Digital Health Divide and Its Impact on Access to Preventive Healthcare Services in Urban India

Background Rapid expansion of telemedicine, mobile health applications, and AI-based tools has transformed healthcare delivery in urban India. However, unequal access to digital technologies and digital literacy may create a new form of health inequity—the digital health divide—potentially limiting access to preventive healthcare services. Objective To examine the association between digital health access and utilization of preventive healthcare services among adults in urban Hyderabad, and to identify socio-demographic determinants of poor digital access. Methods A community-based cross-sectional study was conducted among 1,482 adults in Hyderabad using a structured questionnaire. A Digital Health Access Index (DHAI) and a Preventive Healthcare Utilization Index (PHUI) were constructed. Multivariable logistic regression was used to identify predictors of low preventive healthcare utilization and poor digital access. Results Of the 1,482 participants, 58.7% demonstrated high digital health access while 41.3% had low access. Preventive healthcare utilization was significantly lower in the low-access group (32.4% vs 68.9%, p < 0.001). Older age, lower education, lower income, and limited digital literacy were independently associated with poor digital access. After adjustment for confounders, low digital access was associated with reduced odds of adequate preventive healthcare utilization (adjusted OR 0.41, 95% CI 0.33–0.52). Major barriers included lack of digital skills (46.2%), language limitations (38.4%), and privacy concerns (34.1%). Conclusion A substantial digital health divide exists in urban India and is strongly associated with reduced utilization of preventive healthcare services. Public health strategies must integrate digital inclusion, regional language support, community-based digital training, and assisted digital health services to ensure equitable access to preventive care.