Internet access and health literacy among African/Black Americans residing in rural Alabama

Background: Persistent health disparities in the rural south of the USA—particularly in Alabama’s Black Belt—reflect historical, social, and structural inequities. Health literacy and Internet access are increasingly recognised as important, yet underexplored, factors contributing to these disparities, especially in rural Black communities. Objective: This study examines the relationship between Internet access and health literacy among African American/Black adults residing in Alabama’s Black Belt region. Guided by Digital Divide Theory, it explores how digital barriers relate to individuals’ ability to obtain, process, and understand health information necessary for informed decision-making. Methods: We conducted a cross-sectional survey of 257 African American/Black adults. Health literacy was assessed using two validated screening items, and Internet access was measured through self-reported home Internet availability. Multiple linear regression was used to examine associations between Internet access and health literacy while controlling for sociodemographic and health-related characteristics. Results: Internet access was significantly associated with higher health literacy scores after adjusting for covariates. Participants with Internet access demonstrated higher health literacy, and lower health literacy was more common among older adults. Conclusion and implications: The findings suggest that digital access may represent an important factor related to health literacy in rural Black communities. Efforts to expand broadband availability and support digital inclusion may help address barriers to health information access and contribute to broader health equity initiatives.