Disparities in health-related internet use by US veterans: resultsfrom a national survey

BACKGROUND: The internet can contribute to improved access to information and services among underserved populations. Little is known about veterans' use of the internet for health, and how it is affected by socio-demographic characteristics. This knowledge gap is acute given the US Department of Veterans Affairs' (VA's) deployment of a major patient portal/personal health record system. OBJECTIVES: To assess the frequency and correlates of veterans' use of the internet and identify personal characteristics impeding veterans' health-related internet use. METHODS: Survey of 12 878 randomly selected adults from a panel of 60 000 US households. Veterans were oversampled. RESULTS: Of the 3408 veterans responding, 54% had used the internet and 29% had used the internet specifically for health. In multi-variable analyses, general internet use was positively associated with younger age (OR = 0. 03, CI = 0. 01-0. 06, oldest versus youngest group), higher income (OR = 3. 12, CI = 2. 10-4. 63, > or =75 000 versus <25 000), more education (OR = 4. 2, CI = 2. 92-6. 02, most versus least educated group), and better health (OR = 0. 59, CI = 0. 42-83, fair/poor versus very good/excellent). Health-related internet use was positively associated with more education (OR = 2. 32, CI = 1. 45-3. 74, most versus least educated group), urban location (OR = 2. 41, CI = 1. 66-3. 50), and worse health (OR = 1. 85, CI = 1. 16-2. 95, fair/poor versus very good/excellent). CONCLUSIONS: In the first large, systematic survey of veterans' internet use we found that more education and urban location were strongly, and positively, associated with veterans' health-related internet use, even after controlling for multiple socio-demographic characteristics. Interventions may be needed for less educated and rural veterans, e. g. by providers discussing internet use with their patients, or by the VA training veterans in health-related internet use.