Social and health inequities in attitudes toward and use of digital health technologies: Findings from an online cross-sectional study in Germany

Abstract Aim Although the use of digital health technologies (DHTs) offers health benefits, it can also exacerbate health inequities. This applies in particular to socially disadvantaged population groups, among whom DHT use is lower, limiting opportunities for good health. Additionally, attitudes are considered relevant predictors of their use, which has rarely been addressed in research, especially considering social and health-related characteristics. Subject and methods The purpose of this analysis was to investigate whether social and health-related characteristics influence individuals’ use of digital health applications (DHAs) and DHTs. We used data from an online cross-sectional survey (STELLAR) of 1200 participants conducted in March 2022. The quota sample was based on the 2021 Eurostat database. An exploratory factor analysis was conducted to obtain an assessment of attitudes toward DHAs. Binary logistic regressions were then used to determine the influence of social and health characteristics on attitudes toward DHAs and their use. Results DHT use was lower among older generations and among individuals with lower subjective social status. Moreover, DHT use was higher among those with positive attitudes toward DHAs and higher levels of digital health literacy. With regard to attitudes toward DHAs, an inconclusive picture emerged after stratifying for social and health-related characteristics. Conclusion Although there was no clear evidence of a digital divide in attitudes toward DHAs, there were signs of a digital divide concerning DHT use. Thus, measures are needed to counteract this divide, such as by promoting digital health literacy.