English Proficiency and Online Health Information-Seeking Behaviors Among Older Whites, Hispanics, and Asians

Background. As the world’s largest library, the Internet has contributed to promoting individuals’ health by providing useful health-related information. Previous studies have reported low utilization of the Internet for health-related information by older members of minority groups. However, since previous studies have mainly focused on older Whites, factors affecting the health information-seeking behaviors of minority older adults have not been thoroughly explored. Therefore, this study aims to identify factors that are associated with the use of the Internet for health-related information seeking, focusing on English proficiency, a key barrier to health care access.

Methods. This study used data from the 2011-2012 California Health Interview Survey (CHIS). As the largest state health survey in the US, CHIS has collected health related information from more than 55,000 randomly-selected households in California since 2001. The 2011-2012 CHIS sampled 42,935 adult respondents (age 18 +) and 14,115 respondents were over the age of 65. To the question asking about their experience in using the Internet, approximately 57% of these senior respondents (n=8,109) responded “ever used the Internet”. Among those who have used the Internet, a total of 7,646 respondents, 6,839 older Whites, 384 older Hispanics, and 423 older Asians, comprised the subsample for this study. The dependent variable of this study, online health information-seeking behavior, was measured using the question “in the past 12 months, did you use the Internet to look for health or medical information?”. English proficiency was measured using two questions: “language at home” and “language of interview”. Hypotheses were tested using weighted logistic regression analysis.

Results. The results indicate that English proficiency is negatively associated with online health information-seeking behaviors among older Whites and Hispanics, while it was positively associated among older Asians. Also, different patterns of health information-seeking behaviors were observed according to demographic factors. Among older Whites, younger age, being female, being married, higher educational attainment, and greater psychological distress were positively associated with online health information-seeking behaviors. On the other hand, among Asians, higher educational attainment, better economic status, functional limitation, and greater psychological distress were positively associated with older adults’ utilization of the Internet for health-related information.

Implication. This study found that low English proficiency limits older Hispanics’ utilization of the Internet as a health tool. To translate this finding into practice, the development of multilingual websites providing translation into languages other than English would be beneficial for increasing access to online health information among those with limited English proficiency. As opposed to older Hispanics, disadvantaged older Asians with limited English proficiency, functional limitations, and psychological distress, were more likely to use the Internet to seek health information. This result suggests that online health information can serve as an important resource for those suffering from chronic or mental illness that prevents them from accessing health information through traditional channels. Therefore, the development of additional user-friendlier multilingual health-related websites for older Asians would assist those who may suffer from medical exclusion due to limited English proficiency, functional limitations, and perception of a stigma regarding mental illness.