department of Media and Communication, has designed a study to investigate the factors contributing to mobile health information seeking (MHIS) to profile such information seekers in Asia using data from 10 Asian countries. The findings were presented in The Digital Divide and Seeking Health Information on Smartphones in Asia: Survey Study of Ten Countries, published in the Journal of Medical Internet Research.
A total of 9,086 adults were recruited from 10 Asian countries (China, India, Indonesia, Thailand, the Philippines, Malaysia, South Korea, Japan, Vietnam and Singapore) in 2016. Participants ranged in age from 18 to 55. Nearly three-quarters of them had completed college or above, and more than half were married and had at least one child. Approximately 88% of them were employed or self-employed. The participants reported how frequently they used their smartphones to seek health information. This item was adopted to measure their MHIS. Both objective and subjective socioeconomic status of the participants were taken into consideration. The project also looked into the country-level digital divide by making reference to the Information Communications Technology (ICT) Development Index, the GINI Index and the current health expenditure per capita of each country. To analyse the collected data, multilevel linear regression models were constructed to determine the effect of individual-level characteristics and country-level inequalities in MHIS.
To profile mobile health information seekers in Asia, it is found that women tend to use smartphones for obtaining health information more often than men owing to their higher engagement in health-related activities for themselves and their family members. Younger and older generations emerged as being more likely to use smartphones to seek health information than middle-aged individuals. This may reflect the fact that younger generation is more familiar and comfortable with using smartphones to meet their everyday needs, whereas older generation has a strong motivation and need to look for any health-related information available.
Understanding how individual-level and country-level differences in MHIS are affected by socioeconomic conditions is important for developing and evaluating public health policy. This study examines the digital divide at both individual and country levels. The results of the analysis confirmed that individuals who are of higher education or social status, married, parents, and/or employed are more likely to use smartphones to seek health information. However, individual-level digital divide may still exist in spite of ubiquitous access to internet or advanced mobile technology. Further studies should focus on the second level of digital divide with respect to people’s ability to comprehend the information found online. At the country-level digital divide, it is found that participants from countries that spend less on health per capita such as India, the Philippines, Vietnam and Thailand were more likely to rely on smartphones as a source for health information. In developing countries where health or digital resources are limited, mobile technology may also help individuals to access health information and manage their health. In such case, smartphones can act as tools to bridge health inequalities between countries.
This study has been considered as by far the largest multinational survey on smartphone users’ health information seeking behaviour in Asia. It adds a new dimension for understanding the digital divide in mobile health at both the individual and country levels. The findings suggest that although smartphones represent a readily available source of health information, they can also create inequalities in the access to health information among different socioeconomic classes of society. Public health efforts should thus be put on better investigating and addressing issues pertaining to people’s ability to seek, understand and appraise health information from electronic sources. At the same time, the findings imply that smartphones are widely accepted as a tool for daily activities and communication in developing countries in Asia. In that light, mobile technology appears to be a particularly useful complement for the management of health in developing countries.
Achievements and publication
Wang X, Shi J, Lee KM (2021). The Digital Divide and Seeking Health Information on Smartphones in Asia: Survey Study of Ten Countries. Journal of Medical Internet Research, 2022;24(1):e24086. https://doi.org/10.2196/24086