Who’s Left Behind? Exploring the Digital Divide in Health App Use Among Adults with Hypertension and Diabetes

Background

Mobile 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

Objective

To 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.

Methods

Data 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).

Results

Significant 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.

Conclusion

Persistent 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.