Disparities in telehealth utilization during the COVID-19 pandemic: Findings from a nationally representative survey in the United States

Abstract

Telehealth is an important source of health care during the COVID-19 pandemic. Evidence is scarce regarding disparities in telehealth utilization in the United States. We aimed to investigate the prevalence and factors associated with telehealth utilization among US adults. Our data came from the Health, Ethnicity, and Pandemic Study, a nationally representative survey conducted in October 2020, with 2554 adults ≥ 18 and an oversample of racial/ethnic minorities. Telehealth utilization was measured as self-reported teleconsultation with providers via email, text message, phone, video, and remote patient monitoring during the pandemic. Logistic regressions were performed to examine the association between telehealth use and factors at the individual, household, and community levels. Overall, 43% of the sample reported having used telehealth, representing 114.5 million adults in the nation. East and Southeast Asians used telehealth less than non-Hispanic Whites (OR = 0.5, 95% CI: 0.3–0.8). Being uninsured (compared with private insurance: OR = 0.4, 95% CI: 0.2–0.8), and those with limited broadband coverage in the community (OR = 0.5, 95% CI: 0.3–0.8) were less likely to use telehealth. There is a need to develop and implement more equitable policies and interventions at both the individual and community levels to improve access to telehealth services and reduce related disparities.

Use of Telehealth Among Racial and Ethnic Minority Groups in the United States Before and During the COVID-19 Pandemic

“…The increase in telehealth use aligns with prior research. 4 , 15 , 21 , 22 Studies reported that the number of telemedicine visits significantly increased during the pandemic, while the number of in-office visits declined. 4 , 15 , 21 , 22 Two studies noted that telehealth use was higher among female patients than among male patients, similar to our study.…”

“…2 The Health Resources & Services Administration defines telehealth as “the use of electronic information and telecommunication technologies to support long-distance clinical health care, patient and professional health-related education, health administration, and public health.” 3 Telehealth includes a range of virtual communications: telephone calls, remote monitoring, and video conferencing. 4 Along with reducing exposure to health care providers and patients, telehealth has been important during the pandemic to improve access to health and social services. 5 However, given the range of health disparities across the United States, it is reasonable to assume that not all people benefit from using telehealth.…”

“… 14 Two studies (one in 2020 and another in 2021) reported that Asian survey respondents were less likely than non-Hispanic White survey respondents to have a telehealth visit. 4 , 15 Although studies examined telehealth use before COVID-19 and during the first few months of COVID-19, little information on trends in the use of telehealth before and during COVID-19 has been published. Our study objective was to examine the use of telehealth services among racial and ethnic minority groups before and during the pandemic.…”

Gender difference in working from home and psychological distress - A national survey of U.S. employees during the COVID-19 pandemic

“…A total of 2,709 web-based responses were collected, constituting a weighted sample from the American Association for Public Opinion Research (AAPOR). NORC conducted weighting procedures to align the distributions of the study sample with the broader sociodemographic distribution of the U.S. in order to better approximate a nationally representative sample [15][16][17][18] . The NORC Institutional Review Board reviewed and approved this study (NORC IRB Protocol #20.10.43), and obtained written informed consent from each participant.…”

Barriers to telepsychiatry in the geriatric Asian American population during COVID-19

“…Compared to other medical specialties, psychiatry was the second most utilized telehealth specialty during COVID 19, with general medicine being the first [7]. However, in the nationally representative survey of "Health, Ethnicity, and Pandemic Study," Zhang et al report that Asian Americans had the lowest utilization of telemedicine [8].…”