Digital Divide in Hypertension and Diabetes

BackgroundMobile health (mHealth) applications are promising tools for managing chronic conditions such as hypertension and diabetes. However, disparities in access and use, often described as the digital divide, may limit their benefits for vulnerable populations ObjectiveTo assess the prevalence of mHealth app use among U.S. adults with hypertension or diabetes and examine sociodemographic, technological, and health-related factors associated with digital engagement. MethodsData were drawn from the 2024 Health Information National Trends Survey (HINTS 7). Respondents with self-reported hypertension or diabetes (n=3,172) were included. The outcome was self-reported mHealth app use. Independent variables included sociodemographic characteristics, technological access and health-related factors. Survey-weighted log-binomial regression estimated adjusted prevalence ratios (RRs) and 95% confidence intervals (CIs). ResultsSignificant disparities in mHealth app use were observed. Adults aged 65-74 (RR=0.70, 95% CI: 0.56-0.88) and 75+ years (RR=0.50, 95% CI: 0.35-0.71) were less likely to use apps than younger adults. Males (RR=0.85, 95% CI: 0.74-0.97) reported lower use than females. Higher income ([≥]$100,000: RR=1.39, 95% CI: 1.06-1.81) and education (college+: RR=1.42, 95% CI: 1.17-1.73) were associated with greater use. Smartphone non-ownership (RR=0.42, 95% CI: 0.24-0.75), never using the internet (RR=0.07, 95% CI: 0.01-0.46), lower digital confidence (RR=0.74, 95% CI: 0.56-0.97), and high frustration with technology (RR=0.61, 95% CI: 0.43-0.87) were strong barriers. Health-related factors were not significantly associated. ConclusionPersistent disparities in mHealth use among adults with hypertension and diabetes underscore the need to address digital access and literacy to promote equitable engagement with digital health tools.