Immigrants' Use of eHealth Services in the United States, National Health Interview Survey, 2011-2015

Yang Wang, D. Phuong Do, Fernando Wilson

Research output: Contribution to journalArticle

Abstract

OBJECTIVES:: Little is known about the use of electronic health (eHealth) services supported by information technology in the United States among immigrants, a group that faces barriers in accessing care and, consequently, disparities in health outcomes. We examined differences in the use of eHealth services in the United States by immigration status in a nationally representative sample.

METHODS:: We used data from the 2011-2015 National Health Interview Survey to assess use of eHealth services among US natives, naturalized citizens, and noncitizens. Our outcome variable of interest was respondent-reported use of eHealth services, defined as making medical appointments online, refilling prescriptions online, or communicating with health care professionals through email, during the past 12 months. We analyzed use of eHealth services, demographic characteristics, socioeconomic status, and health status among all 3 groups. We used multivariate logistic regression models to examine the association between immigration status and the likelihood of using eHealth services, adjusting for individual demographic, socioeconomic, and health characteristics.

RESULTS:: Among 126 893 US natives, 18 763 (16.1%) reported using any eHealth services in the past 12 months, compared with 1738 of 15 102 (13.0%) naturalized citizens and 1020 of 14 340 (7.8%) noncitizens. Adjusting for socioeconomic factors reduced initial gaps: naturalized citizens (adjusted odds ratio [aOR] = 0.81; 95% confidence interval [CI], 0.75-0.87) and noncitizens (aOR = 0.81; 95% CI, 0.72-0.90) had approximately 20% lower odds of using eHealth services than did US natives. However, the differences varied by type of eHealth service. Immigrants with higher English-language proficiency were more likely to use eHealth services than were immigrants with lower English-language proficiency.

CONCLUSIONS:: Targeted interventions that reduce socioeconomic barriers in accessing technology and promote multilingual electronic portals could help mitigate disparities in use of eHealth services.

Original languageEnglish (US)
Pages (from-to)677-684
Number of pages8
JournalPublic health reports (Washington, D.C. : 1974)
Volume133
Issue number6
DOIs
StatePublished - Nov 1 2018

Fingerprint

Health Surveys
Health Services
Interviews
Population Groups
Emigration and Immigration
Language
Logistic Models
Odds Ratio
Demography
Confidence Intervals
Technology
Health
Social Class
Health Status
Prescriptions
Appointments and Schedules
Delivery of Health Care

Keywords

  • disparities
  • eHealth services
  • immigrant
  • language barriers
  • minority health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Immigrants' Use of eHealth Services in the United States, National Health Interview Survey, 2011-2015. / Wang, Yang; Do, D. Phuong; Wilson, Fernando.

In: Public health reports (Washington, D.C. : 1974), Vol. 133, No. 6, 01.11.2018, p. 677-684.

Research output: Contribution to journalArticle

@article{a7c56760d18e4eacbd0bc3a3f6a6214c,
title = "Immigrants' Use of eHealth Services in the United States, National Health Interview Survey, 2011-2015",
abstract = "OBJECTIVES:: Little is known about the use of electronic health (eHealth) services supported by information technology in the United States among immigrants, a group that faces barriers in accessing care and, consequently, disparities in health outcomes. We examined differences in the use of eHealth services in the United States by immigration status in a nationally representative sample.METHODS:: We used data from the 2011-2015 National Health Interview Survey to assess use of eHealth services among US natives, naturalized citizens, and noncitizens. Our outcome variable of interest was respondent-reported use of eHealth services, defined as making medical appointments online, refilling prescriptions online, or communicating with health care professionals through email, during the past 12 months. We analyzed use of eHealth services, demographic characteristics, socioeconomic status, and health status among all 3 groups. We used multivariate logistic regression models to examine the association between immigration status and the likelihood of using eHealth services, adjusting for individual demographic, socioeconomic, and health characteristics.RESULTS:: Among 126 893 US natives, 18 763 (16.1{\%}) reported using any eHealth services in the past 12 months, compared with 1738 of 15 102 (13.0{\%}) naturalized citizens and 1020 of 14 340 (7.8{\%}) noncitizens. Adjusting for socioeconomic factors reduced initial gaps: naturalized citizens (adjusted odds ratio [aOR] = 0.81; 95{\%} confidence interval [CI], 0.75-0.87) and noncitizens (aOR = 0.81; 95{\%} CI, 0.72-0.90) had approximately 20{\%} lower odds of using eHealth services than did US natives. However, the differences varied by type of eHealth service. Immigrants with higher English-language proficiency were more likely to use eHealth services than were immigrants with lower English-language proficiency.CONCLUSIONS:: Targeted interventions that reduce socioeconomic barriers in accessing technology and promote multilingual electronic portals could help mitigate disparities in use of eHealth services.",
keywords = "disparities, eHealth services, immigrant, language barriers, minority health",
author = "Yang Wang and Do, {D. Phuong} and Fernando Wilson",
year = "2018",
month = "11",
day = "1",
doi = "10.1177/0033354918795888",
language = "English (US)",
volume = "133",
pages = "677--684",
journal = "Public Health Reports",
issn = "0033-3549",
publisher = "Association of Schools of Public Health",
number = "6",

}

TY - JOUR

T1 - Immigrants' Use of eHealth Services in the United States, National Health Interview Survey, 2011-2015

AU - Wang, Yang

AU - Do, D. Phuong

AU - Wilson, Fernando

PY - 2018/11/1

Y1 - 2018/11/1

N2 - OBJECTIVES:: Little is known about the use of electronic health (eHealth) services supported by information technology in the United States among immigrants, a group that faces barriers in accessing care and, consequently, disparities in health outcomes. We examined differences in the use of eHealth services in the United States by immigration status in a nationally representative sample.METHODS:: We used data from the 2011-2015 National Health Interview Survey to assess use of eHealth services among US natives, naturalized citizens, and noncitizens. Our outcome variable of interest was respondent-reported use of eHealth services, defined as making medical appointments online, refilling prescriptions online, or communicating with health care professionals through email, during the past 12 months. We analyzed use of eHealth services, demographic characteristics, socioeconomic status, and health status among all 3 groups. We used multivariate logistic regression models to examine the association between immigration status and the likelihood of using eHealth services, adjusting for individual demographic, socioeconomic, and health characteristics.RESULTS:: Among 126 893 US natives, 18 763 (16.1%) reported using any eHealth services in the past 12 months, compared with 1738 of 15 102 (13.0%) naturalized citizens and 1020 of 14 340 (7.8%) noncitizens. Adjusting for socioeconomic factors reduced initial gaps: naturalized citizens (adjusted odds ratio [aOR] = 0.81; 95% confidence interval [CI], 0.75-0.87) and noncitizens (aOR = 0.81; 95% CI, 0.72-0.90) had approximately 20% lower odds of using eHealth services than did US natives. However, the differences varied by type of eHealth service. Immigrants with higher English-language proficiency were more likely to use eHealth services than were immigrants with lower English-language proficiency.CONCLUSIONS:: Targeted interventions that reduce socioeconomic barriers in accessing technology and promote multilingual electronic portals could help mitigate disparities in use of eHealth services.

AB - OBJECTIVES:: Little is known about the use of electronic health (eHealth) services supported by information technology in the United States among immigrants, a group that faces barriers in accessing care and, consequently, disparities in health outcomes. We examined differences in the use of eHealth services in the United States by immigration status in a nationally representative sample.METHODS:: We used data from the 2011-2015 National Health Interview Survey to assess use of eHealth services among US natives, naturalized citizens, and noncitizens. Our outcome variable of interest was respondent-reported use of eHealth services, defined as making medical appointments online, refilling prescriptions online, or communicating with health care professionals through email, during the past 12 months. We analyzed use of eHealth services, demographic characteristics, socioeconomic status, and health status among all 3 groups. We used multivariate logistic regression models to examine the association between immigration status and the likelihood of using eHealth services, adjusting for individual demographic, socioeconomic, and health characteristics.RESULTS:: Among 126 893 US natives, 18 763 (16.1%) reported using any eHealth services in the past 12 months, compared with 1738 of 15 102 (13.0%) naturalized citizens and 1020 of 14 340 (7.8%) noncitizens. Adjusting for socioeconomic factors reduced initial gaps: naturalized citizens (adjusted odds ratio [aOR] = 0.81; 95% confidence interval [CI], 0.75-0.87) and noncitizens (aOR = 0.81; 95% CI, 0.72-0.90) had approximately 20% lower odds of using eHealth services than did US natives. However, the differences varied by type of eHealth service. Immigrants with higher English-language proficiency were more likely to use eHealth services than were immigrants with lower English-language proficiency.CONCLUSIONS:: Targeted interventions that reduce socioeconomic barriers in accessing technology and promote multilingual electronic portals could help mitigate disparities in use of eHealth services.

KW - disparities

KW - eHealth services

KW - immigrant

KW - language barriers

KW - minority health

UR - http://www.scopus.com/inward/record.url?scp=85055193847&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055193847&partnerID=8YFLogxK

U2 - 10.1177/0033354918795888

DO - 10.1177/0033354918795888

M3 - Article

VL - 133

SP - 677

EP - 684

JO - Public Health Reports

JF - Public Health Reports

SN - 0033-3549

IS - 6

ER -