How Does Internet Access Influence Health Status? Moderated Mediation Model Based on the Digital Divide (Preprint)

BACKGROUND Nowadays, a number of people have Internet access in the U.S. Despite there being strong reasons to assume that Internet diffusion may improve individuals’ health status, there remain some questions. OBJECTIVE Information and communication technologies (ICT) play an important role in almost every aspect of citizens’ lives. However, access to these technologies is not equally distributed among all groups, which can cause inequality. The current study aims to reveal the mechanism of how internet access influences individuals’ health outcomes based on the digital divide theory. METHODS The empirical data for this study were drawn from the Health Information National Trends Survey (HINTS) 5, cycle 4, 2020 (N=3,635). Mediation and moderation analyses were conducted to test the hypotheses proposed in this study. RESULTS The study investigated the digital divide at all three levels (access, skill & use, and outcome). The findings reveal that Internet access is positively associated with health status through the serial mediation of eHealth engagement and health efficacy. The study also identified health self-efficacy as a mediator between the second (skill & use) and third (outcome) of the digital divide. Additionally, the study found a negative moderation effect of education on the relationship between Internet access and eHealth engagement. CONCLUSIONS To promote better public health conditions, it is essential to ensure more equitable access to the Internet. Internet access can improve individuals’ eHealth engagement, which can then facilitate their health self-efficacy and eventually enhance their overall health condition. Furthermore, we recommend that healthcare providers pay more attention to patients’ health self-efficacy during online interactions and information offerings.