ArticleAdvances in health information science and practice2025
Heterogeneity in Online Medical Record Use Based on the Intersectionality of Community and Racioethnicity: A National Study Using Health Information National Trends Survey Data.
Article in Advances in health information science and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: An individual's racioethnicity can affect their use of digital health tools and access to digital resources. In this study, the authors examine the relationship between community Social Determinants of Health (cSDoH) and racioethnicity with access and use of online medical records. Methods: Data were used from the Health Information National Trends Survey (HINTS)-specifically, HINTS 5 Cycle 1 (2017), HINTS 5 Cycle 2 (2018), HINTS 5 Cycle 3 (2019), HINTS 5 Cycle 4 (2020). Predicted probabilities of accessing online medical records based on interactions of cSDoH and racioethnicity were estimated using adjusted weighted logistic regression. Among online medical record users, the authors explored how they accessed the Internet by racioethnicity and cSDoH. Results: A combined analytical dataset was created with 16,092 pooled observations from all four HINTS 5 cycles, including 14,103 respondents who answered a question about whether they accessed their online medical record (with 5,766 responding yes). From a range of predicted probabilities between 0 and 1, Hispanic, Non-Hispanic (NH) Black, and NH White communities had predicted probabilities for accessing online medical records of 0.20, 0.33, and 0.38, respectively, in the most disinvested neighborhoods. We also found differences in how individuals accessed their online medical record by racioethnicity and cSDoH. Conclusions: Results suggest that incorporating cSDoH and racioethnicity in digital health decision making may help bridge the digital divide. Further research should explore the complex interplay between cSDoH, racioethnicity, online medical record access and use to promote digital health equity.
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