Cohort difference-in-differences reveals digital divide's effect on health behaviours, indicating the need for inclusive policies.
Abstract We study the behavioural impact of the 2007 launch of the NHS website on older adults in England. Using eleven waves of the English Longitudinal Study of Ageing (2002–2022), we implement a cohort difference-in-differences design that scales post-2007 changes by a pre-period digital propensity index (Ppre i ) estimated with cross-fitted gradient boosting. A one–standard deviation increase in Ppre i is associated with increases of about 1.2 percentage points in GP contact (3 months), 3.0 percentage points in any screening, and 2.4 percentage points in exercise participation, alongside a small, imprecise decline in smoking. Event studies show flat pretrends and gradual post-2007 accumulation. Mechanism analyses indicate both a direct online channel (greater health-information use) and a GP-mediated channel (more routine checks), with larger effects among higher-education respondents. Results are robust to placebo policy dates, alternative constructions of Ppre i , and fixed-effects variants. Curated public digital information can shift utilisation and selected behaviours in older populations, but complementary inclusion and accessibility policies are needed to avoid widening disparities.
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Wang et al. (2025) studied this question.
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