Sociodemographic factors and health digital divide among urban residents: Evidence from a population-based survey in China

Background: The deep integration of digital technology and healthcare services has propelled the healthcare system into the era of digital health. However, vulnerable populations in the field of information technology, they face challenges in benefiting from the digital dividends brought by digital health, leading to the emerging phenomenon of the "health digital divide." Methods: This study utilized the sample of 3547 urban from the 2021 Chinese Social Survey data for analysis. Models were constructed with digital access divide, digital usage divide, and digital outcome divide for urban residents, and structural equation modeling was implemented for analysis. Results: The impact beta coefficients (95% CI) of urban residents' digital access on the frequency of digital use, internet healthcare utilization, and patient experience were (beta = 0.737, P < 0.001), (beta = 0.047, P < 0.05), and (beta = 0.079, P < 0.001), respectively. Urban elderly groups were at a disadvantage in digital access and usage (beta = -0.007, beta = -0.024, and beta = -0.004), as well as those with lower educational levels (beta = 0.109, beta = 0.162, and beta = 0.045). However, these two factors did not have a significant direct impact on the patient experience in urban areas. Conclusions: The health digital divide of urban residents exhibits a cascading effect, primarily manifested in the digital access and usage divide. To bridge health digital divide among urban residents, efforts must be made to improve digital access and usage among the elderly and those with lower educational levels.