The Paradox of Online Health Information-Seeking: Higher Usage and the Increased Likelihood of Unmet Medical Needs

Background and Purpose: Unmet medical needs in rural areas are of grave concern to perpetuating health disparities for racially minoritized population in the United States. With the advent of digital devices and enabling technologies, the Internet and social media have become critical means for accessing essential information concerning personal health and well-being. For low-resource settings characterized by restricted availability of health care providers and infrastructure, the utilization of online health information may benefit people in performing health-related tasks, thus, satisfying some of their medical needs. However, there is a limited body of empirical evidence examining the association between online health information-seeking behavior and unmet medical needs, particularly in rural areas. The aim of this study is to test the variance of unmet medical needs in underprivileged communities by the degree of online health information-seeking behavior.

Methods: A total sample of 191 Black/African American adults aged 18 years and older residing in the counties within the Alabama Black Belt region were recruited through convenience sampling methods. Unmet medical needs were quantified by evaluating responses to three key healthcare access questions, assessing the unavailability of needed physical, mental, and dental care over the past 12 months, with a summed score distinguishing between fulfilled (0) and unfulfilled (1) healthcare needs. Online health information-seeking behavior was measured using a 12-item scale adapted from the Health Information National Trends Survey, capturing the frequency of internet use for health-related purposes. Binomial logistic regression analysis was conducted to examine the relationship between online health information-seeking behaviors and the prevalence of unmet medical needs among the study population.

Results: About one-fifth (20.4%) of the participants experienced unmet medical needs. The mean score of online health information-seeking behavior 2.37 (range: 0-12). Many of the participants were older than 50 years old (60.2%), females (68.1%), with annual income below $25,000 (60.2%), and unemployed (57.6%). Out of a five-point Likert scale, respondents rated overall health as fair (M = 3.65). Our findings challenge the initial hypothesis that increased online health information-seeking behavior would correspond to reduced unmet medical needs. Contrary to expectations, the study revealed a significant association where greater engagement in online health information-seeking behavior was linked to a higher likelihood of experiencing unmet medical needs (OR=5.95, 95% CI 1.27-27.77).

Conclusion: Our study conducted in the Black Belt region of Alabama revealed elevated levels of unmet medical needs attributable to variables including younger age and lower self-rated health scores. The heightened engagement in online health information-seeking observed among residents suggests a reliance on digital platforms due to limited access to traditional healthcare services in rural areas; consequently, individuals who perceive that they receive inadequate care based on online information gathering may be more likely to report unmet medical needs. This investigation underscores the imperative to expand telehealth interventions and enhance oversight of digital health resources, particularly tailored towards rural populations. Such initiatives hold promise for mitigating the prevalence of unaddressed healthcare needs.