Does Racial Discrimination Affect the Online Health Information Seeking Behavior Among Korean American Immigrants in Deep South?

Background: Online health information seeking (OHIS) has been increasingly popular for the past few decades due to its ease of access, anonymity, and immediacy, bringing numerous benefits to users. However, little attention has been paid to exploring predictors of OHIS among marginalized groups, particularly among immigrants residing in rural areas. Given the growing immigrant population living in the U.S., the present study aims to examine OHIS among Korean American (KA) immigrants living in rural areas of Alabama and its predictors.

Methods: Cross-sectional data were collected in two sites in Alabama between September 2019 and February 2020. Self-identified KA immigrants aged 21 and older residing in Alabama were eligible for inclusion. Recruited by a convenience sampling, 278 KA immigrants completed the survey (return rate = 96%). The respondents with missing information on variables of interest were excluded (n = 17), resulting in a final sample of 261 adults aged 23 to 75. Descriptive statistics were reported to understand the characteristics of the sample and levels of online health-seeking behavior. Multiple linear regression analyses were performed to examine the relationship between OHIS behaviors and social determinants of health after controlling for covariates.

Results: Most of the participants had at least one online health-seeking behavior (n= 214, 82.0%). Several prominent aspects that KA immigrant went online to deal with health-related issues are as follows: (1) Used a website to help them with their diet, weight, or physical activity (n= 125, 47.9%); (2) Bought medicine or vitamins online (n= 123, 47.1%); (3) Looked for health or medical information for someone else (n= 109, 41.8%); (4) Visited a “social networking” site, such as “Facebook” or “LinkedIn” to read and share about medical topics (n= 105, 40.2%); (5) Looked for a health care provider (n= 98, 37.5%); (6) Used email or the Internet to communicate with a doctor or doctor’s office (n= 73, 28.0%). After controlling for demographic variables, age (B = -.044, p < .05), marital status (B = 1.132, p < .05), race/ethnic discrimination (B = .821, p < .05), have computer or tablet (B = 1.286, p < .05), and access to internet (B = 1.778, p < .01) were significantly associated with OHIS among KA immigrants. Participants who were younger, married or partnered, have access to Internet and computer or tablet, and feel discriminated were more likely to address health-related issues online.

Conclusion: Due to the disparities of technology device ownership, people are at further risk of being digitally disconnected and missing out on an important source of health information. Substantial efforts should be devoted to narrowing the access gap and providing offline health information services for those who do not have internet access and who have limited health literacy. Moreover, culturally competent healthcare services and information, including health navigators who speak the same language or health brochures written in multiple languages, should be provided to better serve racial or ethnic minority populations.