Health Disparities and the Digital Divide: The Relationship between Communication Inequalities and Quality of Life among Women in a Nationwide Prospective Cohort Study in the United States

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Abstract
Background: Communication inequalities can affect health-seeking behaviors yet the relationship between Internet use and overall health is inconclusive. Communication-related inequalities vary by race/ethnicity and SES but existing research primarily includes middle-class Whites. We therefore examined the relationship between communication-related inequalities—measured by daily Internet use—and health-related quality of life (QOL) using a nationwide prospective cohort study in the United States that consists of primarily low income, minority women. Methods: We examined Internet use and QOL among participants in the Women’s Interagency HIV Study. Data collection occurred from October 2014-September 2015 in Chicago, New York, Washington DC, San Francisco, Atlanta, Chapel Hill, Birmingham/Jackson and Miami. We used multi-variable analyses to examine the relationship between daily Internet use and QOL. Results: The sample of 1,915 women was 73% African American and 15% Hispanic; 53% reported an annual income of ≤$12,000. Women with daily Internet use reported a higher QOL at six months, as did women with at least a high school diploma, income >$12,000, and non-White race; older women and those with reported drug use, depressive symptoms and loneliness had lower QOL. Conclusions: Overcoming communication inequalities may be one pathway through which to improve overall QOL and address public health priorities. Reducing communication-related inequalities—e.g, by providing reliable Internet access—and thus improving access to health promoting information, may lead to improved health outcomes.
Funding Information
  • Atlanta Clinical and Translational Science Institute (UL1-TR000454)
  • Center for AIDS Research, University of North Carolina at Chapel Hill (P30-AI-050410)
  • Clinical and Translational Science Institute, University of California, San Francisco (UL1-TR000004)
  • National Institutes of Health (K01-DA-039804A, U01-AI-031834, U01-AI-034989, U01-AI-034993, U01-AI-034994, U01-AI-035004, U01-AI-042590, U01-AI-103390, U01-AI-103397, U01-AI-103401, U01-AI-103408, U01-HD-032632)

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