Digital device use and disparities in health literacy among older adults

This is the authors' abstract. We don't add key points for this paper.

Objectives: This study examined whether the frequency of digital device use is associated with health literacy among older adults, identifying the digital divide as a potential social determinant of health. Methods: Using data from the 2020 Survey on Health Literacy among Older Adults ( N=600, aged 60–79), this cross-sectional study applied stratified quota sampling and structured face-to-face interviews. Health literacy was assessed using the Korean HLS-Q16 and COVID-HLS. The main independent variable was the frequency of digital device use: none, 1–3 days, 4–6 days, and daily. Multiple regression analyses were conducted controlling for sociodemographic, psychosocial, and health-related covariates. Results: Device use showed a partial dose-response pattern. Compared with nonusers, daily use was significantly associated with higher health literacy on both measures, with a stronger effect for COVID-HLS (b=7.755, p<.0001). Use on 4–6 days was associated with higher COVID-HLS only. Education was positively associated with health literacy, whereas female sex was negatively associated. Age, social support, and chronic disease were associated with COVID-HLS, whereas self-rated health was associated with HLS-Q16. Conclusion: Frequent digital device use is a significant determinant of health literacy among older adults. Targeted digital literacy interventions and accessibility policies are warranted to reduce health literacy inequalities.